2014年华西临床超声模拟培训课程-教学日志

mazuigyc

3.13晚讲课现场

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yy111

回复 7# mazuigyc

上课前一天去购买猪心，不幸，已售完。嘱咐老板第二天预留三个，且多留一些心脏附属血管。
老板很守信，预留四颗，冷藏。腔静脉未见，稍有遗憾。
上课开始，心超老师讲解心脏模型的立体重建，左心室的17节段。
30分钟的理论讲解结束，各小组开始工作。
本人WET LAB组。我们的任务是逐步解剖心脏展示主动脉、主动脉瓣、左右冠状窦、左右冠脉开口、左右冠脉及分支走形、左心室的冠脉支配，然后再按照左心室基底段、中间段、心尖段及心尖的分段，分层切开左心室，展示左心室不同节段的切面，并调整角度与TEE超声表现相对应。
虽然是猪心，跟人心的解剖对应关系真的很好，用它来帮我们理解TEE的检查切面真的很有用！
对于几乎零基础来学习TEE的我来说，真的太有帮助了。
以前总觉得TEE对于麻醉医生来说门槛太高，起步太难。现在有心超老师的带领，信心猛增。

心超学袁2014

回复 5# 心超


    谢谢宋老师设计的形象生动的授课！印象深刻！这样一节科就深记了左室17节段！

心超

image tee cases echocardiogram
January 2014
January Question: In this patient with a history of a myocardial infarction, which coronary artery is most likely affected? Assuming there is no other major coronary disease, is the circulation right or left dominant? (Video clips 1,2,3) What about in the patient represented in video clip 4?

                               
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Video '1'   (click to enlarge)

                               
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Video '2'   (click to enlarge)

                               
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Video '3'   (click to enlarge)

                               
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Video '4'   (click to enlarge)


January answer: In first 3 clips, there is evidence of a basal inferior and posterior wall infarction. This implies RCA involvement with a right dominant circulation. The dominance means that the PDA or posterior descending artery, which supplies the posterior wall, originates from the RCA. In the last video clip the anterior, lateral and posterior walls are affected; this means that the left main coronary is affected and the circulation is left dominant, that is, the PDA comes off the circumflex. See image.

                               
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Answer Image '1'   (click to enlarge)

心超

March Question: What's wrong with this picture?

                               
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Video '1'   (click to enlarge)