Saturday, 25 May 2013

Awkward Examination - Orthopaedics Chapter

So I'm currently back in London, on a pretty good Orthopaedics and Rheumatology firm - there's a lot of variety to the clinics available, and the teaching has been pretty good (probably the best i've had on firms)!

In fact each week we get rheumatology teaching, and on Thursdays we get an orthopaedics OSCE themed tutorial, and on Friday we come back to practice on each other.

Our consultant splits the group into boys and girls, and we go off to our side rooms/examination rooms to  practice, and the consultant whizzes in and out between the two groups to watch/teach....

...and as it happens, the consultant comes back into the girl's room as i was examining the spine.


Tofu: "ah, okay i think i've finished my exam now"

Consultant: "So tofu, let's say your patient has sciatica, how would you test for it?"

Tofu: "ah! yes i forgot to test for it! well i will get the patient to lay flat, and i will elevate her leg, and i suppose i could press on her perineal region and see if that elicits pain"

Consultant: "her perineal region?"

Tofu: "yes, her perineal region"

Friend playing the patient: *laughs* "umm.. i don't really want you pressing my perineal region"

Consultant: "Tofu, where is the perineal region?"

Tofu: "it's the area behind the knee"

Consultant: "are you sure?"

Tofu: "yes..." 

*AND then it hit me.. nooooooooooooooooooo!*

Tofu: "NOOooooooooooooooooooooooooooooooooooooooo! i mean her popliteal region! the Popliteal region!"

For reference the top image demonstrates the popliteal region, and bottom image shows the perineal region - definitely not part of the spine exam!

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