All's well that ends well

Short version: I passed my first anatomy exam. Yay! It feels odd to have a different bar to aim for than as an undergrad. The stakes are higher and so is the bar in medical school. In college I consistently tried to ace every exam and get at least an A-. Things are different now. I'm glad I passed, and since the exam was so hard, I know that I'm lucky to have been able to. Shoot for the P, since Honors isn't happening in this class.
We had some strange units in class this week. We covered the topography of the skull and the cranial nerves, both of which will be covered to exhaustion in later units. Consequently, right after the exam it was hard to jump right back into the long study hours. I don't think that I was resting on my laurels (such as they were), but having such general sections kind of threw me off my groove.
Some of the hardest stuff to master this week, and I have by no means mastered it, was the deep face. The area behind the angle of the mandible (the part of your lower jaw where it changes from horizontal to vertical) is chock full of nerves, arteries and a couple muscles. The arteries are pretty tough because they are quite tortuous in their tracks. While this is handy in allowing you to open your mouth without tearing blood vessels, it makes tracing them and their branches difficult. Identifiying structures is doubly difficult because several things are named very similarly if not identically, for instance there are two buccal nerves which arise from totally separate cranial nerves; there is also a hypoglossal nerve, but a hyoglossal muscle. Keeping everything straight is pretty tough. It's hard when there is a long section to learn because you don't have any down time to catch up, you just need to study the next section hard so have a few hours to go back and learn the older stuff again.

Mediastinum and a long day

Yesterday we had our first embryology lecture. Here, embryology is taught once a week concurrent with the gross anatomy course. That means we have ten embryology classes, and one pass/fail final. Since we didn’t have gross yesterday, that meant no dissection and a little more time to study the dissections from the previous two days. Since the first lecture was pretty superficial and ‘big picture’, the locker room consensus was that it wasn’t worth our time to study embryology until we got some more detail. I’m inclined to agree with this assesment, since time is precious and embryology isn’t a big portion of the course. “ But you’re in medical school to learn all you can!” I hear you cry. So I am, but I study between 6-10 hours a day just trying to master gross anatomy without tossing embrology into the mix. If I had the time, I would study it every week, since it would actually facitlate the understanding of why certain structures are posistioned where they are in the body.
Regarding pace: We have about 90-120 minutes of lecture a day for gross anatomy. I asked my friends who took gross as undergrads what the pace was like with respect to their previous experience. It turns out we cover in one lecture what took them a week to cover before. That means we’re going about 5 times as fast as an undergrad. This is why I study so long. It’s exhilirating in a way, but I also know that it’s like riding a bike at 20 miles an hour along the top of a median barrier. It’s a rush, but there isn’t a lot of margin for error. If I miss just a little, the consequences are dire. THe material is pretty cumulative, so you need the previous day’s lecture to understand today’s lecture.
Today was just such a day. It wasn’t my turn to dissect (we rotate dissectors every day), so I studied for a few hours after lecture until the lab opened up to the rest of us. Our dissection for the day was the mediastinum and the pleural cavity. These lie directly below the ribcage, and include the heart, lungs and associated structures between the diaphragm and the clavicle. Our individual is rich in adipose tissue which really slows down a dissection because it has to be removed before you can actually see anything. The lungs weren’t in very good shape at the time of death, and the dissection process hadn’t aided matters. Everything was still really jumbled together when I got to the lab, so it was pretty tough to learn from the cadaver. The fact that I couldn’t see firsthand what I had been studying for a few hours set me back in my schedule quite a ways. I felt pretty panicky and behind as I left the lab frustrated and annoyed. A friend of mine who is a pretty talented dissector and has been helping me through anatomy offered to come in early before class and help me to see everything on his cadaver. Tomorrow morning at 6:45 we’re going to go over the mediastinum and everything else in there before lecture....