Welcome back to the (very occasional) Anatomy for EM podcast.
I just gave a lecture at the excellent late summer school organised by the sono4you group. The course was in Graz in Austria but I was safely in my office at home unfortunately. The idea was to provide an anatomic refresher for those just starting to learn point of care ultrasound, in this case a group of super enthusiastic med students.
Thanks again for the invite and hopefully the lectures are somewhat informative.
Some of the images used in the talk were found via these great resources:
Welcome back to the (very occasional) Anatomy for EM podcast.
I just gave a lecture at the excellent late summer school organised by the sono4you group. The course was in Graz in Austria but I was safely in my office at home unfortunately. The idea was to provide an anatomic refresher for those just starting to learn point of care ultrasound, in this case a group of super enthusiastic med students.
Thanks again for the invite and hopefully the lectures are somewhat informative.
Welcome back to the (very occasional) Anatomy for EM podcast.
I just gave a lecture at the excellent late summer school organised by the sono4you group. The course was in Graz in Austria but I was safely in my office at home unfortunately. The idea was to provide an anatomic refresher for those just starting to learn point of care ultrasound, in this case a group of super enthusiastic med students.
Thanks again for the invite and hopefully the lectures are somewhat informative.
046 | Sensory Innervation of the Foot
Jan 18, 2018
Welcome back to the Anatomy for EM podcast. Today we cover the innervation of the foot through the lens of the ankle block.
So, yes this is another very much exam focused one. Ankle blocks are certainly handy but I always find that the foreign body is right on the overlapping border of all the territories and you end up having to block everything.
These days it might just be easier to an ultrasound guided sciatic and get everything you need but I digress…
I’m entering a few months prep for the UK and Ireland exit exam in Emergency Medicine: the FRCEM. I’ll be adding lots of little notes on pearls I’ve learned along the way. A lot of my revision is based around the Handbook of EM as a curriculum guide and review of contemporary, mainly UK guidelines. I also focus on the areas that I’m a bit sketchy on. With that in mind I hope they’re useful.
You can find more things on the FRCEM on this site here.
This one is special and has turned into an AFEM episode
This seems to be a favourite for examiners and not something i use commonly in real life
4 Nerves involved (the biggies in bold)
auricolotemporal [V3]
greater auricular [C2,3]
auricular branch of [X]
lesser occipital [C2]
Also note the names of the parts of the ear
The block (from the OHEM)
Greater Auricular
1cm below ear lobe all the way from post border of SCM to angle of mandible
Lesser occipital
infiltrate just behind the ear
Auriculotemporal
just anterior to the EAM and tragus (watching out for the superficial temporal artery
Here’s a video from EMRAP with a further somewhat simplified method
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The AFEM podcast will always be free but feel free to donate to help cover hosting and the cost of web hosting and producing new episodes
This was the final podcast on the hand but we’ll be back again in a month or two with a series on dental problems and max fax bits and bobs. Thanks again for all the paypal donations. It really helps.
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The AFEM podcast will always be free but feel free to donate to help cover hosting and the cost of web hosting and producing new episodes
038 | Hand Part 06 | The Nerve Supply
Dec 03, 2016
Welcome back for another podcast. This time it’s the turn of the nerve supply to the hand. In particular we’re covering the sensory supply. We’ll talk about motor supply when we discuss the intrinsic muscles of the hand.
Double-dorsal versus single-volar digital subcutaneous anaesthetic injection for finger injuries in the emergency department: A randomised controlled trial. PMID 26991958
Huge kudos to ALIEM who have some recent great posts on this that were released while i was prepping for the podcast. Thanks again to Michelle Lin for allowing their use.
033 | Hand Part 01 | The Lingo and the soft tissues
Sep 10, 2016
We’re back… after a few years hiatus (blame the children…) we have a series of podcasts on the hand. The hand needs some special anatomic attention for EM as we see so many injuries and their misdiagnosis and mismanagement has great potential for long term morbidity.
I’m not sure how many podcasts this series will stretch to but let’s get started.
