Chapter 142 Knowledge points skyrocketed (Second update, please subscribe)

Author: Jiangdi Youbai

Chapter 142 Knowledge points skyrocketed (Second update, please subscribe)

"The lateral epicondyle of the humerus is the starting point of the forearm extensor muscle group. From top to bottom, there are mainly brachioradialis, extensor carpi radialis longus, and extensor carpi radialis brevis originating from the front and outside of the lateral epicondyle of the humerus."

"There are also extensor digitorum, extensor carpi ulnaris and brachialis muscles originating from the posterior and lateral aspect of the lateral epicondyle of the humerus."

"Based on this anatomy, think again, which muscle is causing the most severe pain?" Long Yuan chewed up the knowledge points and started feeding them.

This is the benefit of academic teaching in teaching hospitals.

People who have no basic skills will be confused after hearing this, but Wu Xie's anatomy is at the proficiency level, so Long Yuan only gave him a slight push, and Wu Xie immediately reacted.

At the same time, he also saw that the panel immediately flashed: "Get fundamental guidance, knowledge points +1!"

"Extensor fingers, extensor carpi ulnaris, and brachialis! Because grandma's lateral epicondylitis is mainly concentrated behind the lateral epicondyle." Wu Xie thought of it and went for a physical examination.

"Grandma Zhang, please stretch out your fingers and keep your wrist still!" Wu Xie immediately pinched his wrist and then demonstrated to Granny Zhang.

The digital extensor muscles control finger extension. If it is a reaction caused by pain in the digital extensor muscles, and the wrist extensor muscles do not move, then it can be determined that such a physical examination is correct.

Wu Xie's physical examination has also improved to a proficient level, and he can still handle such details.

Mrs. Zhang followed Wu Xie's example, moving and hissing, gasping for cold air, and then looked at Wu Xie: "Doctor Wu, will this hurt?"

"Okay, okay, if you don't move, don't move if it hurts. Grandma Zhang, can you try turning your little finger and ring finger outward again and stretching the wrist joint to move it?"

"Yes, it just tilts outward like this!" Wu Xie continued to experiment.

This is to examine the relatively specific contraction of the extensor carpi ulnaris muscle, its impact on pain, and a physical examination of a single muscle.

When Long Yuan saw this, there was light in his eyes, and he looked at Wu Xie with great relief, feeling that Wu Xie had a very strong understanding.

Mrs. Zhang turned over twice, and the pain became even worse. She looked at Wu Xie with a wry smile: "Doctor Wu, please stop playing tricks on me. The movements you asked me to do are the most painful. You must have thought of it."

What's the problem?"

You don’t have to think about it. Wu Xie can make her do two movements so accurately. Each time it hurts, he must have seen it very clearly. It’s better than others in the county who watched movies and told her to take medicine and exercise.

too much.

Wu Xie nodded and said with a smile: "Grandma Zhang, let's not move. I know you are in pain. We are also doing a pre-diagnosis physical examination. We want to make your condition more clear and understandable."

When Mrs. Zhang's daughter saw Wu Xie being so miraculous, she clicked her tongue and said, "As expected of an expert from Tongji Hospital. Now we understand everything. When we were at the county hospital before, we never did this. We just shouted outside."

Just turn it around and stop doing it if it hurts."

His face was full of smiles and admiration.

But obviously, her admiration was not what Long Yuan wanted, so Long Yuan continued to explain: "Reading plain films and reading reports is a state. Seeing the location and nature of the disease is a state, which means you understand

."

"Being able to see some details and the reactions therein is a certain level, right?"

"Look, the diagnostic report for lateral epicondylitis is one thing. You can see that there is inflammation here, which is a deeper layer. Then you can see that there is bone hyperplasia, periosteal reaction, and sclerosis. This is another layer of depth.

."

"Then if we go deeper, we will look at the layers. The lateral epicondyle is also divided into front, back and inside!"

"The starting points of the muscles on the anterolateral and posterior sides of lateral epicondylitis are different, so the target point of pain is different, right?" Long Yuan explained in detail, it requires a lot of skill, and Long Yuan has this skill

of.

What Long Yuan said was a level of detail beyond proficiency in film reading, which Wu Xie needed to learn and understand.

"Get fundamental guidance, knowledge points +1!"

On the panel, it jumped again.

Long Yuan's strength is definitely not as good as Xiong Yao's, but his teaching level is higher than Xiong Yao's! Maybe it's easier to teach in clinical medicine.

"Yes, senior brother, I didn't think about it that much before." Wu Xie was overjoyed and saw that after receiving fundamental guidance, not only the knowledge points increased, but also the upper limit of upgrades was also continuously reduced.

This is equivalent to double the knowledge point income!

wild!

Long Yuan continued: "Then think about it, why did this old lady get lateral epicondylitis? Let's make a guess?"

Tennis elbow is more common in young and middle-aged people, athletes, chefs and other occupational factors. The correlation is very close!

When Wu Xie heard this, his eyes flickered, and he was about to ask, but when Long Yuan saw this, he interrupted: "You have to think, don't ask about the medical history first, guess first, and then think about the answer."

This really troubled Wu Xie, or in other words, Long Yuan was simply making things difficult for him.

In fact, once you ask, you will understand everything. Instead, you have to meditate here.

However, there are also corresponding factors, that is, there is a lot of activity or stress on the elbow joint.

