Trauma Surgery: Day 2

I was only in from 6a-6p today, so I actually have some time to spend with Mike!!! :) We started the day with 6 patients, then discharged 3 and sent 1 in for surgery and had no new admits, so you can imagine today went pretty smoothly as compared to yesterday!

An interesting case of the day: A patient presented to the trauma service, and s/he has a textbook-variety Cranial Nerve III Palsy: This nerve supplies innervation to most of the eye muscles, the upper eyelid muscles, and parasympathetics that cause pupillary constriction. So, with a CNIII Palsy, the eye is forced in a "down and out" position, the eyelid is unable to open , and the pupil is dilated and unresponsive. I can't even tell you how much more educational a real patient is over a textbook or lecture! It was really interesting to see. CNIII palsy results from damage to the oculomotor nerve anywhere along its course, from the nucleus in the dorsal mesencephalon, through its fascicles in the brainstem parenchyma, to the nerve root in subarachnoid space, or in the cavernous sinus or posterior orbit.  A common causes of CNIII Palsy include Increased Intracranial Pressure; an uncommon cause is an expanding aneurysm in the Posterior Communicating Artery (PCA) in the brain. This patient was particularly interesting because we could not determine the cause of the palsy. After many scans and consults, we can't say why it occurred...which is a rare phenomenon. This so-called "isolated CNIII Palsy" often resolves spontaneously within 3-6 months.


I may be the first person in the history of Danskos to actually NOT love them...my legs have never felt so horrible and swollen in all of my life as they were last night after 14 hours of wearing them. I'm going to try them again sometime this week, but ouuuuuuuch I am waiting until my pain subsides a bit. I spent half of my day studying (since it was a slow day, we were told we could study and wait for a trauma page if a trauma case was to come), so my legs got a nice half-day off! Listen to me, its only been 2 days and already I'm complaining! ;)