Happiness!

I passed anatomy.

On Sinuses

In our head and neck section, we learned about sinuses. As you know, those are the things that get clogged when you're sick, but I'd never figured out what they were until now. It turns out that they're mucosa lined cavities which are carved out of skull bones during development for the sole purpose of getting congested during illness. Just kidding. Their purpose is debatable, but the most reasonable one I heard was that they function to make the skull lighter.

One sinus is particularly interesting because it lies between the nasal cavity and the brain, specifically the pituitary gland. Some brain surgery is now done through this sinus. It's called the sphenoidal sinus. What happens is that they stick these really long laproscopic tools up the patient's nose, punch through the floor of the sinus at the top of the nasal cavity, then punch through the roof, and voila! they're in the brain right where the pituitary gland sits. This technique is nice because is minimally invasive, and patients recover much better.

One of the tools they stick up the patient's nose is a camera, so we had the opportunity to watch clips from one of these surgeries. The clip I really want to tell you about is the one where they repair the holes they poked in the beginning. They gather up little bits of bone and mucous and such and pack the hole they've made. To hold it all in place, they'll also use some biologically resorbable material. One of the things they pack up the hole with is fat. Yes, the patient's own fat. They harvest it from elsewhere on the patient and start sticking it up their nose. We watched little pincers holding a string of fat go all the way up the nostril, drop off the fat, pack it down, go all the way back down the nostril, pick up more fat, and then repeat. It was rather surreal, because you start with something familiar and normal, and then it rapidly turns into something that you never expected to see happen to a nose. There's a nose, an ordinary nose, but then all of a sudden, you see these pincers holding a yellow gob of fat. And not only that, those pincers are actually traveling up the nose, and for some reason, you're going with them. All of a sudden, you're not looking at someone's nose anymore, which is a perfectly normal thing to do, but you're actually hanging out inside their nose with some fat from their belly, which is not a very normal thing to do.

So, before I go, one last note on sinuses. You know when you get sick there's one particular pair of sinuses that feels particularly congested and horrible? It's the pair right under your cheek bones right? Those sinuses are called the maxillary sinus. The problem with those sinuses is that the hole they drain through is relatively high up. Imagine something like a teapot, where is spout is high, so it actually needs to be tipped over in order to drain. Now, there are cells in the sinus that sweep mucous up towards the opening, and this is all well and good when you're not sick, but when you're sick and there's tons of mucous, they're overwhelmed, and you end up with a congested sinus. So, based on where the hole is for drainage, one thing you might try when this happens is tipping your head over. That might help. Let me know how it goes.^^

Blini

Dinner last night was the first time I've ever been to a Russian restaurant. We went to Russian Teatime. I had pancakes, technically blini. They ranked high on the yummy scale. I wish I had a picture to post, but as I just moved, my camera is still packed away, and I'm really leery of unpacking more than I have to, since I'll be moving again shortly.

Since there's no picture, an explanation will have to suffice. Blini bear only a passing resemblance to American pancakes. They're round, flat, starchy, and pan fried. Beyond that the resemblance ends.

A taste comparison: According to my source of information on Russian food, blini involve a cultured component which gives them a bit of a tang. Since they're leavened, they don't have the funny baking powder aftertaste that American pancakes sometimes have, and they're a lot less sweet, both qualities that I appreciate. The sweetness also has a bit more depth, since they are leavened.

A texture comparison: Somehow, and I honestly have no idea about why or how this happens, they're actually kind of custardy on the inside. American pancakes get their air from baking powder and baking soda, so they're light, fluffy, and bubbly in texture, but blini are stretchy and smooth and creamy. And again, I have no idea how, but in the process of frying, they acquire actual crispiness on the outside, which American pancakes lack, at least in my experience.

Does this explanation do the blini justice? Do they sound appetizing? I'm not sure how successful my description was, but I like them a lot, and hopefully I'll learn to make them myself.

They were served in the restaurant with sour cream and raspberry sauce. I've never had sour cream on a pancake, but it was a brilliant idea. It was sweet, but with a lot of depth. Sophisticated sweet. I believe that you can also serve them with caviar or smoked fish for traditional savory versions. They're quite versatile, so you can probably serve them with anything your heart desires for an infinite number of non-traditional versions.

And lastly, in my ode to the blini, my intent is not at all to disparage American pancakes. They have their time and place as well, and all breakfast foods have a special place in my heart and stomach.

Quote of the day:

"Beginning in the left upper quadrant, pass the jejunum and ilium between your hands and appreciate its length, position, and termination."

-Grant's Dissector

All I can say is: ewwwwwwww.

We've finished the abdominal dissection, and it's my least favorite dissection so far. It's gross, things are not nicely arranged, there's a lot of variable anatomy, and well, it's gross. And not only is it gross, the smell reminds me of seaweed, which is a food I enjoy, and the gallbladder leaked, so half the intestines are green, and there's this frothy bubbly stuff floating around from melted fat. All in all, it sort of looks like a totally revolting little ocean in there. The only thing it has going for it is color. It's definitely the most colorful dissection we've done so far what with the yellow fat, green bile and red coagulated blood against the the general greyish and whitish rest of the body.

