Sunday, January 31, 2016

CircusK9 Basking

We had some sun this afternoon, a brief respite from the nearly biblical volumes of rain that have fallen in the past two months. Everyone approved.

Diary of a First-Year Vet Student: Studying Old School

There's no getting around the fact that gross anatomy is an old-school topic that all vet students must slog through. There are so many ways this course could be made more interesting. A start might be to focus more on clinical applications and less on fiddly bits. But for some odd administrative reasons that are far beyond the scope of this blog, the newly hired instructor is not being allowed to even use his own material. He has to use slides and content created by the instructor whom he replaced. That has to be frustrating for him too.

So I've resorted to one of the most old-school study aids there is to get through this old-school content: flash cards. Except that anatomy isn't a game of just terms and definitions, although we have to learn thousands of new terms each quarter (over 700 in just the first half of this quarter alone!). You also need pictures.

Here are a couple of my creations, the first for general anatomy of the pharynx, and the second for the major salivary glands and lymph nodes of the head.

Most of us also use mnemonics to help us memorize groups of things, such as the names and general functions of the twelve cranial nerves. Each informal study group tends to come up with their own mnemonics but for the cranial nerves, two in particular raced like wildfire through the entire class.

Oh Oh Oh, To Touch And Feel Very Good Velvet After Hours. That tells me the names of the cranial nerves: olfactory, optic, oculomotor, trochlear, trigeminal, abducens, facial, vestibulocochlear, glossopharyngeal, vagus, accessory, hypoglossal.

Some Say Money Matters But My Brother Says Big Boobs Matter More. That tells me the general functions of these nerves: S for sensory, M for motor, and B for both. Sure, you need to memorize additional details but you'll never get started with that until you have the big picture in your head. Oh, and the boobs thing? If you have time to worry about that while in vet school, you probably aren't studying enough. But if it really bothers you, change it to books. Most of us thought boobs was funnier.

I've come up with some of my own. Most of the muscles of the hyoid apparatus? Many Good Things Satisfy Sheep: myohyoideus, geniohyoideus, thryohyoideus, sternothyroideus, and sternohyoideus. Notice how neatly SaTisfy tells me the name of sternythyroideus, different from the others. I worked pretty hard on that one. How about muscles of the laryngopharynx? Please Paint His Tin Can Silver: pterygopharyngeus, palatopharyngeus, hyopharyngeus, thyropharyngeus, cricopharyngeus, and stylopharyngeus. The H, T, and C muscles contract in that order when you swallow to push food into your esophagus. For all of the muscles, all of them, we also have to learn the origin, insertion, innervation, and action. That means the fiddly bone bits the muscles attach to and what nerves tell them what to do.

I wasn't kidding: over 700 new terms just in these first four weeks, plus all their associated details. And that is just one class. I've got four classes this term just like this one.

Antler Kabuki

So much drama over nothing more than an antler chew.

Friday, January 22, 2016

Diary of a First-Year Vet Student: The Smartest Muscle in Your Body?

Despite my continued frustration with our gross anatomy class, I can't ignore the fact that we are learning some pretty amazing things. One of our anatomy professors told us that the "smartest muscle" in our bodies was our external anal sphincter. I'm not sure I completely agree.

See, you have two anal sphincter muscles, an internal one and an external one. The internal one is controlled by your autonomic nervous system. It tells you when it is time to poop! However, you have conscious control of your external anal sphincter. If you want to poop now, great. You can also choose to poop later, perhaps when it is more convenient. But the external anal sphincter will always eventually lose out to your lizard brain and the internal sphincter. So maybe it's not so smart after all.

Tuesday, January 19, 2016

Diary of a First-Year Vet Student: BRRAAAAINS!

Instead of a module within our first-year physiology course, we are taking a full 10 weeks of neuroanatomy this term. The best part is the laboratory--dissection of brains. Lots of brains. Dog and sheep brains for the most part, but they have all the key bits that we need to know about. I think we might get a cow or horse brain later in the term. They aren't particularly special, just bigger so some features are easier to find.

You have to appreciate a professor, who, writing in our lab manuals for our first dissection exercise, describes the preserved brain as having the "consistency of a ripe avocado." Terribly, grossly apt. It even has a tough outer skin, the dura mater. No pit though.

