Lots of newbies here not aware of these subtle spelling/area

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I've tutored many MTs over the years, and have always added little anecdotes to their "lessons" (whether they liked it or not) which seemed to help them remember certain things.  I was taught that way, and it seemed to work. 

Anyway, what you newbies really, really need to do is brush up on your English, spelling, punctuation and grammar skills.  If you make a mistake with a medical term, more than likely your QA will forgive that.  But if you make errors on things you should have learned in high school, it's bad.  There is no excuse in MT to make these kinds of mistakes. 

My anecdote now:  When I was in college, because of taking extra courses not required in my curriculum, I had to take courses which were not typical of my curriculum but were acceptable for the credits I needed.  One was called "Advanced rhetoric and expositional writing."  There were no other med sec majors in my class.  These were people who were majoring in politics, government, physics, economics, and other lofty 4+years things.  They were able to spin about what was going on with the Vietnam war, the race riots, etc. It was a hot time (in a bad way) and the issues were mindblowing.  The president of SDS (Students for a Democratic Society) was in my class!!!   I was in awe.  I didn't fit.  Little med secretarial major me was so naive that I wrote on subjects like "my most embarrassing moments," etc.  My subject matter just couldn't compare with these other classmates who were so far ahead of me, but I got a B+ (!!!)  for the course because of my grammar, spelling, and punctuation skills. 

Lesson:  Goes to show ya how important this is.  Good English skills is a foundation everyone needs--especially in this business. 

I misspoke, okay? I usually associate the word with abdominal/pelvic CTs because that is when I usually hear it. I was trying to help, and I didn't expect to be jumped on. I have been doing medical transcription since 1971, so I do have a little experience.

And re "peroneal," I happen to hear that most often when transcribing CTs or MRIs of the knee. Per Wheeless' Textbook of Orthopaedics (below) the peroneal nerve branches off the sciatic nerve and runs almost the entire length of the leg.  And I won't even get into the peroneal arteries and veins (which run from the knee to the ankle), muscles (peroneus longus and brevis), and tendons (which are the only part that is confined only to the ankle area, as mentioned above).

- Anatomy: 
- common peroneal nerve is derived from (L4, L5, S1, S2) as a part of the sciatic nerve; 
- posterior component, supplies short head of biceps femoris in thigh, crosses posterior to lateral head of gastrocnemius, and becomes subcutaneous behind head of fibula; 
- it penetrates the posterior intermuscular septum, and becomes closely opposed to the periosteum of the proximal fibula; 
- it then divides into superficial & deep peroneal nerves; 
- the nerve also gives off a lateral sural cutaneous brach which joins with the the medial sural cutaneous nerve (from tibial nerve) to form the sural nerve; 
- superficial peroneal nerve: 
- supplies lateral compartment of leg, first passing between peroneus longus 
 - passes in a straight line from the common peroneal nerve; 
- along the length of the proximal one third of the fibula, the superficial peroneal nerve is on the lateral cortex of the fibula; 
- passes between peroneus longus & peroneus brevis; 
- superficial sensory nerves: 
- subcutaneous superficial sensory branch lies between peroneus brevis and EDL msucles. 
- superficial peroneal nerve is accompanied by a true vascular axis that is supplied by tibialis anterior artery along its course. 
- about 10-12 cm above the tip of the lateral malleolus, the superficial peroneal nerve pierces the fascia; 
- about 6-7 cm distal to the fibula, the superficial peroneal nerve bifurcates into intermediate and medial dorsal cutaneous nerves; 
- location of cutaneous nerves: (from Huene and Bunnell 1995) 
- branches of the superficial peroneal nerve or the sural nerve may be injured during ORIF of Ankle frx; 
- these nerves are most at risk at the junction of the distal and middle thirds of the lateral border of the fibula; 
- in 22% of legs, braches of either nerve will cross the frx site; 
- in 54% of legs, branches of superficial peroneal will lie within 5 mm of the anterolateral border of the fibula; 
- safest interval is 12 mm posterior to the anterolateral border of the fibula at 10 cm from the fibular tip, and 10 mm posterior to the anterolateral border at 5 cm proximal to the tip

Okay, I'm transcribing a SOAP note and this word that I'm trying to figure out is under the ASSESSMENT AND PLAN part. She says the word three times and I am now thinking she is saying something like "number next or number next is." What do you think?

(Normonaxis) Anemia may be caused from a recent epistaxis. He will start an iron pill daily over the counter called Fergon. Next visit we will check a hemoglobin, iron studies. (Normonax) He was in for right shoulder pain in the past. This was resolved. (Normonax) Recent qualm was treated with doxycycline.

Also, I was told to transcribe this using a straight SOAP format, but the doctor dictates things like "Review of Systems" and "Exam." I didn't think those headings or subheadings were in a SOAP format. She never dictates "Subjective" or "Objective," only "Assessment And Plan" as one heading towards the end of the report. Any advice?

I found it in my Sted's Electronic Dictionary. Really good source for everything.

Little area

I use google first and get to healthgrades dot com if I know the state and then I only click on the CACHE button thru google and only the MD I'm searching for will highlight in all the states.  I hope I made myself understood in that sentence.  I also use anywho dot com and 411 dot com, 411locate dot com, dr-411 dot com, and last but far from least:

http://www.upinregistry.com/provider_form.asp

http://upin.ecare.com/

lots of times they also say *dependent rubor* which is a color change to the lower legs as they hang down in a *dependent* position so to speak.  *S*

:)

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In Florida this is the Baker act. 

and many more in the upper extremities.......

sounds like what?  s/l?