DPT Summer 1 - DONE. Time to go
backpacking far away from the city!
WARNING: Long Post.
Here's a general overview of MY EXPERIENCE this summer for those who are curious (or are on break and finally have time to read here on SND) as well as for future reference to those who happen to come across this thread.
I agree that all of my exams for
Anatomy Lecture,
Physiology,
Neuroscience had a ton of clinically oriented questions. I finished the summer term with a 4.0 by changing the way I looked at the material and aimed to understand the concepts inside and out. I spent hours, days, weeks to understand everything in-depth. This led me to find all of these types of questions relatively "simple" just because I knew what was correct and what was not. Don't get me wrong, it has been the hardest summer of my life, but I got through it by not getting behind and using every available resource available.
When I was studying
Anatomy Lab structures, I always studied lecture there as well. It worked both ways. I remember dissecting the infratemporal fossa and identifying the structure there needed for lab exam, but I also tried to connect everything together with problem-based questions just like the gun-shot question below. I also went and talked about the ganglia and parasympathetics in the head with my lab partner as we were dissecting...this made studying for lecture so much easier since we could always think back to the moment when we found stuff and placed it all together in lab.
Neuroscience was the toughest subject to understand and I did have a hard time to understand some things, especially the tracts and their roles. The basal ganglia was fun, but the UMN & LMN lesions were my favorite.
Physiology was the second easiest subject, but still required comprehension of the material to answer all of the questions with confidence.
My final class was the easiest course this summer and very fun to study for. It was a 1 credit
PT course that included 2 written exams (that were specifically scheduled to work with anatomy so we had all of the muscles down) on origin, insertion, action and innervation of muscles (UE exam 1, LE exam 2) and a final practical exam where we drew 4 bony landmarks out of a stack, 5 muscles out of another stack, and 1 dermatome (C2 to S2) out of a final stack. We then had 10 minutes to organize ourselves and performed the clinical type introduction and palpation, testing, identification and explanation of all of these structures to a patient (classmate).
I drew:
Muscles: gracilis, lateral deltoid, extensor carpi radialis brevis, flexor digitorum longus, peroneus longus
Bony landmarks: medial epicondyle of humerus, spine of scapula, head of fibula, base of patella
Dermatome: T1
I introduced myself, and explained to the patient what I was planning to do and asked if she had a sports bra and was okay to take of her shirt for the palpation as well as for her shoes and socks. I then asked for a minute to organize myself as I drew the cards and arranged them to run the practical more smoothly. I started by asking her to stand up and explaining what a dermatome was and and pin-pointed
T1 on her body. I then placed my hand on the lateral side of her elbow and asked her to push into my head while keeping the elbow straight (I also demonstrated) and pinpointed where the
lateral deltoid was. I asked her to turn around and I went on to palpate the
spine of the scapula. I asked her to then face me and have a seat on the examining table. I went on to palpate the
medial epicondyle of the humerus and then explained that I was going to check for a muscle in her forearm. I palpated the muscle belly and tendon of
extensor carpi radialis brevis while asking her to make a fist with her palm down and bend the wrist up and towards her thumb while I resisted the movement. I then asked for permission to go down to the leg and went on to palpate the
base of the patella and
head of the fibula. I then went towards the medial aspect of her tibia and palpate the pes anserine; I flexed her knee and asked her to keep it flexed as I pulled on it so I could feel the three tendons more prominently. I felt the tendon of
gracilis and told her to resist while I push on the inside of her knee (to test for adduction) in order to feel the tendon "pop" into my finger. Afterwards, I went down to her foot and asked if she could point her toes to the floor and bring the outside of her foot towards her nose to palpate the muscle belly of
peroneus longus as well the tendon going posterior to the lateral malleolus. Finally, I asked if she could relax and then point her toes again towards the floor, but this time to also curl her toes down as I tried to resist them in order to palpate the tendons for
flexor digitorum longus. I went on to find the tendon running posterior to the tendon of tibialis posterior running behind the medial malleolus as she did the toe flexion and plantarflexion of the foot.
I remember making my own notecards and getting together with different classmates and drawing them out as we practiced for hours on the weekend. This was very fun and challenging to not only palpate efficiently, but also to organize and make the palpations transition smoothly from bony to muscle to bone all while attempting to make the patient as comfortable as possible.
Here are some sample questions for my 3 toughest courses. Anatomy Lab practicals were just structure identification which you pretty much knew what it was if you studied enough.
Anatomy:
A woman has injured her wrist in a fall, and experiences tingling of the fingers and a weakened grip. A
lateral X-ray of her wrist reveals that her lunate has dislocated and is pressing on the structures within the
carpal tunnel. Which of the following structures are found within the carpal tunnel?
A. Palmaris longus
B. Ulnar nerve
C. Flexor carpi ulnaris
D. Flexor carpi radialis
E. Flexor pollicis longus
A self-inflicted gun shot is producing severe bleeding in the posterior nasal cavity of a 19-year-old woman.
As an emergency measure to stop the bleeding you are asked to ligate (tie off) her right maxillary artery at
its origin. Which artery could still provide its normal blood flow after this procedure?
A. Inferior alveolar artery
B. Middle meningeal artery
C. Lingual artery
D. Mylohyoid artery
E. Mental artery
Neuroscience:
A patient presents to the emergency room with a stab wound to the mid back which severed the left half of his spinal cord.
Which of the following are the likely sensory deficits?
A) No touch/proprioception on R leg, No pain on L
B) No touch/proprioception on R leg,No pain on R
C) No touch/proprioception on L leg, No pain on R
D) No touch/proprioception on L leg, No pain on L
A woman severed her spinal cord at T8 in a car accident visits your clinic for a routine checkup. When you test her left leg pain response it jerks back and her right leg kicks forward. How is this possible?
A. This is a miracle and she can now walk
B. She was faking her injury for workers compensation
C. Her spinal synapses have regenerated her spinothalamic pathway
D. You activated the flexion cross extension spinal reflex
Physiology:
The Babinksi reflex is used to test for damage to the:
A. basal ganglia
B. Golgi tendon organs
C. cerebellum
D. corticospinal pyramidal motor system
E. muscle spindle organs
An elderly nursing home resident has had severe diarrhea for 3 days. He is brought to the emergency room, and blood gases were drawn. The arterial blood sample showed the following: pH = 7.30; PCO2 = 30 mmHg; HCO3 = 17 mEq/L. The most likely correct interpretation of this patient's acid-base status would be:
A. respiratory acidosis
B. respiratory alkalosis
C. metabolic acidosis
D. metabolic alkalosis
E. he has a normal acid-base status
Anatomy: E, C
Neuro: C, D
Phys: D, C
