Musculoskeletal Exam/ Erb's Palsy

The beautiful brachial plexus.  This plexus is a source of frustration trying to memorize the many branches, and great appreciation of the intricate engineering once it is dissected out.  One of the injuries to the C5 and C6 roots cause Erb's Palsy.  This leads to a medially rotated shoulder and extended arm called "waiter's tip."  It's one thing to see it in a book, but it's a totally different experience to see it in person.

During our musculoskeletal exam lesson during our introduction to clinical medicine class, one of our tasks was to palpate the clavicle to the acromioclavicular joint.  As i was palpating my partner, I noticed that his left AC joint was significantly lower than his right due to a broken clavicle as he was pulled out during birth.  This clavicle fracture impinged his nerve, leading to Erb's Palsy.  He was unable to completely flex his arm or abduct his shoulder.  His biceps muscle, the main supinators, were not working properly.  He also couldn't abduct his arm, or lift it to the side.  It was exciting to get a chance to see it in person and develop another perspective on the disorder.

Visiting Physician

Once or a couple times a semester we have a visiting physician who comes to give a presentation of their experience in medical school, doing well on the USMLE, and life as a practicing physician.

I had the opportunity to talk to a visiting physician, a pathologist, during her office hours.  She started off getting a Master's degree in microbiology but later decided to go to medical school.  Pathology naturally became her interest because of the ability to incorporate her microbiology degree.  She mentioned that her routine consisted of going to school from 5pm to 5am most days; her way of avoiding some of the classmates she found annoying as she jokingly stated.  Her work days vary widely as some days are normal hours and some days she's going in very late.  She claimed to be in a lot of debt, but isn't concerned because of some loan forgiveness plan.

Part of what attracted her to medicine is the diversity in what she's able to do.  Such as clinical trials, teaching, research, public health, etc.  She plans to transition into private practice soon.  It's always nice to get a perspective who's already "been through the fire."

First Mini

I had my first mini on Monday.  Well second first mini I guess, as I am repeating the semester.  Thank God for a second chance.  I passed it for the first time with a 77%.  It's not as high as I would like but it is a start in the right direction.

A few days before that I was vomiting on campus.  I tried to go to a review that Friday, but I couldn't stay long, so I just went home and got some sleep.  After lab on day I had got very sick and nauseous after anatomy lab on day.  The first time that had happened.  But it only lasted a few days and I felt better after resting.  I think it was the formaldehyde that got to me this time and I got nauseous.  That's what I get for not eating very much before lab.

Our cadaver was a fighter, she lived 102 years old.  She had a pacemaker and the report listed her cause of death from general in-balance.  Sounds like they weren't to eager to investigate the cause of death.  I have really started to enjoy going to Anatomy lab, because I have a greater appreciate and understanding of the anatomy after repeating the course.  Our last dissection was the brachial plexus.  It was very tedious, trying to identify all the branches coming off the lateral, medial, and posterior cords.  However, it definitely is amazing to see the engineering of the nerves and the routes they travel to innervate the body.  I've seen the youtube video of drawing the brachial plexus in 10 seconds and that's been my go to video for learning.