We had our second anatomy lab today, and this time the case revolved around a guy who has electric conduction problems in his heart. Basically we are studying conduction in the heart all week, so this was just to get us started. A cardiac surgeon went over the conduction pathway with us, and then we put all of our protective gear on and went into the lab. There were two cadavers today. One we had already seen last week, and the resident did a review of the heart, lungs, blood vessels, and nerves with us. The other cadaver was a new one with diseased lungs (emphysema). You could see and feel that they weren't like normal. Lungs are supposed to feel kind of spongy, but these felt hardened and there was a bunch of air trapped inside them.
There were two other stations with hearts for us to look at. One had the same group of preserved hearts that we looked at last week, and the other had fresh pig hearts. It's pretty uncanny how much pig hearts look like human hearts, although they aren't exactly identical. On a kind of related note, I finally learned from one of the residents how to tell the right and left sides of the heart apart from one another. It's easy to tell the ventricles from the atria, but I always was struggling to distinguish between right and left. He showed me how to do it by looking at the grooves in the heart.
Our PBL case involves a girl who is basically healthy except that she has a somewhat abnormal EKG. It looks like there is a problem with her ion channel conductance. Back in August we had that patient with the sodium channel problem who had this same conduction abnormality (along with a bunch of other problems). My learning objective for Wednesday is how to read an EKG.
In the afternoon, I spent some more time in the anatomy lab looking at the cadavers and pig hearts. Anatomy is just one of those things that you have to keep studying over and over until you finally get it. I still feel like I barely know anything, but I learn a few new things every time I go over there, and I think I am finally starting to make some sense of it all. Dr. Drake is going to give us an extra session on the nerves later this week.
Tomorrow afternoon I have my first clinics session. On one hand, I can't believe they are actually going to let me start seeing patients. I don't know anything yet! On the other hand, I am really excited, because this is such a huge part of the reason why I'm here.
Monday, October 09, 2006
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