Saturday, May 29, 2010

TRI-5, Wk3, Day 282 - Memorial Service


Friday started with the typical Physical Dx I, Diversified IV, Physical Dx I sequence of classes. Through Physical Dx I learned that the waif super model from the mid to late 60s, aptly named "Twiggy" had amenohhrea which is an absence of menstrual periods. Also, Barabra Bush had Graves' Dz which pertains to hyperthyroidism.

After those three classes we normally have Logan Basic Technique III but our teacher wanted us to attend a memorial service for veterans. It was a nice presentation and several of our student veterans were honored. The presentation also included some heavy hitters including Missouri Secretary of State Robin Carnahan as well as representatives from MO governor Kit Bond. A slight downside related to the event was that I ended up missing our 11 a.m. Dx Imaging tutoring session.
There was a very impressive military lady who talked during the later portions of the event. She was a 2001 Logan graduate. One of the things that made her talk so impressive were her references to things previous speakers had said so we knew hers was not a canned talk. One of the things she referred back to was a resolution that had just passed in the house which would mandate access to chiropractic care for all veterans. We learned may soldiers may carry up to 85 pounds of equipment and gear on a regular basis and low back pain (LBP) is one of the most common complaints among soldiers.
Previous studies by the government have already established the best treatment for LBP is chiropractic and exercise but maybe the branch of the government which concluded that study didn't adequately communicate their results to the arm of the government called our military.

Another interesting thing was a new program Logan College is implementing which would provide for free chiropractic care to all veterans, police, fire and EMS personal.

The study session after school went well. The person I'm studying with attended Dx Tutoring. I found out that the daughter of Terry Yochum is our tutor on Thur & Fri. Dr. Yochum is the main author of our radiology book and his daughter is a Tri-6 student at Logan.
Our Dx Imaging teacher was in the classroom at the beginning of tutoring and mentioned the best way to get a good grade out of his class was to attend the tutoring.

I'm still trying to make sense of everything but it appears our midterm will test us over things we aren't formally going over in class but need to learn on our own. Essentially, a big part of the midterm includes normal anatomy found on x-rays as well as roentgenometrics which are various measurements used on x-ray films.
The 12-188 page reading assignment contains much of the normal anatomy we'll need to be familiar with but there is no reading assignment for the roentgenometrics. So, even though it's not formally assigned we took it upon ourselves to start reading chapter 2 which covers measurements. That chapter is 60 pages long and we knocked out 20 pages with a plan to knock out another 20 on Saturday and the final 20 on Monday. We have about 3 weeks before our midterm. I think I'll use today's blog for a little review and list the roentgenometrics recently covered.

For the Skull:
  1. Vastine-Kinney Method of Pineal Gland Localization
  2. Sella Turcica Size aka Pituitary fossa size(the sella turcica is the location of the pituitary gland)
  3. Basilar Angle
  4. McGregor's Line, aka Basil Line
  5. Chamberlains Line, aka Palato-occipital line
  6. Macrae's Line, aka Foramen magnum line - The foramen magnum is the big hold that the spinal cord comes out of. Through this reading we learned the anterior or front portion of that hole is called the basion and the rear portion of that hole (foramen) is called the opisthion.
  7. Digastric Line
  8. Height Index of Klaus
  9. Boogard's Line & Angle
  10. Anterior Atlanto-Occipital Dislocation Measurement, aka Power's Index
In the Cervical Spine:
  1. Atlantodental Interspace (ADI), aka Atlas-odontoid space, predental interspace, stlas-dens interval
  2. Method of Bull
  3. George's line, aka posterior vertebral alignment line, posterior body line (this line is pretty popular and one I'd heard of before this class)
  4. Posterior Cervical Line, aka spinolaminar junction line, arch-body line.
  5. Sagittal Dimension of the Cervical Spinal Canal
  6. Atlantoaxial Alignment, aka spread of the atlas
  7. Cervical Gravity Line
  8. Cervical Lordosis, aka angle of hte cervical curve, cervical (lordotic) angle
  9. Stress Lines of the Cervical Spine, aka Ruth Jackson's Lines
  10. Prevertebral Soft Tissues, aka Retropharyngeal interspace (RPI), retrolaryngeal Interspace (RLI), retrotracheal interspace (RTI)
Thoracic Spine:
  1. Cobb's Method of Scoliosis Evaluation, aka Cobb-Lippman method
  2. Risser-Ferguson Method of Scoliosis Evaluation
  3. Thoracic Kyphosis
  4. Thoracic Cage Dimension
Lumbar Spine:
  1. Intervertebral Disc Height
  2. Lumbar Intervertebral Disc Angles
  3. Lumbar Lordosis
  4. ...
There are many more pages for the lumbar spine but, that's where our 20 pages ended for the day. The next 20 pages of reading are almost exclusively devoted to lumbar spinal measurements.

