Study Weekend

The winter suddenly hit Prague.Snow was falling from morning to evening non-stop. Unfortunately the temperature never dropped blow zero, which means a lot of slush-puppy on the roads. More fortunately thou, is that is it perfect weather for reading, something both me and Kristýna need to do.

I'm having the very first checkpoint test for this semester, in the only subject we will get continuously tested in; pathophysiology.

The other subject are Pathology, Pathobiochemistry, Microbiology and Propadeutics of Internal Medicine but no tests will be held - instead you are expected to read up on each subject by yourself.

Kristýna will face her state exam in paediatrics in less than two weeks, so of course her mind is in between the pages as well.

The pathophysiology course began four weeks ago by introducing a hardcore chapter right from the start, namely haematology - including all the leukaemias, lymphomas, coagulatopathies and anaemias. An interesting but heavy chapter which takes time to wrap your head around.

Dense Regular Skeletal Connective Muscle?!

Histology is finally over, or at least so I hope - it all depends on how my slide test went.
I feel good about it, but as I recently discovered, feeling good about something is usually a bad thing.
We got two random slides each and was supposed to identify the tissue(s) within the sample as well as label them in a short description.
The first look at my first slide puzzled me. It saw for sure a lot of parallel fibres but also a lot of nuclei. My first thought was dense regular connective tissue from a tendon sample but it still had too many nuclei around the fibres from what I was used to see in this type of sample. So perhaps it's striated muscle? but there was no striation visible what so ever.
I wrote down a quick description and moved on to the next slide which was easier. The description didn't take too long and I could go back to the first slide again.
It really bugs me because I still don't know whether I choose the right answer or not.
Especially these two types can be really hard to distinguish since it looked like an awful mutation between these three pictures:


From left: Skeletal Muscle (1), Dense Regular Conn. Tiss. (2 & 3)

As you can see there's many similarities and it's going to be a long and curious wait for the answers next week.
Below I put up some nice mobile shots from our histology slide practice as well as a photo from today's anatomy lecture.

Today should be a day off, but I doubt that'll be possible since biophysics and Latin exams are just around the corner...

Waiting is the worst part

The hallway outside the dissection rooms were packed with anxious students. I wasn't as nervous as I usually am before these kinds of exams, more focused and just wanted to go in there and preform.

The waiting is the worst part and it's interesting to see how different people cope with stress. Some persons do crazy revision, some sits down on the floor just quietly drowning in nervousness, some guys are jumping around joking and some just try to block everything out with music.
There are some things that I really don't like to do and some things that I have to do before a big exam, this is my protocol:

- I never study on the day of the exam. I don't believe in last minute learning.
- I try not to discuss the exam material before the exam.
- I need at least 8 hours of good sleep to get all the information straight.
- I need a good breakfast.
- I try to drink or eat something rich in sugar right before the exam starts.
- Being nervous is fine, to a certain level. I always try to calm down and even if I'm not
I always put on a calm mask during oral exams.

The first names started to get called out and after 5 minutes the first two guys came out, with smiles on their lips. Facial expressions are the best way of telling if a person passed or not.
Over all the exam seemed to be easy and I confirmed that just minutes later. I was called in and had to sit down and watch my colleague being examined by the head of the Anatomy department Professor Grím. This is where my pulse went up. My exam started off on the anterior compartment of the upper limb and I got approximately ten questions.
It was amazingly easy and I feel a bit disappointed, not only because I screwed up one of the questions but because I wanted to be examined on all of my knowledge. I guess it's supposed to be an introduction because I doubt that the finals are going to be this comfortable. Of course I am glad for passing but the thing is that I was so prepared and I really wanted to get my knowledge confirmed. I still don't have the answer to the question: "do I know enough?"

Insomnia part 2

When I was on my way home I really thought I'd get one night of proper sleep.
But gosh, I really can’t sleep any more.
Usually when I have this insomnia I tend to be very sick, starving or a complete nerve wreck about something – like the first night in the army.
This is something different. My head is so filled up with thoughts, course material, upcoming presentations and philosophic questions, and the only time I can really, thoroughly think it all through is when I go to bed.
It’s like putting a computer to waiting mode instead of shutting it down. The shell is quiet but the core is still making calculations - my body is sleeping, almost paralysed, but my head is in a high activity state.

I hardly hit any REM sleep at all and my curve should look like a straight line of 'xtc. I usually remember the majority of my dreams and I am often able to share them but lately I hardly dream at all, which is a big loss since I really like dreaming.
Now it is more like I’m processing and sorting all the incoming information during my “not-asleep-nor-awake”-state.

This quote is from one of the posts from one of the nights during the premed in Stockholm and I've been waiting for it to come back. Imagine this and then compare a Duck Tales Magazine with Sabotta Atlas of Anatomy and then you'll get the estimated difference.
Surprisingly it's showing up rather late which of course is a good sign.

