At Least That's Done

Well, for better or worse the exam is over campers. I think I passed, at least a cursory review of the practical looks like I got maybe 60% right, which would be ok. The written exam was, to say the least, grueling. I took that part last, after nearly 4 hours of testing before it. I was starving because I was too nervous to eat before the exam. It was extremely challenging, every question was really tricky. Some I had to outright guess on because, to my knowledge, we had never discussed it in lecture.

The questions were mostly clinical vignettes where you had to tease out the relevant facts and answer the questions. There were very few "what attaches to this bone" type questions, but they were a nice break when I could get them. The vignettes would be a few sentences of scenario, followed by a question. Here is an example: A young man presents to the ED after a bicycle accident where he hit his shoulder against a light pole. He has numbness along the outside edge of his shoulder, his pinky, and is unable to extend his wrist joint. What was likely damaged? Then there are 5 closely matching answers, out of which you hope to find the correct one. Did he avulse the top roots of the brachial plexus? did he damage a cord? a terminal branch? which one? were there several nerve injuries that could match this scenario? of these possiblities, you have to figure out the right nerve(s) and hope your answer matches those available.

There was also a slide portion where they showed cross sections of a cadaver, MRI, CT, Radiograph(x-ray), and drawing. The tricky thing about cross sections is that the convention in medicine is to use the inferior view, rather than a superior view. For example if you have a cross section which shows the shoulder joint, you are looking at the section from "below" rather than a bird's eye view from above. The real trickery comes in some of the paintings where you can tell that it's a superior view that has been digitally flipped so that the left and right match an inferior view, despite being able to clearly see the chest as you would from above. The CT's were pretty straightforward, at least in the thorax. My only difficulty came in trying to discern between pulmonary arteries and veins. Check out images 13 and 21 on this page if you want to see some good CT's and know what I'm talking about. #37* and #30 are the vessels in question.

I realize it would be more convenient if I just posted the pictures on my blog, but there are copyright implications and I'd rather not mess around with that.