TRAINING MODEL FOR MEDICAL APPLICATIONS
20200043371 ยท 2020-02-06
Assignee
Inventors
Cpc classification
G09B23/00
PHYSICS
International classification
Abstract
The present disclosure is directed to an anatomical model and methods for using the same. The anatomical model of the present disclosure includes a plurality of simulated bodily structures that emulate the naturally occurring structures (e.g., organs, bones, and tissue) of the human body. The anatomical model of the present disclosure can be used to simulate clinical conditions observed in infant subjects and carry out medical procedures and interventions commonly practiced by clinicians under real-life conditions.
Claims
1. An anatomical model comprising: a plurality of simulated bodily structures, the plurality of simulated bodily structures comprising: a thorax comprising an internal cavity, an outermost surface and a plurality of ribs; at least one membranous layer, wherein said at least one membranous layer is affixed to the outermost surface of said thorax; and a heart comprising a pericardial sac that substantially surrounds the heart, wherein said heart is located within said internal cavity and is affixed to the internal cavity.
2. The model of claim 1, further comprising: at least one lung within the internal cavity, wherein the lung comprises at least one bronchus operably connected to the at least one lung; and a trachea within the internal cavity, wherein the trachea operably connects to the at least one bronchus.
3. The model of claim 2, wherein said model comprises two lungs each of which is located on opposing sides of the heart.
4. The model of claim 1, wherein said at least one simulated membranous layer comprises a skin layer and a subcutaneous layer.
5. The model of claim 4, wherein said subcutaneous layer comprises an adipose layer.
6. The model of claim 4, wherein said at least one simulated membranous layer further comprises a muscle layer.
7. The model of claim 4, wherein said at least one simulated membranous layer comprises an adipose layer and a muscle layer.
8. The model of claim 4, wherein the skin layer is about 1 mm thick.
9. The model of claim 5, wherein said adipose layer is between 0.5 mm and 5.0 mm thick.
10. The model of claim 6, wherein said muscle layer is about 1 mm thick
11. The model of claim 7, wherein said skin layer is adhered to said adipose layer, and wherein said adipose layer is adhered to the muscle layer.
12. The model of claim 4, wherein said skin layer s adhered to a first surface of the subcutaneous layer, and wherein a second surface of said subcutaneous layer is adhered to the muscle layer, wherein said muscle layer is adhered to the outermost surface of said thorax.
13. The model of claim 1, further comprising an intercostal space between each of said plurality of ribs each of which is substantially the same as an intercostal space between each of a plurality of ribs of an infant human of about 0.5 kg to about 3.5 kg.
14. The model of claim 1, wherein the pericardial sac is configured to contain a pressurized gas and/or a fluid in a space formed between the innermost surface of the pericardial sac and the outermost surface of said heart.
15. An anatomical model comprising: a plurality of simulated bodily structures, the plurality of simulated bodily structures comprising: a thorax comprising an internal cavity, an outermost surface and a plurality of ribs; at least one membranous layer, wherein said at least one membranous layer is affixed to the outermost surface of said thorax; at least one lung within the internal cavity, wherein the lung comprises at least one bronchus operably connected to the at least one lung; and a trachea within the internal cavity, wherein the trachea operably connects to the at least one bronchus.
16. The model of claim 15, further comprising a heart comprising a pericardial sac that substantially surrounds the heart, wherein said heart is located within said internal cavity and is affixed to the internal cavity.
17. The model of claim 16, wherein said model comprises two lungs, each of which is located on opposite sides of said heart.
18. The model of claim 15, wherein said at east one simulated membranous layer comprises a skin layer and a subcutaneous layer.
19. The model of claim 18, wherein said subcutaneous layer comprises an adipose layer.
20. The model of claim 18, wherein said at least one simulated membranous layer further comprises a muscle layer.
21. The model of claim 18, wherein said at east one simulated membranous layer comprises an adipose layer and a muscle layer.
22. The model of claim 18, wherein the skin layer is about 1 mm thick.
23. The model of claim 19, wherein said adipose layer is between 0.5 mm and 5.0 mm thick.
24. The model of claim 20, wherein said muscle layer is about 1 mm thick
25. The model of claim 18, wherein said skin layer is adhered to a first surface of the subcutaneous layer, and wherein a second surface of said subcutaneous layer is adhered to the muscle layer, wherein the muscle layer is adhered to the outermost surface of said thorax.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0015] The present disclosure will be better understood by reference to the following drawings, which are provided as illustrative of certain embodiments of the subject application, and not meant to limit the scope of the present disclosure.
