Another week come and gone.
This week was a lot better than last, in short. We had two embyro lectures and a lot of PPS which reduced the amount of new anatomy I had to learn. PPS is Patient Physican and Society, which the clinical bone they throw us in the pre-clinical years. This week we had a lecture on pain, the only formal didactic session on chronic pain that we’ll recieve. The professor alleged that 80% of office visits pertain to chronic pain of some kind. If this is in fact true, you would think that we would have more instruction. There was a gentleman with chronic back pain secondary to a workplace injury who talked at length with how he came to grips mentally and emotionally with his intractable back pain. We then practiced interviewing a standardized patient about chronic pain issues. We haven’t gotten to do this 1:1 yet, but we have a small group and one of the group interviews while the rest of us watch. The guy who was interviewing was pretty choppy and stilted in his interview style. As several of my LDS friends who were in different groups and I debriefed the PPS session together, we all talked about how serving a mission helped us a lot to easily talk to strangers about intimate subjects.
Anatomy: this week we learned the following:
Posterior triangle of the neck: This region is defined basically as the area in front (anterior) of your trapezius and behind the platysma muscle. If you exaggerate a frown and push your face forward, the muscle that bulges out on your neck is the platysma (roughly speaking). The superior (upper) border is the matoid process which is the bony protusion behind your ear. In this little space we have the cervical plexus, the brachial plexus, and some small muscles that help to hold your head up. There are a host of blood vessels which are very difficult to remember. The brachial plexus is especially hard to remember, this innervates the arm and hand, as well as some of the pec muscles and the muslces of the shoulder. It’s easy to draw on paper, but tracing the actual nerves through the arm and shoulder is pretty tough, at least on my cadaver.
The Axilla: Simply put, this is the armpit. It contains the brachial plexus, and some major vessels, including the axillary artery and vein, a lot of fat, and a whole lot of lymph nodes. Human anatomy is a lot like street naming in a big city. Streets will change names for no good reason, same thing applies in anatomy. The brachial artery is also the axillary artery is also the subclavian artery is also mostly the brachio cephalic vein, depending on where you are.
Posterior Mediastinum, the junk behind the heart and lung.
We had another practice practical in lab on saturday which was extremely frustrating. They pinned the same structures several time in different areas so you would be tricked. I realized after taking the practical that I need to spend a lot more time with the actual body so I can get a subconcious understanding of where things ‘ought’ to be in relation to other things. You can learn so much faster by seeing the real article than by studying the abstract version, it’s just a lot harder to study the body because it’s not clean and well colored. The majority of the contents of a cadaver are white, brown or yellow. Veins are sometimes blue, but lymph ducts can look a lot like a blood vessel too.