Anatomy
This week we've been digging into the abdomen...and no, I don't use "digging" figuratively. Our lady was a little big and the internal abdomen is a pretty fatty cavity to begin with, so, needless to say, we've had to remove a lot of extra stuff. We got a good look at the liver, the hepatic portal system, the gall bladder, stomach, spleen, small and large intestines, and all the associated vasculature. We opened up the stomach and the first part of the small intestine (duodenum) to get a look at some of the structures inside. Today we got to study the kidney. This is by far one of the most complex and fascinating organs in the human body. These guys are, on average, the size of a small potato but filter a liter of blood every minute! Our professors are working this afternoon to hemi-sect our cadavers at the pelvis (cutting the pelvis in half and removing one leg) so we can get a better look at the structures down there.
Radiology
Radiology is actually part of our anatomy grade but is taught by PA school faculty and Radiologists from the hospital. Since last week, we've been learning how to read one of these.
Apparently, this is one of the most difficult films to read in all of medicine. Doctors do a 3 year residency plus a year long fellowship to be proficient in this field. We got a lecture, a lab, and a couple Q&A sessions with Radiologists before we had to take a quiz yesterday. I got a 90% but I am by nooooo means good at it. What you see above is a normal chest film. There is an insane amount of variation in an abnormal film. Here are a few things you need to be aware of. How's the exposure of the film? Is the pt centered or is she rotated? Did she take a deep breath? How about the bones? Any broken? Is the diaphragm in the right spot or is it raised/depressed? Is there any discoloration in the lungs? What kind, blackness or whiteness? Where is the discoloration? Whole left side? Up top? Down low? Is there any mediastinal shift? If so, toward what side? If one side is showing up all white and the mediastinum is shifted toward that side, it's indicative of a collapsed lung. If you note blackness where lung signs should be and the mediastinum is shifted away from the blackness, you have a tension pneumothorax. Do you see a meniscus sign? Pleural effusion. Any Kerley B lines in the lateral aspects of the lungs? CHF. Notice any masses? How about the hilar vessels? Good size or enlarged?
And on, and on. There is so much to check and be aware of. Luckily, our quiz wasn't super difficult and the doctor that spoke to us right beforehand was a-maz-ing. She showed us one slide of a collapsed lung. Go ahead, ask me why the lung was collapsed. Because when the patient got in the car accident, he inhaled one of his teeth that had been knocked out and it plugged his right main bronchus. True story.
Medical Communications
We don't have any more lectures for this class. We just go to the simulation lab every Wednesday and practice interviewing a patient. Today went really well. A lot better than last week. Tomorrow, we'll meet in our lab groups and go over gametape again with our faculty adviser.
See, just more of the same stuff. :) Nothing exciting here.
That's a lot of information to take in.
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