Posted 14 hours ago

aspiringdoctors:

tobedoctorly:

tobedoctorly:

How to Draw the Brachial Plexus in 10 Seconds!

Probably one of the most useful resources for memorizing the brachial plexus for the upper limb exam. I drew this on the back both of my both practical and written exams, and listed the nerve fibers for each branch and the muscles innervated. Well, as many as possible. The video helped me get the foundation and visual very quickly. Learning the innervations and the paths and which fibers are found in each nerve? That’s a different story. Here is a rundown of all of the branches:

Remember To Drink Cold Beer - Roots Trunks Divisions Cords (Terminal) Branches

Branches from the Roots:

  • Lateral Thoracic Nerve (C5-7) travels with Long Thoracic Artery to innervate and supply the Serratus Anterior (and breasts)—L travels with L
  • Part of the phrenic nerve comes from C5 (remember this one?)
  • Dorsal Scapular Nerve (C5) goes around the back (dorsal side) of the scapular to innervate the levator scapulae and rhomboids

Branches from the Trunks:

  • Suprascapular Nerve (C5-6) goes through the suprascapular notch (on the superior aspect of the scapular), under the superior transverse scapular ligament to innervate the supraspinatus and infraspinatus muscles (or as I just remember, the spinatus muscles). Note about this: there is also a suprascapular artery that goes over the same ligament—you can remember “Army over Navy" in that the artery (army) goes over the ligament (a bridge), whereas the nerve (navy) travels below and under.
  • Nerve to Subclavius (C5-6) is self-explanatory

Branches from Divisions - NONE

Branches from the Lateral Cord (C5-7 with the exception of lateral root of median n. (C6-7)):

  • Lateral Pectoral Nerve to pectoralis major—p. major is bigger than p. minor, receives nerve fibers from two sources
  • Lateral root of Median Nerve to hand and anterior forearm—median n. innervates the anterior forearm and goes through the carpal tunnel and plays a role in carpal tunnel syndrome
  • Musculocutaneous Nerve provides motor to anterior arm (pierces the coracobrachialis m. before traveling between biceps brachii and brachialis mm.) and sensory to forearm (this is the cutaneous part of the name)

Branches from the Median Cord (ALL C8, T1):

  • Medial Pectoral Nerve to pectoralis major and minor muscles—p. major is bigger than p. minor so it gets innervated by both lateral and medial pectoral nn while p. minor only gets innervated by medial pectoral n.
  • Medial Brachial Cutaneous Nerve—Brachial = Arm, Cutaneous = Skin; ergo sensory to arm
  • Medial Antebrachial Cutaneous Nerve—Antebrachial = forearm, Cutaneous = Skin; ergo, sensory to forearm
  • Medial Root of Median Nerve (see above @ Lat root of Median Nerve)—C6-7 from lateral root, C8-T1 from medial root
  • Ulnar Nerve—motor to portion of forearm and hand (flexor carpi ulnaris can’t be innervated by anything else…)

Branches from the Posterior Cord (C5-6 with exception of radial n. (all) and thoracodorsal n. (C6-8)):

  • Upper Subscapular Nerve innervates the subscapular muscle.
  • Lower Subscapular Nerve innervates the subscapular muscle and teres major muscle (minor over major—these muscles are named major and minor based on their size, but it just so happens that the minor muscle is located superior to the major muscle)
  • Thoracodorsal Nerve (middle subscapular n.) innervates the back (dorsal) muscle of the trunk (thorax), the latissimus dorsi
  • Axillary Nerve goes through the quadrangular space (see here) that is bordered by the humerus, what muscles inserts on the humerus? Deltoids. And then there’s also teres minor (I can’t remember how I remembered this).
  • Radial Nerve, as my labmates says, is a beast of a nerve. It gives motor fibers to posterior arm and forearm and throws out cutaneous sensory nerves left and right—which is why it gets motor fibers from all roots C5 through T1.

I wish I made this post earlier (although this tumblr had yet to exist when I was studying this material), as I would’ve remembered it better. I don’t doubt that this will be helpful recalling the brachial plexus come time to study for the boards. Nevertheless, I hope this will be helpful and useful for anyone learning/reviewing/anticipating! To my fellow peers, please feel free to add anything or make corrections (I admit I’m a bit rusty with brachial plexus now!), and as always my askbox is open for questions!