I think Netter's Flashcards may be available in the bookstore for radiography.

We're coming up on week 4 in school. We're off Monday due to Memorial Day. In week 5 we have our homecoming and will only have classes on Monday, Tuesday and the first half of Wednesday. Our Physical Lab Dx practical will be in week 4 and we will have many of our first test in other classes in Week 5 before homecoming. I should know exactly which test are forthcoming in week 5 ...no time like the present to figure it out - I'll consult my spreadsheet ...

Week 4 -
Wed, 6/2 - Physical Dx Lab Practical

Week 5 -
Diversified Practical
Physical Dx Exam I
Cardiopulmonary Dx, Exam I
Laboratory Dx, Exam I

I'm not sure about toxicology or HCP and I believe our two radiology classes will be testing around week 7. That Diversified practical in week 5 kind of took me by surprise. We've got a lot of work to do to get ready for these exams - thank goodness we've got Monday off to help boost our study times.

Today's picture is of the Missouri Secretary of State, Robin Carnahan.

Thursday, May 27, 2010

TRI-5, Wk3, Day 281 - Stab Lab! :)


I've got to hang it up for the night. I thought I could at least knock out one chapter of reading for my Basic III class and even though I've only got 5 pages left, the focus left me several pages ago.

We had our stab lab today and performed venipunctures today. We need three successful blood draws in order to fulfill that portion of Lab Dx. So, one down & 2 to go. For today's picture I opted to post a fake arm which was very much like the ones they had in the lab for students to practice. Apparently, we use these same arms to demonstrate blood draws for Comp Boards.

Heck, I just realized I was reading the wrong book. I meant to read a book by Dr. Coggins but was reading a text on Logan Basic Methods by Hugh B. Logan, D.C. Oh well, I need to read them both anyway and it looks like Chapter 2 in both books deals with basic anatomy.

I can't believe it's 10:30 already. I really just want to sleep for longer than I have available.

My class recordings have really become a win-win situation for me. I've been stopping off at various parks on the way home and listening to my lectures while hitting the trails. I've managed to walk 34.11 miles in the last 6 days :)
...maybe that's part of the reason I'm so tired.

I do need to at least review what's going on tomorrow in terms of classes. Let's see....
Physical Dx starts the day. checking my spreadsheet I see we need to get Chapters 1, 3 & 4 read this weekend to get caught up.
Diversified IV is next - simply show up for class and practice adjusting then another hour of Physical Dx lecture.
Basic III is being replaced tomorrow (along w/ our lunch hour) with a Memorial type presentation in the main auditorium. I just have to read a lot and understand more for this class.
I'm beginning to get the impression that Basic technique is an extremely powerful adjusting technique but, it's almost more of an art. You really have to understand a body's biomechanics to fully utilize basic to it's full potential.
SHC Practicum - For now, just show up to class. I don't see any reading assignments for that class. It seems like we're just getting used to taking notes and various documentation.

