#1 What I Learned Today

Essentials of Clinical Practice

We spent most of the day lecturing about the purpose of monitoring vital signs in a clinical setting, and how to successfully determine them. For every patient that enters the clinic, the practitioner will need to check pulse and blood pressure.

Why is it important to do so? One of good reasons is to screen for high blood pressure. Patients with hypertension can be referred to their physician for further consultation. As well, patients who do have high blood pressure and are taking medications to counteract it can have possible oral complications. This includes changes to the ginigiva (in the forms of lichnoid mucositis and gingival hyperplasia.

Taking pulse is pretty simple. All you need to do is find the radial artery (located superiorly from thumb, on wrist), and count pulses for a minute. It is important to make sure as a practitioner not to use your own thumb, as it has its own pulse which may disrupt your ability to measure. A weak pulse is defined as bradycardia, while a fast pulse is defined as tachycardia. A clinician should be aware of this as it may be an indication of infection or dehydration.

To take blood pressure, a cuff is attached to the arm, and a stethescope is placed over the brachial artery on the inner upper arm. The cuff is inflated to roughly the patient's base BP plus 30 mm Hg. The air is released from the cuff so pressure falls about 3 mm Hg per second. At the onset of two consecutive beats, the systolic pressure is read. When the beats become muffled, the diastolic pressure is recorded.

Gross Anatomy I

Today we lectured about a range of topics, covering bones, arteries and nerves in the pectoral region. We discussed the make-up of the external, internal and innermost intercostal muscles, and how they contract during inhalation and exhalation. We talked about basic innervation, where dorsal root bring sensory information to the spinal cord, and how ventral roots relay motor information from the spinal cord to the muscles. Also discussed was the lymphatic system of the mammary glands. It's unfortunate to note that with many breast cancers, metastasis is a major concern due to the fact that the lymph system has multiple pathways to other areas including the other breast, liver, axillary nodes, etc.

In Laboratory, we began dissection on our cadavers. Very interesting stuff; we began by removing the cutaneous tissue from the posterior of the leg, and isolated some of the major muscles. This isolation included the semitendinosus, semimembranosus and rectus femoris muscles, which make up what is typically called the major 'calf' muscles. Also, we were able to find the sciatic nerve, which is the longest nerve in the human body. It's size was simply startling.

Long story short, fun day.