One Down, Four To Go

I got one exam out of the way today in my five day marathon of finals. It was the written part for the clinical portion of my course, called Veterinarians and Society or something rather silly sounding. Basically, we begin to practice physical exams on a variety of species, gain experience working with dogs, cats, cows, horses, pigs, sheep, goats, chickens, rabbits-- you name it, and learn a little bit about various sundry other topics from practicing doing ultrasounds to practicing a cranial drawer.

It wasn't too bad, which is good, as I didn't expect it to be. It wasn't exactly easy either and I definitely need to work on some things before my oral exam/clinical skills test on Thursday morning.

I studied this evening with a classmate, working through last year's final that our professors gave us access to online. It was HARD! It made me a little nervous about passing, which is something I haven't worried about too much since my midterm.

I had to laugh about some things though. We reminisced about our fondest memories from the semester. Mine is definitely from gross anatomy lab when we were dissecting the inguinal canal (in the female the external pudendal artery and some fat passes through the inguinal canal, and there is a superficial inguinal lymph node externally that drains through the inguinal canal; in the male the testicular artery and vein, ductus deferens and lymphatics pass through the inguinal canal). I-- along with the rest of the class-- was very confused about the vaginal ring, basically an outpocketing of peritoneum that wraps around the structures in the inguinal canal. I was having an argument with my gross lab partner about whether anything goes through the vaginal ring. She adamantly insisted nothing passed through the vaginal ring. This did not appear to be the case to me on gross inspection (I have since learned what one thinks one sees can actually be very deceiving) and so I went to ask one of our professors circulating in the gross lab about this. The professor I addressed is a very famous, old school anatomist. In the words of another very famous professor, 'He is a big muckety-muck.' (I like that phrase). The following conversation took place:

Me: 'Dr., what stuff goes through the vaginal ring?'
Dr. Big Muckety-Muck, exploding, 'STUFF!!! There is NO "STUFF" in anatomy. NEVER say STUFF. AND NOTHING GOES THROUGH THE VAGINAL RING.' (spitting in my face with his vehemently delivered reply)

I think for the rest of my life that dramatic exchange will be a memory that stays with me. And I will never forget that nothing goes through the vaginal ring, it is the wrapping that forms the vaginal tunic for the testes (quite suitable as vagina means sheath).

A few days later classmates in my tutor group were discussing what structures passed through the vaginal ring. I told them nothing, but they didn't believe me. But I was right and for once I was dead certain of it.

I think I will pass on a few wise words of advice to next year's class. Among them, use Konig Liebich's veterinary anatomy text for the larynx and use Pasquini's anatomy text for the reproductive system, in particular, a careful study of Pasquini's image of the spermatic cord and vaginal tunic will head off the massive confusion experienced by my class. Or perhaps I shouldn't pass on these words of wisdom as they will not get to experience the fun I had laughing over these trials and tribulations.

And now, back to histology and then more reproductive anatomy.

After all, I have to know my 'stuff' :)

Addendum: It occurs to me that what I wrote might come off as seeming like I don't like Dr. Muckety-Muck. Rather to the contrary. He is very helpful, kind and totally dedicated to teaching. However, it took me some time to realize that he is also rather dramatic and to not be intimidated by his style. And, as my study partner commented, 'He would never say stuff because he has a Latin term for EVERYTHING!' So true. Only in vet school can one appreciate the usefulness of knowing every bump on every animals' body and that is why Dr. Muckety-Muck is so amazing.

You Know Finals Are Near When...

1. You sleep through your alarm and in your haste to get out the door on time, you put your shirt on backwards and don't realize it until after lunch. (That was last Friday).
2. You sleep through your alarm again on Monday, even after sleeping in all weekend (perhaps because you are so used to getting up at 6 am that you don't ever sleep past 8 am even on weekends).
3. You have no milk so you have your granola cereal with water (Monday and Tuesday).
4. You eat all the buffalo stew you made and start in on the frozen dinners (Wednesday).
5. You forget/mis-remember a good friend's birthday (sorry!)
6. You don't understand your own cryptic notes. I looked at something I had scribbled in the margins during a case presentation-- LR6SO4-- and could not figure out what it referred to. It had once made perfect sense to me, so much so that I wondered why our ophthalmology professor had said it was the last thing her resident said to her before walking out the door to take his boards. I remember thinking it was so obvious that no one would ever need a mnemonic to remember it. After much searching, it stands for the extraocular muscle innervation. Cranial nerve VI (abducens nerve) innervates the lateral rectus and retractor bulbi. Cranial nerve IV (trochlear nerve) innervates the dorsal oblique (superior oblique). Cranial nerve III (oculomotor nerve) does everything else. And so LR6 stands for lateral rectus muscle cranial nerve VI, SO4 for superior (dorsal) oblique muscle cranial nerve IV. All this to help me try to remember on tomorrow's test that abnormal deviation in the position of the globe of the eye can look like ventrolateral strabismus (lesion involving oculomotor CN III), medial strabismus (lesion involving abducens CN VI) or rotation of the globe (trochlear CN IV), which can be difficult to see if the pupil is round because the deviation in the position of an elongated, ellipsoid pupil is the easiest way to assess whether the glove of the eye is rotated (otherwise one is forced to look at the position of the retinal blood vessels on the back of the eye, the fundus). All that just for the eyes! And cranial nerves are just a small part of a neurological exam, there is so much more to the nervous system and so much more to just a basic physical exam (especially when one considers species ranging from chickens to alpacas to cows)!
   