This is the third of a series of podcasts I’m doing on basic eye anatomy for the CEM FOAMed Network. This is a developing resource which aims to provide a fully mapped college curriculum with FOAMed resources. Be sure and check it out and get the podcast. This podcast went out a while ago on the CFN and I’m just providing it for everyone else who hasn’t got it already.
The single most important resource you need is Ophthobook.com
031: Eye Anatomy Part 2
May 03, 2015
This is the second of a series of podcasts I’m doing on basic eye anatomy for the CEM FOAMed Network. This is a developing resource which aims to provide a fully mapped college curriculum with FOAMed resources. Be sure and check it out and get the podcast. This podcast went out a while ago on the CFN and I’m just providing it for everyone else who hasn’t got it already.
The single most important resource you need is Ophthobook.com
030: Eye Anatomy Part 1
Dec 28, 2014
This is the first of a series of podcasts I’m doing on basic eye anatomy for the CEM FOAMed Network. This is a developing resource which aims to provide a fully mapped college curriculum with FOAMed resources. Be sure and check it out and get the podcast. This podcast went out a while ago on the CFN and I’m just providing it for everyone else who hasn’t got it already.
The single most important resource you need is Ophthobook.com
029: Critical Care Neuroanatomy SMACC Gold Talk
Nov 10, 2014
Back in March 2014 I had the pleasure of speaking at SMACC Gold in Australia. The whole thing was great fun and I’m sure you’re all aware it’s going to Chicago in May 2015 so be sure to be there. Indeed Registration opens tonight (in the UK at least) so check it out!!!
Every talk from the conference is coming out via the SMACC podcast so make sure you subscribe.
As my talk is so predominantly visual, it really needs the slides for it to make sense so I’ve included the slideset here and put the audio over the slides so you can get the feel of the talk.
For people interested in learning some more detailed neuroanatomy I’d strongly recommend headneckbrainspine.com
They’ve done what I’ve always wanted to do and have created scrolling, labelled radiology images that wonderfully demonstrate the anatomy in 3 dimensions. Really invaluable stuff.
Here’s a list of previous neuro related podcasts I’ve done:
028: Anatomy of the fasica iliaca block
May 26, 2014
Hi Guys, sorry for the big gap in posting. Life has a way of taking over as you all know.
I’m currently trying to introduce fascia iliaca blocks as part of routine care for patients in our department so i thought a podcast on some of the anatomy wouldn’t go a miss. If you want some light reading on the literature, then I’ve included a big list below. If you’re more practically orientated then I’d strongly recommend the following:
1.Godoy Monzón D, Vazquez J, Jauregui JR, Iserson KV. Pain treatment in post-traumatic hip fracture in the elderly: regional block vs. systemic non-steroidal analgesics. Int J Emerg Med. 2010;3(4):321–5.
2.Mouzopoulos G, Vasiliadis G, Lasanianos N, Nikolaras G, Morakis E, Kaminaris M. Fascia iliaca block prophylaxis for hip fracture patients at risk for delirium: a randomized placebo-controlled study. J Orthopaed Traumatol. 2009 Aug 19;10(3):127–33.
3.Høgh A, Dremstrup L, Jensen SS, Lindholt J. Fascia iliaca compartment block performed by junior registrars as a supplement to pre-operative analgesia for patients with hip fracture. Strat Traum Limb Recon. 2008 Sep 2;3(2):65–70.
4.Godoy Monzón D, Iserson KV, Vazquez JA. Single fascia iliaca compartment block for post-hip fracture pain relief. JEM. 2007 Apr;32(3):257–62.
5.NZ Guidelines Group. Acute Management and Immediate Rehabilitation After Hip Fracture Amongst People Aged 65 Years and Over. 2003;:1–40.
6.National Clinical Guideline Centre. The management of hip fracture in adults. 2011;:1–664.
7.SIGN SIGN. Management of hip fracture in older people. 2009 Jun;:1–56.
8.(null) INHFDSG. Irish Hip Fracture Database Preliminary Report 2013. 2014 Mar 4;:1–50.
9.(null) TCOEM. Clinical Standards for Emergency Departments. 2013;:1–16.
