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2/16(金) セミナー参加

◆今日の気持ち
(整形外科 3週目)
・睡眠不足….体調管理は大切で

●目指す医師像
まずは、医者

●今の目標
・整形外科を味わいきる

●今日の新患・診断
・陳旧性骨折にまぎれた舟状骨折?

●今日の病院滞在時間
7時半〜18時半

●今日行ったこと・見たこと・知ったこと
・頚椎造影
・脊柱管造影

・コラーゲン摂取の効能

・手動脈
 尺骨がmain。損傷したら、血管外科に頼んでバイパス、が早い。血流チェックはアレンよりcapillary refillingが早いことが多い
・中手骨
 示指・中指は動かない。骨折しても問題ないこと多い
・CM関節
 DIPの次にOAおこりやすい
・舟状骨骨折
 専門家でも読みにくいことあり。偽関節になりやすい
・指の骨折
 屈曲時の回旋変形に注目
・green stick fracture
・爪損傷 Schiller法

・腹腔内感染症
 混合感染が多い。横隔膜より下は、腸管内にE.coliよりずっと多い嫌気性菌、特にβラクタマーゼを産生するBacteroides fragilisがいることが、問題! これが悪さをする。だからβラクタマーゼ阻害剤などが必要になる。…よって、横隔膜より上の消化管からの感染症はアンピシリンで十分。
 腸球菌はいても、悪さはしないことが多い。コンプロマイズドでなければ。
 メトロニダゾールは腸管からの吸収よく嫌気性菌に有効

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