Pre-Exam Drudgery

I've been studying since noon, it is now past 5 pm. I'm about to eat dinner and then head into school to meet up with a classmate to study for a few more hours.

I'm tired of studying. On the up side, I got to spend the afternoon at home curled up with my cats.

On the down side, I have a stack of flashcards a foot thick.

I'm busy re-learning all my large animal terminology that I once memorized for tech school and then forgot. Wether is a castrated adult male goat. Farrowing is when a pig gives birth. Etc.

I'm also reviewing all my histology. From Peyer's patches in the ileum to arcuate arteries in the kidney.

Last night I did get a bit of a break. Where was I last night? On the necropsy floor. I like necropsy. It's interesting. It's also a break from spending every evening studying.

Back to the grindstone.

My first exam is Friday. I then have exams the following Monday, Tuesday, Wednesday and Thursday.

There are moments when it is grey and rainy and I have been studying all day when I wonder why I didn't choose to go to a vet school in a warm, sunny location. Or a vet school that gives multiple choice exams (seems like they all do except for Cornell).

Instead I am about to experience one of the most grueling and infamous exam periods of any vet school in the country.

Addendum: My favorite word of the evening-- 'British term for a yearling sheep of either sex.' You guessed correctly if you guessed HOGGET. Uh huh.

Picture Perfect Weekend

We had lovely weather this weekend-- warm and sunny. I was studying most of the time but did get outside to go to the farmers' market and for a run. Above is me last weekend at the farmers' market with my friend FishVet, also from California, who is going to be a fish veterinarian (you guessed it).

Below is my house and another view from my window.


One week till finals. I'm trying to remember everything I learned. My favorite today-- when asked to name the specific area of the superficial leaf of the greater omentum where the short gastric arteries run from the spleen to stomach and I was able to say, gastrosplenic ligament. There is also apparently a duodenocolic fold or ligament. Who knew?

I've been enjoying cooking with my crock pot. It's perfect for my busy schedule. After doing a buffalo stew last week I am preparing to do a lamb with green tomatoes stew this week.

Fall In Ithaca

Above: The view behind me as I pulled out of my driveway at 6:30 am Friday morning to go to school.

Below: The view driving up my road to come home from school Friday afternoon.



Above: The view looking down from the road onto my favorite running trail's entrance taken this afternoon (Saturday) on a study break when I went for a run.

Below: The view running back towards the trailhead at the end of my run.


Below: Me at the trailhead with a German shepherd belonging to a hiker entering the trail-- for the entirety of my run I was the only person on the trail!




Above: The view out my bedroom window behind my desk of the fiery orange leaves of a tree in fall.

Below: Simon and Lindy curled up on my bed.

Week 9: First Patient, First Snow

I spent the afternoon practicing physical exams on horses. I was mostly listening to gut sounds, but here it appears I am ausculting the heart or lung sounds (or both!)

Last night I had the opportunity to be a student clinician at the low-income veterinary clinic run by Cornell for the first time.

Today it snowed for the first time.

I'm tired. I miss the sun and warmth of California.

I am busy learning all the muscles, nerves and vessels of the limbs.

12 more days till my first final!

Week 8: Back In The Saddle Again

Above: Me in my bovine abdomen lab today. One of my professors commented that I must enjoy the hands-on labs because I smile so much during them. It's true. Like he said, I like getting to actually touch the animals. I miss working. I miss putting my hands on a patient. I know I picked the right career because I am happier doing it than studying!

I'm in the middle of week 8 and it's back to the frenetic pace of the first semester of vet school after a luxurious long weekend.

So what have I been up to lately?

• New York State Veterinary Conference-- I went to a session geared towards students and learned some of the pluses of being in a small, rural practice and of owning one's own business, both of which I hadn't given serious thought before.

• I also attended a fabulous talk by Dr. Bonnie Campbell, DACVS who spoke on the "Amazing Omentum." The omentum facilitates hemostasis, releases angiogenic factors (new vessels invade omentalized tissues within six hours), releases neurotropic factors that promote re-innervation and help modulate pain (algolytic products), is involved in immune surveillance and can absorb fluid via peritoneal lymphatic drainage (thereby acting as a physiological drain). To take advantage of all these amazing properties, one can increase the size of the omentum by releasing the ventral leaf from where it attaches to the greater curvature of the stomach or one can reflect the omentum cranioventrally and release the dorsal leaf from the dorsal body wall. To further elongate the omentum one can make an L shaped incision in it. One then places the omentum over the desired site or you can even tack it in place. One can tunnel omentum through subcutaneous fat to non-healing axillary wounds. One can even omentalize the brain and spinal cord. Pretty darn cool.

• I helped paint part of the OTS house as my pledge promise. Friday is my initiation. All I know is that I am supposed to wear coveralls. Only in a veterinary fraternity does one have to wear coveralls to events.

• I went to the farmer's market and bought a ton of vegetables and made a vegetable stew kind of like the ones I enjoyed so much in San Jose last fall. I got to test my brand new crockpot, which is great because I don't have to pay any attention to the stew while it is cooking (I've been a bit of a space cadet in the kitchen lately and that has posed something of a fire hazard).

• I enjoyed the cat-dog interactions in my house, watched the cats and studied while the cats and dogs watched me and the whiteboard I draw on intently.

• I tried to get outside and enjoy some of the good weather that we had on Saturday.

• I got a flu nasal spray in an effort to try to avoid the seasonal flu this year (the H1N1 flu vaccine is not yet available).

• I caught up on sleep.

• I got in some nice runs on nearby trails.