10.Beaudoin FL, Haran JP, Liebmann O. A Comparison of Ultrasound-guided Three-in-one Femoral Nerve Block Versus Parenteral Opioids Alone for Analgesia in Emergency Department Patients With Hip Fractures: A Randomized Controlled Trial. Academic Emergency Medicine. 2013 Jun 12;20(6):584–91.
11.Elkhodair S, Mortazavi J, Chester A, Pereira M. Single fascia iliaca compartment block for pain relief in patients with fractured neck of femur in the emergency department: a pilot study. Eur J Emerg Med. 2011 Dec;18(6):340–3.
12.Williams R, Saha B. Best evidence topic report. Ultrasound placement of needle in three-in-one nerve block. Emergency Medicine Journal. 2006 May;23(5):401–3.
13.Christos SC, Chiampas G, Offman R, Rifenburg R. Ultrasound-guided three-in-one nerve block for femur fractures. West J Emerg Med. 2010 Sep;11(4):310–3.
14.Fletcher AK, Rigby AS, Heyes FLP. Three-in-one femoral nerve block as analgesia for fractured neck of femur in the emergency department: a randomized, controlled trial. Ann Emerg Med. 2003 Feb 1;41(2):227–33.
15.Beaudoin FL, Nagdev A, Merchant RC, Becker BM. Ultrasound-guided femoral nerve blocks in elderly patients with hip fractures. Am J Emerg Med. 2010 Jan;28(1):76–81.
16.Haines L, Dickman E, Ayvazyan S, Pearl M, Wu S, Rosenblum D, et al. Ultrasound-guided fascia iliaca compartment block for hip fractures in the emergency department. JEM. 2012 Oct;43(4):692–7.
17.Rashid A, Beswick E, Galitzine S, Fitton L. Regional analgesia in the emergency department for hip fractures: survey of current UK practice and its impact on services in a teaching hospital. Emergency Medicine Journal. 2013 Jul 22.
18.Abou-Setta AM, Beaupre LA, Rashiq S, Dryden DM, Hamm MP, Sadowski CA, et al. Comparative effectiveness of pain management interventions for hip fracture: a systematic review. Ann Intern Med. 2011 Aug 16;155(4):234–45.
20.Foss NB, Kristensen BB, Bundgaard M, Bak M, Heiring C, Virkelyst C, et al. Fascia iliaca compartment blockade for acute pain control in hip fracture patients: a randomized, placebo-controlled trial. Anesthesiology. 2007 Apr;106(4):773–8.
027: Basic Anatomy of Abdomen and Pelvic Trauma
Apr 15, 2013
This is the second part of a recent lecture I gave to some first year med students to get across how important their anatomy is to understanding trauma.
This is a screencast of a recent lecture I gave to some first year med students. It’s mainly to give the students some clinical info to keep their regular anatomy teaching relevant. It’s not designed to be a comprehensive intro to trauma in any way.
It’s longer than the usual podcasts so I’ve split into two parts.
Feedback, is as always, welcome.
I don’t expect anyone to pay for this but feel free to donate to help cover hosting and the cost of producing new episodes
This one’s a little bit different. You’ve all heard of SMACC I’m sure. If not which rock where you hiding under?
It’s the the most exciting conference happening this year. All the your favourited FOAMites in one place giving it dixie on all things EM and Critical Care. There is still time to get booked in for it.
I, alas, will be holding fort on the Emerald Isle supporting the dog, wife and her ever enlarging bump and saving the spondoolies for next years SMACC (that’s happening lads isn’t it?)
They’ve put out the challenge for short, high impact teaching videos for the EM/CC community in the form of PK talks. Below is my offering. It’s a rehash of some old material but hope you like it.
024 – Shoulder: Nerve compressions
Jan 05, 2013
All show notes over at emergencymedicineireland.com
023 – Shoulder: Disclocations
Dec 18, 2012
All the show notes over at emergencymedicineireland.com
022 – Shoulder: AC and SC Joints
Nov 30, 2012
Continuing or walk through the shoulder joint
021 – Shoulder: subacromial space and labrum
Nov 24, 2012
More on our walk through the shoulder joint
020 – Shoulder: The Rotator Cuff
Nov 10, 2012
There is more to managing shoulder pain and injuries than just x-ray and ruling out fracture. This short podcast starts with the rotator cuff.
