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  • aplusmedics - A+ Medics 馃彞 @aplusmedics 32 minutes ago
  • Reposted from @justageneralsurgeon 
Evacuation of a large hematoma of the leg! This patient fell off a ladder and got a large laceration and bruise two weeks ago. They had the wound washed out and sewn up in the ER after getting a tetanus shot. Their PCP removed the stitches this morning and freaked out when the incision popped open and started 鈥渂leeding鈥. They referred the patient to me urgently.

On exam, the 鈥渂leeding鈥 was simply liquified hematoma oozing out. The incision did dehisce, or pop open, so the underlying hematoma was evacuated. Normally, we leave hematomas alone unless they are compressing, or pressing against a nerve or major blood vessel.

A hematoma forms when a blood vessel bursts for whatever reason. Blood spills out and accumulates in the tissues. Usually a hematoma is 鈥渟elf-resolving鈥. As the hematoma gets larger, it presses against the blood vessel and stops itself (and because it鈥檚 usually a vein that pops open). Veins are much lower pressure than arteries so they are more likely to stop with compression and are more likely to rupture.
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A hematoma solidifies (big blood clot), then the body breaks it down (liquifies the hematoma) and then the body gradually reabsorbs it (which is why a bruise changes color from blue to brown to gold).
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It鈥檚 black and gelatinous because it is an old blood clot. It is dark because the blood has no more oxygen in it (oxygenated blood is bright red). It is also dark because the body is breaking down the blood and releasing iron. Also, it is gelatinous because it鈥檚 a big blood clot.

Follow @aplusmedics for more inforMEDitive content 馃槉 Reposted from @justageneralsurgeon Evacuation of a large hematoma of the leg! This patient fell off a ladder and got a large laceration and bruise two weeks ago. They had the wound washed out and sewn up in the ER after getting a tetanus shot. Their PCP removed the stitches this morning and freaked out when the incision popped open and started 鈥渂leeding鈥. They referred the patient to me urgently. On exam, the 鈥渂leeding鈥 was simply liquified hematoma oozing out. The incision did dehisce, or pop open, so the underlying hematoma was evacuated. Normally, we leave hematomas alone unless they are compressing, or pressing against a nerve or major blood vessel. A hematoma forms when a blood vessel bursts for whatever reason. Blood spills out and accumulates in the tissues. Usually a hematoma is 鈥渟elf-resolving鈥. As the hematoma gets larger, it presses against the blood vessel and stops itself (and because it鈥檚 usually a vein that pops open). Veins are much lower pressure than arteries so they are more likely to stop with compression and are more likely to rupture. . A hematoma solidifies (big blood clot), then the body breaks it down (liquifies the hematoma) and then the body gradually reabsorbs it (which is why a bruise changes color from blue to brown to gold). . It鈥檚 black and gelatinous because it is an old blood clot. It is dark because the blood has no more oxygen in it (oxygenated blood is bright red). It is also dark because the body is breaking down the blood and releasing iron. Also, it is gelatinous because it鈥檚 a big blood clot. Follow @aplusmedics for more inforMEDitive content 馃槉
  • Reposted from @justageneralsurgeon Evacuation of a large hematoma of the leg! This patient fell off a ladder and got a large laceration and bruise two weeks ago. They had the wound washed out and sewn up in the ER after getting a tetanus shot. Their PCP removed the stitches this morning and freaked out when the incision popped open and started 鈥渂leeding鈥. They referred the patient to me urgently. On exam, the 鈥渂leeding鈥 was simply liquified hematoma oozing out. The incision did dehisce, or pop open, so the underlying hematoma was evacuated. Normally, we leave hematomas alone unless they are compressing, or pressing against a nerve or major blood vessel. A hematoma forms when a blood vessel bursts for whatever reason. Blood spills out and accumulates in the tissues. Usually a hematoma is 鈥渟elf-resolving鈥. As the hematoma gets larger, it presses against the blood vessel and stops itself (and because it鈥檚 usually a vein that pops open). Veins are much lower pressure than arteries so they are more likely to stop with compression and are more likely to rupture. . A hematoma solidifies (big blood clot), then the body breaks it down (liquifies the hematoma) and then the body gradually reabsorbs it (which is why a bruise changes color from blue to brown to gold). . It鈥檚 black and gelatinous because it is an old blood clot. It is dark because the blood has no more oxygen in it (oxygenated blood is bright red). It is also dark because the body is breaking down the blood and releasing iron. Also, it is gelatinous because it鈥檚 a big blood clot. Follow @aplusmedics for more inforMEDitive content 馃槉
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