Throwback! For all the first years who are learning the brachial plexus now :)

We gave our first years lunch today and they are working on this now. Good luck!

Posted 21 hours ago
What are some good resources for studying anatomy? Like do you know any apps, good books, etc..
futurecristinayang asked

aspiringdoctors:

thisfuturemd:

studylikeadoctor:

Ooooh I love this question! 

Let’s get down to business: 

1. The first thing is, you need a good book.

Anatomy is an ancient discipline  and there are tons of good books out there that you can use as a reference. In my case, I use Sobotta and Netter quite a lot, there are people who prefer Gray’s anatomy, which is pretty great too. I would recommend you Sobotta, the draws are clear and realistic, so it is really clarifying. I also use “Rouviére’s anatomy”, but I don’t know if that one is available in english, because I only found it in spanish. Anyway, that’s a pretty good book if you want good theory, but not for the illustrations. You’ll find any of these books in your university library. Undoubtedly, the best and quickest resource is Fenei’s anatomy book

image

As you can see, the illustrations are so neat and clear you can look everything up in a second, and everything’s marked with numbers so you can know what you’re looking at. It’s one of my favorites and is so small you can carry it anywhere (I always take it with me to university).  ♥︎♥︎♥︎♥︎ You can buy the Feneis pocket atlas of human anatomy here: 

http://www.amazon.es/Pocket-Atlas-Human-Anatomy-Founded/dp/3135112055/ref=sr_1_2?ie=UTF8&qid=1402927667&sr=8-2&keywords=feneis

There’s also a book that I only found in spanish, but medical terms are really similar in different languages because they all come form the latin, so I don’t think you’ll have lots of problems, and anyway the best part about this book are the illustrations. It has more than 1000 pages and it only costs 35 euros!! You can look it up here: 

http://www.marbanlibros.com/libro.php?isbn=9788471018168

2. Draw. Anatomy is the most visual subject you’ll ever study, so draw, draw and draw everything you can. In my university, we need to buy a book called “Human anatomy in dissection planes”. I talked about this book in one of my posts (http://studylikeadoctor.tumblr.com/post/88657697174/as-promised-here-are-some-photographs-of-the) but this one is pretty expensive so just draw, because it will help you to memorize and understand everything. Draw flow charts of circulations, of muskuloskeletal systems, of nervous systems, of EVERYTHING. You have an example here: I drew the nervous apparatus of the heart

image

3. Use color-coding. When I have to study the muscles that are innervated by different nerves, I paint all the muscles of the same group with the same color. Use that technique for the different arteries and veins that come from the same main artery or vein too, for the nerve endings that innervate the same structures, etc.  

4. Quiz yourself. When I have to study anatomy, I print out blank images, with no names at all, and after studying I put the names of all the structures I can see in that diagram. That way I make sure I’ve understood everything and that I know what I’m talking about. Using blank diagrams and illustrations with no names is a good way of realizing what you’ve learnt and what you haven’t. 

5. Observe the bodies. I don’t know if your university offers it, but if you have the possibility of studying in a dissection room with real human bodies, observe everything. Touch the body, realize how differs the touch of veins and arteries and nerves, how ligaments and tendons are not the same… 

6. Here are some good apps: if you’re an android user, I’d check these ones out: 

https://play.google.com/store/apps/details?id=com.hssn.anatomyfree&feature=search_result#?t=W251bGwsMSwyLDEsImNvbS5oc3NuLmFuYXRvbXlmcmVlIl0. 

https://play.google.com/store/apps/details?id=com.GoodwillEnterpriseDevelopment.Anatronica

However, if you’re an apple user like me, I’d recommend 3D 4 Medical apps. They’re so clear and interactive, those are my favorites: 

http://applications.3d4medical.com/essential_anatomy_3/ 

In this page you can also see images and animations, and the have apps for android users too!! 

http://www.pocketanatomy.com (this one is also great) 

To study the skull (which is the hardest thing ever), use this app: 

http://www.iso-form.com/skullviewer/ (ugh I love this one) 

7. Reason as much as you can. Use mnemonic devices. Anatomical names have the advantage of being really obvious, clever and reasonable. If the thyro-epiglotticus is called like that it’s because its origin and insertion points are the thyroid and the epiglottis cartilages. That simple. If you can’t remember which are the vases that arrive to a lymphatic ganglion and the ones who leave, remember the “Afferent vases” are the ones which “arrive”, and the “efferent” ones, are the exit point. See? I just made a simple relation with the initials that helps me memorizing things! 