More info here: http://wp.me/p2GZ98-A4
019 Scaphoid Fracture
Jun 24, 2012
Quick and simple, likely not anything too new.
018 Scapholunate injuries
Jun 11, 2012
More detail on the wrist and in particular the Terry Thomas sign and carpal instability. As always there’s much more going on in the x-ray than just the bones.
OK so this one is a little bit different than the usual but still some anatomy to learn. Check out emergencymedicineireland.com for the show notes.
015 – Superior Mesenteric Artery Syndrome
May 16, 2012
Hi guys. This is yet another Zebra diagnosis but it’s a great one for illustrating some of the relevant anatomy. Let me know what you think.
Here’s the link to the article mentioned
Rudinsky, Sherri L, and Michael J Matteucci. “Emergency Department Presentation of Superior Mesenteric Artery Syndrome: Two Cases in Marine Corps Recruits..” JEM 42, no. 2 (February 2012): 155–158. PMID 19111427
014 Cavernous Sinus
Apr 27, 2012
Still in the skull but this time looking at the cavernous sinus.
Continuing where we left of. This time you’re the patient…
011 – Anterior and middle cerebral arteries
Apr 07, 2012
The differences between ACA and MCA strokes in terms of vascular supply to the brain
The nice little picture of the brain in the case presentation can be found here
010 – The Internal Capsule
Apr 07, 2012
This is key knowledge I think – if you want to understand the stroke syndromes and the different presentations then you need to understand the internal capsule and its importance
009 – Brain Herniation
Apr 07, 2012
This is a quick run through of the 3 main brain herniation syndromes. Enjoy
008 – Dural Venous Sinuses
Apr 07, 2012
A quick run through venous drainage of the brain
007 – Cricothyroidotomy
Apr 07, 2012
As mentioned in the video here are some of the cric resources out there on the interweb
006.3 – Spinal Cord Injury
Apr 07, 2012
And the final spinal cord video, if you have the er… spine… for it…
006.2 – Spinal Cord Injury
Apr 07, 2012
Here’s number 2. Let me know what you think
UPDATE:
The very smart and astute Chris Nickson points out that central cord syndrome normally presents with motor weakness in the distally (in the hands) rather than proximally in the case in the video.
My bad…
He is of course right and has a nice little mnemonic for remembering it MUD: Motor/Upper/Distal
And remember that the symptoms and signs are relative not absolute:
motor>sensory upper>lower distal> proximal
Based on the pure anatomy – with the corticospinal tracts arranged somatotopically with the highest spinal segments most medial – one would expect proximal weakness (C5,6 etc..) more than distal (C7-8, T1 etc…). But since when does the textbook play ball with reality! Maybe it’s just representative of the level of lesion in cervical cord (ie a lower lesion when the upper segments have already exited the cord) but it has me beat. Let me know if you have a better answer
Either way the more important thing is that central cord syndrome more usually presents with distal not proximal upper limb weakness.
Kudos to Chris for spotting it.
006.1 – Spinal Cord Injury
Apr 07, 2012
There was just too much good stuff for one spinal cord vid so I did three. They’ll be out over the next couple of weeks
005 – CSF circulation
Apr 07, 2012
Trust me CSF circulation is more relevant than you think.
As always, feel free to download and reuse or embed or whatever.
Let me know what you think
004 – Lisfranc injuries
Apr 07, 2012
Here’s the next (not so) exciting installment. Thanks for the emails and encouragement. Some neuro stuff is in progress!
And if you have a slightly more accurate account of where the LisFranc story is from then I’d love to know
As always this is free to re-use as you see fit, it’s also downloable for free too. If there’s technical things that are bugging let me know and I’ll see if I can fix them.
Andy
003 – The ankle
Apr 07, 2012
In 10 minutes this is only a very brief look at the ankle, so there may have to be a part 2 to this.
002 – vertebral artery
Apr 07, 2012
Origins, course and things that go wrong with the vertebral artery
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