2012-06-27

Importance of the Basic Sciences; Clinical Anatomy

Anatomy is definitely an important subject for every single doctor with all specialties, in the anaesthesia world you do practise with anatomy every single day, from airway control from mask-assisted ventilation to airway device placement from an LMA to endotracheal tube or even to endobronchial tube placement. To get the proper position of the devices you placed in you do have to adjust to suit the anatomy of your patient.


Vascular access; both arterial and venous access you do have to know the anatomy of the vascular trees, where you can palpate the peripheral pulse so that you can take arterial blood samples, or you can see either anaesthesist or trainee put an cannular in the artery in order to monitor the invasive BP; yes, can be anywhere from brachial a., radial a., ulnar a., femoral a. and dorsalis pedis a. The venous system is so important when you need a great vein access for rapid fluid resuscitation or infusion of vasoactive agents. 


Neural blockade; the central neural blockade you have to know from skin to the subarachnoid space, the spinal cord and in the modern world the epidural anaesthesia/ analgesia is a superior route to manage the pain control from the intraoperative period to the early postoperative care. With the help of ultrasonography/ the ultrasound machine the peripheral nerve block can be easily performed such as the brachial plexus anaesthesia at the infraclavicular access, or for the abdomen TAP, transversus abdominis plain block can be performed with this ultrasound guide technique. For an ankle block, you do have to know where you can block the nerves in that area, that would apply to the wrist and nerve of the region as well.


The anaesthetist should be able to read the CT scan of wherever of your patient, although it may not be related to anaesthetic management, but it is important to anticipate the complications that may arise from the operation, you may have to know some surgeons' point of view what he/she may perform to get rid of this/that/those, so that you can make a plan for anaesthetic management for your patient in a much better way.


Hope that you would agree with me that Anatomy is so essential for all disciplines of medicine.

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