Just Kidding!

Looks like you're going to be getting multiple small posts leading up to midterms. ^_^ Today, I just wanted to say: Sometimes attending SGU is just like my undergrad back in the states.

Sometimes, however, it's not:When I was going to check my mailbox this afternoon I ran into a herd of five cows just randomly trotting through campus! You could tell who was a term 1 student because we all just stopped and stared. I mean, cows! On campus! Bizarre.

I didn't have my camera on me (although, now I feel I should be carrying it everywhere) but I found a pic on flickr someone had taken of a cow on our campus.(http://flickr.com/photos/sravishankar/4512973/)

At any rate, I had better get back to my studying!

Random anatomy tidbit of the day: The first part of your duodenum is suspended in the hepatoduodenal ligament where the 2nd, 3rd and 4th parts are retroperitoneal (behind the peritoneum). The ligament is also important in that the portal triad (hepatic artery, hepatic portal vein and bile duct) runs through it as it goes to the liver. This is very significant clinically as you can put your finger under this ligament through the epiploic foramen which easily allows to access to the lesser sac or to clamp off the portal triad and also gives you direct access to the inferior vena cava posteriorly. All in all, a very important little place.

No More Posting Until After Anatomy Midterm

dancing...lemurs....so....hypnotic...

Do you know where _your_ pancreas is?

Today when I was studying congenital defects associated with the embryological development of the pancreas I came across a somewhat disturbing defect. I won't bore you with the details... ok, who am I kidding? Of course I'll bore you with the details. And since my roommate has already caught on to my not-so-secret designs to (inadvertently) turn my blog into an anatomy review I might as well continue on in the same vein. Sorry my friends (and poor passerby), until I finish anatomy you're going to be hearing about it. Again and again.

Back to pancreatic development! Ok, the pancreas is actually a production of fusion between the ventral and dorsal pancreatic buds. Essentially, around day 26 of of your happy womb floating time a dorsal bud appears right at the demarcation of the foregut and midgut and a ventral bud appears on day 28. Around the seventh week rotation and fusion occurs (note: this is rotation by the duodenum which is what the pancreatic buds come off of - that's the first part of the small intestine for you non-science people). So, there is this defect where the ventral bud is bifid and can actually then encircle the duodenum and compress it. It's like your pancreas is choking your small intestine!

My mind immediately supplied me with a vivid image of my pancreas throttling me in my sleep. What a way to go. (yes, yes, this is patently implausible, but you try studying embryological development for hours on end and not get a little loopy!)

Also, remember that if you're ever having a splenectomy (or performing one) to be careful not to damage the tail of the pancreas since it's veeeery close to the spleen.

Why yes, midterms are approaching at warp speed and I'm cramming a seemingly endless pile of random facts in my head that tend to spill over if I'm not careful. Why do you ask? *_*

Like...let's see, that the rectus sheath doesn't continue all the way down posteriorly and where it stops (1/3rd of the distance from the umbilicus to the pubic symphysis) is called the arcuate line and so after that the rectus abdominis is in direct contact with the transversalis fascia?

Or... that a indirect inguinal hernia passes laterally to the inferior epigastrics (why, oh why am I obsessed with the epigastric vessels??).

Right. You can expect my posts for the next two weeks to be similar to this one. Scattered. Random. And full of anatomy facts. Maybe even an occasional biochemistry detail just to shake things up at bit.

Sounds of a Grenadian Night

As I was walking back from the library tonight, latest anatomy group discussion guidelines clutched in my hands, I enjoyed the slight warm caribbean breeze and idly wondered if it was possible to go to medical school in a more forbidding environment than the idylic one I currently reside in. It's been said, and I've found it to be true, that it really hits home that you're not home when the sounds of night are unfamiliar. The sounds of a Grenadian night consist, for me at least, of the distant rumbling of the ocean waves and these ever present light chirping noises.

I finally decided tonight that I'd track down the source. And, lo and behold, I did! Eleutherodactylus johnstonei, otherwise known as the 'West Indian Tree Frog' or 'Whistling Tree Frog' was the source of the chirping. They are small, only about an inch long or so and very cute.

