Days Four - Six

I’ve got a little time before review session so here’s what happened on day four.

Pleural Cavity and Lungs – after a short lecture complete with demonstrations using balloons and fists to visualize the sac enclosing the lungs, my group and I were ready to remove Penny’s ribcage and see what she was made of. It’s a simple procedure involving one of two methods. Option A: A small rotary bone saw. Fast, clean edges, with the potential to cut too deep too quickly (also, every table wanted to use them). Option B: Giant hooked forceps with a scissor like blade and the free end instead of serrated pinchers (see this website for an example http://www.htasurgical.com/products/p_13.jpg).

We elected option B and I started clamping down on her ribs about where her arms would rest naturally. It was surprisingly easy to do until I got to the clavicle (collar bone) which was tougher – I naturally loosened it and let the strong guy in the group finish that part. Another girl proceeded to cut the left side of her ribcage and soon we were ready to clip the sternum and open her up. One snag though – we couldn’t left the ribcage… We pulled, expecting that part of the pleural cavity lining (that balloon I mentioned) would be attached but this was just wrong. The right side loosened up just fine with a little help from our hands, but the left side was in no mood to be parted. I am definitely the ‘cutter’ in the group and there is another girl who has become an excellent digger – she shoved her hands in there and even she couldn’t get it to separated. (We were trying to be delicate of course). Finally a professor came over and yanked, revealing a remarkable anti-smoking campaign of a lung that was nothing more than a shredded mess of wet, brownish, scar tissue. Which I will mentioned fused not only to the front of the ribcage, but to the sac around her heart and the back of her ribcage as well. Digger had her work cut out for her over the next couple days while the rest of us cleaned up the ribs and right lung – which by the way was ENORMOUS most likely as a way to compensate for the mess her left lung was in. And though the right lung was more spongy like it should have been, it was really heavy and dense – not a good thing.

The next day was the heart. I consider myself fairly well versed in the dynamics of the cardiac system – ask me to draw you a blood flow diagram sometime. But as I mentioned, on day three we learned that her lung had fused to her pericardium. Lots of scar tissue removal did open up to a small heart roughly the size of my fist surrounded by fat making it a little difficult to observe the blood vessels. It got done though and it was the easiest lab we had thus far. Well, maybe until day six and the mediastinum (that is, the remaining part of what was inside her thoracic cavity. I don’t recall anything super exciting here – her left side was shot, yadda yadda yadda, and her right side was pretty well defined. Oh – we did learn what she died of though. She did suffer from Lung Cancer but it was a cardiac arrest that finally did it.