8. OBSERVE. Seriously, I can’t recommend you this enough. Observe the human body. Observe diagrams, illustrations, human cadavers and human bodies in action. Analyze, understand, and then, you can memorize everything you study, but if you just go to the theory without observing and analyzing, you’ll be doomed. Learning anatomy is like learning a new language, so make it fun, live it, and you’ll learn it quicker than you think. 

Excellent post about studying anatomy.

Man! I wish I had seen this when I was an M1!!!

Posted 2 days ago

usmlenotes:

Nephritic vs. Nephrotic!

Posted 6 days ago
The master has failed more times than the beginner has even tried
Stephen McCranie
Posted 1 week ago
Anatomy
Anonymous asked

medicowesome:

Anatomy

- Head, neck and face (ENT and otolaryngology also included here)
Innervation of the tongue, palate, pharynx & larynx with mnemonic
Extrinsic muscles of the tongue
Lymphatic drainage of the tongue
Memorizing how to draw the nasal septum
How to draw the tympanic membrane
Parotid tumors mnemonic
- Upper extremity
Hand of Benediction and clawing mnemonic
Supination and Pronation of  Forearm
Why do we feel temperature with the back of our hand and why not the front?
- Lower extremity
Peroneal nerve branches mnemonic
Gluteus maximus is innervated by the inferior gluteal nerve
Sciatic nerve distribution and Sciatica
An artery is always palapated against a bone
- Abdomen
Left testicular vein drains into (Mnemonic)
Peritoneal ligaments of liver
-Histology
Cell mnemonics
Which cell secretes what? Gastrointestinal mnemonics
- Neuroanatomy
Coronal section of the brain highlighting lentiform nucleus, caudate nucleus & internal capsule
Ventral and dorsal view of the brainstem highlighting cranial nerves (Diagrams only)
Amyotrophic lateral sclerosis
♥ Location of synthesis of neurotransmitters mnemonic
Embryological origin of brain mnemonics
Parasympathetic ganglia mnemonic
Fasciculus gracilis and cuneatus
Vestibular nerve, pathway and mnemonic for the receptors
Cochlear nerve, pathway and mnemonic
Spinal cord organization mnemonic
Cerebellum mnemonics
♥ Lateral medullary syndrome and lateral pontine syndrome mnemonic
♥ How to remember the difference between Wernicke’s area and Broca’s area
- Ophthalmology
Layers of the cornea mnemonic
Refractive indices of the eye mnemonic
Prolate and Oblate ellipse mnemonic
Tropia vs Phoria
Myopia and Hypermetropia mnemonic
Progression of visual field defects in Glaucoma mnemonic
Difference between Iris repositor and IOL dialer
- Embryology
Steps of mitosis mnemonic
♥ Aortic arch derivatives mnemonic images
Nervous system origins mnemonic

Posted 1 week ago

dewgonair:

lockrocksandcoke:

131-di:

veggiebaker:

therunscape:

Heart attacks symptoms are different for women. I recently learned this. 

Everyone should know these things.

thanks to mainstream media and being unable to show breasts on TV, way too few people know about female signs of cardiac distress, and impending heart attacks. they only know about the “pain in the left arm” male symptom.

i had all these symptoms once and they sent me right to hospital

it was scary bc i didnt know these were the symptoms for female heart issues

Please, please, PLEASE, reblog this. i don’t know if I did save or called false alarm, with my boss’ life tonight. I felt I was being a bit paranoid, overreacting, but I told Mirage my thoughts and he, after reading over the article I showed him, immediately sprung into action and then shooed her off to the hospital. I don’t know if I did or not, but I knew she’d been super stressed. She’d off-handedly commented on her arm tingling and I asked her if she felt queasy on a hunch. I went to look at the symptoms and we went from there.

Posted 2 weeks ago
Posted 2 weeks ago
usmlenotes:

TUMOR MARKERS!

usmlenotes:

TUMOR MARKERS!

Posted 2 weeks ago

medicowesome:

immense-immunology-insight:

7 reasons why cancer cells are immortal

1. Cancer cells don’t age.
Normal cells go through senescence through shortening of telomeres with every cell division. Cancer cells however have telomerase that will sustain the telomere length of the chromosomes rendering the cell virtually immortal.