I give you, the sounds of a Grenadian Night: http://www.geocities.com/yournameheremd/frogx.mp3

Mmmm... Glycolysis

I'm now proactively studying biochemistry since I came to the realization that perhaps studying 26 lectures worth of material two days before unifieds was maybe not the brightest thing I've ever done. Ah well, not too much harm done in the long run. But since I have a tendency to ignore biochem since it's essentially pure review for me I've decided that I should just go ahead and get the many wonderful cycles down that we'll need to know. Ah, nostalgia. ^_^

We are now 14 days pre-midterm and I'm defintely feeling it breathing down my neck and am trying my best to not panic prematurely (that's a special moment saved for the saturday morning of the weekend before when I realize that I'm counting down in hours before the anatomy midterm). I have to say that the time period between unifieds and miterms feels quite a bit smaller post unified. When I think about the amount of material I have to cram into my poor overstressed neurons I start to get a little faint. Then I start thinking about preganglionic nerves and post ganglionic fibers and Dr. Bashir and how amsuing it is that I finally really get that and then start freaking out slightly because I can't remember exactly which vertebral levels that the parasympathetic nervous system originates from (craniosacral outflow by the way, spinal nerves 3, 7, 9 and 10) and then I start ruminating (inexplicably) on the epigastric arteries which are really quite fascinating since the superior epigastric artery is a branch of the internal thoracic artery and the inferior epigastric artery is a branch off of the external iliac artery but the superior and inferior anastamose with each other and so are in actuality continuous and run in the posterior rectus sheath. My eyes are usually swirling at this point. @.@ As I imagine yours are. Unless of course you're here in term 1 with me in which case you'd probably scoff and wonder why I'm still going on about epigastrics when I should be worrying about five million other more important things that I don't know, such as cardiac embryology because it is currently kicking my sorry self all around the non-existent field I'm frolicking in - it's in my own personal La La land that I frequent frequently these days. *slightly crazed grin* See, normally, the crazy pre-test manic state (which I was recently described as being in) starts a day or so before a test. But here.... You see, in undergrad, if you procrastinate as I did, you'd normally start studying for a test the night before and that was cramming. In med school? You start cramming three weeks ahead of time. Hell, to be completely honest, I should have been 'cramming' since day one. What can I say? I was lulled into a false sense of thinking that studying a few hours a day meant I was doing ok. Yeah, not. I've upped my studying about three fold or so and it seems the more I study the more behind I feel! Gyah! Miterms! Run for the hills!

Hills I could conceivably run to:
Ok, now that I've convinced all of you (that weren't aware already) that I'm neurotic I'll impart good news! I made an awesome score on my Histology unified. Almost perfect, only missed one question. Go me! Go my half hour of power skim studying! Oh Histology, how I love thee. Why oh why can't my other classes be as easy? Or as material light? And the midterm will have photomicrographs (fancy term for 'pictures') which will be make it even better. Looking at slides is the best. I mean, really, how hard is it too tell a pyramidal cell body in the cerebral cortex from a purkinje cell from the cerebellar cortex or from a from a pseudounipolar cell body in a dorsal root ganglion? *pouting* I'm telling you, cellular nervous system is so much easier than gross anatomy level nervous system. Although I imagine there are many people who would disagree with me.

Since you've read (or skimmed) this far I will give you pretty pictures to back up my claims of simplicity in Histology photomicrographs. Sorry people, not ocean. The closest my roommate and I have gotten is that we opened our blinds this morning to see natural light. Natural light! It was so...bright. We stayed in studying all day yesterday and didn't venture out until dark in search of something edible that wasn't a sandwich.

Ok, ok, promised pictures! Our first picture hails from the wonderful place called the Cerebellar Cortex. Isn't it pretty? Ok, ok, the arrows are pointing the the aforementioned purkinje cells. See the pretty cells? Ok, those make up the, you guessed it, the purkinje cell layer. The dark layer underneath them is called the granular layer. The lighter area above the purkinje cell layer is the molecular layer. See? Makes sense and is easy to figure out. These three layers make up the outer gray matter of the cortex.
Ok! Next we have something a bit different, a photomicrograph of a dorsal root ganglion (basically, a collection of nerve cell bodies outside the central nervous system, so in other words, other than the spinal cord and brain). See the pseudounipolar neurons? Aren't they just adorable. All round and happy (well, not that happy since they're dead, fixed, sliced and stained but you get the idea). They were happy once. And isn't that what's important?

Ok, I'm not actually as crazy as I sound sometimes. Really. And sorry for the long post where I inadvertently (I swear!) started teaching you histology. *sheepish* Totally wasn't my intention! But now you know some histology. Ha ha! :P

Back to the books!! I think I'll go 'study' fatty acid oxidation (and if you know me you understand why FAO is in quotations). *grin* Bye!