We did see some interesting x-rays today, though. There was someone who had a Sky vodka bottle lost in their guts. That must have been really painful beause those bottles are enormous. It took up so much of the abdomen. And I really wish I knew what kind of explanation the patient gave for that.

Some Haikus AND the Dance of Many Cloths

This is a bonus double post since I haven't posted in so long.

Anatomy lab.

Question: S'pose we need this thing?

Likely not. Whack. Oops.

Invisible lines,

Black on black and white on white,

Radiology.

The Dance of Many Cloths is not as romantic as one might guess from the name I've given it. It involves many props:

1. A balloon with some tubing, two strands of red yarn, a strand of yellow yarn, a strand of green yarn, and a strand of blue yarn attached. This will represent a testicle and all the vessels and nerves trailing along with it. There is the vas defrens which is the tubing. It has its own dedicated artery, which is represented by one strand of red yarn. The second strand of red yarn is the artery for the testicle. The yellow is nerve, green is lymphatics, blue is vein. So this should be a sign. If you don't want to read about testicles, you should stop reading now.
2. A sheer, gauzy white cloth. This is the transversalis fascia.
3. Three striped clothes. These will represent the tranversus abdominis muscle and the external and internal oblique muscles. The stripes indicate the directionality of the muscle fibers. Transversus abdominis and internal oblique fibers run in the same direction, and both are perpendicular to the external obliqe.
4. A fleshy colored cloth somehow formed into a sac. This is the scrotum.
5. 6 people. One person per prop.

And now to setup for the dance. One person holds the testicle aloft. He or she will stand in the back because the testicle develops prety much right up against the back in the area where the heart is (actually, the ovary does this too). One person holds up the transversalis fascia. This is the layer of connective tissue between the abdominal wall and all the guts inside. The muscles will be held up in this order from back to front: transversus abdominis, internal oblique, external obliqe. Transversus abdominis needs to be held slightly higher than the others. The fibers of external oblique point down and towards the middle. Lastly, someone will hold the scrotum.

After all the setup, the dance is actually quite brief. The testicle, plus its associated dancer, moves forwards. As it does, it acquires a covering of everything except for the transversus abdominis, which it passes under. After acquiring all these layers, it then is dropped into the scrotum. And so here we have it, the Dance of Many Cloths, and interpretation of the descent of a testicle.

Quote of the day:

"Did you guys eat lunch?"

The rest of the medical school class has joined us MSTPs in anatomy lab. We've completed dissections of the arms, legs, and back in the three or so weeks we've been there. After seeing how dissected The Body was, someone asked, "Did you guys eat lunch?" I laughed pretty hard. We've done about 40 hours of dissection on our body. If only we could have done it over lunch. Sighs. Only one and a half months of anatomy left to go.

It's not actually that I dislike it. It's just such an inconvenience. You smell repulsive until you shower. You have to change in a locker room with a bunch of other people at least twice a day. Things get gross and you want to prevent as much cross-contamination as you possibly can between the stuff that goes into lab and the stuff that doesn't. And it just takes such a long time. If I felt more free then it would probably be better, but as it stands, I'm trying to make living arrangements, I still need to clean, do laundry, cook, and run errands. It's been two months since I moved here and only this week did the mailbox get fixed.

So, I'm not sure when this turned from a post about anatomy to a rant about all the things I need to do, but in conclusion, there's such cool stuff in anatomy, but I just feel too busy to enjoy it properly.

Oh, and dissection is much better than the week of looking at embryology cross-section slides on the computer that we just finished.

Overly Poked

Today we learned how to give each other injections! I am now richer by 1mL of saline solution and three extra holes in my body.

We did intramuscular injections and subcutaneous injection. I hate being poked with needles. My heart rate goes up, I get nervous, and I might actually breath a little fast, but it's never as bad as I'm expecting it to be. Perhaps it's good that my expectations are always so low. It hurts, but not terribly. I think menstrual cramping is worse. It's just that this is a voluntarily accepted pain and it's a foreign, pointy, scary-looking object piercing your skin.

The intramuscular injection needle was LONG. Maybe two inches? Because I try not to look when people are giving me injections, I was under the impression that only part of the needle goes in, but actually the whole needle ends up going into your arm. I was so scared when I found out. In fact, I still shudder to think of it now. It turns out that most people have more than enough deltoid muscle to prevent the needle from getting to bone. Even anorexic girls can get shots this way. I got injected first, and it actually wasn't more painful than the injections given to me by experienced nurses. Then it was my turn to give an injection, and when I actually started concentrating, all I saw was this skin and needle. There was a certain detachment that came from this rather narrow field of vision, and giving an injection was also not as hard as I thought it would be. It also helps that you don't have to push very hard to get the needle in, so it doens't seem like you should be causing much pain. The needle is very sharp. *shudder* I still dislike the idea of getting a length of metal stuck into me.

Next were the subcutaneous injections. They actually hurt more than the intramuscular injections. I was surprised because I figured that getting stuck in the fat shouldn't hurt as much as getting stuck in the muscle, but there you go.

We also learned how to take blood pressure, vitals, and how to do a skin prick to test for blood sugar. My blood pressure was 110/70 (hooray!) and my blood sugar was 119 about an hour after eating dinner (also good).

Oh yeah, in case it wasn't clear, we gave a half mL injection of saline per practice shot, which is why I'm now 1mL richer in saline solution.