2. Cancer cells have a way around apoptosis, their programmed cell death.
They overexpress antiapoptotic molecules and can multiply forever.

3. The Grim Reaper can’t recognize them.
The Natural killer cells, or the Grim Reaper; are supposed to cause death of the tumor cells. However, cancer cells remain undetected because they down regulate their MHC proteins or use decoy proteins to look innocent.

4. If recognized, the Grim Reaper can’t kill them.
Tumor cells block the death receptor pathway and directly interfere with the perforin/granzyme pathway. That is why, natural killer cells fail to kill them.

5. Cancer cells don’t need anything.
Cancer cells are self sufficient on growth factors. This means that they can continue to proliferate and divide independently, as opposed to normal cells that need external growth factors.

6. And if they do need something, they order it to come to them.
When cancer cells need of oxygen and nutrients, they stimulate angiogenesis; which is inducing growth of new blood vessels.

7. They have metabolic super powers.
The metabolism of malignant cells is usually more anaerobic than that of normal cells and is greatly accelerated. Malignant cells have the ability to withstand hypoxic conditions. They have increased glucose and amino acid uptake. In addition, they have high levels of hexokinase increasing their glucose utilization.

Poor Grim Reaper :’(

Posted 2 weeks ago

THE B IN B VITAMINS STANDS FOR BUMMER

aspiringdoctors:

I always mix up the stupid B vitamins and their actual names vs their number, and I told my internal med attending this and now I have to do a mini presentation tomorrow about B vitamins. So here is the handout I came up with, all basically from Step 1 First Aid.

B VITAMINS ARE COOL YEAH!

Vitamin B1 (th1am1ne)

  • What does it do: cofactor for all the things in glucose breakdown
  • Deficiency: impaired glucose breakdown = ATP depletion. Wernicke-Korsakoff. Beriberi (wet/dry). Seen in folks whose primary diet is husked white rice. Dx = increase RBC transketolase following thiamine administration

Vitamin B2 (riboflavin/r2b2)

  • What does it do: component of FAD and FMN (source of e-), cofactors, kind of a big deal
  • Deficiency: cheilosis, corneal vascularization, magenta-colored tongue

Vitamin B3 (niacin/sunglasses cat face—> B3 )

  • What does it do: NAD+ and NADP+, redox rxns, Derived from tryptophan. Synth from B2 and B6. Used to tx dyslipidemia (lowers VLDL/raises HDL)
  • Deficiency: glossitis. Pellagra (anything that decreases tryptophan absorption or inc metabolism) = diarrhea, dementia, dermatitis
  • Excess: facial flushing, hyperglycemia, hyperuricemia

THERE IS NO B4!!!

Vitamin B5 (pantothenate/5 pants)

  • What does it do: essential component of CoA and other things
  • Deficiency: dermatitis, enteritis, alopecia, adrenal insufficiency

Vitamin B6 (pyridoxine/siX)

  • What does it do: synthesis of lots of things (neurotransmitters, heme, molecules) and cofactor of transamination
  • Deficiency: convulsions, hyperirritability, peripheral neuropathy, microcytic sideroblastic anemia, cheilosis/stomatitis. MCC etoh and isoniazid.

Vitamin B7 (biotin/ALMOST has 7 letters)

  • What does it do: Cofactor for adding 1-carbon group
  • Deficiency: dermatitis alopecia, enteritis, fasting hypoglycemia. Can be caused by eating too many raw egg whites (avidin binds biotin).

WHO NEEDS B8 NOT YOU

Vitamin B9 (folic acid/9 months of pregnancy)

  • What does it do: converted to THF; synthesis of nitrogenous bases for DNA/RNA.
  • Deficiency: macrocytic megaloblastic anemia, hypersegmented PMNs, glossitis, NO NEUROLOGIC SX. Increased homocysteine, normal methylmalonic acid. MCC deficiency in US, dt etoh or pregnancy.

 10 and 11 ARE SILLY NUMBERS!!!

Vitamin B12 (cobalamin but who calls it that let’s be real)

  • What does it do: cofactor for important things
  • Deficiency: macrocytic megaloblastic anemia, hypersegmented PMNs, parathesias, subacute combined degeneration of dorsal columns, lateral corticospinal tracts, and spinocerebellar tracts. Increased homocysteine AND methylmalonic acid.