Fri & Sat study -
Bates book for Physical Dx reading,
medical bag for taking Vitals (practice for upcoming Phys Dx practical)
Diversified DVDs to study & practice from.
Dx Imaging book is a MUST - so much to read .... this book is also invaluable for our Rad Positioning class (I have to improve upon my 17 minute time to take an x-ray) :)
Cardio Dx could use some more reading and more interpretation of EKG's
Lab Dx - maybe looking over some ponies to get a better idea of what we're going to be tested over. I think we'll need to know normal values for various body compositions such as normal levels of WBCs, Calcium and various things like that. We received a two page handout full of these normal values so we better go over those at least a few times this 3 day weekend.
Biomechanics needs more reading
Toxicology needs more reading.

I guess I just need to bring every book I own to make sure I have what's needed for studying tomorrow after class. We can do this! :)

Wednesday, May 26, 2010

TRI-5, Wk3, Day 280 - Rad What?

Lots of balls to juggle this trimester - Holy Cow. I've already been thinking I need to step my game up to successfully make it through this semester and was thinking about trying to get a couple more study groups going throughout the week instead of just on Friday and Saturday but, we had some tutoring classes posted on our board today so that should help supplement things nicely.

Dr. Guebert, one of our radiology professors was pointing some things out on an oblique x-ray of the cervical spine at the end of our Rad Positioning class today and I thought my head was going to explode. All the teachers are just as nice and helpful as can be and I'm starting to understand a few things but I've really got to think about what's going on in the x-ray so there's a considerable time delay between what we're being shown/taught and my eventual comprehension. I did finally figure out the orientation of the holes that the spinal nerves come out of. Those holes are called foramen - intervetebral foramen or IVF's for short. It was after class and about 10 miles on my way home when it finally made sense to me.

If we put a pt in a Right Anterior Oblique position then the pt is facing the bucky (behind the bucky wall is where we find the x-ray film) at about a 45 degree angle with their right shoulder against the bucky and the x-ray will show the IVFs on the right side of the patient.
If the patient is at a Right Posterior Oblique position then their right shoulder will still be against the bucky but there back will be towards the bucky. In this case, the IVFs on the left side of the spine will be showing. Apparently, I still need to stand up and stick my arms out like Dr. Kuhn, our Dx Imaging teacher has shown us to do but, at least I can figure it out and it makes sense to me.

Now, I just need a lot of repetition to improve my speed. Dr. Guebert timed me today as I played doctor and was taking an oblique x-ray of a classmate. With help from the teacher it took me 17 minutes and 49 seconds. For our practicals we need to get it done in less than 5 minutes. Dr. Guebert then did a much more complex x-ray and got it done in about 3.5 minutes. Not too bad considering it was my first time and he's a board certified radiologist with decades of experience. :)

Anyway, I'm in Group C and there's a group D class after ours and am thinking it would be a very good use of time to hang around and maybe see if I can sit in on that D class to get some extra exposure.

Our Dx Imaging tutoring will be held on Thursday from 3:45 to 5:45 and on Friday from 11 to 1. On weeks I don't have Laboratory Dx I could actually get out of class at 12:50 on Thursdays but, with so many people having to take that class over and the massive intimidation level of that class I think I better hang around for tutoring. Every upper tri I've talked with have told me tutoring is a must for that class.

I think I'll be drawing blood tomorrow in our Lab Dx class. Those labs are broken down into 6 groups and I'll only have to go every other week until everyone has had three successful blood draws. The smaller groups are mainly for safety at this point but, once we start doing BUN test with urine we might all start going to lab early as one group. Apparently urine isn't as scary as blood. :)

Next week is our first practical in Physical Dx. We had our mock practical today and it should be pretty easy, it's mainly a matter of technique and coordination. We're just doing vitals or blood pressure, a manual systolic bp, temperature, heart rate and ventilation rate. I should do alright but it wouldn't hurt to get more bodies to practice on. If we don't have our own equipment we lose 50% right off the bat.

One of the books for Basic is by Dr. Coggins and I noticed his name on one of our buildings today. Physical Dx lecture is another class a lot of people are taking over. You're only allowed to miss one Physical Dx lab so, maybe some people missed more than one class which is why we have so many repeating. I'm trying to make up notecards during class of important points then punching them out and using a ring to hold them together.

