Saturday Studying/Immersion :)

Before going home last night I went to the library and printed out around 500 sheets worth of powerpoint slides from Anatomy and have started to tape them all over my home.  Doors, hot water heater, walls, etc.  Soon, the sacroilliac joint will be as common place to me as the nose on my face.  

Our gross anatomy tutoring session got changed from 3 p.m. Sunday to 6 p.m. Saturday so I'll need to start getting ready for that soon.  I know all the muscles in the lower leg and foot and the nerves which innervate those muscles.  I need to brush up on the artery supply to each muscle.  I know the glutes pretty well and have a start on nerve innervention and artery supply.  I will be going to Denny's tonight to study with a classmate and work on all the origins and insertions - I'll need to pick up some bones from the library today so I can better understand exactly where everything inserts and originates from.  

I have a slew of test coming up next week - I'll have to check out the test board in our classroom today so I know exactly what's coming up - 

below is a blog i wrote for my fitness site to a lady who mentioned she suffered from chronic back pain.  I kept the blog factual and hope the suggestions can help provide some relief and help her eliminate some stress from her spine to help ease her pain.

...

Hi Joan - I'm a current chiropractic student and just wanted to share a few tid-bits worth of back facts that may be relevant or useful to you. whenever you lay horizontally and axial compressive forces are removed from your vertebrae then the intervatebral (IV) disc between your vertebrae fill back up with water. After about 5 hours these IV disc between your vertebrae are fully hydrated which is good on one hand but, on the other hand you should be aware that when they are filled up (as is the case after a good nights sleep) then the internal pressure in those disc is increased about 240% which makes a person vulnerable to "throwing a disc out of place" I put that in parenthesis because it isn't exactly what's going on but I think it gets my point across. With that extra internal pressure in your disc we want to avoid the combination of flexion and rotation of the vetebral column to avoid aggravating those disc. Which is to say, avoid bending forward at the waist and then twisting. If you take a shower first thing in the morning and need to bend over and reach across your body to grab the shampoo, for instance, that's the kind of movement you want to avoid immediately after waking up. I've thrown my back out more than once from that exact movement but never knew why before. The structure of your disc if very much like a jelly donut. The jelly in the middle of your disc is like the nucleus pulposis (NP) in your vertebrae and the dough part of the donut surrounding the jelly is like the membrane of the disc. However - the dough part of the donut is not symmetrical - it's thicker in the front and thinner towards the rear so, when we bend forward we press the NP back towards the weaker part of the disc. Anyway - the more you can bend your knees in the a.m. hours, the more your back will thank you. Also - when sitting in a chair, try to make sure your hips are a little higher than your knees. The optimal angle between your spine and the top of your thighs to reduce stress on your spine is about 135 degrees. I can also relate to a situation of carrying extra weight around the midsection. The curve in your lower back is called a lordosis (and you should also have a lordosis in the cervical region of your spine) but when there is extra weight anterior to the spine then the lordosis can be exaggerated which would also press the NP towards the posterior portion of the disc between your vertebrae. So, avoid bending forward at the waist and twisting (especially in the mornings) and try to sit in chairs which keep your hips slightly above your knees. Hopefully, GHF may assist in reducing anterior pressure on the spine by dropping a few pounds (still working on it myself) Best to you in health and happiness, Scott :)

Day 26 - Surviving ...

This is quite a ride ...

Let's see ...Biochemistry was very interesting this morning.  We're kind of covering the life of a proton as it travels from bicarbonate, dissociated CO2, hemoglobin and fun stuff like that.

Spinal Analysis - I had my midterm practical today.  Hands on palpation sort of stuff.  I probably did rather well and expect an A.

Prosection - i ran a little late to this class since I was in the last group to take the spinal analysis midterm.

Dissection - I primarily worked on the neck of our cadaver - we're ripping out spinal erector muscles (kind of literally).  I know one group had transverse processes breaking off vertebraes because of severe osteoporosis in their cadaver.  There's a lot of fascia in a body and that's just the fibrous sheaths that cover muscle groups (among other things) and we can tell a lot about the activity level of our cadavers when they were alive because if they were active not active then the fascia undergoes scaring and the muscles aren't able to glide across each other easily but, if they kept active during their lives then the muscles are more easily separated.

