Superficial Femoral Artery

-the artery you feel when you palpate the femoral pulse
-superficial refers to the part of the femoral artery after the branch point of the profunda femoris from the femoral artery.

Tinel's: patients wrist is tapped. if the patient feels shooting electricity/pain to the thumb or index finger, it indicates a compressed median nerve.

Phalen's: The patient is asked to hold their wrist in complete and forced flexion (pushing the dorsal surfaces of both hands together) for 30–60 seconds.  Symptoms such as burning, tingling or numb sensation over the thumb, index, middle and ring fingers convey a positive test result and confirms carpal tunnel syndrome.

I went into the OR today thinking I would get to see an ORIF (open reduction internal fixation) of tibial plateau fracture (even spoke to the patient before the operation) but was soon whisked away to another OR (there were too many people) by the chief. 

Today, I was asked by one of the residents what the criteria were for doing an bypass of a lower extremity.  I kinda froze (was too busy holding up the heavy leg of the patient who had just had below knee amputation).  I was not sure of exact criteria although I knew it had to be signs/symptoms indicating that the tissue was still viable (like how it looked? gangrene?  any tissue loss? how it felt -- cold? like are the blood vessels still intact?).  I couldnt spit it out though!!

After doing 2 weeks of Surgery EC and then 2 weeks of Vascular Surgery at the VA, i find myself back at good old Ben Taub.  There are things that I absolutely despise about that hospital:  poor computer/info-management system, handwritten everything (can't read other people's notes, problems finding patient records), and generally more work.  However, BTGH also has some important Good points:  get to do a lot of stuff and learn more faster.

Today at Vascular surgery (VA), i got pimped on the circle of willis.  By now, i should know it backwards and forwards but I had seriously not looked at that thing for a while.  I could only recall 1/3 of what was asked of me... pretty crappy and annoying.  But the residents are really cool and teach well.

So anyhow, this is a picture of the circle of willis:

Shock

Invasive Monitoring