Chapter 193 A rare cause of death! A detail!
Of course, high difficulty means high final scores.
The final score of this assessment will be linked to the difficulty.
For some patients with simple causes of death, relatively speaking, more points will be deducted for wrong judgments and fewer points will be added for correct answers.
The corpse selected by Xu Qiu is very difficult, and fewer points will be deducted for wrong judgments, but higher scores can be obtained for correct answers!
Different corpses, the workload and the difficulty of dissection are impossible to quantify, and the assessment team can only rely on manual adjustments to ensure fairness as much as possible.
…
On the dissection table, Xu Qiu and others quickly entered the state and began the dissection.
Chen Qiao is not like others. She is still a student. Because she is afraid of vomiting, she hardly eats anything.
After retching several times, she slowly adjusted her state and stood by with a pale face watching.
Wang Fan took a glance and saw that Chen Qiao seemed to be eager to try. He stretched and said, "Chen Qiao, just follow me and cheer. Brother Xu doesn't intend to let us do it!"
Pu Chou: "Yes, I'm ready to lie down."
Chen Qiao was a little unconvinced. She looked at Li Xue, Yun Mei and others.
As a result, she found that everyone had an expression of standing by and learning, and from time to time, they would say "Great" and "This knife is amazing"...
"Awesome teacher!" Chen Qiao couldn't help but sigh.
The dissection lasted for more than three hours.
At about twelve o'clock in the morning, Xu Qiu put down the scalpel and relieved his sore right hand.
In this half day, Xu Qiu had completed the dissection of the abdomen, chest, upper and lower limbs.
Only the most important head and face remained.
This is also the dissection order chosen by many medical schools.
The head and face are actually the most difficult part of the dissection.
This is not just from the operational level.
It is also a psychological test for doctors.
When dissecting other places, doctors will not have any psychological pressure.
But, looking at the face of the corpse, there are probably not many who can calmly cut.
"Doctor Xu, you have completely separated all the anatomical structures of other parts. At present, only the last eleven parts of the head and face are left... If you find all of them, you will get full marks in the fine dissection project..." The examiner Lu Dandan of the team recorded the data with a look of surprise on his face.
The famous knife competition has been held for more than ten sessions, almost following the medical reform.
But, in all these years, no one has ever completely separated all the structures in fine dissection!
The tiny structures in the human body are very easy to damage.
What's more, it is a corpse that has been soaked for a long time?
Many structures may have melted into the muscle tissue, or simply necrotized into an unknown object. Where can they be found?
But Xu Qiu did it...
"Go on." Lu Dandan had more respect for Xu Qiu.
...
The brain is divided into three grooves and five lobes.
There are many important blood vessels hidden between the grooves and below.
Xu Qiu previously mastered the master-level skull base tumor resection, so he is very familiar with the structure of the human brain.
The dissection of the head and face was not difficult for Xu Qiu.
But...
There was still a difficult problem at the moment - determining the cause of death.
He had found possible evidence of death when dissecting the abdomen and other parts before.
For example, the intestinal mucosa of the corpse fell off, which might be due to enteritis.
Many organs in the abdominal cavity melted.
But these were all tissue autolysis!
After the death of the human body, under the influence of internal and external environment and human factors, organ tissues will undergo autolysis.
Organs containing digestive enzymes, such as the pancreas, contain a large amount of digestive enzymes, hydrolases and esterases, and are the earliest and most likely to autolyze.
Then came the large and small intestines of the ileocecal region, and the last to autolyze were the skin and connective tissue.
From the autolysis of the corpse, Xu Qiu did not find the cause of his death, but determined that he had been dead for about 12 to 20 hours when the corpse was processed.
And judging from the body shape, the most likely causes of death from obesity, such as atherosclerosis, fatty liver, obstructive sleep apnea hypopnea syndrome, etc., did not meet the physical signs.
In addition,
this cadaver teacher had another very confusing point.
He looked like he had a sudden cardiac death!
However, a careful examination revealed that although the patient's body was enlarged and pale, which looked like myocardial infarction, the examination of the blood vessels revealed that there was no sign of interrupted coronary blood flow.
Combined with the autolysis, this body did not die of myocardial infarction!
Any inexperienced doctor would probably diagnose it as sudden cardiac death!
…
Xu Qiu's eyes were still calm. He believed in his judgment that the cause of death could only be in the head and face.
"Frontal muscle."
"Depressor procerus muscle."
"Posterior inferior cerebellar artery..."
Xu Qiu found the anatomical parts in the test questions one by one.
A few hours later, he found a subtle abnormality.
Although the body was already swollen overall, the left cheekbone of the body was still swollen.
In addition, when the mouth was opened, several black spots could be seen on the white mucosa, which was a sign of contusion.
After a careful peeling and inspection.
Xu Qiu also found that there were traces of bleeding under the patient's left temporal scalp, and even fine blood clots were found at the base of the brain.
However, these blood clots are very hidden and can be easily confused with the various fats, blood and flesh that have fallen.
Xu Qiu accurately followed the blood clots and finally locked them next to the basilar artery.
The cerebral blood vessels here——
Xu Qiu's pupils shrank, and he quickly separated them with a scalpel, finally finding the problem here.
Moyamoya disease!
"What is here?"
"There is a blood clot."
"This is... Moyamoya disease?!"
Yunmei was stunned.
Guan Chuyu, the patient who was bullied by the teacher in the preschool education institution and was accidentally diagnosed with Moyamoya disease, was the patient of Yunmei at the time.
When Xu Qiu performed vascular bypass surgery, Yunmei also served as an assistant.
Therefore, she could see at a glance that this cerebral vascular malformation was very similar to Moyamoya disease!
Xu Qiu nodded: "Yes, Moyamoya disease."
As soon as these words came out, Li Xue and others were shocked and broke out in a cold sweat.
It turned out to be this rare disease!
Moreover, the malformed vascular mass was just blocked by a blood clot.
If it was a normal dissection, it would definitely be peeled off here - if so, it would cover up this malformed vascular mass and completely miss the direct signs of Moyamoya disease!
However, Xu Qiu chose the most cumbersome way, carefully cutting the blood clot, and finally completely exposing the vascular mass below.
This one detail determines the success or failure of determining the cause of death!
Lv Dandan was also stunned.
She didn't know the cause of death, but when she saw Xu Qiuru's skills like unraveling a cocoon, she suddenly felt that her anatomical ability and surgical level seemed to be not as good as such a young man...
This is not right!
The person who came to participate in the famous knife competition is indeed a genius, but he can't be better than her, the retired chief physician, in the past!
