Gou in the operating room to add some upgrades

Chapter 142 Shocking show! (Please subscribe)
The application of level 4 puncture technique lies in the precision and the absolute control of the depth, strength and sense of puncture breakthrough!
The positions of the gross organs and organs are almost unchanged.

In the process of puncture, in addition to understanding the important anatomical shape between the puncture approaches and avoiding blood vessels and nerves, it is also necessary to have a very keen detection of the subtle puncture sensation of the outermost envelope when puncturing the cadaveric organs ability.

Otherwise, one point more will cause more injury, and one point less will result in insufficient puncture depth.

The three most important organs to be punctured are the heart, liver and kidney.

However, during cardiac puncture, this is cardiac puncture, not pericardial effusion puncture!

When there is no effusion in the pericardium, it is very difficult to puncture and open the pericardium without damaging the heart muscle at all.

The liver capsule is also called "Glisson's capsule".

It is composed of regularly arranged collagen fibers, most of which are type I collagen, a few are type III collagen, and there are fibroblasts and small blood vessels.The hepatic capsule is thickest at the inferior vena cava and the first hepatic hilum, and surrounds the afferent vessels and hepatic bile ducts at the hepatic hilum.

Therefore, the optimal solution for the puncture of the liver capsule is the thickest part Fang Xian is puncturing at the moment.

There are not only liver organs, but also the inferior vena cava and hepatic bile ducts. Whether you can feel the rupture of the capsule without hurting these structures depends on the technique and feel, as well as profound anatomical knowledge.

Anatomy knowledge was originally attributed to basic medical theory, but later, more and more professors discovered that anatomy cannot be simply twisted out, but must be integrated with specialist knowledge.

Separate anatomy must be combined and applied flexibly with clinical practice, because the anatomy of patients is basically not the anatomical structure of normal people, so there are specialists and pathological anatomy...

What can be seen is that Fang Xian's expression at this moment is dignified and serious.

The operation is capable, decisive, sophisticated and does not hesitate.

It seems that it is not an assessment, but a study, and it seems that it is performing, and it seems that it is immersed in being yourself.

Yes, just be yourself.

In order to respect the general teacher even more, I have to perform my operations vividly and vividly, which has nothing to do with the simple assessment. All my attention is focused on the operation, and I don't put any attention on other places at all.

Because Fang Xian himself knows that maybe after today, there will never be such a complete general teacher again, and give it to him for study. Even if he wants to practice anatomy again, he can only use a single organ, or Only a leg, a hand, an organ or a part can provide you with the opportunity to practice and learn.

Therefore, under such cautious circumstances, Fang Xian slightly slowed down his operation speed.

Especially in level 4 of the puncture technique, when it is applied comprehensively, it is necessary to puncture to the same area multiple times, and five punctures must not have more than 2 passages. Such a high requirement makes Fang Xian's operation more cautious!
Of course, for a total of 10 punctures, it took Fang Xian less than [-] minutes.

Five times for the heart, five times for the liver, and ten times for the combined number of punctures for the left and right kidneys.

After giving up everything, Fang Xian continued to cut.

This incision is completely different from the previous incision on the skill training device. This incision requires a full-thickness incision of all the tissues of a teacher.

Including skin, subcutaneous fat, superficial fascia, deep fascia...

Oh, this teacher has no subcutaneous fat, it is almost skinny or skinny, subcutaneous fat is almost undetectable.

Therefore, the traditional basic anatomical knowledge and the application of incision still need to be changed accordingly.

And this is not difficult!
Moreover, after Fang Xian cut open the superficial skin bit by bit, he also found that there were some small bumps under the old man's skin, and there were also some subtle lesions on the superficial layer of the muscles.

After seeing these lesions, Fang Xian chose to debride and resect them.

The method of debridement is slightly different for subcutaneous lesions and lesions in the muscle layer...

This process is actually relatively cruel, because the skin needs to be peeled to expose the subcutaneous tissue, and the muscle layers must be separated one by one. Observe and learn with yourself to see clearly their true shape.

It is said that the dead teacher has no blood luck, so naturally he will not bleed.

However, Fang Xian still carried out the separation carefully, avoiding damage to medium or even small blood vessels. Li Qiu connected all the blood vessel shapes to the muscles, restoring them one by one and exposing them to the field of vision.

When encountering some places, such as small aneurysms, Fang Xian only exposed them.

The aneurysm needs to be dealt with in the patient, but in this teacher's body, it does not need to be dealt with, and it is meaningless.As an observation, it is excellent to know the general structure of an aneurysm.

