Last week I talked about some of the more commonly understood tools that we have as medical students. This week I want to bring out the big guns and talk about the REALLY cool stuff! If you didn’t get to check out last week’s post, you can read it here.
A couple more of the big ticket items we usually get are an ophthalmoscope and otoscope. An ophthalmoscope is used to look into the eye. You can use it to look at the blood vessels, the lens, or macula. I would like to mention the macula especially because it tends to be one of the harder structures to examine. Searching for the macula can be tricky because the patient must maintain a gaze away from the light. If the patient begins moving his or her eyes and they come in contact with the (VERY) bright light, you’ll have a cranky patient with a headache. This was one of the more frustrating tools to learn. I vividly remember this lab—and how many people came out with headaches.
Here is a video to give you a glimpse of what we see when using an otoscope:
An otoscope is the device with the light on it that a doctor uses to look in a patient’s ear. It’s probably the easiest to use out of all the equipment we have. This is embarrassing but I’ll say it anyways! During one of our labs, we had to examine our partner’s ears and document our findings in the appropriate paperwork. I had an excellent view of my partner’s ear. I jumped right into my paperwork so I could document everything very clearly because I actually saw what I was supposed to see (this tends to be kind of hit or miss sometimes!). After finishing my notes, I notice that I left the specula (the protective coverslip on the otoscope) in my partner’s ear! I was so embarrassed, but she never let on that it was still in there—even while I went into a frenzy documenting the normalcy of her ears.
And here is a quick video demonstrating the Weber/Rinne tests:
There are also several smaller items that are handy to have around during an examination, too. First up is the famous reflex hammer. It is up there with the ophthalmoscope for me; I don’t care much for it. Some patients are extremely easy to illicit a reflex from. Some are not so easy. I wind up beating my partner’s joints black and blue trying to illicit a response. Okay, so I’m not THAT bad, but I did feel as if the world may be a more…comfortable place if I chose a specialty that would allow me to leave my reflex hammer at home.
On the flip side, I’m definitely a tuning fork kind of guy. Some may call it old school, but, hey, it still works! We learned to use a tuning fork to help evaluate and diagnose hearing loss via the Weber and Rinne tests. These tests evaluate Cranial Nerve VIII, and whether any diminished hearing loss is due to a blockage or a problem with a nerve. I think these tests are easy and fun, but I know a lot of my peers don’t appreciate them as greatly as I do (they probably prefer reflex hammers…). This probably also stems from my first positive pathologic test being a Weber/Rinne test. I was preparing for a practical exam on a friend. It turns out he developed a hearing loss a couple years ago, and I was able to figure it out! 99% of our classmates are normal and healthy (as they should be). We’re so used to faking signs and symptoms to quiz each other and learn, that this took me completely off guard. I was on Cloud 9 for about a week!
The last staple we come to is the pen light—simple and sophisticated, yet highly applicable. If you can’t tell by that statement, it’s one of my favorites, too. Now that I am writing this all out, I think almost everything is a “favorite.” Anyway, a pen light is usually used during a simple neurological exam. A physician can use it to track a patient’s eye movement, dilate the eyes, look into the throat, or even use it as a flashlight. It’s so versatile! The pen light probably ranks right up there with highlighters for me. (I think I have 3.)
These are just some of the basic items that we need to learn how to practice basic medicine. There are a few others that are handy to have around, but not as popular, such as tongue depressors and cotton balls or sharp objects used to test sensations on the skin. Some of my classmates prefer to use a clipboard notebook, some don’t. As I’ve tried to stress, some students and physicians will place different emphasis and importance on each piece of equipment differently. Everybody has their favorites, and now you know mine!
Don’t forget that if you have any questions, or just want to say hello, to leave me a comment or shoot me an e-mail at Justin.firstname.lastname@example.org!