Cardio Dx needs more reading on my part - Biomechanics also needs more reading done ....and we also have some reading assignments for Laboratory Dx class - oh, Toxicology also.
Diversified IV is the last class i have to deal with.
I think Pro-D should be pretty simple. We only have that class on Monday. This past Monday someone made a comment that the teacher didn't like - I didn't hear it but we were reminded to be respectful and if we weren't he would drop a huge project on us.... I kind of sat up straighter after that comment. Our Pro-D teacher is a local chiropractor who has been very successful. He mentioned something about being able to go to his office - maybe to work? volunteer? something on Monday evenings and shadow each of the different doctors in his office. I'm kind of curious about his offer.

I've got a spreadsheet I made up online with all our reading assignments ...I'm glad we're off Monday, I just might be able to make it through - I know for Dx Imaging I still need to read pages 12 through 188. Is it even legal to assign so many pages?!?!? and that's just part of the reading assignment for that class but, I was able to finish the other part of it this past weekend.

Eyes are no longer functioning properly - gotta get to bed! ;)

Tuesday, May 25, 2010

TRI-5, Wk3, Day 279 - Tuesday

We get out of school a little earlier today, at 2:40 so I'll be able to beat most of rush hour on the way home and only one adjusting technique lab in which we continue our work on upper cervicals. Two hours of Dx Imaging and I'm ahead in our reading assignments for that class. A little biomechanics, Laboratory Dx and two hours of Cardio Dx.

I'm not sure if I mentioned this but we'll have some extra credit questions on our first Cardio Dx class in which we'll have some EKG strips and have to fill in the blank as to what abnormality is being represented.

Continuing to check over the upcoming week, we've got our mock practical tomorrow in Physical Dx. I need to run by student services and see what the tutoring schedule is for this trimester. Some students from upper tri's have highly recommended attending the tutoring for classes such as Dx Imaging and Rad positioning.

I had a comment left on a previous post from a St. Louis Chiropractor with a website named vitalforceclinic.com - cool name for a website :)
Her website mentions upper cervical chiropractic and I'm wondering what technique she uses. Dr. Montgomery at Logan has a Spears technique he uses which is very gentle. It's not a class taught technique but I've heard talk he may teach it during weekend type classes.

Wow, the tagline under that previously mentioned website after Vital Force is Upper Cervical Clinic. This is cool, Dr. Bagley of the Vital Force Clinic graduated from Logan and just had twins! :) Good stuff :)

I better get moving so I can beat most of rush hour this morning ;)

Today's picture shows the back of the head and some of the muscles associated with the upper cervical vertebrae.

Monday, May 24, 2010

TRI-5, Wk2, Day 278 - Monday

8:30 p.m. - got home around 7 p.m. - long days ...
with my recorder I was able to listen 4 of my classes before I got home. Did another 5 miles in the park which makes 15 over the past 3 days - definitely need sleep.

...getting distracted a lot lately - it's 9:44 now -
emails & IMs. classmate from high school died yesterday, checking to see if anyone was going to the wake and if they wanted to go together.
heard from another friend over the weekend that I hadn't heard from in a long time. I was saddened to hear that her daughter died of cancer. She'd also lost a brother the same way.
Think I'm going to head to bed, let my brain reset. Get up tomorrow and try to keep doing what's right.

Sunday, May 23, 2010

TRI-5, Wk2, Day 277 - Friday

It's Sunday, about 15 minutes until midnight as I enter Friday's blog.

....well, i got distracted and when I got back to this blog it was 3 a.m. and I had to get to bed ....we'll pick this up w/ the Monday blog ;)

Friday, May 21, 2010

TRI-5, Wk2, Day 276 - Thursday


I absolutely LOVE my new digital recorder! I was able to listen to four of my classes before I even got home from school yesterday - one on the way home, one at the gym, and a couple while at the park.

It seems the best medicine for helping to keep my stress levels down is lots of studying. The recorder has five folders and I think I'll be keeping each day of the week in a different folder then uploading to my laptop at the end of each week.

Closing in on 6 a.m. and I've got to get my butt on the road - FRIDAY!

