Hands and Exams

Yesterday in lab, we dissected Emelia's hand. There is something different about the hand than much of the rest of the dissections. Emelia's fingernails were still neatly manicured with a few chips that likely happened after her death. Her knuckles were worn, slightly crooked and likely arthritic as could be expected from an 83 year old. There is something uniquely human about the hand, which may be part of why it is harder to dissect.

The hand is amazingly complex. After dissecting for a few hours I realized why hand surgeons have such a long training. There are so many tendons, nerves, blood vessels, and muscles that allow us to do all of the small motions with our hands. I was fascinated by the complexity inside the hand. If the training weren't so long and ridiculous, I think being a hand surgeon would be rewarding and challenging and something I would enjoy. The training and the lifestyle that come with that specialty choice rule it out for me though.

Today marks the halfway point to our first exam. Two weeks from today I will have my first anatomy exam which will cover the back, the upper limb and the lower limb. The limbs also include where they attach (shoulders and hips). There are a lot of muscles to learn in those sections. We have to know where all of the muscle attachments are on the bones, all of the different parts of the bones, what nerve innervates the muscles, and what arteries supply the muscles with blood. We also have to know where everything is in relation to the other parts. Which parts are superficial, which parts are deep, etc. We are also expected to be able to put everything together. If they tell us that the median nerve is damaged, we should be able to say every structure that would be affected and how it would be affected. Also included on this exam is the first four weeks of development of an embryo. I'm looking forward to that first exam being over. I want to see what the exam structure is and how I can more effectively study. I'm also definitely looking forward to having a weekend off!

I also just bought the medical equipment that we need for patient exams. I bought a stethoscope, and oto/ophthalmoscope (eyes and ears), and a few smaller, less expensive pieces of equipment. These costs add up so quickly! We start practicing physical exam techniques on each other starting next week and have a taped standardized patient interview (basic history of present illness) in just two weeks!