Advice for those about to start PT school soon

[thorn22]

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Review as much gross anatomy as you can!!!

I just started the DPT program at the University of Colorado on June 1st. I am wishing that I had tried to get the bone landmarks, muscles, attachments, innervations, and actions committed to memory before I got into the program.

To give you an idea of how our Anatomy class is, we are in lecture from 8am-10am Monday-Friday. From 1-5pm, twice a week, we are dissecting in the cadaver lab.

During a single lecture (2 hours) we covered the entire arterial supply to the upper extremity and the brachial plexus. It would have taken us 2 weeks to cover that in undergrad!

The program is definitely fast-paced and difficult/frustrating at times, but I am really enjoying it so far. I just thought I would share some advice with those of you potentially starting in the Fall or even next year. Use your "spare" time wisely while you still have it; you will lighten your load once in your program!

 

[lee9786]

Review as much gross anatomy as you can!!!

I just started the DPT program at the University of Colorado on June 1st. I am wishing that I had tried to get the bone landmarks, muscles, attachments, innervations, and actions committed to memory before I got into the program.

To give you an idea of how our Anatomy class is, we are in lecture from 8am-10am Monday-Friday. From 1-5pm, twice a week, we are dissecting in the cadaver lab.

During a single lecture (2 hours) we covered the entire arterial supply to the upper extremity and the brachial plexus. It would have taken us 2 weeks to cover that in undergrad!

The program is definitely fast-paced and difficult/frustrating at times, but I am really enjoying it so far. I just thought I would share some advice with those of you potentially starting in the Fall or even next year. Use your "spare" time wisely while you still have it; you will lighten your load once in your program!

Thorn thanks for posting this. The more specific info regarding various programs the better. Thanks a lot. I will utilize your recommendation.

 

[thorn22]

No problem, I hope that it helps some people.

Also, I forgot to mention that in my Anatomy class, the professor expects you to learn all of the things I listed on your own time. She does not hold our hand through lecture and say "Now this is spine of the scapula", etc.

This is why I HIGHLY recommend you all to start learning this info now. Thus, once you jump into your program you will be ready to run with the speed.

Gotta go, time to write out the brachial plexus 😎

 

[HCO]

I really should do this since I have plenty of time on my hands before school starts in August. Do you have any specific suggestions of what to use (or what you have used) to review the muscles/bones etc? Flash cards? Books?

 

[xMerryx]

Thanks!

 

[Coach Hoski]

Thank you! I was wondering if I was wasting my time, but I've been ravaging through my Netter's book trying to get some things fresh in my head. I'm kind of administering my own little undergrad anatomy class for myself, starting with the axial skeleton, then appendicular, paying attention to bony landmarks that will be origins or insertions, and then I'll move onto muscles and their O,I,As.
Anything else you would recommend?

 

[PTtoBe]

Thanks a bunch. It's definitely valuable info as it will be closely similar to what most of us will go through. I'm guessing in a way some of this stuff goes faster anyways since most of it you've seen before, although AP classes differ a fair amount.

In my AP class we never got into facial muscles at all; do you anticipate this is something you'll be covering as well? I'm pretty much just planning on blowing those off and focusing more on the muscles of everything from the neck on down (except hands/feet).

Sounds like it's sort of fun, but pretty stressful, which is more or less what I'm expecting. The dissecting must be pretty interesting.

 

[soccer31]

Thank you! I was wondering if I was wasting my time, but I've been ravaging through my Netter's book trying to get some things fresh in my head. I'm kind of administering my own little undergrad anatomy class for myself, starting with the axial skeleton, then appendicular, paying attention to bony landmarks that will be origins or insertions, and then I'll move onto muscles and their O,I,As.
Anything else you would recommend?

plexuses and muscles innervations as well

 

[myr11]

thanks for sharing! about to start in less than 2 weeks at NYU...are you only taking anatomy or are you taking another class as well right now? We start with histology and I have heard that it is a tough one..

