Preparation Propaganda

I’ve already implied many times that my main way of studying anatomy is through drawing. For anatomy all you really need is a good atlas, a source for regional dissection topography and a source for PNS and CNS pathways. I can write a whole chapter on which literature to prefer and for the beginning of next semester I hope I can share my thoughts to the first year students.

The first thing I should have done differently in anatomy was to print the exam questions in the beginning of the course, not in the end. It is true that you answer a lot of the questions during the year but it is one thing to know the fact and to be able to present it. I started with the first questions and it took me a great deal of time to write it all down. I understood that this was not the way to go so I started to build simple skeletons of the questions with criteria I had to cover.

By putting up a simple model of each question and by repeating the anatomy in the atlas I was able to recall the knowledge – it is true that once you’ve touch a subject, even just briefly, the knowledge comes back to you. There are some questions that require more theory than others, for example the general structure of bones and muscle, so those you must read up on a lot. More straight forward anatomy questions I found being up to date in my head and I spent little or no time on those.

I was told that being able to draw something about everything was a good way to go and I spent a lot of time repeating my schemes and drawings just to get the details right. My girlfriend Kristyna, who’s in fifth year of her studies and an anatomy assistant, helped me out by listening to me – mostly via Skype since she were by this time about to end her vascular surgery Erasmus exchange in Helsinki, Finland. Reading up on the questions and presenting them for someone is a great, and perhaps the very best, way to practice for the oral part of the exam.

I also found out that having a drawing to relay on during the presentation is, at least for me, essential. If I forget something I can go back to the drawing, re-present the statement and even expand it by adding things as I go.
Some of my preparations were drawings only, and I just kept the written things in my head, some examples below:

The Structure of the Final Anatomy Exam

I will write as if anatomy is a subject of the past without revealing too much - thus keeping the final battle review unwritten for yet some time.
There's a lot to cover leading up to the exam and one part is the preparation work and the anxiety that comes with it.

The system of the University is built up so that you need one ore more credit(s) from each subject in order to advance to the next semester. Credits are obtained in the end of each course, or earlier if one manage to pass a special test. They are earned by staying within the limited amount of absences, usually four, and by passing all the checkpoint tests during the course.
Of course all the tests tended to accumulate during the end and one have to plan it correctly. As the analogue signatures of credits are getting signed in the index book, or "the golden book of God" as one of my friends once put it, one can seriously starting prepare for what really matters: the final exams.

The Anatomy exam can be broken down in three steps starting off with a straight forward slide test composed of 30 images, schemes or drawings with one unidentified label respectively. You need 21 correct answers to pass to the next round.
All indexes of the students that passed are then collected and randomly distributed to the professors, thus, you never know which examiner you will face until after the slide test (not that it would matter).
The students that failed are being called and sent home while the rest are placed with their examining professor. Two further tasks must be conquered; the practical dissection and the oral examination. Some students begin with the practical part and some directly to the oral.

The dissection is rather straight forward. You enter the dissection rooms to your examiner who starts of at one of six stations: bones, cadaver (muscles), thorax, abdomen, brain and CT/X-Ray. You answer the questions and are graded accordingly.

In the last part of the final exam, the part that you in my honest opinion ought to fear the most, you will be forced into a face off with one of the professors. The oral part is composed of no less than 191 questions, or rather, categories. Out of the 191 you pick a randomized number coding for a set of four question. Here are the division, total number of questions for each category (in brackets) and some examples:

Skeleton and its connections, muscles, fascias, osteofascial compartments (30)
-Bones and joints of foot including X-ray images, plantar arches and their support
-General features of striated muscle, its auxiliary structures, motor end plate, motor unit, muscle spindle, Golgi tendon organ, denervation atrophy
-Muscles and fascias of thigh, femoral triangle (draw transverse section and boundaries)
Gastrointestinal tract (17)
-Pharynx – description, syntopy, blood supply, innervation, swallowing reflex
-Liver - structure, nutritional and portal vascular bed, intrahepatic bile ducts
Respiratory system (8)
-Trachea and bronchi, bronchial tree - description (draw scheme), structure, syntopy, tracheotomy
-Pleura – visceral and parietal, borders of pleura, pleural dome and recesses, pneumothorax
Urinary and reproductive system (15)
-Urinary bladder – structure and position, fixation and syntopy in male and female (draw scheme)
-Prostate - structure, topographic relations, prostatic urethra, ejaculatory ducts
Heart (7)
-Heart - description, chambers, heart wall arrangement (draw section through ventricles)
-Coronary arteries, coronarogrpahy, veins and nerves, lymphatics
Arteries (9)
-Common carotid artery, internal carotid artery
-Abdominal aorta, unpaired visceral branches and their clinically important anastomoses
Veins (8)
-Cranial veins, sinus durae matris, intracranial tributaries of internal jugular vein
-Superficial and deep veins of lower and upper extremities, varicose veins
Lymphatic system (8)
Central nervous system – CNS (29)
-Cerebellum – structure, subdivision and functional organization
-Association and commissural fibers of hemisphere, internal capsule (draw scheme of tracts in internal capsule)
-Lemniscal system (dorsal column tract), proprioceptive and tactile sensation
Peripheral nervous system – PNS (20)
-General structure of the spinal nerve, perineurium, vertebromedullar topography, segmental innervation, radicular areas, dermatomes
-Radial and axillary nerve, paralysis
-Abdominal and pelvic sympathetic system, pre-vertebral plexuses and ganglia
Sensory organs, skin, endocrine glands (13)
-Eyeball (draw sagittal section), cornea, sclera and vitreous body
-Choroidea, iris, ciliary body, eyeball chambers, circulation of aqueous humor, glaucoma
Regional Anatomy (27)
-Topography of abdominal wall, blood supply, innervation and surface projections of abdominal organs
-Inguinal region, inguinal canal, hernias (draw schema of inguinal canal)
-Topography of supramesocolic part of peritoneal cavity (draw transverse section through lesser sac)

The complete list of questions is available here.
As you can see the categories are rather wide and wont cover all the possible questions the Professors can come up with - more or less anything they have touched (and to be honest also not touched) during the year.
I am amazed over the fact that all of us, who passed, have managed to learn such magnitude of information in 9 months of time. Combined with the knowledge of Histology we should be able to zoom in on any part of the human body and be able to explain the structures building up that part, both macro- and microscopically.
I hope the rest of my colleagues will fight for a good grade this week, the fourth round of examinations, and that their outcome will be satisfying.

Luck comes with the prepared...

Great Measures in Busy Times

As usual, I make a meme-spoof...

So here I am again, in a defensive stance against myself and the optimistic thought that keeping this journal alive would be a piece of cake. It most certainly is not.
You all most probably know why, especially if you've gone through the same thing and for those who yet have the experience ahead of them I will in the following posts tell you a bit of what to expect.

Since the previous time I posted here, about a sunny day filled with highlights if I recall it correctly, there have been both ups and downs.
March 22nd is the date stamp and, to be perfectly honest, all that follows is rather blurry.

I can happily say that I am alive and more than just alive. I lived through what might have been the most intense three months of my life "so far" - and with that said in quotation marks - I expect more of it.
If I look back the winter was just about to turn its back on us and spring came rushing in through the door. Anatomy and histology was just about to step up their games by introducing the head-on Anatomy Dissection course simultaneously with the Peripheral and Central Nervous System (henceforth PNS & CNS), all together stretching over one month.
I was prepared for a rough ride but when Histology finally swapped into developmental Embryology, a complete different subject, it just hit me in the face like a metal bucket filled with icy water - and by that I mean water first and bucket next.

As the finish line got closer for every day and with more and more material to conquer I entered a sort of pseudo-doubting roller coaster. The only way to cling on to sanity was to prioritize, hence, histology simple had to end up on the self for the time being.

With my mind freshly set on Anatomy there were days I felt I had it under control. I passed all my practical tests with good marks and was, with a good push in the back from Kristyna and my colleague Gal, almost ready to book a pre-term final exam.
CNS dragged me back into obscurity and that was the phases I gently swayed between; pre-term or not pre-term. Gal is amazing and I admire her for staying on track with her plan. Damn sure, she did it to the end - as one of the very first to fight and survive against the professors of Anatomy.
I failed in staying to the plan and scheduled my anatomy one week after the school ended, something that after the event seems to have been a good move anyway. Since I'm not much for "what-if's" I tend to save my energy not speculating whether it would have been better to do the pre-term.

The last day of school came to an end and the real preparation could begin.
My own final battle with Professor Elizka sure is a nice story, with an outcome that I am mightily proud of, and I am sure I will find the inspiration to give you the details in a separate post later on.