It's all pretty amazing.  There's a lot of muscle in the neck region.

Cell Biology - I feel sorry for our teacher, Dr. Anaad sometimes because his class is right before Anatomy and everyone usually ends up studying for their upcoming test and ignores his lectures and he's a very nice man.  We're supposed to have a mid-term in that class sometime soon.

Anatomy - OK - I was ahnihilated.  I had actually visualized shouting "Praise Jesus" after getting a 100% on the test but the reality was far from anything praise-worthy.  I'm not sure what I did wrong.  I had studied at Denny's on Friday night until 5 a.m. and at least 6 hours on Monday night but it wasn't enough and I ended up getting one of my lowest test scores.  There was an opportunity for extra credit and I got all of those questions correct.  

I did talk with people from the psycology department at SLU today and sent in a retainer of $50 for testing.  The total price is $280 for the battery of test but, if they can help me and my studies in any way then it will be worth it.  This course of action was recommended by one of our school councelers who is a DC and a psychiatrist.

It's way too late tonight for me to still be up but there's just a ton to do ...I'm shocked tomorrow is only Wednesday - it seems I've put enough work this week that tomorrow should be Friday :)

Day 25 - Multifidus

I had various topics in mind for today's blog but can't remember everything I was going to put down.  I've been studying for my Anatomy test tomorrow - we're working on the muscles of the back now - which ones ....why, all of them of course!  

I don't have all these memorized like the lower extremities but that's probably because we just started learning them.

I know we have extrinsic and intrinsic back muscles and those can be further catagorized as superficial, intermediate and deep - let's see what's in my head.

For superficial extrinsic back muscles we have the more well known muscles such as the trapezius, latissimus dorsi, major and minor rhomboids and the lesser known levator scapula.  A major function of these muscles is to attach the arms to the torso.  for intermediate extrinsic back muscles we merely have the posterior serretus muscles, both inferior and superior.  

now ...about those intrinsic muscles -..... splenius capitus and splenius cervicis - the cover the deep muscles in the neck and that's it for the superficial layer of the intrinsic muscles - 

NOW - we get to a Mnemonic I made up to remember the intermediate and deep muscles of the back (at least that's how I'm thinking of them at this point)

I Love Spines - Spine Muscles Rock!

I - Iliocostalis

L - longissimus

S - Spinalis

S - semispinalis

M - Multifidus

R - Rotatores

and I like to put an Italian accent on the Rotatores muscles!

the three muscles from I Love Spines make up the erector muscles and in the order I L S that is the order they run laterally to medially which works out nice because the most medial muscle is the spinalis muscle and the most medial position on the back just happens to be the spine.  

and the Spine Muscles Rock part of the Mnemonic runds from lateral to medial also (sort of) I guess you might say superficial to deep but, I know what I'm talking about - the Semispinalis comes first, then the Multificus and the deepest little muscle is the Rotatores!

I volunteered for a multifidus study at school and my first ultra sound was today at 11:30 a.m.

The multifidus muscles are found in the lower back.

I'm tired - quite tired - very tired - sooo need to sleep - I so much would like an extra 2 hours each day.  One hour would be spent on extra sleep and the other hour could be studying or working out  :D

btw - we had another FANTASTIC speaker today we got to listen to in our philosophy class - this guy really rocked.

coffee isn't having the effect i was looking for - i'm going to have to get up super early tomorrow to get a couple extra hours of studying in  - i've also got to print out some documents for my spinal analysis class ....i should really order some ink for my home printer for times like this.

let's see ...what did that guy say today ....can't locate the notes - will follow up - can't keep eyes open any longer - 

G'nite all!  :)