I think there's a Beginning of the Tri party tonight but there's only a 4% chance I'll be making that event -about a 100% chance of studying tonight.
Tomorrow and Sunday is some historical chiropractic event going on in St. Louis. I can get an extra point towards my Basic technique grade if I attend... which makes me wonder if that isn't a bit of a kickback as Dr. Sanders was talking about in class yesterday. Maybe a 50% chance of attending.
Sleep without an alarm clock tonight - 100% probability.

Today's pic is a good likeness of my new digital recorder. I really love that thing. For the most part by hearing the lectures so soon after the class I can usually visualize everything the instructor is discussing - good memory exercise I'm thinking. I sure hope the extra effort is reflected in my grades :)

Wednesday, May 19, 2010

TRI-5, Wk2, Day 274, 275 - Tue & Wed

Even though we only had 2 1/2 days of class last week and three days of class this week, I'm already thoroughly intimidated by this semester. I've been dead tired by 5 p.m. the last couple days. Yesterday I managed to stay up until 9 but today I fell asleep before 6 and got a couple hours sleep. I could tell I didn't feel as stressed when I woke up.

On Monday we had our first professional development class hosted by Dr. Jason Goodman. What I remember most is that he encouraged us to step up our game each trimester. I'm pretty sure the DC program at Logan is geared to get progressively more challenging with each trimester in spite of the fact that I found Tri-4 to be my easiest trimester to date.

Last night, on my way home from school, I stopped by Best Buy to buy a digital recorder and after recording four of my classes today I'd have to say it was a *very* worthwhile investment. The length of my commute allows me to listen to two full one hour class lectures. I listened to Cardiorespiratory Dx on my way home today and then listened to Basic III and Biomechanics after I got home. I'll listen to Rad Positioning on my way to school tomorrow.

Tomorrow we'll kick off the day with Dx Imaging - a small three hour class that tripped up an awful lot of upper tri's so I need to head the implicit warning and make sure to study hard for this class. I know Dr. Kuhn said to read a little bit each day from our Yokum text.
With 11 classes; only 10 minutes of attention to each with a minute of transition between each class we're looking at two hours and I could probably spend 10 minutes just on organizing and keeping up to date. I'm not sure how practical it is to hit every class every day but, as noted Dx Imaging will need to be a priority in spite of the fact I have four other classes which constitute more credit hours.

I'm going to have to schedule my study times more efficiently. Friday and Saturday are already pretty good study days since I have a class mate to study with.

I noticed one of the guys sitting in front of me in Dx Imaging had his book with him so I think I'll do the same thing for tomorrow. It was this class - Dx Imaging on Tuesday which started my feelings of intimidations ...

Laboratory Dx is our 2nd class tomorrow. I'm certain we're going to have more powerpoints forthcoming in that class. Currently we're discusing the various advantages and disadvantages of different types of clinical laboratories. One interesting aspect of these discussions have been the scams a couple labs have tried pulling over the years. One place in St. Louis was able to bilk medicare out of 2 milliion dollars in 90 days. Another place mentioned took the government for 22 million dollars over the course of 18 months.
I've been typing out the power point presentation in class to a word document. This seems to help keep me involved and allows me to quickly add additional information given by the teacher.

Class hours 3 & 4 tomorrow are for Diversified IV. I mainly just need to show up for this class and I should be set as far as gowns are concerned. Having bought 7 gowns thus far, I now have two spares kept in my locker at school and a third gown in my doctor bag.

Cardiorespiratory Diagnosis is our 5th class - Again with Dr. Christy. I've already listened to his lecture a 2nd time today and have a decent handle on that class. I'm hoping to do very well on the first exam. If I do well enough on the first three exams (meaning I have an A average) then I can omit the final exam which will be very helpful in providing extra time to my remaining classes.

Laboratory Dx is our last class of the day and all 3 groups will be meeting at 12:55 to fulfill some OSHA requirement. If we miss that class we can't do any of the subsequent labs. I'll be there :)

Today, I was a little stunned in Physical Dx to learn that we have a mock practical coming up next week and an actual Practical the following week! Dang - that was fast! It was just last week that I listened to my first blood pressure sounds. Those sounds, btw, are called Korotkoff sounds which is a name I was trying to come up with when chatting with a guy that works out with my Dad.

