So, in my anatomy book, in the discussion about estimating pelvic measurements in a pregnant woman, I came across this gem of a phrase:
Another useful clinical guide is the subrapubic arch: the examiner's four knuckles (i.e. his clenched fist) should rest comfortably between the ischial tuberosities below the pubic symphysis.
In other words, you should be able to comfortably rest your fist between the patient's sit bones, under their pubic bone.
Ehhh...author? You might want to come up with a better way of describing that. Especially for some of theborderline Asperger's very literal-minded males in my class. Thanks.
Another useful clinical guide is the subrapubic arch: the examiner's four knuckles (i.e. his clenched fist) should rest comfortably between the ischial tuberosities below the pubic symphysis.
In other words, you should be able to comfortably rest your fist between the patient's sit bones, under their pubic bone.
Ehhh...author? You might want to come up with a better way of describing that. Especially for some of the
9 comments:
I love it; it's like a uncouth Mallampati score for difficult deliveries!
AHahahah---oh YEAH!
Excuse me Sir, I am just going to use my fist to assess your upper airway...
Excuse me doc can I see your hands before we begin?
Just wait until the horrors of your OB rotation are visited upon you. You will have new respect for the resilience of vaginas once you see your attending stick his wrist up one to deliver a blood clot.
I quit at Eisenhower because I saw an OB shove his hand up a poor woman's vagina all the way up to his elbow to "retrieve a clot" - no pain med on board - without so much of a hint to the woman (Hispanic) what he was going to do. She almost crawled to the top of the bed....
It's with satisfaction that I see there is no longer a "Birthing Center" at Eisenhower here in Palm Desert......
Hey ABB,
I just wanted to say that I love your blog and think you're wicked awesome!
I'm building up my own blog... it's pretty boring compared to yours, but I think it can go somewhere if I keep putting the time in.
Anyways, just thought I'd post that I'm a fan and I look forward to reading your posts.
Keep up the great work and good luck with your electives.
ABB: I keep going back to the idea things would be stated much differently had the old guard examination/assessment texts had been authored by females. Loved the Asbergers comment, too, too true.
CC: I saw something similar happen to a Hispanic patient on my critical care rotation in school. The doc came in and performed a TEE on a un-sedated, intubated, restrained patient without so much as an attempt at an explanation, let alone informed consent. I will never forget the terror in her eyes as the doc rammed the probe down her throat. I desperately tried to remember enough high school Spanish to give some kind of explanation. All I could come up with was, "Es la machina fotografia para tu corazon," and hold her hand.
That doc is just lucky I was but a scared nursing student. These days his ears would be scorched.
ick.
(that is all)
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