medical simulator

But Wang Huan couldn't keep up a little bit, so he wrote and drew quickly in his notebook.

The opportunity to learn is hard to come by, and her current talent seems to be excellent!

But in fact, she is not outstanding, and many people can replace her, so she needs to work a little harder.

If a girl wants to go to surgery, she needs to work harder.

Therefore, she cherishes every learning opportunity very much.

Now, she can have such a good teacher, Wang Huan will definitely not waste it.

She knew her qualifications were not good.

The time in a person's life is limited, and the learning process is just such a period. Every step of effort in this process will eventually have a result.

There were only two NMRs that Zhou Cheng brought, and he inspected them one by one, and said, "Wang Huan, look, these levels are all excellent. However, these eight levels are actually superfluous. There is no point."

"When we look at ankle ligament injuries, we must pay attention to the direction, there are these..."

"Then you look again, many aspects of this second nuclear magnetic field are actually repeated, and there is not much meaning. Even for the comparison of T1T2, it is not necessary to compare so many aspects."

"Of course, this is what we need to see in the process of diagnosing this disease. Then there are some normal structures. You can see the medial ligaments, as well as many ligaments in the foot."

"Look here, there's the posterior tibial artery, the dorsalis pedis artery arch, and the saphenous nerve. Did you see this one..." Zhou Cheng's teaching ability must be unquestionable.

But he wants to teach Wang Huan to understand that this requires certain methods and abilities.

Wang Huan listened carefully, his eyes were a little blurred, and he was under pressure. At the same time, he accepted it passively, taking notes and trying to follow along.

After Zhou Cheng talked for a while, he turned to say: "Xiaohuan, first observe these levels yourself."

"The principle of MRI is the same. The knee joint and the ankle joint contain the same types of structures, just a few types—"

"Bone, muscle, nerve, blood vessel, fat, synovium, ligament, fascia."

"It's just that the name, location, anatomical shape and continuity of the anatomical structure are different. Last time we tried a full-thickness MRI interpretation of the knee joint, and just now we looked at the MRI level of the ankle joint in relative detail."

"You can compare and see how many things you can find and how many things you count."

Many people may think that the content learned in junior high school, including elementary school, is not very useful.

Indeed, it may not be useful, and it has little applicability in life, but this kind of learning idea!

But it is the most precious wealth.

In the process of learning, there will be examples and exercises.

In fact, the exercise and practice of each professional skill is the process of learning and absorbing knowledge. There are example questions, and then we can do the exercises by ourselves.

Whenever you do exercises, you can improve your proficiency a little bit, and practice makes perfect, and you will get an improvement in proficiency.

After the proficiency is improved, it will continue to improve and leap forward in this kind of thing.

Wang Huan was startled and flustered: "Huh? Master, I can only read the reports now. What if I read the films?"

"I might not even be able to get started."

Just now, Zhou Cheng listed several levels of film reading for him.

To get started, first learn to read the NMR report.This is a directional diagnostic report given by a doctor in the imaging department after reading the film.

Understand this first, even if you are getting started.

Don't think that being able to understand the report is a very simple matter, and it also requires a relatively in-depth knowledge reserve and foundation.

Even the MRI report of the knee joint, which is not in the professional field of sports medicine, is just wandering outside the door.

For example, in Wang Huan's MRI report, there was an MRI reading report, which stated that the lateral ankle ligament was sprained (degree II).

At present, the definition of ligament injury is based on the American Medical Association Sports Medicine Committee's "Sports Injury Standard Nomenclature", which defines ligament injury as a sprain.

An injury to a muscle or tendon is defined as a strain.The sprain grading standard is.

First-degree injury (minor injury): refers to the ligament being strained or contused, and its continuity is intact, only the change of congestion and swelling.

Second degree injury (moderate injury): This refers to partial tearing of the fibrous connective tissue of the ligament, with mild to moderate joint instability.

Third-degree injury (severe injury): refers to the complete rupture of the ligament or the avulsion of the starting point and insertion point at both ends of the ligament, which greatly affects the stability of the joint.

According to the severity of the ligament injury, it is suggested that patients can be treated with plaster, external fixation with braces, and surgical suture repair, and some ligament reconstruction can also be considered.

In terms of this definition, Liu Yihong's suggestion is correct. Second-degree injuries to the ankle ligaments do require external fixation or plaster.