SHC Practicum I is on Friday and I'll definitely need to start typing in ppt notes from that class for two reasons - one is because I was falling asleep in class last week and two is because the ppt's shown in class don't match up with the ones provided to us by the instructor.

I think I'll end the night by going to FlashMyBrain.com and making up some flashcards for various X-ray views we'll need to know for Rad Positioning.
Today's picture pertains to Rad Positioning, it's an oblique cervical view. It's basically a view of the human neck with the base of the skull up top and a couple of ribs at the bottom. The black holes seen along the cervical vertebrae are IVF's or intervetebral foramen. (the word foramen just means "hole")

Monday, May 17, 2010

TRI-5, Wk2, Day 273

So, what does Netflix have to do with chiro school? Well, for one thing it helped put off my studying for tonight since, with Netflix, I now have Pandora Internet radio streaming through my television. Pandora is smart, you tell it what you like then it plays more of the same. I originally started out by entering Carpenters and it's been playing golden oldies ever since. However, even more related to school, I can click on a button and Pandora will tell me why it's playing a certain song. For a song by Elton John it mentioned the song had a "mild rhythmic syncopation" I wasn't sure what that meant in music lingo but I remembered seeing the word Syncope in my cardiology reading; there it means fainting. In music, it refers to a shift of accent in a passage or composition ...then, I guess my attention deficit self had to check out the etymology of the word and found it dated back to c. 1400 from Latin and Greek meaning contraction of a word or cutting off. Per the heart I'm guessing this has something to do with cutting off SA node influence.

Toxicology! Here's another fascinating teacher that I'll never be as smart as by the time I graduate but, I use a baseball analogy to deal with this lack of intelligence quandary. I figure there's different levels of professional baseball and our teachers are in the major leagues with several Hall of Fame potentials. As a student, by the time we graduate we should be ready to play ball in one of the farm leagues, either single, double or AAA ball from which we can work our way up into the majors.
Marcus De Geer M.D., D.C. is our Toxicology teacher and apparently the name of the class will be changing to pharmacology in the near future. Dr. DeGeer started out as an M.D. which is a degree he obtained in Stockholm, Sweeden. In his own words, he hated med school, became a doctor, married an American lady, moved to America, went to Logan and became a Chiropractor in December of 2001. He's got a cool accent.

Sunday, May 16, 2010

TRI-5, Wk1, Day 272, Friday

For the record, Tri-5 students didn't have any class on Thursday and only a couple of classes on Friday. Part IV National Boards were still going on Friday and a wing of our building was closed down for testing. Honestly, the most exciting part of the day was the studying I did after classes were over. Along with a classmate, we focused on Cariorespiratory Dx, specifically the 12 lead EKG and various sinus rhythms.

I may have done a better job blogging on Friday because I'm getting mired down in pensive thought. I'm trying to put puzzle pieces together. I'm considering failure of the SA node to fire which may be expressed as Sick Sinus Syndrome, Sinus Arrest or SA Block (the terms are synonymous) Possible etiologies include ischemia of the SA node, certain drugs and, of course, increased vagal tone or vagotonia. Recall, the vagal nerve is parasympathetic Cranial Nerve X. The right vagus nerve directly innervates the SA node and the left vagus n innervates the AV node. Vagotonia would be a hyperexcitability of this nerve and since it's a parasympathetic nerve it would lessen the excitement of the SA node or preferred pacemaker of the heart.

What jumps out here is all the study we did on sympatheticotonia which would be a hyperexcitability of the sympathetic nervous system. Now, if a function of a chiropractic adjustment say, in the thoracic region of the spine is capable of helping to reset the sympathetics back to normal so they aren't so hyper then I would think a cervical type adjustment should have a similar effect on the parasympathetics and, in this case, of the vagal nerve which innervates the heart. We don't necessarily want the vagal nerve to be hyper, just normal in function.