It has been naturally shaped by blood perfusion!
The various uses of [Incision Technique] were vividly interpreted by Fang Xian.

The usage of [Debridement Technique] was used to the point by Fang Xian.

And after the incision was completed, when Fang Xian confirmed the corresponding manifestations in the joint cavity one by one, he did not see the damage to the cartilage surface, which was only a small amount in the joint.

There is no cartilage, and no pinhole structures can be seen on the bone surface.

This means that Fang Xian's previous puncture only penetrated the joint and did not cause any other surface damage.

Time passed slowly.

Fang Xian was like a non-stop learning and dissecting machine, carefully starting the dissection step by step.

The old professors who were watching could not stand it anymore and left silently one after another. Only a few of them could continue to watch Fang Xian's operations, and there was no need for everyone to guard.

But not many left.

On the 24th, there were no competitions or tasks, and the old professors did not need to go to work.Even those who are employed have been given a holiday by the hospital due to competition duties, so they are not afraid of not having a good rest tomorrow.

Moreover, some of the old people were already light sleepers, so they found a nearby lounge to lie down in the medical association. Also in the early morning, they returned to the on-site examiner's seat in the skills assessment room.

Around one o'clock in the morning.

Such a scene appeared on Fang Xian's operating table.

On the table, the following organs are placed in a humanoid manner.

The heart one is centered, the top.The lungs surround the heart with two great arteries and veins cut open.

The liver, one, is divided into left and right lobes, placed on the right side, flush with the gallbladder.

The bile duct system also corresponds to it one by one.

The spleen, stomach, pancreas and liver are juxtaposed.

The parts of the small intestine and the large intestine are sewn into two blind ends, arranged in a line, several meters long!
Bladder, Takawan and epididymis, YJ, prostate, vas deferens and Takawan sheath are located at the bottom.

In addition, some small organs were also removed one by one.

Lymph nodes, thyroid, larynx, trachea, glands, etc. are all listed one by one.

Moreover, the lesions that have been cleaned up on these organs are also in one-to-one correspondence.

It looked like an accident scene, but compared to the accident scene, it was extraordinarily orderly.

Moreover, Fang Xian only had one knife, and he was slowly picking out the bones.

The human skeletal system consists of approximately 206 bones!
These bones form the skeleton of the entire body.But there are some bones that are not separated even during the teaching of anatomy, namely the brain and skull.

There are about 22 pieces.

The patient was alone in a separate place, waiting to be incised to observe the brain, cerebellum, medulla oblongata and other tissues.

Other vertebrae: including the cervical spine, thoracic spine, lumbar spine, sacrum, and coccyx, there are 33 vertebrae in total. After Fang Xian directly removed the intervertebral discs, they arranged them in piles in order.

Then there's the sternum and the ribs with the cartilage cut off!

One sternum and 12 pairs of ribs!A total of 24 pieces.

The upper limb bones include the scapula, clavicle, upper arm bone (humerus), ulna, radius, metacarpal bones and finger bones, a total of about 64 pieces, which are listed in order from left to right.

The bones of the lower limbs include the hip bone, femur, tibia, fibula, talus, ankle bone, and toe bone. There are about 62 bones in total. White bony patchwork structure.

This is completely showing off skills, and it is also a very in-depth study.

In addition, Fang Xian is now carefully handling the muscles, separating the muscles and blood vessel sheaths one by one, and after exposing the perfect shape except the heart, Fang Xian sews the heart and the great blood vessels together again , connected into a humanoid super long blood vessel.

Such an anatomy is incomparably shocking to watch.

In the middle of the night, a group of old men and women around were whispering as if they had been given blood.

"Have you ever seen or heard of such anatomy teaching before?"

"I've heard of it, but I haven't seen it."

"Almost no one dares to do this, and it has never been done before. The completeness of all organs is preserved to the greatest extent, including the outer layer of skin, which is peeled off. This is not ordinary."

"Human skin is no better than cowhide! It's not easy to peel it off like this."

"Especially when removing the organs, if they are not good enough, they will break open, but Xiao Fang has peeled off the envelope of the organs. This is the work of an incision."

"Tsk tsk!"

"what?"

"Where are Professor Guang and the others? Are they gone? When did they leave?" Suddenly an old man looked over there and found that none of these people were sitting there anymore.

Because Fang Xian's autopsy was really good, they really didn't look in the direction of those people.

What's the point of looking at an old face? Is there a young face that looks good?
Is the genius’ showmanship good to watch?
This is the younger generation and the future of China.