Tonight was bad. My head was sort of imploding from hyperactivity and I mixed foraminae of the skull with visions of my future, dreams about spiders laying eggs in my throat (after paralyzing me with venom) with anatomical topography repetition, good memories from the past with nightmares of being chased by mouthfaced zombies (zombies with faces only containing a big mouth), pasta recipes containing not pasta but optic nerves and so on, the whole night through.
I think I got one hour of effective sleep and on top of that I twisted my neck so now it hurts.

By that processed and said, I'll end this post with some rather good news. Anatomy seminar just ended and I finally got the skull test out of the way so now I can concentrate 100% on the dissection exam on Friday.

Preparing for a busy week

Next week is dedicated to dissections.
Every day from noon till evening we're going to have intense dissections and we've been promised tough studies to keep up with the course and little sleep.
I'm looking forward to it due to the fact that we'll start from the beginning, dissecting our way through the different layers of the body to finally isolate different structures in the task given to us. This means that we'll cover pretty much everything from skin, subcutaneous layers, muscles, nerves, arteries and veins - repetition of these chapters will be crucial over the weekend.
Simultaneously I've chosen to study and get tested on the skull which in fact are one of the most heavy parts of the winter course, at least so I've been told. Some of my colleagues are taking the skull test on Friday to get rid of it before the dissection course start but since I've spent time on Latin and Czech, perhaps a bit too much, I don't feel ready for a pretest.
I'm positive that I'd pass it if I'd take it but I rather study it properly and thoroughly simultaneously with the dissection in order to keep up my good marks.

Last week's hard labor got payed off rather good; getting back a really good result on the previous Anatomy test of the axial skeleton as well as passing the Czech test and the Latin test of this week. Tomorrow we'll get back the Histology test and as previously posted I do believe I'll pass it as well which makes me really happy.

I'd love to write a lot more, but time is not to be wasted these days, and soon I'll give a bunch of friends a Latin crash course walk-through for their test tomorrow...

Two weeks of Muscles finally over

Today I can lean back and enjoy the result of my hard labour.
Studying for the muscle test have been a top priority for the last two weeks and it have pretty much postponed everything else such as buying groceries, working out, going out, cleaning as well as staying sane.
Looking into the fridge was rather depressing and living off white bread, defrosted lunch packages, egg and coffee have filled me with a crave for proper food.
In general it's not an overstatement to say that I've been studying for at least five to six hours a day after school.
I've even sacrificed lessons in Czech and lectures of biophysics to be able to participate in dissections.

The first week we pretty much broke down all the muscles of the upper limb into compartments of function, innervation and position.
We knew that the test was going to cover both the upper and the lower limb so what I did was to first focus on the upper limb and for the last week spend time on the lower.
This schedule was rather disturbed because it took me more time than I'd anticipated to cover the upper part.
The hand was originally the big bitch in the drama but later on it turned out that the forearm was a lot more complex than I'd imagine it to be and pretty much overtook that title.
The theory of muscles is massive. The upper extremity contains approximately 50 muscles and the lower almost as many. Remember that every muscle have at least 4 parameters (origin, insertion, function and innervation), big muscles often have more than just four.
If you add this up it's going to be a rather big number but note that much of the information is the same for some muscles and you can usually group them in subcategories.

During this time my colleges frequently discussed whether the test was going to be oral or a slide test.
First of all I just have to say it again; making up theories regarding such matters are just time consuming and you better spend that precious energy on revision. (Those who're closest to me know what I mean because I've kept saying that every time a discussion like that started - sorry for that but you got to admit that we all over projected the whole thing a bit, still it's easy to be wise after the event...)

During the last week we confirmed that the test was going to be held orally on the actual specimens of the dissection department.
At first I thought of it as really bad news but after a while I just started to like it more and more. I spent a lot of hours in the open dissections just orientating myself. I joined up with my colleges Solveig and Yonathan and together we tried to prepare as good as we could.
It's really hard to have practice on the dissected specimens yourself since there's no answers to what you think you're looking at.
You pretty much have to guess your way and compare it to the atlases.

There is no simple way of learning this great amount of information and the only tip I can give is that repetition is the key.
I'm glad I've been spending almost 12 hours in dissection because not only did it help for the test but it will be very useful during the future dissections.

Yesterday, the day before the test, I didn't feel comfortable at all. I didn't feel prepared and I know I didn't have all the facts straight to 100% which of course is what you aim for.
Me, my roomies and our friends were invited to Nabeel, a third year student, who had offered to help us before the test.
He held the revision and went through all the structures and compartments of the muscles very thoroughly and I can honestly say that I wouldn't have passed with such a good grade without his help - due to the fact that he mentioned all these small details that I otherwise would have missed. I was also very lucky during my oral test because my questions were on all these small details which I had fresh in my head from the night before.

Before the oral test we had to draw cross section schemes of the limbs, once again divided into three groups. Each group had different tasks and my cross sections turned out to be sections of the foot and the upper arm.
We got twenty minutes to complete these drawings and those minutes sure just flew by. My drawings turned out to really good and I was very satisfied it and left for the dissections with relief.

Tomorrow I'll also get the result from last weeks Histology test but today I'll just let my mind off the studies for once and go get a celebrating beer at the Pivovarsky Dûm with Solveig and Yonathan.