With atril fibrillation or flutter we consider that beta blockers are prescribed to hep quell sympathetic stimulation which, again would be an objective of the chiropractic adjustment.

Kind of thinking out loud but, if a doctor prescribes something to subdue the sympathetics then the underlying assumption would be hyper sympathetics to begin with however a prescription of beta blockers, for instance, would be treating a symptom but WHAT IS THE CAUSE? What is causing the sympathetics to be hyper in the first place?

Although there may be multiple reasons I don't think the relationship between form and function should be overlooked. With this, my thoughts go to Rene Cailliet, M.D. whose article I read on the effects of anterior head carriage which points out deleterious effects on lungs, gastrointestinal function and diminished proprioceptive signals which reduce endorphin production.

I think, if a misaligned spine is difficult for people to relate to various medical issues then perhaps it would be easier for people to consider a portion of the brain being squeezed in a quarter of an inch. Say, for instance, a temporal portion of the skull because misaligned and compressed the cortex of the brain by a quarter inch, or even an eighth of an inch. I think most people could see how such a compression could be a vital issue and perhaps cause problems in the quality of a persons life. Well, the spine is directly plugged into our brain and pretty much daily, we see x-rays of spines out of wack along with various physical maladies.

Maybe today's blog is more an expression of current thinking and an indication of various things I'm trying to put together in order to more fully understand the profession of chiropractic and it's relationship to human health.

Friday, May 14, 2010

TRI-5, Wk1, Day 271, Wednesday


Wednesday was a great day at school. I can tell things are shifting gears and we're no longer spending so much time with the basic sciences and are now spending more time geared towards diagnostics.

A class I was most impressed with today was Radiographic Positioning. I'm not sure of the total people in that class but we have a projected total of 63 people. Our class was divided up into four different groups so, about 16 people per group and each group meets down by four of our x-ray machines for an hour each. Not only that, once in the x-ray lab we were divided up again into three groups and each group went into an x-ray room with a teacher who went over some of the basic operations of the x-ray machine. We just had an entire semester learning about the nuts & bolts of x-ray but this is now hands on. Anyway, after about 10 or 15 minutes with the teacher we went to a different x-ray room with a different teacher who again went over everything, and then ...we went to a third x-ray room with a third teacher who went over the particulars with their x-ray machine. I was amazed at the individualized attention and the worthy repetition by these three teachers. Two of them were even DACBARs which means they had diplomats in radiology which means they had an additional three years of x-ray training after they got their doctorate in chiropractic.

Dr. Kuhn was one of the teachers down there and he's the guy who's also teaching us Diagnostic Imaging.

We also hit the ground running in our Physical Dx Lab. The teacher had two things to say at the beginning of class and that was "Gown up!" (she said it twice)
Gee, I wasn't even sure if I should bother bringing my medical bag with but, I did - however, I had no gown so, I quickly snuck out of the back of the lab room, ran up to the bookstore and bought my 7th gown! Luckily, I made it back and was gowned up as a teacher was taking attendance ...if we're not gowned up it's points off. We get 15 points each class for simply showing up but, we have to be prepared and part of that is being gowned up. The next part of being prepared came with the next directive from our teacher, we were to take out our stethoscopes, dx kit, aneroid and watch - missing any of those items results in a 5 pt attendance deduction. Heck! I didn't have a watch ...yeah, once again, I ran up to the book store. They have little clip on watches so I bought two of those (another guy from class gave me a $20 to pick one up for him) Once again, I made it back just in time to have all my equipment checked and got full credit for being in class.

Wednesday evening I went to my parents house and for the first time actually did a blood pressure reading on my parents and it was fascinating! For some reason I was always trying to hear a pulse with my stethoscope before I pumped up the cuff bladder but, I no longer think I'm supposed to hear anything at that point. I worked with my Mom first, pumped up the bladder then slowly let the air out of the cuff while listening...as the pressure went down I started to hear a pulse and the pulse got louder and louder - it was absolutely fascinating! When the pulse stopped I knew I had my diastolic reading. Both my parents got to hear the pulse as well with my stethoscope and blood pressure kit.