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DETAILED DESCRIPTION OF THE DISCLOSURE
[0028] In the discussion and claims herein, the terra about indicates that the value listed may be somewhat altered, as long as the alteration does not result in nonconformance of the process or device. For example, for some elements the term about can refer to a variation of +0.1%, for other elements, the term about can refer to a variation of 1% or 10%, or any point therein.
[0029] As used herein, the term substantially, or substantial, is equally applicable when used in a negative connotation to refer to the complete or near complete lack of an action, characteristic, property, state, structure, item, or result. For example, a surface that is substantially flat would either completely flat, or so nearly flat that the effect would be the same as if it were completely flat.
[0030] As used herein terms such as a, an and the are not intended to refer to only a singular entity, but include the general class of which a specific example may be used for illustration.
[0031] As used herein, terms defined in the singular are intended to include those terms defined in the plural and vice versa.
[0032] References in the specification to one embodiment, certain embodiments, some embodiments or an embodiment, indicate that the embodiment(s) described may include a particular feature or characteristic, but every embodiment may not necessarily include the particular feature, structure, or characteristic. Moreover, such phrases are not necessarily referring to the same embodiment. Further, when a particular feature, structure, or characteristic is described in connection with an embodiment, it is submitted that it is within the knowledge of one skilled in the art to affect such feature, structure, or characteristic in connection with other embodiments whether or not explicitly described. For purposes of the description hereinafter, the terms upper, lower, right, left, vertical, horizontal, top, bottom, and derivatives thereof shall relate to the invention, as it is oriented in the drawing figures. The terms overlying, atop, positioned on or positioned atop means that a first element, is present on a second element, wherein intervening elements interface between the first element and the second element. The term direct contact or attached to means that a first element, and a second element, are connected without any intermediary element at the interface of the two elements.
[0033] Reference herein to any numerical range expressly includes each numerical value (including fractional numbers and whole numbers) encompassed by that range. To illustrate, reference herein to a range of at least 50 or at least about 50 includes whole numbers of 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, etc., and fractional numbers 50.1, 50.2 50.3, 50.4, 50.5, 50.6, 50.7, 50.8, 50.9, etc. In a further illustration, reference herein to a range of less than 50 or less than about 50 includes whole numbers 49, 48, 47, 46, 45, 44, 43, 42, 41, 40, etc., and fractional numbers 49.9, 49.8, 49.7, 49.6, 49.5, 49.4, 49.3, 49.2, 49.1, 49.0, etc.
[0034] This disclosure is directed to an anatomically correct model that includes a plurality of simulated bodily structures. Each of the plurality of simulated body structures are at least substantially anatomically correct and are each formed of materials that substantially correlate to the natural structure and feel of their corresponding anatomical elements. For example, a skin layer can include a silicon material or mesh or fabric that emulates the feel, structure and consistency of a human dermal layer. In one instance, an adipose layer can be composed of a gelatin having a consistency and thickness that emulates that of a human. Other materials and their corresponding organs or structures, which can be used in the models of the present disclosure, will be known by one of ordinary skill in the art.
[0035] The disclosed anatomical model can include several components, including a thorax forming an internal cavity, with a heart, at least one lung and a trachea located within the internal cavity and an at least one membranous layer that substantially covers the exterior surface of the thorax.
[0036] As shown in
[0037] The anterior portion (4) and the posterior portion (6) of the thorax (2) form an internal cavity (8), which can then be surrounded, in whole or in part, by a plurality of ribs (10). As shown in