When people are old, there are not many things to like to see.

"I always have to be shameless. I still have doubts and suspicions, how to apologize, how to apologize, how to deal with things in hospitals and schools, how to report, how to report."

"With Fang Xian's skill, do you still have doubts?"

"Are you really shameless? Clinging to Master's mistakes, a whole life, a bunch of people won't be able to turn around?"

"The feudal rule has been overthrown for more than 100 years, is there still a theory of sitting?" Someone rolled his eyes.

Others were very angry: "None of them can repeat such a gross anatomy, so why are they here, being a mascot?"

"I left early, a little after eleven o'clock. What's left now is Xiao Fang's solo show."

"At least I didn't lose my face. I look forward to Xiao Fang's Waterloo in hemostasis or other basic operations."

"Stop talking, stop talking. There is a professor of regional anatomy giving a live broadcast here. Please put on your headphones and listen. The doll inside is really interesting..."

"Are you still on the operating table?" an old man taunted.

"Aren't you addicted to sex? Are you unable to study?"

"Are you going to change the slogan "Live and learn?"

However, neither the whispers of these people nor the departure of Professor Guang Puyuan and others affected Fang Xian's operation.

Fang Xian only felt a little tired, but other than that, everything was fine.

He struggled to identify and operate each step.

This is an old man who has used his body to be a teacher for himself, which cannot be repeated. Such an opportunity should be cherished very much.

Even if you stay up late, you must finish studying them and don't give up halfway.

Moreover, Fang Xian is not a selfish person. If these organs are obtained well, they can be used as specimens for the younger brothers and sisters to watch.

What you have to do is learn what you can learn to the extreme.

The things that can be operated are also brought to the extreme, making the best use of everything!
Maybe this will delay the overall duration of the assessment, but it doesn't matter.

The study at this moment is no less than the study in the operating room of the trauma center, and it is more precious than the study opportunity there, because there is no patient who can open his whole body so unscrupulously, to watch and learn for himself, Give yourself a general view of all the distortions of the real human body.

For example, this series of blood vessels, from the abdominal aorta, is divided into left and right common iliac, left and right internal and external iliac...

For example, this string of blood vessels is divided into other branches, and then turns back and intertwines together.

For example, these nerves go directly into a certain muscle, and the nerve roots that come out of the spinal canal are from this point on to the palms and fingers.

Such a connection is the wonder of the human body and the mystery of life.

The anatomy done in the past was all a mess. How could it be possible to see it so comprehensively?
As for the preciousness of corpses, it is almost impossible for individuals or mature doctors to go through an overall partial dissection, which is for students and those who are just getting started.

It can be said that no one has such an opportunity except the undergraduates of regional anatomy!

It is a reward for a genius that the Hubei Provincial Medical Association can give itself.

Operation continues.

The nerve that should be severed must be severed, otherwise it will affect the integrity of the muscle layer.

The ligaments should be cut as well, otherwise the shape, direction, and size of the muscles cannot be fully observed.

The local operation area of ​​living patients is just the tip of the iceberg, and the field of vision that can be seen is really limited.

For example, the skin that Fang Xian is seeing now is clearly visible under the skin area measured by the machine.

Although the commonly used calculation formula is based on the BSA formula proposed by Du Bois and Du Bois: BSA = 0.007184 × height (cm) ^ 0.725 × weight (kg) ^ 0.425 The data calculated are slightly different, but such a general view, convenient I have never seen it.

Because almost no one would choose to peel off the skin as a whole anatomically, and it wouldn't be as good as that.

Moreover, in the process, Fang Xian almost reshaped an unprecedented spectacle!
According to the study, the total length of large and medium blood vessels can be cut and connected one by one.

This includes major arteries and veins such as the aorta, pulmonary artery, vena cava, common carotid artery, etc.It is estimated that the total length of large and medium blood vessels is about 60 to 00 kilometers. They were twisted into a string by Fang Xian. It is estimated that they are not so long, but if they are cut off one by one and stretch for one to two thousand kilometers, it should not be possible. Down……

The total length of the peripheral large and medium nerves is approximately between 20 and 000 km.

This range includes various large and medium nerves, such as sciatic nerve, femoral nerve, ulnar nerve, radial nerve, median nerve, etc.

Fang Xian's is not so perfect, but if it is cut off and connected one by one, it will be no problem if it stretches for one or two thousand kilometers.

But at this moment, they are just a bunch, lying there like a tangle instead of a tangle!
There was a complete silence at the scene!

Note: The total length of capillaries and nerve networks in the human body is much longer than this.