 

[thorn22]

Hey everyone,

Glad you are all thinking of taking my advice, it will be worth it I promise. To answer some of your questions:

I am using a Gray's Atlas and the Clinically Oriented Anatomy 6th edition textbook by Moore. I also have Gray's flashcards that help with more of a review, rather than initial learning. I think any material would be fine to use for preparation. I would not suggest taxing yourself and getting too specific with what you go over, but I would definitely focus on basic level anatomy. For example, I would recommend going over bony landmarks of all bones in the limbs and the spinal vertebrae. (Keep in mind, every landmark is there for a reason!)

After landmarks, I would focus on muscle ATTACHMENTS. I would suggest, as my professor has, to understand and know the proximal and distal attachments of the muscles, rather than the origin and insertions. This is because the origins and insertions can change depending on the position someone is in. The attachments, however, always remain the same.

After muscle attachments, I would go over the actions of each muscle, especially those in the upper and lower extremities.

As far as Facial Muscles, I am sure we will go over them, but we have not as of yet. Don't fret over those, the muscles of the appendicular skeleton are what you want to get down if you can.


As for my classes, I am currently taking:
Anatomy + Lab (Includes palpation and cadaver labs) - 5 credits
Foundations in PT - 1 credit
Exercise Science - 2 credits
Histology - 2 credits
Examination/Evalution - 2 credits

I hope all this info did not bore you and some people can find it useful in their studying. If I had one piece of advice, it would be to just do a little bit each day/weekend. Don't go crazy and burn yourself out trying to learn the entire upper arm musculature in 3 hours. Take it one muscle, vessel, and nerve at a time and get familiar with all that you can. Trust me, you will have plenty of time to study once you are in your programs 😀

P.S.- For those of you really wanting a textbook, my anatomy professor considers the Muscles book by Kendall, found here http://www.amazon.com/Muscles-Testing-Function-Posture-Kendall/dp/0781747805/ref=pd_sim_b_2 to be the Bible in PT. It may be more than you need in review now, but I would recommend you all to get it once in your program. It is amazing.

 

[soccer31]

After landmarks, I would focus on muscle ATTACHMENTS. I would suggest, as my professor has, to understand and know the proximal and distal attachments of the muscles, rather than the origin and insertions. This is because the origins and insertions can change depending on the position someone is in. The attachments, however, always remain the same.

This statement got me somewhat confused. For me, distal attachment = insertion, and proximal attachment = origin. Therefore, those terms could be used interchangeably. For example, the origin of the rectus femoris is going to be the ASIS and its insertion it is going to be the tibial tuberosity, and this is not going to change if you are laying in prone, supine, standing, or any other way. Do you mind expanding on what you meant by that?

 

[fallbackplan]

This statement got me somewhat confused. For me, distal attachment = insertion, and proximal attachment = origin. Therefore, those terms could be used interchangeably. For example, the origin of the rectus femoris is going to be the ASIS and its insertion it is going to be the tibial tuberosity, and this is not going to change if you are laying in prone, supine, standing, or any other way. Do you mind expanding on what you meant by that?

Think of your Origin and Insertion in terms of the attachments that are more stable and movable. The origin residing on the part of the body that is more stable, insertion on the part that moves most freely.

Example of Rectus Femoris above:

O: AIIS, Groove above Acetabular rim
I: Common insertion into tibial tuberosity via patellar tendon.

Example of Rectus Abdominis: (this one doesn't fit the proximal/distal relationship)

O: Pubic Symph
I: Xyphoid Process, cartilage of ribs 3-5


The system is not perfect, it is just how it is.


As far as O and I changing depending on position, I have never heard of that, and I would also be interested in an explanation of what your professor's reasoning behind that is.

 

[Coach Hoski]

This statement got me somewhat confused. For me, distal attachment = insertion, and proximal attachment = origin. Therefore, those terms could be used interchangeably. For example, the origin of the rectus femoris is going to be the ASIS and its insertion it is going to be the tibial tuberosity, and this is not going to change if you are laying in prone, supine, standing, or any other way. Do you mind expanding on what you meant by that?