Sunday Studying

I had a couple hours free time in the morning/afternoon but didn't really get moving until about 1:30 when I left for school.  Along with two other people, I had tutoring on the cadavers and we mainly learned about the arteries of the lower extremities.   I'll still need to go over the arteries of the gluteal region but have at least have a pretty good handle on the rest of the legs - 

from the inguinal ligament there is a femoral canal and the artery that goes through there is called the femoral artery (it has a different name before it passes through that canal).   the femoral artery passes down to a hole provided by the adductor magnus muscle and once it passes through that hole it is called the popleteal artery which runs behind the knee.  after passing the knee it goes through a hole in the interosseous membrane which is the membrane between the tibia and fibula and after passing that hole it's called the anterior tibial artery.

back up to the top - the femoral artery branches off after going through the femoral canal and that branch is called the deep femoral artery or, with a little Latin flair is called the profundus femoral artery and that artery has to immediate branches which come off it called the medial circumflux artery which makes a U-turn and provides blood to the posterior side of the neck of the femur.  the other branch is the lateral circumflux artery which provides blood to the anterior side of the neck of the femor.  below those two branches there are 4 perforating branches of the deep femoral artery and i think those supply blood to the adductor magnus (among other things)

In the Poleteal region of the artery (in the knee area) we have the superior medial and lateral genicular arteries, the middle genicular artery and inferior lateral and medial genicular arteries.  there are also two sural arteries which branch off the popleteal artery and supply blood to the lateral and medial heads of the gastrocnemius.   the .....i think it's the inferior medial genicular artery which is just superior to the poplitius muscle which is used to lock the knee when we are standing.  

While the anterior tibial artery (ATA) is the part that runs through the interosseus membrane, the other branch stays posterior in the leg and is called the peroneous or fibular artery.  

I believe it's the ATA which then becomes the dorsalis artery ...dorsalis something artery??? which changes names shortly after the ankle and becomes something else - 

I know there's an arcuate artery down there and medial and lateral arteries in the foot but am not sure where they come from 

BUT - everything I just wrote is from memory - some of the spelling may be off but at least I've got something to work with.  

oh, just below the adductor hiatus, the popliteal artery has a branch called the saphenous artery which is a terminal cutaneous artery

The talus bone in the foot is one of two bones in the body that doesn't have any muscles attached to it - i believe the other one is the incus muscle in the ear.  The talus bone in the ankle region is sometimes called a mortar joint as it's sandwiched between the lateral and medial malleolus

i've got a pretty good start on the muscles - kind of lost on all the ligaments ...

anterior thigh - 

vastus medialis & lateralis, rectus femoris, rectus intermedius, adductor longus, adductor brevis, adductor magnus, pectineus, obturator externus, sartorius

and the sartorius, gracilius and semitendinosus form the pes ansurance (goose foot) triad of tendons which insert on the medial side of the superior portion of the tibia.  

The biceps femoris has a long and short head, the semimembranosis lies deep to the semitendinosis which we already mentioned, on the lateral portion of the thigh we have the tensor facia lattae muscle which connects with the iliotibial or IT band.

How about the butt???  ok, let's see - we have the ....

gluteus maximus

gluteus medius

gluteus minimus, 

the tensor fascia lattae is sometimes listed as part of this region

the superior gemellus

obturator internus

inferior gemellus

quadratus femoris muscle ...

...I'm missing one - let me check ....

OMG!  would you believe it - i missed the piriformis muscle - I should know that one better than any of the rest!

anyway - 

we have Tom, Dick and Harry in the posterior leg ....anterior ti....geez, if it's an anterior muscle then we aren't talking about any anterior muscles - 

so, let's make that the anterior leg - Tom, Dick an Harry - Tibialis Anterior, Extensor Hallucis Longus and Extensor digitorum longus along with the peroneus tertius

laterally, we have the peroneus longus and peroneus brevis - we know we have those two becuase the peroneus tertius muscle means the "third" (from tert)

and since we have extensor muscles it would be a good idea to have flexor muscles in the rear of the leg - and we do - flexor hallucis longus, flexor digitorum longus and tibialis posterior - again - Tom, Dick an Harry - 

the 'an' part of Tom Dick an Harry means "artery and nerve"

those three muscles have a Dad in the rear - a POP - a popliteus muscle (previously mentioned)

the superficial muscles of the back of the leg include the gastrocnemius, soleus and plantaris

the plantaris muscle is very cool looking!  :)