This is what you can see when you look at the report.I am also a doctor of sports medicine, and I need to master the content of MRI reading at the entry level.

Zhou Cheng ignored it, and slowly pointed out to Wang Huan: "Read the report first, and then find the relevant lesions on the MRI level."

"The lesion is a positioning thing. First of all, you have to see that the lesion and the damaged part are indeed the ligaments of the ankle joint.

"Then, according to the degree of damage to the ligament, redefine the classification of the injury, rather than simply making a diagnosis and treatment based on the radiologist's report...

"After the lesion, look at the complete anatomy to see if there is a complete fracture, etc. If there is no fracture, and through physical examination, no instability of the patient's ankle joint can be seen.

"Under such circumstances, performing plaster external fixation is actually overtreatment!"

"It's not necessarily an over-treatment for money and making money, but just an erroneous scale for accurate diagnosis and appropriate treatment!"

Based on Wang Huan's performance, Zhou Cheng judged that what Wang Huan could see, the upper limit was that he could understand the anatomical structure.

This is one of the more difficult factors of being a doctor. The knowledge reserve required is far more than you can imagine.

If it is more in-depth, with a level 5 MRI reading skill, you can also roughly guess the patient's injury mechanism, whether it is an inner and outer injury, or the starting and ending points of the final stress of the injury, whether there is a tear at the root of the ligament, etc...

"Okay, Master." Wang Huan replied weakly.

I thought to myself, maybe my teacher is better, and the requirements and standards for students are more demanding.

I'm too difficult.

When reading films, you need to concentrate, especially at the beginner stage!

Now, Zhou Cheng is going to teach Wang Huan, so he needs to give directions one by one to understand where Wang Huan is, what level he is, and how to reach a higher level next step.

Wang Huan read the report first, then the autopsy!

And after the anatomy is over, go to the layers!

This is Zhou Cheng's understanding, because looking at a shrine that is deeper than anatomy requires more careful attention, because each section may contain a lot more than the previous section.

For example, at which level, the anterior tibial artery should appear, at which level the dorsalis pedis artery should appear, at which level the posterior tibial artery should appear, and at which layer the peroneal artery should appear.

Then find the accompanying veins, nerves and other anatomical structures based on the arteries.

After getting more proficient, you can know at a glance what level you are in, what ligaments, blood vessels, and fascia you can find...

This is how the top experts and professors see so many outpatients in a day. This is how they learned and accumulated.

Wang Huan could also understand Zhou Cheng's intentions and intentions!

This is also a manifestation of Zhou Cheng's own kung fu. If a layman who doesn't understand can't even distinguish what level Wang Huan is in, then he still teaches a woolen thread?

Teaching does not always have to be one-sided feeding to show the strength of the teaching teacher, but at the right time, give the most appropriate "feeding method" and give the most appropriate learning measures and suggestions. This is teaching up.

Zhou Cheng had already taken Wang Huan to see the ankle injury that Wang Huan had found from the department!

Wang Huan participated in the operation, knew the diagnosis, and probably had a certain impression and understanding of the anatomical structure. He knew that the injured part of this patient was the anterior tibiofibular ligament and anterior calcaneofibular ligament.

The anterior tibiofibular ligament is the ligament that connects the tibia to the fibula, and the anterior calcaneofibular ligament connects the calcaneus to the fibula.

Wang Huan had to find them first, and to find them on the NMR, she had to find these corresponding bones.

"Master, here, look, there are two levels in total, both of which show the anterior heel-calcaneofibular ligament, and three levels show the anterior tibiofibular ligament."

"The anterior calcaneofibular ligament is broken here, and the anterior tibiofibular ligament is also discontinuous here."

"Is this after the ligament was injured, freed or contracted?" Wang Huan asked after reading it.

Hearing this, Zhou Cheng scanned again: "This patient's ligaments should have shrunk! If they are older, the ligaments will not be as tough and will float out."

"On the NMR level, it appears in the form of flocculents or tails, floating in the middle of the bone, which can only be seen from the coronal or axial view."

The level of NMR is divided into many directions, similar to the different directions of the cube seen in our high school learning process.

Simple and easy to understand, it is the front view, side view, and top view...

Wang Huan suddenly felt a sense of enlightenment. This may be because she has accumulated enough before, so she can understand what Zhou Cheng said, or it may be that Zhou Cheng can easily distinguish the content that needs to be seen at each level.