My understanding is that an insertion is defined as the site at which a the muscle is attached which moves during contraction of the muscle. Proximal attachment does not necessarily always equal origin, because the proximal end may be the part doing the movement while the position of the distal end remains static.
So in your example, if the patient is doing a prone plank, the upward movement of the hips will require shortening of the rectus femoris, and the ASIS will act as the insertion.

 

[thorn22]

Think of your Origin and Insertion in terms of the attachments that are more stable and movable. The origin residing on the part of the body that is more stable, insertion on the part that moves most freely.

Example of Rectus Femoris above:

O: AIIS, Groove above Acetabular rim
I: Common insertion into tibial tuberosity via patellar tendon.

Example of Rectus Abdominis: (this one doesn't fit the proximal/distal relationship)

O: Pubic Symph
I: Xyphoid Process, cartilage of ribs 3-5


The system is not perfect, it is just how it is.


As far as O and I changing depending on position, I have never heard of that, and I would also be interested in an explanation of what your professor's reasoning behind that is.

The example that she used was trapeze artists, acrobats, etc. If they turn upside down and do a handstand, the origin and insertions have now switched because of the attachment that is shortening/elongating. However, the 2 attachment sites never change, even with changing body position.

I will ask if she can elaborate further and get back to you.

 

[PTtoBe]

A PT student that just completed their first year recommended getting/reviewing "Quick Medical Terminology" by Shirley Steiner, saying they were tested on medical terminology and used it heavily during the year.

 

[pttrac]

Thanks guys, I will definitely start reviewing asap.

 

[MinnDasota]

Hey guys...Studious bunch you are!

Anyways, about the origins and insertions vs. proximal and distal.

Origins and insertions do change. For example, in a closed chain knee extension (standing from a squat), the origin is at the knee and the insertion is at the pelvis as the quad is being pulled towards the knee to extend the knee. In an open chain knee extension (kicking the knee straight when seated in a chair or knee extension machine), the origin is at the pelvis while the insertion is at the knee as the quad is being pulled towards the pelvis to extend the knee.

Another example are the abs during a situp. When doing a regular situp, you are bringing the chest/ribs towards the pelvis. Thus the origin is at the pelvis and the insertion is at the ribs. When doing a lower abdominal crunch, you are bringing the pelvis towards the ribs. Thus the origin is at the ribs and the insertion is at the pelvis.

Proximal and distal attachments will always be the same as it is based on the actual anatomy and not influenced by action/pull of muscle. That is why it is better to learn as proximal and distal.

BTW, sorry to be general with the attachments, but didn't feel the need to be specific. I'll leave that to you!

Oh, and I do agree that you should learn the innervations of each muscle.

Finally, during my anatomy dissections, we learned all the facial muscles. Was not as stressed as the rest of the body but definitely was taught. Focus on the neck down for now. Learn the rest if you have the time.

 

[PTtoBe]

Hey guys...Studious bunch you are!
Origins and insertions do change. For example, in a closed chain knee extension (standing from a squat), the origin is at the knee and the insertion is at the pelvis as the quad is being pulled towards the knee to extend the knee.

I always thought of it as the quad being pulled towards the pelvis (traditional origin) to straighten the leg, regardless of what the movement is. Or basically do you mean that since the lower legs are stationary, and the pelvis-on-up is moving, it really is "pulling towards the knee" to move all of that above the knee. So basically, whatever is moving is on the insertion end?

Thanks for explaining!

 

[MinnDasota]

I always thought of it as the quad being pulled towards the pelvis (traditional origin) to straighten the leg, regardless of what the movement is. Or basically do you mean that since the lower legs are stationary, and the pelvis-on-up is moving, it really is "pulling towards the knee" to move all of that above the knee. So basically, whatever is moving is on the insertion end?

Thanks for explaining!

"whatever is moving is the insertion end" might be be too much of a generalization, but I can't think of any movement that would disprove it at the moment...although it is usually only the case with muscles that cross two joints. When going deeper into biomechanics, this gets explained more in detail. Thus, for the sake of studying anatomy, I recommend thinking proximal/distal.