But for now I'm satisfied, and done, with wrapping up the prologue...

Sunshine and Pineapple

Sunset over Anatomy Department...
Some days are just better than others. Today was such a day.
There are not really solid criteria for what makes a good day, I rather find the spontaneous and come-by-chance moments inspirational and "day-seizing".
  Me and my friend Paymon usually talk about this in terms of "highlights of the day" which can take the form of pretty much any random situation.
A completely random thing that might turn into a highlight of the day is for example when you watch a beach saleswoman from Thailand teach the world how to slice up a pineapple on Youtube.

The weather today was like waking up from a shitty dream due to the sunlight shining through your dirty windows - okey, that was what really happened this morning and with that revealed; yes, I really need to clean my windows. I believe it's a good thing that mum is coming here on Friday.
  After waking up, starting off the day with some histology and bio-genetics I went for the first lecture on the interesting topic "cell cycle and its regulation" but it was honestly and most unfortunately not very effective, knowledge-wise speaking. I dare to say and, although this is not the right place, to give the constructive criticism about the Uni power-point presentations that overall, just like in the Swedish Army, are very disappointing from many perspectives. If time allowed I would gladly make a template and convert them all just to get rid of eye burning colours and massive text boxes - maybe an interesting future project - but for now, neither of my concern nor place to complain, which means I'll leave this thought here.

The two and a half hour break before this day's last class in Czech language came as a relief because this meant that I could catch some hours in the blazing spring sunshine.
Right above the Institute of Histology and next (laterally?) to the Institute of Pathology there is a nice sloping park that got to be the cleanest park in Prague. There wasn't much wind at my spot and the sun was facing the hillside just right for maximum exposure - and that we enjoy, right?
  I occupied a bench, took off my shoes and socks and for the first time this season my white, clean soles got to feel grass and gravel - just as my face got the first effective time in the sun.
The books were with me and I eliminated one hour by reading and the second and last one by taking a nice lying position and sleep off the recently ingested salami sandwich.

On my way home I took a right turn and bought a fresh pineapple at the Potraviny.
Not much is needed to create an over-the-average good day...

"We are going to die, thus - we are the lucky ones"

Inspirational words from Richard Dawkins on the fact that we're the lucky ones to die, and more importantly - live...

Holding a Heart

This week is all about the heart, a subject very close to my own heart. Even though today's lecture didn't give me much new knowledge I spent the time drawing, 1,5 hour result below.
I can happily say that I handed in my drawings to a Professor in the czech part of the anatomy department who obviously are interested. I hope he will like the originals and I'm curious to hear what he thinks and what he wants to do with them.

During Wednesday's anatomy practical we spent a lot of time in the dissection room studying the authentic heart. Holding it in your palm is a strange but exciting feeling.

As I said - it's all about the heart...

Out of the Ordinary

A lot of things make me happy:
Waking up early to and get chills from the cold air and then taking a hot shower, having a good breakfast, drawing while listening to relaxing music, seeing the sun set in the horizon along the Swedish west coast, drinking a beer on the cliffs with good company - I can make the list long.
But last Saturday Kristýna completely gave me a new definition of the word "happiness".

I won't give away any details here but believe me when I say that it sure was a surprise to. She took me down to a calm place by the river in the middle of the city light drenched Prague. There I got to open my early birthday present.
She put a box in my hands and when I opened it I found myself speechless.
I usually don't get presents with such a personal touch to them - I believe me and Kristýna share the same frequency.

No, I wont get lost... To be honest, I know exactly where we are...

Beginning of 2nd Semester

There is a wide gap from this date to the next. Almost as much as a month. I guess the urge to write come in periods.
I could write a long recap of the time I spent in Sweden after finishing my biophysics and first aid exams but I believe this photo above summarize it all up pretty damn good.

After spending some quality time with Kristýna (yes, love is in the air) in my frozen west coast home town we had to kiss goodbye and go separate ways again. At that point we hadn't been apart for too long - only a couple of weeks due to her Erasmus exchange semester beginning in Helsinki, Finland.


I went back to Prague for the second semester knowing that I had to step up my game a bit in order to keep up with the pace.
Currently I've got through two anatomy tests with good results and also increased my studies of the histology. I believe that I'm back in my previous study-gym-eat-sleep routine and that I'll be able to keep it for the rest of the semester.

There's of course a lot more to tell but I'll continue from here on...