Tri-6, Wk9, Day 375, Thursday

"look at the rotation of the head" says Dr. Bub as we watch the fight video at the start of our 2^nd hour of Neurology.

Neurology is a pretty fun class. Our teacher, Dr. Bub, always starts the 2^nd hour of our lecture with a fun video that's related to what we're learning in class. I had an idea of putting down a few lines in my blog during each class but, that first line was all I had time for – Waaaay too much material to spend time doing anything other than trying to absorb everything coming our way.

Dr. Bub did go over some of our fill in the blank questions from our midterm so I was able to copy them down to review. Here is a sample of one of our questions;

QUESTION: Your 72 year old hypertensive patient presents in your office one morning complaining that he has noticed difficulty walking because his right leg is weak. He states that his right arm feels like it is getting weak too and he is dropping things from his right hand because he cannot hold onto them. He also cannot get his right arm up over his head to comb his hair. He has also noticed that he seems to have double vision when both eyes are open. If he closes one eye, his vision is fine. This all started several weeks ago and it seems to be getting worse over time. During the history, his speech is fluent and memory/recall is good. One examination you notice that his left eyelid seems to be drooping (blepharoptosis). His left pupil is 7mm and the right pupil is 3mm. On testing the extraocular muscles, he could not elevate, depress, or adduct the left eye, but abduction of the eye was fine. When asked to smile, the left side of the mouth did not elevate, but both sides of the forehead wrinkled. There is weakness, increased done and hyper-reflexia noted in the right upper and lower extremities. A right sided Babinski sign was present. On finger to nose testing on the left there is no ataxia or tremor, however, on the right, the patient had difficulty elevating the right arm sufficiently to attempt the test.

38. What is the significance of his speech being fluent and recall being good?
39-40 List 6 abnormalities noted in the examination and the structure/part of the nervous system responsible for the demonstrated abnormality.

Internet in the classroom was a lifesaver today. Both of our teachers (neuro and EENT) had posted new powerpoint presentations just before class and I was able to download both ppt's and copy the pics & verbage into my notes.

There's a lot to get figured out this weekend before signing up for my Tri-7 specialty classes. We got info on Irene Gold Part II National Boards prep today and that will be taking place on the Friday's and weekends of Jan 7-9, Feb 11-13 and Feb 18-20.

Hmmm, that's not too bad. My IHS weekend classes don't start until March but I also think we'll be taking our Part II Boards in March but haven't been able to find the date yet. The NBSE website doesn't have the new schedules up.

hehehe ….just checking my mail – I've got library fines for $10.75 so my in class internet has probably already paid for itself because I usually check my logan.edu email in class and can quickly renew my books online if I get a notice my books are overdue. In Tri-1 I had over $150 in library fines!

I better get some school work done before bed. We have our PT class tomorrow morning. I have a feeling I don't have the correct PT book for that class and I bought every PT book that was in our Tri-6 section from the bookstore. It seems the books we specifically use for the class are kept in different areas.

Oh, I played doctor today in our Clinical Reasoning class. Last week I caught a fracture that the ER docs missed and this week I pretty much called the diagnosis right off the bat …well, it wasn't really all that difficult, just a broken radius at the distal end but, I did know it was called a Collies fx. It's kind of tough to have to go through all the hx and examination procedures when you know you just need to get some x-rays taken of the patient.

Today's pic – We're going over Imbalance Vertigo & Hearing Loss in EENT and today's picture is from that lecture. It's called Frenzel lenses and gives a magnified view of the eyes (in case you didn't notice) J