OK - on the dorsum of the foot we only have two muscles - think about this - they're on top so they better be extensors - right?

how about extensor digitorum brevis and extensor hallucis brevis

bottom of the foot - i know this one!

layer one - 

abductor hallucis

abductor digiti minimi

flexor digitorum brevis

layer two - 

quadratus plantae

lumbricals (one medial, four lateral)

layer three - 

flexor hallucis brevis

flexor digiti minimi brevis

adductor hallucis

layer four - 

dorsal interossei (4 of them)

plantar interossei (3 of them)

let me check my list and see if I missed anything ...

i did pretty well - there is also an articularis genus in the anterior thigh along with the illiopsoas muscle (made up of the psoas major and iliacus) but, other than that I pretty much nailed it

now i just need to know each artery that goes to each one of those muscles as well as the names of each nerve and then brush up on all those ligaments and then memorize all the back muscles we just started studying ....

I think I'm ready for bed now :)

Day 24 - WOW!

Well ....I survived four test in four different classes this week and next week should be extra special with 3 test in one class alone - ie, Anatomy.

Here are some things I learned from our prosector, Frankie, today.  

Cranial Nerve CN II is responsible for brain freeze - the appendix actually does have a function, there are 6 teres in the body.  pudendal is derived from the Latin, pudere, which means to be ashamed of or embarresing.  

People have pudendal arteries running behind their knees.  Vice President Dick Chaney had an embolism or maybe it was anurisms in those arteries in both of his legs ...as well as a pace-maker, quadruple bipass and defibrilator for his heart.  

Speaking of Dick - we have Tom, Dick and Harry in Anatomy, which stands for Tibialis Posterior, Flexor Digitorum Longus an Hallucis Longus (the 'an' stand for an Artery and Nerve)

Flexor Digitorum Longus, i.e. Dick - is a Dick for four reasons - 

1.  He's the closest in origin to an actual dick - medially speaking

2.  He crosses over Tom

3.  He has an extra muscle (quadratus  plantae which makes him greedy)

4.  He has worms - lumbricals.  

vaso vasorum is the term given to larger arteries which have arteries of their own - in other words some of our arteries are of such magnitude that they need their own blood supply from arteries

 - some arteries have their own artery supply. ...vaso vasorum

plenty of little things were clarified today - we have muscles called Peroneus Longus and Peroneus Brevis and then there's a Peroneus Tertius but it didn't occur to me when I was learning the muscles originally that the prefix tert was for tertiary which would mean the third in a series of peroneus muscles.  

and when your leg falls asleep it's due to pressure on the common peroneal nerve as opposed to when your thigh might fall asleep - a condition known as parastesia (something like that) which is from sciatic interference.  

Philosophy was amazing today - 

Put a brick in a bucket of water and the water rises.  Step into a tub filled with water and the water rises.  Now, step into a 300 acre lake and the water would still rise but the change would be imperceptible to us, we wouldn't be able to perceive the change.

Our body and whatever abuses we incur to our body are a lot like jumping into that 300 acre lake - the changes tend to be imperceptible and aren't anything we'd notice on a day to day basis but, matter has limitations and eventually we would notice the ill effects of poor health care.  

I have to study - we have two regions of the body that we're being tested over next week in Anatomy along with our Midterm on Friday (also in Anatomy)

ToodleS! & Pars Interarticularis :)   hehehe

Day 21 - Tuesday, February 17, 2009

It's actually a little after 4 a.m. on Wednesday, Feb 18 but I still needed to get this blog in for yesterday - I've got 4 more test over the next three days and need to study now.  Yesterday was a bit rough in the cadaver lab since we cut the legs off some of our cadavers in order to study joints such as the knee.  I could only wonder if the people who donated their bodies knew their legs were going to be cut off.  My feelings pertaining to this matter are probably not very pragmatic but it's just the way I am currently.  

well - back to studying!  :)

Sunday Studying :)

the following blog is a copy from my GHF blog - 

I cut out of the gym a little early to go spend some quality time with my cadaver at school. I'm always fascinated and gain new appreciations everytime I reflect back the skin and start digging around.