Listening to: 地獄少女 オリジナルサウンドトラック

I Passed!! 奇跡だよ！

OMG! I actually passed the Anatomy Portion of the Unifieds! I only lost a few points!! You guys have NO idea how happy this makes me. I was completely convinced that I failed the anatomy section so miserably (damn you ASD's and your many different versions!) that they'd kick me out of school by flinging me off a convenient sea cliff with a small raft and a paddle in the general direction of Florida and then quietly erase my name from the registrar and pretend to never have heard of me. So I've spent the last few days moping and trying to figure out a secondary career path (couldn't get past offering to do math problems on the side of the road). But I passed!! Yipeee!!! I don't have to drop out of medical school!

The histology, biochemistry and bioethics grades aren't up yet though so perhaps my celebrations are a tad premature. But I PASSED ANATOMY! I am, right now, passing anatomy. Ok, ok, it's only 7.69% of my grade but, dammit, that's a good 7.69%. Take that!

....I need to go study the thorax like no one's business now before the universe decides to punish me for being happy. I hate it when that happens.

17 Days Until Midterms!

Me After Unifieds

Me Before Unifieds

They're only worth a few percentage points, they're only worth a few percentage points, they're only worth a few percentage points, they're only worth a few percentage points....

TIG Moment

In anatomy lab yesterday I experienced my first 'TIG Moment' as well as being introduced to the phrase. The water in the anatomy building was turned off. o.o Really, imagine a hoard of first term medical students heading for the sinks to wash their hands after spending an hour poking and prodding cadavers to find...nothing. Note: many of these students had already put soap on their hands. Whining abounded. Hand sanitizer was passed out in small amounts, its market value skyrocketing in seconds. People's expressions ranged from vaguely distasteful to outright disbelief. Multiple students tried each sink, just in case, you know, that'd it would work for them even though they just watched others try in vain. Eventually, we shuffled out of wet lab and headed to dry lab - many holding their hands at arm's length, others were sacrificing water bottles just to at least have the illusions of having washed their hands.

Upon entering Dry Lab I was informed by our clinical tutor (after my harmless 'you'd think they would have a backup water supply for the anatomy lab if nothing else!') that it was a 'TIG Moment'.

This. Is. Grenada.

She then laughed and informed all of us that it wasn't so bad since we'd had gloves on. Oh, and not to touch her accidentally in any way. -.- At any rate, the small mix up with water aside, my anatomy lab went very well yesterday.

My group and I were all very well prepared and hit the bulls eye on each question time after time. Truly a triumph of..well, us. :) Apparently listing all the forearm and hand muscles on this blog proved a good luck charm (or it could have been the time I spent in wet lab the night before, or the notecard making, or my rewatching of the lectures, or my reading of the textbook...). I really should start paying attention to my other classes. I know, you didn't realize I was even taking other classes with how I go on about anatomy. But really, I was so happy last night when I looked at a cross section of the forearm and could identify the flexor carpi ulnaris and remembered it was innervated by the ulnar nerve and was one of the one and 1/2 muscles in the anterior compartment that wasn't innervated by the median nerve (the half is from the medial half of the flexor digitorum profundus).

Sidetracked again! Biochemistry. Histology. And even Bioethics. These are the classes that will gain my attention briefly for the next few days. If only to ensure I'm up to speed. And possibly to make a few notecards if necessary.

Upcoming Unified's may either cause me to blog every day or you may not hear from me until next tuesday... time will tell. ^_^'

I will Survive! (maybe)

The honored director of our anatomy course played this video for us in lecture today. I think it speaks for itself. And now I must go spend some quality time with a bunch of corpses! See ya!

It's Sunday

I promised a blog entry this weekend and somehow without me noticing sunday night has arrived. Quite without my permission I assure you.

I thought of a novel concept - typing an entry that doesn't consist of random anatomy terms that make my head spin in addition to being fairly incomprehensible to my poor readers. I mean, I would never just, say, list all the muscles of the forearm and hand as practice. Right. That wouldn't be very interesting. But it'd probably be helpful.... ok, I give in, just skip over it to the (hopefully) more amusing bits after my compulsive anatomy listing....

Anterior Compartment of the Forearm
-Superficial Layer-
Flexor carpi ulnaris
Palmaris longus
Flexor carpi radialis
Pronator teres
-Intermediate Layer-
Flexor digitorum superficialis
-Deep Layer-
Flexor digitum profundus
Flexor pollicis longus
Pronator Quadratus

Posterior Compartment of the Forearm
-Superficial Layer-
Brachioradialis
Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor digitorum
Extensor digiti minimi
Extensor carpi ulnaris
Anconeus
-Deep Layer-
Supinator
Abductor pollicis longus
Extensor pollicis brevis
Extensor pollicis longus
Extensor indicis

Intrinsic Muscles of the Hand
Palmaris brevis
Dorsal interossei
Palmar interossei
Adductor pollicis
Lumbricals
-Thenar Muscles-
Opponens pollicis
Abductor pollicis brevis
Flexor pollicis brevis
-Hypothenar Muscles-
Opponens digiti minimi
Abductor digiti minimi
Flexor digiti minimi brevis

Ok, I would say I feel better, but I actually think I feel worse. After studying many, many hours this week on anatomy I still feel like this:

...oh, and just in case there is any confusion as to what represents what... :P I am Zazu. Scar is like the beast that is Anatomy - genial one second and then *bam* there goes your head! >.>

Hm. I do believe that just created yet another entry about nothing but anatomy. I woke up this morning thinking about the cutaneous innervation of the hand. *sigh* No hope I tell you. None at all.