For those wondering what closed chain vs open chain is: Closed chain is when the distal end is fixed and the proximal end is moving (eg. standing from a squat). Open chain is when the proximal end is fixed and distal end is moving (eg. knee extension when sitting). This has huge implications in rehab (ACL tears especially) so will be important to know in the future.

 

[stive112]

Hey everyone,

Glad you are all thinking of taking my advice, it will be worth it I promise. To answer some of your questions:

I am using a Gray's Atlas and the Clinically Oriented Anatomy 6th edition textbook by Moore. I also have Gray's flashcards that help with more of a review, rather than initial learning. I think any material would be fine to use for preparation. I would not suggest taxing yourself and getting too specific with what you go over, but I would definitely focus on basic level anatomy. For example, I would recommend going over bony landmarks of all bones in the limbs and the spinal vertebrae. (Keep in mind, every landmark is there for a reason!)

After landmarks, I would focus on muscle ATTACHMENTS. I would suggest, as my professor has, to understand and know the proximal and distal attachments of the muscles, rather than the origin and insertions. This is because the origins and insertions can change depending on the position someone is in. The attachments, however, always remain the same.

After muscle attachments, I would go over the actions of each muscle, especially those in the upper and lower extremities.

As far as Facial Muscles, I am sure we will go over them, but we have not as of yet. Don't fret over those, the muscles of the appendicular skeleton are what you want to get down if you can.


As for my classes, I am currently taking:
Anatomy + Lab (Includes palpation and cadaver labs) - 5 credits
Foundations in PT - 1 credit
Exercise Science - 2 credits
Histology - 2 credits
Examination/Evalution - 2 credits

I hope all this info did not bore you and some people can find it useful in their studying. If I had one piece of advice, it would be to just do a little bit each day/weekend. Don't go crazy and burn yourself out trying to learn the entire upper arm musculature in 3 hours. Take it one muscle, vessel, and nerve at a time and get familiar with all that you can. Trust me, you will have plenty of time to study once you are in your programs 😀

P.S.- For those of you really wanting a textbook, my anatomy professor considers the Muscles book by Kendall, found here http://www.amazon.com/Muscles-Testing-Function-Posture-Kendall/dp/0781747805/ref=pd_sim_b_2 to be the Bible in PT. It may be more than you need in review now, but I would recommend you all to get it once in your program. It is amazing.

I enter school Fall 2010 and i have been going over Netter's flash cards, all o,i, nerve innervations, and actions, so your advice makes me feel little at ease. What is your exercise science class and histologly class like. I've been out of school for almost 3 years and forget alot of the exercise science info so any advice would be great. Thanks

 

[xMerryx]

It has been really slow at work this summer, so I wan to take time to review; however, I'll feel uncomfortable by bringing books to work. Can anyone recommend a good website. Believe me I prefer books, but I will prefer a website now due to the circumstances. Thanks in advance!

 

[jesse14]

Is been really slow at work this summer, so I wan to take time to review; however, I'll feel uncomfortable by bringing books to work. Can anyone recommend a good website. Believe me I prefer books, but I will prefer a website now due to the circumstances. Thanks in advance!

This is a fun and pretty great site in my opinion:
http://www.getbodysmart.com/

 

[xMerryx]

Great! thanks!

 

[thorn22]

I enter school Fall 2010 and i have been going over Netter's flash cards, all o,i, nerve innervations, and actions, so your advice makes me feel little at ease. What is your exercise science class and histologly class like. I've been out of school for almost 3 years and forget alot of the exercise science info so any advice would be great. Thanks

You should be in good shape if you are reviewing like you say.

My exercise science class is just like any other. We have our classes 1-3 times/week depending on our schedule, and go over basic exercise physiology and concepts. I am not sure if it would be in your best interest to try and get exposed to this right now. I would suggest focusing your efforts solely on anatomy where it is more rote memorization without a lot of concepts; save the concepts and applications for your professors to provide, afterall you are paying tuition! 🙂

The same can be said for histology. Our class would be better suited with the name "Cell Biology" because it is essentially a mini Physiology class with emphasis on nerve, skin, and muscle cells.

