Heart and lung block
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1. Orient the specimen at the start of the video. Is the view anterior or posterior? Which side of the screen represents superior? Which is the right lung and which is the left?
2. Identify the tracheal bifurcation, right mainstem bronchus and left mainstem bronchus.
3. What’s inside the airway, upon opening.
4. Are there any adhesions in the right lung? Between what lobes are they?
5. Review what anatomic abnormality is present the right lung.
5. At 1:45 a structure is revealed with the scissors. What is this structure? How does the pathologist proves this anatomically?
6. At 1:58 begins a discussion of the hilar structures. What are the main tubes of the hilumuscle Order them from stiffest to most floppy. Why does each have this particular consistency based on its function (discussed in the audio).
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Case Notes - About this video
This video shows blood in the airways right at the beginning.
The structure being opened is not a blood vessel.
It is the trachea at the bifurcation.
It is filled with blood when it should have air in it.
The remaing video shows a careful dissection of the medial part of the aberrant right middle lobe (see prior videos).
This is where the tumor is sitting (which was biopsied).
The pathologist is trying to find a hole that was likely caused by the biopsy and which led to bleeding.
The hole would be very small because the biopsy was a needle biopsy.
There are also interlobar adhesions (at 1:03 and 1:11).
The tissue is dissected laterally to medially down to the hilum.
The structure encountered at 1:46 is the external and lateral view of the right pulmonary artery at the hilum.
Towards the end, the pathologist explains how to tell the difference between the main hilar structures and demonstrates how their texture reflects their function.
Overall, the video demonstrates the importance of identifying and preserving structures while making an assessment.
This process was not something the clinician who performed the biopsy could do directly, because he was relying on fluoroscopy to guide the biopsy procedure.
So, there is always some risk to biopsies, especially if there is variant anatomy as there is here.
See prior videos for discussion of aberrant anatomy in this patient.
See the next video for unique features of the tumor that may have predisposed to bleeding during biopsy.
Show me what each option does.
I’ll see a video on the left.
On the right I’ll see a list of key terms or an activity.
I’ll see the same video on the left.
On the right I’ll see a list of discussion questions about the video.
I’ll see the same video but with interactive anatomy pins.
On the right I’ll see the list of pins.
*Only on some cases.
I’ll see the same video but I can draw on it and add numbers to label what I’ve drawn.
I’ll have a sketch pad to draw on.
There’s a male body diagram, a female body diagram and also a blank canvas.