The next day, morning, [-]:[-].

Fang Xian then finished all the anatomy operations.

Looking at the various organs listed and arranged one by one on the display stand, Fang Xian felt a little serious.

Stopped, put the blade on the handle that had been replaced at least fifteen or six times, and put it down.

Slightly squeezed the stiff fingers, then took two steps back and bowed to them one by one.

After getting up again, Fang Xian also discovered that some undried blood was dripping on the display panel.

Looking around again, Fang Xian found that Professor Guang Puyuan and others had left, including many people who watched his operation.

There were only seven or eight staff members, sitting far away, all yawning.

Showing Fang Xian the side effects of staying up late.

Fang Xian thought it was okay. He was relatively young, and he had become a habit of staying up late when he was on duty before, and he didn't feel particularly tired. It was just these hands, if they could be massaged a few times, they would be comfortable.

But this is impossible.

"Teacher, can I end the current operation?" Fang Xian saw that there were not many people watching, and he didn't know whether his previous operation had passed the assessment.

Seeing that Fang Xian finally stopped working and started talking, several staff members, all of whom were old men, straightened their bodies.

"Are you finished?"

"It's fine once it's done, and there's no need to continue the subsequent assessment. It's meaningless."

"Leave these things to us to clean up and handle." One of the staff members said.

Medical societies, in addition to being a place for skill training, human anatomy practice, and anatomy teacher resources, other than universities, the only place where they can legally have resources are the major medical societies.

Dealing with the aftermath is also something they must do.

"Okay, thank you teacher."

After Fang Xian said this, he was still a little worried: "Teacher, can I really leave? I won't be called back again, right?"

Fang Xian asked again to be sure.

If he goes to Kyoto again and someone suspects that he has not completed the operation and calls him back again, Fang Xian will not be happy with such trouble. How can anyone be so troublesome?

I am not a tool.

"Don't worry, this time, our Hubei Province Medical Center will guarantee you. If there are any doubts, we will directly contact the unit and the medical association of the questioner and let them handle it by themselves."

"How could anyone be so tormented?" the staff member also said.

After saying that, I couldn't help but yawn again.

People no longer rely on their muscles and bones for strength. Although Fang Xian's anatomy manipulations are nice to look at, they can't stand looking at them all the time. Most of the staff at the Medical Association are retired professors, who are at least 60 years old.

I can't stand it.

Only then did Fang Xian feel relieved!

Now that the Hubei Provincial Medical Association has come forward as a guarantee, there should be no more mistakes or glitches.

I can also set off with confidence, and it should still be in time.

Professor Gui just passed away yesterday, so it wouldn't be the end of the memorial service today, maybe it just started today, it's not too bad, after all, we need to notify relatives and friends.

Fang Xian started to take off his clothes. After taking off his gloves, he found that his hands were slightly white.

Under the invasion of sweat stains inside, there are many wrinkles.

And dry.

Moreover, Fang Xian's bladder is constantly struggling, as if it is about to burst.

However, compared with these efforts, Fang Xian's gains are so huge that it is unimaginable and there is no comparison at all.

"Wait a moment and come over and fill in the card number."

"Is it convenient for us to give you a small gift?" The staff member said after seeing that Fang Xiangui finished disposing of the surgical gown and gloves.

"Teacher, let me wash my hands first to make myself comfortable. I feel a little uncomfortable." Fang Xian took the initiative to request.

People have three urgency.

Although money is a good thing, these are unavoidable.

"No problem, you come back later, it's because I didn't think carefully." The old man said so again, and at the same time he turned his head and asked some other people about something.

Fang Xian left the skill assessment room first, and after putting the water in, he found his mobile phone, keys, wallet and other personal items on the shelf.

Fang Xian was relieved after making sure that his ID card and bank card were all there.

However, the battery of his mobile phone was not particularly large. Fang Xian thought that he would borrow a power bank as soon as possible after he went out, so he called Senior Brother Bu Su and invited him to rush to Kyoto with him.

There is no need to conduct subsequent assessments, and Fang Xian does not need to go to the trauma center to do anything hard.

However, Fang Xian slid away the phone screen.

I saw an unread message on WeChat.

From Uncle Fang Yun.

Edited from 45:[-] last night.

a photo.

Two sentences.

"Remember Teacher Gui Yuanping's name!"

Ah!
Fang Xian's consciousness was a little unclear, and he nodded independently.

then.

Ok?
After Fang Xian carefully compared the photos, he suddenly felt very familiar——

Isn't this old man the teacher I dissected last night?

(End of this chapter)