Hallucis is derived from Latin and means "great toe" or more commonly what we refer to as the big toe. That toe gets a lot of attention in terms of muscle. If we pull aside the gastrocnemius (calf muscle) we can see the real meat of the lower leg which is the soleus muscle and pulling that muscle aside we get to see a rather long meaty muscle that runs up about 2/3 of the lower leg known as the flexor hallucis longus muscle and the sole purpose of the muscle is to flex the big toe and give us a strong push off when we walk. There is also another flexor muscle for the big toe located in the foot called the flexor hallucis brevis muscle and then there are two antagonistic muscles found on the anterior portion of the leg - basically the same names as the ones in back but with the words "extensor" in front of them - extensor hallucis longus and extensor hallucis brevis.

We have the plantar or bottom of the foot exposed and I was able to pull on the extensor hallucis muscle and feel the tendon moving in the foot to flex the big toe.

I learned there's different types of embalming depending on what is to become of cadavers. When they are used for dissecting it's a formaldehyde based substance which keeps them in decent condition for an extended length of time but when cadavers are used for practice surgery they are embalmed with an ethyl glycol substance (basically antifreeze) which makes them very pliable.

Our first practical is only two Friday's away so I guess I'll have to start uncovering all 40 bodies in our lab to get familiar with the differences so I'm able to name any muscle, ligament, nerve, artery or vein in any of them.

It's all utterly fascinating and I think going back to school to do this is probably the best decision I've ever made in my life.

Fresh out of high school, about 25 years ago, I started out taking some courses for pre-med but was really pretty clueless and then I think back to when I was about 6 years old and remembered I wanted to be one of three things - either and astronaut, magician or doctor. So, I guess I'm getting back on track.

I once read in an article that around the time people are in their 30s or 40s that there is a tendency for them to end up going back to something they thought about doing back in grade school. So, maybe there's something to that.

btw - I learned about kinesiology tape tonight - has anyone else ever heard of it? I was told one of the USA Olympic womens volley ball players had that kind of tape on her shoulder. I was talking to one of the student doctors about inversion of the foot and straining ligaments. He mentioned the tape that's put around, say a football players ankles to help reinforce that area but the kinesiology tape is used to help make weak muscles more easily prone to contracting. It's supposed to help make weak muscles work.

Sometimes, when you twist your angle, and it's most usually an inversion of the foot, that it's due to weak lateral muscles in the leg.

Day 15 - Productive Baby! :)

I Aced my Histology Test! - Yahoo!  & damn, I'm tired! I was up until 12:30 a.m. this morning and got up at 3 a.m. to study extra for my Histo test but it paid off!  :)

Today I had;

Philosophy

Spinal Analysis Lab

Histology

Professional Development

Spinal Anatomy Lecture

Gross Anatomy 1 (2 hours)

Worked out after school then spent 2 hours studying in the cadaver lab.

Day 12 - Patient/Cadaver Dissection

Tuesday, February 3rd, 2009

I really don't have the words or level of writing aptitude necessary to do justice for how grateful students, such as myself, are to have the amazing opportunity to fully explore the human body via dissection.  Nothing I have done, read or seen compares to the profound change I've had in viewing other people more so than human dissection.  

I would imagine if you were going to take your car to a mechanic to get fixed that most people would prefer to have a mechanic that's already been under the hood of a car and knows all the parts to the engine and what they all do as opposed to just reading about it in a book and looking at a few pictures.  With similar logic, I'd have to say that the best doctors, whether it be OD, DC or MD would necessarily come from schools in which cadaver dissection is part of the curriculum. 

I am personally working on a male patient, perhaps of advancing age and probably non-ambulatory since the fascia around the leg is so tough.  We may be able to get a cause of death as well as an age for the cadaver in due time which will help us better understand the condition of the body at the time of death.  

We are fortunate that we have around 40 bodies in our cadaver lab to study to help understand the variances in the human body from person to person.  

Today, I had classes in Biochemistry, Spinal Analysis, Cell Biology, 4 hours of Gross Anatomy and an extra hour of Biochemistry tutoring.