When teaching, be able to lift weights like light.

From reports, lesions, anatomy, theory, and other aspects, you can go in and out with ease.

Can answer any aspect, the question raised by Wang Huan.

This is a treasure house, Wang Huan can just dig it out, there is no need to worry about hollowing out Zhou Cheng.

Wang Huan nodded, and took notes quickly while reading. This is her study habit, and she firmly believes that a good memory is not as good as a bad pen.

Zhou Cheng saw that Wang Huan's savvy was still a little bit better than before he had no adventures, so he had the heart to show her more things.

"This MRI also shows another typical injury, you can look for it."

"This is something we have learned in the basic theory of orthopedics. It is called stress fracture. This is the level of microfracture. Only MRI can show it. See if you can find it." Zhou Cheng said He wanted to teach Wang Huan a broader field of knowledge.

"Ah?" Wang Huan paused and looked at Zhou Cheng.

But Zhou Cheng seems to be a strict teacher at this moment, there is no doubt about it.

However, when Zhou Cheng said this, Wang Huan nodded immediately: "I know, master, stress fractures, although in undergraduate textbooks, it is written about marching fractures, most of them occur in the metatarsal bone."

"But in fact, stress fractures exist in all fields of our orthopedics, but there is no such classic conclusion."

"Osteoarthritis of the knee, after multiple stress fractures, is the result of fracture remodeling, leading to deformity."

"Even during the fracture rehabilitation period, the displacement and healing of stress fractures will occur during functional exercises."

"Here! Here. The signal of edema in the middle, lower and lateral sides of the tibia is different from the signal of common bone marrow edema. The upper edge of the talus is also not the signal of normal edema."

"It's just such a microfracture that doesn't need to be dealt with." Wang Huan replied while showing Zhou Cheng that he had read the book.

I can still do basic skills such as looking at edema and distinguishing bones on MRI.

Not Teletubbies.

"Right, Master?" Wang Huan asked.

Chapter 457 Surprised!

"Wang Huan, Teacher Zhou really told you these things?" In a demonstration classroom, Peng Lingli looked at the shared learning materials Wang Huan took out, and immediately couldn't move her eyes away, her tone was slightly sour.

"Really, I recorded what the teacher just said today."

"I asked my teacher, these things can be passed on. So I took it and shared it with you, Brother Peng. In addition, thank you, Brother Peng, for teaching me so many learning methods." Wang Huan nodded, reciprocating .

She had asked Peng Lingli many questions before, but she never had the opportunity to share something with Peng Lingli.

"Thank you, Wang Huan, these are really good things. I'm afraid there are not many people who can clarify the way of learning."

"To learn MRI reading, first read the report, then the lesion, and then the anatomy. Then look at the level, after reading the theory, and then look at the shortcomings of the current MRI."

"Ms. Zhou, it's not easy. Since you can send this thing, can I send it to Guo Lin for a look?" Peng Lingli suggested.

Guo Lin was an intern with them, but it was a seven-year program, and now he went to another department in turn.

But no matter which major you are in, the general knowledge you learn can be used, so you can also temporarily form study groups.

Now it is mainly Peng Lingli who is leading Wang Huan.

"Okay, no problem."

"Oh, by the way, Brother Peng, I still have two sample questions from my teacher." Wang Huan took the initiative to share, mainly because he felt that he was too good at it. Most of the time before, Peng Lingli brought her to study.

From Wang Huan's point of view, senior brother Peng Lingli didn't hide any secrets. Of course, now that it's the other way around, she can't hide secrets either, and she can tell the whole story.

"Example question? What example question?" Peng Lingli was curious.

Zhou Cheng is such a good teacher that he even prepared example questions for Wang Huan to read the films.

Knowing that Zhou Cheng took Wang Huan to look at the joints and anatomy levels today, Peng Lingli wanted to know what kind of thing Zhou Cheng would give to Wang Huan to strengthen.

Wang Huan opened a zipped package from WeChat on his mobile phone, which contained a set of pictures and several word documents.

Respective titles: [-]. Learning rules, [-]. Standard diagnosis, [-]. Diagnosis analysis, [-]. NMR original film.

"This thing is interesting, open it and have a look!" Peng Lingli approached slightly, but kept a certain distance, not intending to take advantage.

"Learn the rules!"