Hope this helps!!

p.s.- What nerve innervates the Deltoid, what are its myotome segments, and what actions does the muscle assist with? 😉

 

[PTtoBe]

The same can be said for histology. Our class would be better suited with the name "Cell Biology" because it is essentially a mini Physiology class with emphasis on nerve, skin, and muscle cells.

Hope this helps!!

p.s.- What nerve innervates the Deltoid, what are its myotome segments, and what actions does the muscle assist with? 😉

I was hoping to get away from some of the microbiology side of things (I tend to find it boring, and as a result harder to study and remember), but I understand the need to go over cell/tissue biology in PT.

If "myotome segments" refer to the 3 parts of the deltoid (and I could be wrong), then...

- Axillary nerve from the brachial plexus innervates it.
- All 3 parts abduct the shoulder
- Anterior fibers: flex/medially rotate the shoulder
- posterior fibers: extend/laterally rotate the shoulder
- middle fibers: abduct

Is that the type of information you're going over, or do you go to it in more detail? I imagine you can't go into it in TOO much detail if you're doing this for every muscle....I hope. 🙂

 

[thorn22]

I was hoping to get away from some of the microbiology side of things (I tend to find it boring, and as a result harder to study and remember), but I understand the need to go over cell/tissue biology in PT.

If "myotome segments" refer to the 3 parts of the deltoid (and I could be wrong), then...

- Axillary nerve from the brachial plexus innervates it.
- All 3 parts abduct the shoulder
- Anterior fibers: flex/medially rotate the shoulder
- posterior fibers: extend/laterally rotate the shoulder
- middle fibers: abduct

Is that the type of information you're going over, or do you go to it in more detail? I imagine you can't go into it in TOO much detail if you're doing this for every muscle....I hope. 🙂

Nice job, I wasnt expecting you to answer, but you did! It is correct that the Deltoid is innervated by the Axillary nerve. I should have been more clear about the myotomes. What I meant by that was: what are the segments/spinal nerves that give rise to the motor innervation. For the deltoid, it is C5-C6. For my program, every muscle we did in the upper extremity we had to know the myotomes for. And additional example is: Latissimus Dorsi is innervated by the thoracodorsal nerve and supplied by C6-7-8.

While I am on the topic, the reason I suggest that you all start to know/memorize all this information now is because this is just the foundation of anatomy. For example, our Upper Extremity written exam in Anatomy required that you knew all the myotomes, attachments,actions, innervations, etc; however, none of the questions directly asked this information. It was more of an integration test where "A young boy falls off his bike and lands on his elbow. He comes to you and complains of 'pinkie pain'. What nerve do you think is injured and which actions do you anticipate him having difficulty doing?" This really requires that you know the foundations so you can put it all together during the exam.

 

[DPTErudition]

That's how I imagine most programs are based. If it were undergrad the question would be "where does the pec major insert?"

But in gross anatomy the questions all assume you have knowledge of origins, insertions, actions, and such and you have questions like "A man reports having been in a knife fight and was stabbed while his arms were raised. He is now unable to protract, what nerve was likely injured?"

 

[darkangel77]

Hey, we had that question on our first exam 😛

But yeah, definitely review your muscle proximal/distal attachments. I didn't review them much (and I only remembered very little regarding that from undergrad anatomy a year ago) and boy did it give me a hard time! You have to know them very well (especially actions/innervations of muscles, our professor kept stressing how critical that was). About 1/3 of the questions on our exams (we've finished with both the upper and lower limb and are now on the thorax/head/pelvis) were clinical-related.

I started May 19 at NYIT, btw 🙂 We have one more week of anatomy, and then we're jumping into a 6-week long Kinesiology course next Tuesday.

 

[DPTstarlight]

Just curious if any PT students have some great Words of Wisdom! Looking back when you started PT school or as 2nd, 3rd yr students, what do you wish you would've known.....

 

[ptdpt]

Good question

 

[RunnerGirl30]

There is a thread like this already:

http://forums.studentdoctor.net/archive/index.php/t-635916.html

 

[DancerFutureDPT]

thanks Runner girl for pointing that out 🙂 I merged the threads so the OP and anyone else can see it.