An edited version of my Friday Evening Discouse given to the Royal Institution on 11 April 2008.
Abstract: The vagus nerves (cranial nerve X) connects our brainstem to the body, facilitating monitoring and control of many automatic functions; the vagus electrically links our gut, lungs and heart to the base of the brain in an evolutionarily-ancient circuit, similar between mammals and also seen in birds, reptiles, and amphibians. The vagus comprises a major part of the parasympathetic autonomic nervous system, contributing to the motor control of important physiological functions such as heart rate and gut motility. The vagus is also sensory, relaying protective visceral information leading to reflexes like cough and indication of lung volume. The vagus has been described as a neural component of the immune reflex. By monitoring changes in the level of control exerted by the vagus, apparent as beat by beat changes of heart rate, it is possible to indirectly view the effect of pharmaceuticals and disease on brainstem function and neural processes underlying consciousness. The paired vagus nerves of humans have different functions, and stimulation of the left vagus has been shown to be a therapeutic treatment for epilepsy, and may modulate the perception of pain.
This PA Chest X-Ray demonstrates a left sided pleural effusion. In this condition fluid collects between the parietal and visceral pleura and appears as a shadowy fluid level on the X-Ray with obliteration of the costophrenic angles. If you were to examine this patient they might be in respiratory distress from reduced oxygen uptake (so have low sats, high resp rate, possible cyanosis and accessory muscle useage) - they may have reduced chest expansion on the affected side and it would be stony dull to percussion. Fluid transmits sound poorly so breath sounds would be decreased as would vocal resonance/fremitus. Someone with consolidation may have very similar clinical findings but the underlying area of lung is almost solid due to pus from the infective process - as sounds travel well through solids they would have increased vocal fremitus which is how you can clinically differentiate between the two conditions. Clinical examination and understanding of conditions is paramount to practice effective medicine. Before you recieved this X-Ray you should be able to diagnose the condition and use the X-Ray to confirm your suspicions.
In this Chest X-Ray we can identify a left sided pneumothorax - there is absence of lung markings in the periphery and we can also see a shadow which outlines the edge of the lung. A pneumothorax is caused when air enters the potential space between the viceral and parietal pleura and causes the lung to collapse down under the pressure of it's elsatic recoil. In this case it is likely that the pneumothorax has been caused by trauma as we can see air in the soft tissues on the left side (surgical emphysema - clinically feels like bubble wrap). A pneumothorax can be a life threatening condition. The patient presents in respiratory distress with decreased expansion on the affected side. There will be hyperresonance to percussion on that side but absent breath sounds. The emergency treatment is decompression with a large bore cannula in the 2nd intercostal space mid-clavicular line followed by insertion a chest drain in the 5th intercostal space mid-axilllary line
This image demonstrates a fracture of the scaphoid bone. Fractures of the scaphoid are clinically important decause the blood supply enters the bone distally and then moves proximally. If the blood supply is distrupted then there is potential for the patient to develop avascular necrosis of the scaphoid.
This is a link to quizzes made using Wikiversity. During a Student selected component my colleague and I experimented with wikiversity. Although the quizzes made were basic, the concept is that they can be edited and added to by anyone using them to improve them and make them more interactive. The best example are probably the shoulder muscles and lateral aspect of the hand quizzes.
PDF file detailing Anatomy Review, a student-led online anatomical learning resource used at Warwick Medical School. The website contains high quality images of anatomy models used in examinations, associated labels and relevant short answer questions. The resource has received positive feedback and continued use, especially during revision periods.
The site contains an extensive range of MCQs and “fill in the blank” style questions for years one through to five of my Medical degree at Leeds. The site can be viewed here; http://mcqs.leedsmedics.org.uk
The site proved to be very popular. It has had over 18,000 page loads in the last month, with an average of 244 visitors per day. I decided to extend it so that it could provide a wider range of information source for medical students. I did this by approaching the MSRC as I felt that they could benefit greatly from a website. The resulting website now contains a wealth of study resources, links to other student groups, and links to useful information sources (e.g. finance, accommodation, personal support). The site also keeps medical students up to date with news around the medical school and provides a port of call for those wishing to contact members of the MSRC or buy ‘Leeds Medics’ tops from an ethical supplier. This site has also proved to be very popular, with over 4000 page loads in the last month and an average of 77 unique visitors per day. It also gives potential medical students a professional looking point of contact with current students at Leeds.
I have now finished my final exams, but I have handed over instructions for how the site can be managed and updated to the IT Rep in the MSRC and hope that it will continue to provide a useful resource for students studying medicine for years to come.
The site can be viewed here; http://msrc.leedsmedics.org.uk, and the section with MCQs can be viewed here; http://mcqs.leedsmedics.org.uk
A slideshow containing all of the musculoskeletal radiology required to pass most finals radiology OSCE stations, with many examples. Explanations of each radiograph are included after the film has been displayed, giving you the chance to attempt a description first.
This is one of a series of podcasts which I made with bus journey's in mind. They last no longer than 12minutes and deal with 'traditionally difficult' topics in a 'bite-sized' manner suitable for revision. They are short, sweet and designed to help the busy medical student save time and fit their revision in around their crazy lifestyles! They are animated powerpoint slides with an audio voice over.
A complete guide to the diagnosis and managment of thyroid cancer and how to clinically differentiate lumps in the neck. This resource is aimed at medical students in clinical years and foundation doctors.