I was impressed during Mrs. Labor’s pregnancy to learn from her OB/GYN the position of the baby by feel. It was crazy to feel elbows, knees and the butt just be touch.
My questions:
Can MD’s visualize a person’s anatomy? When a patient comes in with some sort of puncture wound is it obvious what organs are affected? Can you tell just be looking or do you need to feel the patient? How do you learn this?
Well, IANAD, but you can have a pretty good idea of what might be affected by the positioning of a wound, yeah. It’s not immediately obvious because a lot depends on the angle of the wound (straight in versus slanting up or down) and the depth of the wound.
MD’s and vets spend lots and lots and lots of time in a fun, nice-smelling place called the gross anatomy lab during school. By the end of this, they’d better be able to visualize the anatomy or they’re gonna flunk out.
Puncture wounds are hard since it’s hard to know how deep they go. With a wound, you generally know the organs, nerves, bones. muscles and blood vessels at risk of damage. This is certainly true for most common wounds. Organs are easier than muscles. MDs learn this by spending hundreds of hours studying anatomy, then using that knowledge daily.
So could you just take one look at me, place your finger on my abdomen and say with great certainty, “About one inch into your body from this spot is the spleen.”
And, if the answer is yes, that’s really cool.
Well, yes and no.
People’s spleens are different sizes (though it would probably be easy to do within one inch, maybe not within one centimeter). All are roughly in the same spot, and you can often feel the spleen by feeling the belly. The spleen is easily ruptured in, say, a high speed car accident, and you make a point of feeling the spleen in a car crash victim. Or if the patient may have Mono, anemia, low platelets, etc.
If you have someone stabbed in a certain spot, you know what COULD be damaged, but not what actually is. You take the attitude, “this guy was stabbed here with a chef’s knife. It might have cut the spleen, the stomach, the small intestine, the rectus abdominal muscles and the gastroduodenal artery.” You work out which using a mixture of physical exam (hmmm, the wound is really, really bloody), checking under anesthesia (I can see the tendon to that finger is cut, so that’s why you can’t move it) and radiologic tests (the CT shows that the knife missed the spleen)…