While I find the fussy, old-school approach to our gross anatomy course frustrating, slicing up brains is pretty fun. We are still learning about physiology and structure and have yet to dive into function, but the clinical applications of understanding the brain and the nervous systems are already clear.

Maybe we are all taking some of our personal stress out on the sheep brains because we have at least two exams or quizzes, and sometimes as many as four, every week of this term. Including the first week! Although this is the start of week 3, it will be a long slog to the end of the term.

Saturday, January 02, 2016

The Art of Restraint

I've finished up my schedule at the vet clinic for the winter break. I could have lazed around the house for three weeks, and don't get me wrong, I like lazing around the house and I know that I've extolled the virtues of naps here before, but I decided to be slightly more productive. Overall, it was a good experience. While routine stuff like vaccinations and nail trims seem to be an easy target to mock if your aspirations are to become an veterinary orthopedic surgeon, for example, my experience on Friday with Caramel, a terrier mix that boards with the clinic fairly regularly, stands out as an example of why every experience in a vet clinic can be a learning experience (name changed to protect the innocent).

Caramel weighs about 20 pounds. He's a low-slung, long-bodied dog with a broken-wire coat that is, not surprisingly, the color of caramel. He's also an asshole. He's fine as long as you don't try to do anything with him or to him. In other words, nearly every action that you have to perform on a dog boarding in a vet clinic falls under the category of "doing something with or to him." Caramel is a biter. He gives no warning and he's fast as a cobra. He's nearly impossible to put a leash on (nearly all of us have been bitten by him while trying to remove a leash). Forget nail trims unless he's sedated for some other reason (too bad he can only be neutered once). Unfortunately, when he was dropped off on Friday, his records showed that he was overdue for his bordatella vaccination. This vaccination is required for all dogs that are boarded in most facilities. The vaccination won't protect against all strains of the virus but it covers many of them. And bordatella, or kennel cough, is amazingly contagious. The vaccine can be injected but there is an intranasal version that takes effect much faster.

Can you see the problem here? Mean little biter who can't be touched but has to have some liquid injected into his nose. You know, that thing located immediately next to his snapping teeth.

The boarding staff are often young people with little vet experience. It's where a lot of vet techs and future vet students start getting that experience. They certainly couldn't deal with Caramel and his issues. So one of the day nurses recruited me.

I put on elbow-length, shearling-lined leather welder's gloves and grabbed a large towel. I trapped Caramel by my legs and swooped him up in the towel, twisting one end around his neck to keep his front feet inside the towel and to stabilize his head. He screamed and bit my hands and screamed some more. But--surprise! That did not produce the result Caramel wanted or expected. He was still wrapped up in the towel. And was he ever pissed about that. Okay, step one completed. Step two: the muzzle. Every time the day nurse got the muzzle even close to his head, he lunged and bit at it, then screamed and bit me some more. Finally, tiring of such rudeness, I shook him and, using the The Voice, I said "knock it the hell off!" I doubt Caramel is rarely told "no"--he was so shocked that he stopped still. The nurse rapidly slipped the muzzle on his face. We let him scream a bit more, then she gently placed her hand on his face, moving it down his snout. Of course he struggled and screamed, but I had a very good hold on him. Once she had his nose in hand--squirt, squirt into his nostrils--and it was done. She immediately removed the muzzle. I bent over and released him, removing the towel and stepping back in one motion. He went right up to one of the boarding techs wagging his tail (unfortunately, it's a ruse--you can't pet Caramel, but she knew that).

Restraining an animal can take many forms. Usually, less is more. A hard hold on an animal can stress them before you even jab then with a needle or clip a nail. Animals might need to be positioned sternally or on their sides, or maybe they need to be standing. The tech or doctor might need access to the head or neck, the back, the flank, a limb. You can use wraps, as I did in the case of Caramel. Precious little bits like the 11-week-old chihuahua pup in for her first vaccinations get the "boob hold"--cuddled in our arms right next to our chest. There's usually some jockeying among the nurses to determine who holds and who pokes in those cases (we always take a temperature before giving a vaccination because you don't vaccinate a sick animal, then there's the needle poke for the vaccination itself)--everyone wants to hold cute puppies and kittens.

Working at the clinic during the day gave me a chance to learn how to finesse my basic knowledge of animal restraint. It was time well spent.