Our regular teacher, Dr. Guebert, has been out of the country. Apparently, he got stuck over in Spain due to some volcano that's been spouting off recently.

One interesting note from our biomechanics class was in regard to stretching and how stretching prior to exercise doesn't necessarily help to prevent injury according to recent studies. On another related point, there isn't necessarily and tissue elongation due to stretching and increased flexibility may actually be a function of a threshold being lowered specifically a lower threshold with our spindles and golgi tendon organs (GTO) Spindles are found within our muscle fibers and respond to stretch while GTOs are found in our tendons and respond to tension.

Today's picture shows the intrafusal or spindles found in our muscles along with various nerves. We studied all that stuff in neuromusculoskeletal diagnosis last trimester :)

Tuesday, May 11, 2010

TRI-5, Wk1, Day 271 - First Day of Class :)



Diagnostic Imaging (Dx Imaging) - first class of the day and it almost seemed like a different class because there were so many people from the semester ahead of us that didn't make it through that class the first time. We have two 5 hour classes (Physical Dx & Lagoratory Dx) and two 4 hour classes (Diversified IV & Cardiorespiratory Dx) so, I'm guessing Dx Imaging might fly under the radar a bit since it's only a 3 hour class but, apparently, it's not one to be taken lightly.

With Dx Imaging, we'll be learning to diagnose various bone related diseases. We'll have a midterm (with slides) worth 40% of our grade and a final exam (with slides) worth 60% of our grade. The final includes fill in the blanks and is cumulative. Part II of Dx Imaging is taken in Tri-6 and the test in that class will be cumulative with what we're learning this trimester.

The Dx Imaging teacher seems solid and is very interactive with the class.

In Diversified IV we have Dr. Wittmer and will be learning adjustments for upper & lower cervicals and extremities.


The regular teacher for Biomechanics is on sabbatical and our replacement is Dr. Haun who kind of reminded me of Bill Murray with his kind of laid back personae but, Dr. Haun also has a diplomat in radiology which, I imagine, is at the opposite end of the spectrum when compared to Bill Murray. I think I have a static page for this class on my blog.


Dr. Sanders is back! :)
We have Dr. Sanders for our Laboratory Dx class, a 5 hour battleship of a class, and Dr. Sanders said we could think of Lab Dx as Pathology III which I liked to hear. Personally, I think Dr. Sanders has some excellent analogies so, I'm really looking forward to what's in store for this class. One of the hours for Lab Dx is for actual lab work where we'll practice out blood draws, hence the moniker "stab lab" as well as other basic test such as BUN and hematocrit analysis.


Cardiorespiratory Dx is with Dr. Christy and I would REALLY like to get a great grade out of his class since I struggled with his neuromusculoskeletal class (NMS) last trimester.


Those were all the classes for today. I bought another book for Biomechanics, Clinical Anatomy of the Lumbar Spine and Sacrum by Nikolai Bogduk. Bogduk is an MD with a lot of other letters after his name. I've been hearing about how great this guy is since Tri-1 and since it's been so long since I've had Spinal Anatomy, I figured his book would be a good investment. Plus, it's listed as a required text for the class.

Friday, May 7, 2010

Preview of Coming Attractions: TRI-5!

Part I, National Boards have been passed.
Master's program application submitted and wheels are in motion.

I'll be taking 14 classes in Tri-5 totaling 40 class hours per week ...kind of like a full time job but with LOTS of work to be taken home. The classes I'll be taking are as follows;

  1. Professional Development V
  2. Biomechanics
  3. Diversified Technique IV
  4. Logan Basic Technique III
  5. Physical Diagnosis I
  6. Cardiorespiratory Diagnosis
  7. Laboratory Diagnosis
  8. Toxicology
  9. Diagnostic Imaging I
  10. Radiographic Positioning
  11. Health Center Practicum I
  12. Anatomy of Human Motion Lab
  13. Psychology of the Athlete
  14. Cardiorespiratory Physiology
I'm reminded of a quote by T.S. Elliot, "Only those who risk going too far can possibly find out how far they can go.",