These common activities in rural areas include:

"Buying vegetables? Cutting vegetables? Farming?" Wu Xie guessed three, but did not mention square dancing. Square dancing will not put any special stress on the elbow joints.

Long Yuan didn't embarrass Wu Xie anymore: "I guess he carried the child."

Then he looked at Mrs. Zhang and her daughter.

Mrs. Zhang laughed and was very happy, but Mrs. Zhang's daughter's face froze: "Dr. Long, are you saying that my mother is here to take care of my child?"

Mrs. Zhang has no sons but two daughters. This is still the youngest daughter, so she is happy to take care of her grandchildren.

"To be precise, it should be carried by holding a child. If you have a lot of children at home, I'm afraid you will have tennis elbow on both hands!" Long Yuan said while showing the movements of holding a child.

Upon hearing this, Mrs. Zhang smiled and said, "That's not possible. My grandson is so thin. He is already one year old this year and only weighs thirty pounds."

After hearing this, Long Yuan replied: "A normal child only weighs more than 20 pounds at one year old. Do you still think he is thin? You have to control the child's diet. The fatter the baby is, the better."

As Long Yuan said this, he signaled Wu Xie to start writing the medical record, and then he told Mrs. Zhang some precautions and exercise methods. She did not need to take special medicine, but the only thing was that she no longer held the child.

Moreover, you should do less chopping movements, and you can cut them lightly.

After returning home, you will mainly do muscle exercises near the elbow joint, and then do some mild anaerobic activities. In this way, combined with external analgesic ointment, the symptoms can be relieved in the near future.

Mrs. Zhang has topical ointment at home, so she doesn’t need to use medicine. She just gave Mrs. Zhang a good prescription. After returning home, if she doesn’t hold the baby for three days, if the pain is not relieved, go for an MRI to see if the pain is relieved.

There is no organic damage such as ligaments.

Long Yuan and Wu Xie's explanation process was very detailed, so Mrs. Zhang's daughter immediately nodded and responded: "Okay, Doctor Long, after I go back, I must ask my mother to pay attention and not let her hug her secretly."

Long Yuan shook his head and warned: "The old man likes children. It's okay not to let him hold them, but not allowed to tease them."

"Hold your legs, just don't stress." Long Yuan also gave him a best-in-class approach, appearing quite experienced.

Mrs. Zhang was very happy when she heard this, and said with a smile: "You see, right? I think it's not the reason for holding the child, but the wrong posture..."

Both of them thanked and walked out, and Long Yuancai told Wu Xie: "Guessing the cause is the principle of analyzing the condition. If you can know that when holding a child, the child's gravity stress generally requires extensor muscles to tense up to resist it, you can

You can see it."

"It's like this. For ordinary cooks and tennis players, their wrist muscles such as the brachioradialis and extensor carpi radialis longus contract violently, resulting in local microfractures and subsequent inflammatory reactions. In them

Due to occupational factors, it is usually the contraction of these muscles that will produce more severe pain trigger points."

"Similar to a robbery, if you pull the trigger, symptoms will occur. This is to carefully read and understand the principle of the disease, and read the film slowly, and you will be able to understand the principle."

"The report, lesions, anatomy and details, levels, principles, are all interconnected and detailed step by step. I can only read part of it." Long Yuan told Wu Xie everything he could understand.

"Get fundamental guidance, knowledge points +1!" Instantly, another prompt flashed on Wu Xie's panel.

After reading this, a patient gained three points of knowledge.

"Senior brother is awesome!" Wu Xie gave a thumbs up and flattered him in an exaggerated way.

But I was thinking about it in my heart. If this was the case, then I would have to make a careful calculation whether I would gain more knowledge points by going to bed or reading books.

However, the fire in Wu Xie's heart had just risen.

The next patient directly extinguished Wu Xie's dream of gaining three knowledge points from a patient.

This is a patient with lumbar disc herniation. After reading the film, Long Yuan said: "I don't know how to look at your situation. You need to find a specialist in spinal surgery."

"Ah? Isn't this all about orthopedics? I also went to see an orthopedic surgeon in the county before?!" The uncle who came in had a particularly bad tone, as if Long Yuan didn't know anything about it.

"Yes, that's because there are no specialties in the county hospital. We only look at orthopedics. You are a spinal surgeon. I have never studied it. I'm really sorry. Sir, you can refund the registration fee."

"I can't help but look at it and then deal with you, right?"

"It's a waste of your time and money to continue watching even if you don't see it. It's not easy to do such a thing." Long Yuan's tone was particularly humble.

"Oh, you're right, but I'm in trouble. I thought this lumbar spondylosis was not a good thing in this county. Doctor Long, can you help me?" Long Yuan's explanation was so appropriate.

The uncle was not embarrassed either.

So he took the phone number and walked out again. Wu Xie caught up with him and said, "My cousin, I'm sorry, but you need to find someone more professional to look at it."

"Uncles, aunts, grandparents lining up outside, we only see orthopedics here. If it's spine surgery or neurosurgery, you don't have to queue up hard! I'm sorry!" Wu Xie yelled at the door.

Specialist treatment. Only by being more professional can diagnosis and treatment be more appropriate.

With such a voice, quite a few people were shouted out, and the person who registered had explained it before, and now he also took the initiative to help with refunds, explanations, etc.

Then Wu Xie introduced the next patient into the clinic. At first glance, this patient was a specialist in orthopedics.
Chapter completed!