Ok, time for some SGU information decimation! That way I can still claim this blog is useful for incoming SGU students. We have approximately (and by approximately, I mean exactly) three grades for each class. A midterm, a final and this little thing called Unifieds. The Unified Quiz, as it deserves capital letters, is only worth 3-5% of the grade for each class. It is a three hour long 'quiz' (I use the term loosely because, really, who here has ever taken a three hour long quiz??) that consists of multiple choice questions from anatomy, biochemistry, histology and bioethics. The bioethics portion is actually the final for bioethics so then I can wash my hands of that particular time waster. I feel I should point out at this juncture that I am certainly not implying that ethics is an unnecessary attribute for medical students. Rather, it was a jab at the organization and teaching of the class which has caused me to regard the entire affair with derision and disdain (really, is showing Weird Al Like a Surgeon to 'cheer us up' after watching a video of a child dying of Tay Sachs appropriate?!). But I'll give a whole separate entry which will mainly consist of me complaining on the farce that is our bioethics class another time.

So, Unifieds are casting fear over the land (of term 1 students) and is casting more than a few shadows of apprehension over me personally. It's an absolutely excellent way to gauge how successful your chosen study methods are. And I fear if I do poorly I'll be demoralized almost beyond redemption. And add to that the fact that midterms are following closely on the heels of unifieds at a mere three weeks post and you can gain some form of appreciation of the definite noticeable increase in my relativistic stress level. @.@

Oookay. Time to break up this pity fest! Here is a soothing picture a two cute european starlings. Aww, aren't they cute? I can feel my blood pressure going down already.Oh, and if you can guess the exact location of where this picture was taken (hint: not Grenada) you get a prize. Note: you must actually know me in order to participate in this contest, not valid outside the continental 50 states LOL

Listening too: The absolute AWESOMENESS that is 屍姫 赫 オリジナル・サウンドトラック

Dear Mom and Dad

I'm writing home to tell you that I'm two weeks into medical school and can pick out the quadrangular space on an MRI! Aren't you proud? Don't know what that is? Why, of course, it's the area formed by the inferior margin of the teres minor, the surgical neck of the humerus, the superior margin of the teres major and the lateral margin of the long head of the triceps and has the axillary nerve and posterior circumflex humeral artery and vein passing through it!
You know, that space? See in the picture? Hint: The big radiopaque spot (white spot) is the head of the humerus! Navigate the treacherous waters of anatomy! You've never looked at an MRI before? No problem! Just dive right in and start identifying! It's fun! Note: I have had seven hours of anatomy today and cannot possibly be held responsible for anything I write. At any rate, I was only following the words of our anatomy professor in class this afternoon who told us that recognizing the quandrangular space on an MRI was something to write home about. ^_^

And since I'm typing when I really really should be working on memorizing nerves (damn you nerves!! why can't we just control our bodies some way that a little simpler??) I'll give the the absolute highlight of my dreaded anatomy lab NUMBER 2 that was today! Aren't you just so excited? Ok, here it is. The highlight moment occured was when one of the course directors (who's absolute favorite expression so far seems to be "Don't be Stupid, Stupid!" comes over to my small group table. In the course of a discussion about palmar arteries (which are actually pretty damn cool, try the Turner test on yourself sometime!) we asked a simple totally unrelated question (never, never ask questions unless you're desperate...or at least have a thick skin and be able to think on your feet). So, we asked a question (wasn't even me, I knew the answer but I was the chosen victim since I was closest...) and Dr. B set his forearm in front of me and asked me to take his pulse.

Me: o.o Um...ok. *tentatively pokes in the area our course director's radial artery attempting in vain to feel a pulse as ten other people look on waiting for the inevitable punchline*

....

Aren't you all waiting too?

Heh. The punchline is that it is apparently hilarious to ask someone to take your pulse when you don't freaking have one because your radial artery was removed to put in your heart!!

To quote Homer Simpson: D'oh!

