mrs_angemi mrs_angemi

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Nicole Angemi, MS, PA (ASCP)  ❤️Wife ❤️❤️❤️Mother🔪🔪🔪Human Dissector 💀Mortui Vivos Docent💀 I HEART AUTOPSY Join Angemi Insiders Now! 🔽🔽🔽🔽🔽🔽🔽🔽🔽

Totally obsessed with this artist!!! (@heather_galler_art )I’m so happy I stumbled across her!!!
Last time I showed you guys her work I couldn’t decide what to get for myself.
I decided to go with the breastfeeding art and the Lady Guadalupe pillow for my bed (9th photo). Now she has something I must get (1st and 7th photos)
What’s your favorite!?
l i n k i n b i o

h i g h l i g h t

s t o r y

Sometimes the stories on my IG are more graphic than the photos.
In a fit of rage, this patient had a knife and decided to stab the wall, rather than the person he was fighting with. The knife did not penetrate the wall, slipped and cut his hand pretty deep.
In this situation, he should be happy with the outcome. The other alternative would have been prison.
Photo: @reian_1

Look at this awesomeness I stumbled upon!! Attention all science geeks and enthusiasts! 🤓🔬
Do you love microscopy!?
I know I do!! Can you identify what is in each photo???
I’m totally getting mitosis, blood, bacteria, circle of Willis, and maybe a heart and brain for my laptop!
@sbculliton knows what science nerds NEED!

This patient was feeding his dogs when he tripped and fell on a piece of metal. Weeks after the injury the the mass started to appear. The patient assumed it was associated with the injury. He blew it off for a while until it grew so large he decided to get it checked out. The doctor took a biopsy of the mass. Before a surgeon will even attempt to cut that thing out- they need to know what beast they are dealing with. A biopsy is just a little chunk of a mass (or unknown pathology) being removed. Biopsies can be done ranging in something as small as a needle, to a hole puncher type tool, to a wide open incision.
Pathology determined the biopsy was a soft tissue cancer called a liposarcoma. “Lipo” meaning fat. It’s arising from the fat in his thigh. With this particular diagnosis of cancer- doctors decided to treat the tumor with chemotherapy and radiation first. Why chemo and rad first? Good question! This tumor is really big, and at that size removing the entire mass might severely disable him or make him an amputee. The theory is for the chemo and rad to kill the tumor, or at least shrink it smaller so it’s easier to cut out. In this case it worked! Doctors were successfully able to excise the tumor! They also removed the little scar of skin from the previous biopsy. Why? Another good question! When you cut a piece of tumor out, the cancer cells can drag through the biopsy site. Leaving this piece of skin with the scar in wouldn’t be a good idea. You could be unknowingly leaving cancer in your patient!
Now, this tumor is sent to pathology again, only bigger. At that time a PA will examine it and take a few more pieces of it to show the pathologist. This information is then passed on to the surgeon. The surgeon and oncologist will then decide the next best course of treatment.
#mysterydiagnosis #pathology #medschool #medicine #medstudent

⚰️Funeral Friday⚰️
Please be patient with me and my horrible illustrations😝I promise I have a point!!! PA’s that perform autopsies do not have a ton of interaction with funeral homes aside from arranging transportation and assisting them with removal of the bodies out of the fridge. There are some things a PA will do to RESPECT the funeral director, knowing they will be going into the body after us.
One of those is paying attention to the carotid arteries. The carotid arteries are used to push embalming fluid up into the head and neck so it is not decomposing during a viewing. In a normal embalming, when a body is not autopsied, this is a non issue because the circulatory system should be intact. The funeral director can make an incision in the neck to access the carotid artery. No big deal. Unfortunately when we do an autopsy, we are cutting things out all over the place and disrupting the circulatory system. We have to be careful not to disrupt the carotids.
Let’s try to figure out my drawings🤣
Photo 1. This is the skin reflected over the head to fully expose the ribs and neck. “Chin” is to orient you. The larynx is outlined as a yellow rectangle. I carefully dissect around the larynx, lift it up, and dissect it off of the backbone. Carefully doing this will leave the carotids long and they can be cut around the clavicle. Some PA’s, like myself, prefer this method. They are very long and the funeral director can easily find them. Some PA’s cut them at any length and tie them with a string so the funeral director can find them. Why do they need them to be sticking out and identified? Funeral directors are very educated in anatomy and would have no issue finding them, however it’s respectful on our part because the arteries can get lost. If they are cut too short they retract up into the head making embalming a bit more difficult.
Photo 2. I make my incision just above the Adam’s apple (thyroid cartilage)
Photo 3. I would cut off the larynx, closely on each side, leaving the carotids intact. The red incision is👎🏻too short. These carotids would be likely to get sucked up into the head. The green incision is 👍🏻better. Funeral directors like it long!😜

When dainty flowers AND anatomy meet, it’s a beautiful thing! 🌸🧠🌸
Which is your favorite??
I’m totally getting the uterus for my ALL girl bathroom!!! 🌸B I O
🧠S T O R Y
🌸H I G H L I G H T


This patient is an employee at a behavior health center. A pediatric patient became very agitated and threw something at his head.
Sutures and he’s good as new!

Rickshaw accident. Partial degloving of the scalp.
Photo: @aizazafzallodhi

Breast cancer assaults a woman twice. First she is told she has cancer and has to face her own mortality. Second, in some cases, she is told she has to cut off one or both of her breasts. It’s a no brainer right? Why wouldn’t you want to cut cancer off of your body no matter what!
Stuff I call old school mentality.
This patient had a lesion that started small on the breast and progressed over the past few years into what you are looking at here. A stage 4, ulcerated, necrotic tumor. At this stage, this patient will not survive this tumor. This was growing under her shirt for years and she didn’t tell anyone. Even her husband! Why? She was scared to tell her husband because she didn’t think he would be ok with it.
Another learning pearl from this photo. Look at her left arm. It looks big, bumpy, pink. These changes are due to lymphedema. The lymph nodes of the armpit are all filled with metastatic breast cancer. The lymph nodes all get big and stuck together forming a mass. This mass then compresses the lymphatic ducts and scars them. This makes it hard or impossible to drain the arm causing these changes to the skin and soft tissue.

a n g e m i i n s i d e r s . c o m

Surgical adhesions!
This patient had a C-section as so many people do! Adhesions or scar tissue is possible in any surgery! Even super common ones like C-sections!
I tried to label this so you can kind of figure out what is going on.
This patient was having their gallbladder removed in a procedure called laparotomy and laparoscopy. This just means they are making small cuts in the abdomen to explore with a camera, and remove any tissue with pathology. In this case, her gallbladder. When her surgeon was in her belly with the camera, he saw this. Her C-section scar is stuck to her internal abdominal wall!
Let’s look at the photo.
Pretend you are the surgeon. You poke a hole under the right ribs with the camera. Then you look down. That is the fundus or top of the uterus. It is attached to the underside of the scar from her C-section surgery.
Adhesions can cause pain and can even sometimes obstruction if they are large enough.
The treatment for adhesions, believe it or not, is more surgery to remove them. Which can then cause more adhesions. If the adhesions are bad a surgeon will risk it. Other times it’s decided to just leave them alone.
Photo: @m.serrano

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