RESUMEN
The pathogenesis of ulnar nerve subluxation and dislocation is widely debated. Upon elbow flexion, the ulnar nerve slips out of the groove for the ulnar nerve, relocates medial or anterior to the medial epicondyle, and returns to its correct anatomical position upon extension. This chronic condition can cause neuritis or neuropathy; however, it has also been suggested that it protects against neuropathy by reducing tension along the nerve. This article reviews the extant literature with the aim of bringing knowledge of the topic into perspective and standardizing terminology.
Asunto(s)
Articulación del Codo/inervación , Articulación del Codo/patología , Luxaciones Articulares/patología , Nervio Cubital/patología , Articulación del Codo/cirugía , Humanos , Luxaciones Articulares/cirugía , Rango del Movimiento Articular/fisiología , Nervio Cubital/cirugíaRESUMEN
Female ejaculation is a contentious topic. From a review of the literature, history indicates that it is not a modern concept; some females were aware of it in times past without understanding the role of the fluid or composition of the ejaculate. Over time, scholars experimented, mainly with anatomical studies, in an attempt to identify the source of the ejaculate and explore its physiological and anatomical benefits for the female sexual experience. Despite these studies, views about female ejaculation remain controversial and inconsistent, with no clear conclusion as to its function. This review discusses the history of studies of female ejaculation and presents various hypotheses from an anatomical and physiological perspective. After reviewing 44 publications from 1889 to 2019, it became apparent that clinical and anatomical studies conducted during recent decades provide substantial evidence in support of the female ejaculatory phenomenon. Anatomical studies have shown that the ejaculate originates in the paraurethral (Skene's) glands, but its composition has been debated. Female ejaculate differs from urine in its creatinine and urea concentrations. The fluid also contains prostate specific antigen (PSA) and could have antibacterial properties that serve to protect the urethra. While the specific function of female ejaculation remains a topic of debate, there is sufficient evidence to support the existence of the phenomenon.
Asunto(s)
Eyaculación/fisiología , Orgasmo/fisiología , Conducta Sexual/historia , Conducta Sexual/fisiología , Femenino , Genitales Femeninos/anatomía & histología , Genitales Femeninos/fisiología , Historia del Siglo XIX , Historia del Siglo XX , Historia del Siglo XXI , HumanosRESUMEN
The use of recorded video in medical education is increasing. Video material may be assigned before scheduled sessions to create a flipped classroom. Here, the instructor may lead a session that is organized for discussion, interpretation, and reflection of the previewed content. We established conditions that lead to increased student participation and engagement with prerecorded content for a medical genetics section in a first-year medical school basic sciences integrated course. Preliminary analysis of an asynchronous video-based pre-professional program directed the design of video material to support a first semester medical genetics course. We compared student participation in, and opinion of, a flipped-classroom session based on written vs. video presentation of material. Student opinion was surveyed with audience response devices (clickers). Shorter videos that were created specifically for the course were preferred by students compared to recordings of previously delivered lectures. Students preferred videos to assigned reading material and consistent scheduling throughout the teaching semester increased student participation. Presentation of medical school content with previously recorded video material can be a useful teaching tool if properly implemented.
Asunto(s)
Educación Médica , Facultades de Medicina , Grabación en Video , Humanos , Estudiantes , Encuestas y CuestionariosRESUMEN
Medical students have difficulty understanding the mechanisms underlying hyperkalemia-mediated local control of blood flow. Such control mechanisms are crucial in the brain, kidney, and skeletal muscle vasculature. We aimed to identify medical students' misconceptions via assessment of students' in-class knowledge and, subsequently, improve future teaching of this concept. In-class polling was performed with the TurningPoint clicker response system (n = 860) to gauge students' understanding of three physiological concepts related to hyperkalemia: membrane potential (Vm), conductance, and smooth muscle response. Vm includes the concepts of equilibrium potential (Veq) for specific ions, as well as driving force (DF = Vm - Veq). Students understood the concept of DF (~70% answered correctly), suggesting their understanding of Vm. However, students misunderstood that hyperkalemia results in depolarization (~52% answered correctly) and leads to an increase in potassium conductance (~31% answered correctly). Clarification of the type of smooth muscle as vascular increased the percentage of correct responses (~51 to 73%). The data indicate that students lacked knowledge of specific potassium conductance in various muscle types, resulting in divergent responses, such as the canonical depolarization in skeletal muscle versus hyperpolarization in smooth muscle cells during hyperkalemia. Misunderstanding of this crucial concept of conductance is directly related to the students' performance. Furthermore, we connected the paradoxical effect of hyperkalemia to pathological acute and chronic hyperkalemia clinical scenarios.