Making Headway

Greetings!

What a week. There is much to catch you up on! But before I get to the fun stuff, let's set the scene a bit. This week we began the head and neck unit of anatomy. This includes learning about the vasculature, musculature and nervous tissue in the brain, spinal cord and surrounding structures. In addition, we have two new classes starting to go along with histology, anatomy and anatomy lab: embryology and clinical medicine.

Of course, the content of embryology is pretty straight forward - human conception and development. I am already astounded that any of us make it to birth. Honestly, there are so many complicated steps that birth indeed deserves its label, the miracle of life.

Clinical medicine, or clin med as we affectionately refer to it, marks the beginning of our training in bedside manner. We are learning about effective lines of questioning and how best to develop trustworthy rapport in a very short amount of time. I am almost certain that our professor was making a joke by showing a Monty Python clip in lecture, but the point was well taken. Those British goofballs were prepping an operating room with all of the most expensive equipment, but couldn't tell what was missing - the patient! The ironic point was - everything else ought to be secondary to focusing on the patient.

OK, now onto the good stuff. On Tuesday I cut open a human skull and took out the brain. It was spectacular. Of course, I was the one working the circular saw (wouldn't have it any other way). The complexity of our innermost workings never ceases to amaze. There were a few neurosurgeons wandering around the lab to answer our questions and it was fascinating to hear about some of the functional deficits associated with certain events, i.e. vision loss in one eye following blunt force trauma to the skull, sudden losses of consciousness.

People, it just keeps getting cooler and cooler.

Friday was elections for Class Senate. I thought it might be interesting to get elected Class Vice President. So I did.

It sounds easier than it was when I put it that way, though. There was considerable competition from two other qualified candidates and my victory was made possible only by a very well received three-minute campaign speech before the student body. Public speaking is like a sporting event. Adrenaline rush before you get up there. Those few deciding moments with no room for stuttering or verbal missteps. You leave it all at the podium and, let me tell you, there is no better feeling than coming out of it a success. Nothing better.

So the studying begins again. About 19 days until our next exam. Still don't have all of our scores back from the last exam, but so far I am satisfied. A slight improvement will put me into course-honoring territory. Considering that the first exam is historically the worst for everyone, I am in very good shape.

That's all for now. Thanks for reading!

Medical factoid of the day: The auriculotemporal nerve is a terminal branch of the trigeminal cranial nerve. It provides sensory innervation to the skin of the temple region on the side of the head. During development this nerve encounters the developing middle meningeal artery, which supplies blood to a protective membrane, the dura, that surrounds the brain and spinal cord. However, instead of coursing around the artery during development, the auriculotemporal nerve splits then comes back together, creating a very rare "needle and thread" appearance with the middle meningeal artery.

Exam Nerves

Hello again!

As the first Anatomy/Histology exam draws nearer, tension in lecture has increased to a palpable level. It seems like most of my classmates are relatively prepared, but still remain on edge since none of us truly know how this first experience will turn out. My philosophy thus far has been to spend my energy on studying rather than worrying, but I realize a healthy dose of anxiety does wonders for motivation.

Along with a couple of review sessions, this week included our very first nerve conference. It consisted of several patients with relevant nerve damage allowing us to question them about their deficits. It was then our job to use our anatomy knowledge to discern exactly which nerves and branches of nerves might have been damaged. Perhaps more than anything it served to remind us of why we are learning all of this information in the first place. It's easy to get wrapped up in the day-to-day struggles of cramming dozens of pages of lecture notes into our skull. Seeing a few patients every now and then is a nice reality check, and a much more effective source of motivation for me than that "uh oh" feeling.

Next week will be an exciting one. Tuesday will be my first round of free clinic work. I look forward to learning the ropes and speaking with the uninsured of Detroit. The clinic is largely Spanish-speaking, which will be an excellent opportunity to shake the cobwebs off of what I learned back in high school.

Alissa has been enjoying her last few days of freedom as she begins year two of physical therapy school on Wednesday. Understandably, she wishes she had a few more weeks to enjoy the summer (I wish she did too, for her sake). Selfishly, though, it will sure be nice to see her a little more frequently with her being back in Detroit for classes!

Wednesday, of course, is also the day of my exam: an eight hour marathon of practical anatomy identification, written anatomy questions as well as histology. Should be fun. I feel well prepared already, but certainly will not be taking any of the coming weekend hours for granted.

Until next time!

Medical factoid of the day: When the nerves of a muscle are irreversibly damaged, causing the muscle to atrophy, surgeons are often charged with the task of moving other properly functioning nerves and muscles into the defect. To accomplish this, surgeons look to several places in the forearm, wrist and hand where functional redundancies occur. For instance, one of the muscles that extends the little finger (extensor indicis) is assisted to a large extent by a superficial muscle called extensor digitorum which runs down the top of the forearm and hand. If a flexor of the hand is knocked out, extensor indicis and it's accompanying innervation can be relocated to the flexor compartment with only mild short-term extension deficit in the little finger. Amazingly, the extensor digitorum soon grows to compensate for the missing muscle.

Scrubbing In

Greetings!


With the first ten days of medical school behind me, I finally feel like I'm falling into a comfortable routine.  Orientation was a gradual introduction to the considerably more fast-paced week that would follow.


It seems an accurate assessment to say that I am already responsible for as much anatomy and histology material as I would have covered in an entire semester at U of M. All is not lost, though! The expected pace of absorption is surprisingly manageable (so far) if I simply stick to the 'ol lecture-gym-study regimen. I also have the sneaking suspicion that squeezing in a few meals each day will be very much a key to success :)


Wayne's facilities are impressive and the instructors knowledgeable. There seems to be a common thread of pragmatism underlying their lectures, making our newly acquired wisdom easily relatable to the procedures and protocols in gross anatomy lab.


The type of bond that will be formed between many of us through this 4-year gauntlet is already apparent. Excitement, intimidation, reverence: just a few of the emotions elicited at the proposition of joining such an elite fraternity of professionals.


For now, it's back to the books.


Medical factoid of the day: During select surgical procedures, it is beneficial to clamp the axillary artery. This can be done without depriving the upper extremity and shoulder of blood because that area of vasculature exhibits collateral circulation. This means there are two completely independent routes oxygenated blood can take to reach the same destination muscles.