[0038] For example, the intercostal spaces (12) between each of a plurality of ribs (10) are substantially the same size as those found in an infant human, which has a weight of about 0.5 kg to about 3.5 kg, from about 1 kg to about 3.5 kg. Also, the skeletal structure of the model 1 can be substantially the same as the chest wall diameter and length of the thorax of an infant human which is between the weights of about 0.5 kg and about 3.5 kg. In some embodiments, the size of the human infant that is being emulated by the present model is an infant having a weight of between 0.5 kg to 3.5 kg, 1.0 kg to 3.5 kg, 0.5 kg to 3.0 kg, 1.0 kg to 3.0 kg, 0.5 kg to 2.5 kg, 1.0 kg to 2.5 kg, 0.5 kg to 2.0 kg, 1.0 kg to 2.0 kg, 0.5 kg to 1.5 kg, or 0.5 kg to 1.0 kg. In other embodiments, the size of the human infant that is being emulated by the present model is an infant having a weight of about 0.5 kg, 0.6 kg, 0.7 kg, 0.8 kg, 0.9 kg, 1.0 kg, 1.1 kg, 1.2 kg, 1.3 kg, 1.4 kg, 1.5 kg, 1.6 kg, 1.7 kg, 1.8 kg, 1.9 kg, 2.0 kg, 2.1 kg, 2.2 kg, 2.3 kg, 2.4 kg, 2.5 kg, 2.6 kg, 2.7 kg, 2.8 kg, 2.9 kg, 3.0 kg, 3.1 kg, 3.2 kg, 3.3 kg, 3.4 kg, or 3.5 kg. Thus, the anatomically correct model (1) of the present disclosure can be of a structure that imitates a human infant's skeletal and organ structure can be used for training procedures on human infant medical procedures. For example, and as shown in the exemplary embodiment set forth in
[0039] Further, as shown in
[0040] As shown in
[0041] In the specific embodiment, exemplified in
[0042] In one embodiment, the at least one membranous layer (16) includes at least two layers or at least three layers. In certain embodiments, the at least one membranous layer (16) includes a skin layer (18), which is composed of a silicon material in a manner that mimics the elasticity, structure and density of the human dermis. In other embodiments, the at least one membranous layer (16) includes a subcutaneous layer (20) composed of a gel and/or silicon that emulates the density, elasticity and structure of human fat (adipose) and/or subcutaneous tissue. In certain embodiments, the anatomically correct model (1) of the present disclosure includes a muscle layer (22) that emulates the density, elasticity and structure of human muscle tissue. In specific embodiments, the model of the present disclosure includes an at least one membranous layer (16) having a skin layer (18) and a subcutaneous layer containing one or more of an adipose layer (20) and/or one or more of a subcutaneous tissue layer. In some embodiments, of the present disclosure the anatomically correct model (1) has an at least one membranous layer (16) that includes a skin layer (18) and a subcutaneous layer containing an adipose layer (20) and a muscle layer (22). See, for example,
[0043] In some embodiments; the skin layer (18) can be adhered to the topmost surface of the subcutaneous layer (e.g., adipose layer (20)) or a muscle layer (22). In instances where the anatomically correct model (1) has a membranous layer (16) that includes a skin layer (18) and a subcutaneous layer containing an adipose layer (20) and a muscle layer (22), the skin layer (18) is adhered to the topmost surface of the subcutaneous layer (20). For example, the skin layer (18) is adhered to the topmost surface of the adipose layer (20), and the bottommost surface of the adipose layer (20) is adhered to a topmost surface of a muscle layer which is then adhered to the outermost surface of the thorax (2). One example of how the at least one membranous layer (16) of the present disclosure is formed is discussed in Example 1, below.
[0044] In other embodiments, such as that shown in
[0045] In embodiments of the disclosed model, such as that shown in
[0046] The various embodiments of the present disclosure that include subcutaneous layers comprising different material layers, enable a user to practice medical techniques including, but not limited to, those that include traversing the at least one needle layer, with a tube or needle. For example, needle aspiration through membranous layer (16) for pneumothorax relief; needle aspiration through membranous layer (16) for a pleural effusion treatment; chest tube placement through intercostal spaces (12) including simulation of injection of an analgesic (e.g. lidocaine) or anesthetic into the membranous layer (16); incising the membranous layer (16) to create a subcutaneous tract and/or tunnel in the membranous layer (16) into the pleural cavity; maneuvering of the a tube anteriorly or posteriorly in the internal cavity (8); suturing a chest tube to the membranous layer (16); and applying appropriate dressing to the exposed surface of a membranous layer (16).
[0047] Although not shown to scale in
[0048] In some embodiments, the skin layer (18) is between 0.5 mm and 1.5 mm thick. In yet other embodiments, the skin layer (18) is between 0.75 mm and 1.25 mm, 0.75 and 1.0 mm, or 0.5 and 1.0 mm thick. In certain embodiments, the skin layer (18) is about 0.5 mm, 0.6 mm, 0.7 mm, 0.8 mm, 0.9 mm or about 1.0 mm thick. The foregoing skin layer thicknesses are important to emulate the thickness, density and elasticity of the human dermis.
[0049] In some embodiments, the muscle layer (22) is between 0.5 mm and 1.5 mm thick. In yet other embodiments, the muscle layer (22) is between 0.75 mm and 1.25 mm, 0.75 and 1.0 mm, or 0.5 and 1.0 mm thick. In certain embodiments, the muscle layer (22) is about 0.5 mm, 0.6 mm, 0.7 mm, 0.8 mm, 0.9 mm or about 1.0 mm thick. The foregoing muscle layer thickness are important to emulate the thickness, density and elasticity of human muscle tissue, specifically that of an infant.