So, I impart the lesson that was imparted upon me today. Always, always be observant! Don't let being put on the spot in front of multiple people and being asked to take the pulse of your super important intimidating course professor while your mind is gibbering that 'maybe you're palpating the wrong side you idiot!' distract you from the twelve inch scar down a man's forearm and wrist indicating that maybe he doesn't have a pulse on that side to begin with because it's been surgically removed! Tricky, tricky.

*twitch* On the other hand, I'll never forget this lesson. Doesn't make it smart any less. Ah, the joys and wonders of anatomy...where you'd had better know your shit or you'll pay. Oh, you'll pay.

In short, anatomy makes me feel like this:

The Problem With Anatomy...

Is that you are living in it! There's no escape!
Example: You throw yourself down in frustration and notice your arm. Ohh, look, the cephalic vein! And let's not even talk about showering! I'm sure I'm vastly amusing in the shower poking my arms for twenty minutes until my skin wrinkles trying to remember all the muscle innervations. And THEN....my skin is wrinkled which gets me started thinking about epithelium and gap junctions and basement membranes....

AHHHHH! Make it stop! It's only been two weeks! My poor little brain.

And I would just like to tell all of you to appreciate all that goes into the simplest movements of your hand (see aforementioned diagram of the brachial plexus - and that's the simplified version).

Ok, ok, since you've read through my rants on why anatomy is kicking me severely I suppose I can put something useful on this post. How does the make up of our anatomy labs sound? Right, that's what you'll get.

ANATOMY LAB is quickly become the sticking point of my week. If my week was a battle, which it often seems like, it would read as follows...
Monday: some minor skirmishes to the east
Tuesday: a few volleys exchanged with the west infantry
Wednesday: ATOMIC BOMB DROPPED ON BASE CAMP! <---this would be anatomy lab

*cough* Ok, I digress with my analogies (for now). Back to information imparting. Anatomy lab is five hours long and starts at 7:45 sharp. We have two hours in small group discussions. For one hour we have practice physical examinations on each other (akward much?). For the next half hour we discuss cases pertaining to the subject of the week and have lively discussions (all helpfully watched and guided by our clinical facilitator). The final half hour in small group is spent going over a review article from the New England Journal of Medicine which also pertains to the area we're studying at the time. After small groups are over we troop over to wet lab! This is, of course, what you are all interested in hearing about. At SGU we have prosected bodies - meaning that we don't have to spend hours a day slaving over a corpse cleaning fat and looking in vain for a parcticular nerve only to find we'd accidentally cut it hours ago. >.>' Instead we are split into groups of four and set loose. For each body you have about seven minutes to find everything that it listed on a little piece of paper about that particular corpse. There are circulating doctors that can help out but be careful! If they catch you slacking (aka, not actually having a clue as to what the suprascapular nerve is or where it should be) you'll pay for their help in doses of humiliation (I kid you not! My group was semi-politely told off within five minutes of being in lab!). Then a buzzer, which I swear sounds like a buzz saw, sounds and you move to the next body and start your search anew! The final portion of lab consists of an hour back in small groups where you discuss more visually orientated cases and answer questions. So, for example, in my last lab we looked over various x-rays and had to identify particular structures and fracture sites, etc. Thus ends the five hour marathon of anatomy lab! Now the caveat is, if you haven't figured it out already, you have to be prepared going in. It's not like undergrad where you just show up to learn. HAH! You had better already know everything before stepping foot in the lab or you are behind. And the anatomy profs aren't timid about letting you know it either. Sheesh... I've never heard so much profanity from professors in a class since, well, ever. O.o Anatomists are definitely a 'tough love' bunch. So COME PREPARED! You had better have memorized all the structures that you will be finding, have read over the cases for small group and have answers ready, have read that review paper and be able to present any section when the clinical facilitator calls you out and for god's sake, never ask "what do we need to know?" or the head of the course will personally never, never speak to you again (luckily for me he's my faculty advisor so I was informed about this multiple times..... >.>').
And there you have it. Anatomy Lab. Now you understand why it was in bold and in all caps?

Now that you've read through this scary (at least to my since I'm living it!) narrative on the horrors of anatomy I will give you yet another picture of the beach that I went to snorkel in saturday morning. It was amazing! The water was warm and so wonderfully clear!
I saw many cool fish and a whole slew (herd, school, murder?) of giant starfish that were very cool! I looked them up and they are called cushion starfish. Here is a picture I found online since I do not have an underwater camera and none of them helpfully washed themselves up on shore like this guy did. (It's the same species that I saw! The picture was taken at the same beach!) These were the size of my head!(http://flickr.com/photos/amarnani/2812551583/)