That's all for now, cheers!

Next phase

We pretty much entered the next phase of the semester today - and the anxiety that followed was the proof.

The anatomy test went down rather quickly, approx. 35 power point slides with pictures covering ligaments and joint compartments of the superior and inferior extremities. To twist it up a bit our teacher added the regular scheme drawing of either a cross-section of the knee or the hip joint, depending on the group you were placed in.
I got the hip-joint which I knew fairly well and made a quick scheme. I would have preferred the knee joint thou since it was my lecture presentation subject and would probably have nailed it.
After the test I felt pretty good about myself until my friend Paymon started to discuss the questions with me. Then I felt the complete opposite (you know how it usually goes after a test).
I know I missed some bits and pieces here and there and I just hope I'll still get an acceptable grade.

After the test we went on to the dissection rooms and got our first view of a bigger piece of the real thing. The room smelled a bit of formalin, the chemical used to preserve the tissues, but when the sheets covering the limbs were removed the odour just got stronger. Since this wasn't the first time encountering the smell, my obviously very selective nose pretty much overlooked the smell and I could focus at the introduction of the muscles of the superior limb.
Since I can't post any photos of our procedure I'll just randomly link to something similar and let someone else get the blame.

(!)Gore alert(!) on the following google links:
Photo of shoulder girdle dissection #1, joint capsule
Photo of shoulder girdle dissection #2, muscles and innervation
Photo of inferior limb and abdomen dissection

The statement of the day is that the muscles (name, innervation, insertion and function) are rather complex anatomies to conquer. They are all shown pretty good in this overview.
The forearm contains loads and once again loads of parts mentioned in brackets above. For every muscle we need to know these different parameters as wells as being able to label them in a dissected arm.
My plan is to once again, break it down to bits and pieces, study different atlases, then sketch and repeat.
A good thing is that the dissection rooms are going to be open for self studies during the weeks so we'll get a chance to repeat on the specimens.

The next week is going to be hectic and I have to increase my time studying. I got two weeks to learn the muscles of both the superior and inferior limb, a histology test covering the histological techniques, staining and both epithelial and connective tissue as well as biophysics labs and lectures that I still keep procrastinating.
I'm growing the fear that I'll all pile up in the end and I'd like to prevent that by being one step ahead. It's damn hard thou due to the high pace, hence the worries, the increase in studying and the increase in coffee drinking.

Tomorrow is a day off since there's a holiday going on in Czech Republic and since I'm always off on Fridays my weekend begins tonight. Nabeel, a really nice guy from third year, asked my roomies out for a beer and I took some time off to tag along. So did Fredrik and Christian and we had a nice chat over a beer and a XXL drink in a crowded, smoky, basement pub called the Black Sheep.
It was a great start of the weekend, and since Halloween is around the corner it's just going to be better.
To smash that party mood up I'll still have to study a lot, so tomorrow is dedicated for studying and a major workout.

Until next post, have a good one - oh yeah got to end it with another fancy quote - this time in Latin I think (since I got pretty good hang of the Latin grammar today...)

"Aequam memento rebus in arduis servare mentem" - Horace

I did well, what a relief

Just came home after a long day, Wednesdays are always busy from 8am until 4pm, and guess what? I did well on the anatomy test.

Our professor divided us into two groups, A and B, and wrote subjects for each group on the black board. The subjects were; scheme of bone blood supply (group A) and scheme of bone ossification and growth (group B). Also, both groups had to do a scheme of the hand.
While we were focused on drawing our schemes our tutor and his assistant went around quizzing us on the bones.
I got the ulna, placed it and told her about its features. When she understood that I knew it she moved on to the humerus, clavicle and finished off with the distinguishing of the carpal bones.
I got an A and went on with my schemes and it wasn't such a big hassle as I'd imagined it to be. Now I know how to study for the test next week.

We handed in the schemes and when I get it back next week I'll post it here for anyone that's interested.

The lesson went on with ligament studies. We took our lab coats on since this was the first time we had seen preserved tissue - which equals chemicals and messy tissue. Each group got a pair of shoulder joints, completely preserved with bone, tissue, ligament and muscle tendons. I'd love to post a descriptive image but since that interfere with ethics I'll Google you something similar instead: how about a link to a shoulder dissection picture?
And yes, before you click, I got to warn sensitive persons.
[Picture 1 - Shoulder Joint] [Picture 2 - Glenohumeral Joint Specified]

The experience of seeing, holding and smelling dissected specimens wasn't as gooey and disgusting as I'd first imagined. Sure the formaldehyde mixture, the preserving fluid, didn't smell like raspberries but I think I'll get used to it. I mean the fish factory back home smell a lot worse.
Having a whole cadaver later on in the dissections with all the tissues intact might be a complete different experience though - but that will have to wait for the time being.

I wish my colleges in the parallel groups good luck for their test tomorrow, hope you'll do great guys!

He who would accomplish little must sacrifice little; he who would accomplish much must sacrifice much...

- James Allen (1855-1942)