[0050] In certain embodiments, the subcutaneous layer contains an adipose layer (20) that can be can be formed in a manner and location that allows for a simulated subcutaneous tunnel or tract to be formed traversing the layer. This tunnel or tract provides a means for inserting a chest tube through the muscle layer (22) into the internal cavity (8) of the model (1) by an operator.
[0051] Referring to
[0052] In other embodiments and as shown in
[0053] As seen in
[0054] For example, as shown in
[0055] As shown in
[0056] Moving to
[0057] In one embodiment, the anatomically correct model (1) of the present disclosure includes a simulated diaphragm (29), as shown in
Methods
[0058] As set forth above, the model (1) of the present disclosure can be used to practice several medical interventions and procedures on an anatomically correct device that emulates the real life clinical conditions faced by clinicians. More specifically, using the disclosed model, operators will be able to simulate the methodology for, amongst other actions, proper chest tube placement.
[0059] As such, in certain aspects of the present disclosure, a method for using the disclosed model for simulations of, for example, preparation, time out, sterile technique, incision, making a subcutaneous tract, perforating into pleural space, placement of a chest tube, draining air or fluid, suturing the chest tube and dressing the site. The disclosed model can also be used to simulate pericardiocentesis in cardiac tamponade or pneumopericardium.
[0060] For example, the anatomically correct model of the present disclosure can be used to practice the following procedures: positive pressure ventilation (PPV) with lung (24) inflation (see
[0061] The methods and model of the present disclosure will be better understood by reference to the following Examples, which are provided as exemplary of the disclosure and not in any way limiting.
Example 1
[0062] An anatomically correct simulated membranous layer (16) of the present disclosure was fabricated using commercially available products from Smooth-On, Inc.. The skin layer (18) was made using Ecoflex 00-30, a platinum catalyzed silicone. The silicone material layer was brushed into a mesh fabric and allowed to cure. See
[0063] When creating skin for a larger subject such as a full term neonatal infant (3.5 kg in weight), a second adipose layer (20a) can be formed on the topmost surface of the first adipose layer (20) as described above.
[0064] This membranous layers (16, 20, 22) then is of such a structure, density and elasticity so as to simulate at least one naturally occurring physical characteristic that can be sensed by an operator performing a procedure on a human person. For example, the pop and tension felt by an operator of the model when inserting a chest tube through the membranous layer (22) simulates the same process conducted in a human subject.
Example 2
[0065] One model of the present disclosure is formed to include anatomically correct skin (18) and subcutaneous tissue (20) affixed to an underlying plurality of ribs (10). Here the model includes an anatomically correct rib cage and intercostals spaces (12), based on actual clinical measurements of both 1.04.5 kilogram (kg) and 3.0-3.5 kg human infant subjects. The ribs (10) and additional elements of the thorax are fabricated with resin by additive manufacturing using 3D printing methods. This creates a precise and anatomically correct model, such as that shown in
[0066] The rib cage of the model is then wrapped in a constructed translucent membranous layer (16) including a skin layer (18), which is tightly secured to pegs (not shown). This permits the visualization and palpation of the ribs, which aids in identifying the placement for thoracostomy tubes. See
[0067] The model also includes space occupying chambers (31) for air and fluid (e.g., balloon or condom), which are important for training clinician to properly insert a chest tube in a subject. See
[0068] Also, a pericardial sac (15) is created surrounding a foam/clay shaped heart located in the internal cavity (8) of the thorax using a latex balloon (e.g., condom) that is capable of being filled with a fluid or gas. See
Example 3
[0069] A model affixed to an angled support (27) was created and tested, as shown in
Example 4
[0070] A model that includes a diaphragm (29) located within the internal cavity (8) of the thorax (2) as formed and tested. See
[0071] The described embodiments and examples of the present disclosure are intended to be illustrative rather than restrictive, and are not intended to represent every embodiment or example of the present disclosure. While the fundamental novel features of the disclosure as applied to various specific embodiments thereof have been shown, described and pointed out, it will also be understood that various omissions, substitutions and changes in the form and details of the devices illustrated and in their operation, may be made by those skilled in the art without departing from the spirit of the disclosure. For example, it is expressly intended that all combinations of those elements and/or method steps which perform substantially the same function in substantially the same way to achieve the same results are within the scope of the disclosure. Moreover, it should be recognized that structures and/or elements and/or method steps shown and/or described in connection with any disclosed form or embodiment of the disclosure may be incorporated in any other disclosed or described or suggested form or embodiment as a general matter of design choice. Further, various modifications and variations can be made without departing from the spirit or scope of the disclosure as set forth in the following claims both literally and in equivalents recognized in law.