I suck at Neuro Cross-Sections and MRIs of Brains

[phoenix89]

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I still have 4 months left for my Step 1, and trying to do Neuroanatomy at the moment, I feel that although my theoretical knowledge is sufficient, I am terrible at cross-sections and radiographic scans.

I am using the Kaplan Videos and High Yield Neuroanatomy; looking at the different cross-sections at different levels (in the diagrams in HY), I have a hard time identifying what section is it, and what the structures (nuclei, tracts etc) are. And the Kaplan videos dont focus much on the cross-sections or radiology either unfortunately.

Any help in what I can do to improve this weak area of mine?

 

[Phloston]

I still have 4 months left for my Step 1, and trying to do Neuroanatomy at the moment, I feel that although my theoretical knowledge is sufficient, I am terrible at cross-sections and radiographic scans.

I am using the Kaplan Videos and High Yield Neuroanatomy; looking at the different cross-sections at different levels (in the diagrams in HY), I have a hard time identifying what section is it, and what the structures (nuclei, tracts etc) are. And the Kaplan videos dont focus much on the cross-sections or radiology either unfortunately.

Any help in what I can do to improve this weak area of mine?

You should take a look at University of Utah Webpath:

http://library.med.utah.edu/WebPath/CNSHTML/CNSIDX.html

If I were you, I'd also arrow back and do some of the examination questions.

Hope that helps,

 

[shan564]

We had to know these pretty well for school... I used Rohan's anatomy atlas.

 

[ipizzy]

I still have 4 months left for my Step 1, and trying to do Neuroanatomy at the moment, I feel that although my theoretical knowledge is sufficient, I am terrible at cross-sections and radiographic scans.

I am using the Kaplan Videos and High Yield Neuroanatomy; looking at the different cross-sections at different levels (in the diagrams in HY), I have a hard time identifying what section is it, and what the structures (nuclei, tracts etc) are. And the Kaplan videos dont focus much on the cross-sections or radiology either unfortunately.

Any help in what I can do to improve this weak area of mine?

It sounds like everything you've attempted to do so far is passive learning. For many (myself included), neuroanatomy will not stick unless you draw out pathways and cross sections (i.e. active learning). For example, for the cross sections of the brainstem, draw out three levels (one for midbrain, one for pons, one for medulla) using your favorite book or atlas and draw in all the nuclei and tracts that are at each level. Next, test yourself by attempting to draw each cross section of the brain stem from memory without using your books or notes. You'll probably suck at it the first time you try to do it from memory, but keep practicing and you will get the hang of it!

Another good (and maybe faster) option is to go get one of those neuroanatomy workbooks and practice identifying structures. Many of these books have blank cross sections with fill-in-the-blank ID questions. I personally am not a fan of this approach...neuroanatomy was one of those things where the time investment of learning slowly and thoroughly paid off, whereas the tendency with workbooks can be to fly through and look at the answers without really trying.

 

[Phloston]

I agree with ipizzy that drawing may help. At the minimum, I would say there's three things you should draw:

1) sagittal cross-section of the brain through the thalamus

2) frontal cross-section of the brain through the thalamus

3) brainstem, posterior view

1 and 2 you can get from HY-Neuro, as you know. 3 you can get from FA2012 (p.455).

All of the other stuff (e.g. brainstem ventral view and spinal cord cross-sections, etc.) is obviously important, but you could probably just nab that from seeing the pictures multiple times. It all really depends on what works for you. The only reason I listed those particular three up above is because that's all I've ever needed to draw out, but that's just me.

Hope that helps,

 

[phoenix89]

It sounds like everything you've attempted to do so far is passive learning. For many (myself included), neuroanatomy will not stick unless you draw out pathways and cross sections (i.e. active learning). For example, for the cross sections of the brainstem, draw out three levels (one for midbrain, one for pons, one for medulla) using your favorite book or atlas and draw in all the nuclei and tracts that are at each level. Next, test yourself by attempting to draw each cross section of the brain stem from memory without using your books or notes. You'll probably suck at it the first time you try to do it from memory, but keep practicing and you will get the hang of it!

Another good (and maybe faster) option is to go get one of those neuroanatomy workbooks and practice identifying structures. Many of these books have blank cross sections with fill-in-the-blank ID questions. I personally am not a fan of this approach...neuroanatomy was one of those things where the time investment of learning slowly and thoroughly paid off, whereas the tendency with workbooks can be to fly through and look at the answers without really trying.

I agree with ipizzy that drawing may help. At the minimum, I would say there's three things you should draw:

1) sagittal cross-section of the brain through the thalamus

2) frontal cross-section of the brain through the thalamus

3) brainstem, posterior view

1 and 2 you can get from HY-Neuro, as you know. 3 you can get from FA2012 (p.455).

All of the other stuff (e.g. brainstem ventral view and spinal cord cross-sections, etc.) is obviously important, but you could probably just nab that from seeing the pictures multiple times. It all really depends on what works for you. The only reason I listed those particular three up above is because that's all I've ever needed to draw out, but that's just me.

Hope that helps,

Thanks a lot guys, these were really helpful advices. I decided to devote the whole day today to just the Brain Stem and memorize each and everything about it by heart AND draw them out as well, and I gotta say it's paying off. I have also discovered this website and it's helping me out tons:

http://isc.temple.edu/neuroanatomy/lab/atlas/C1/

 

[Phloston]

Thanks a lot guys, these were really helpful advices. I decided to devote the whole day today to just the Brain Stem and memorize each and everything about it by heart AND draw them out as well, and I gotta say it's paying off. I have also discovered this website and it's helping me out tons:

http://isc.temple.edu/neuroanatomy/lab/atlas/C1/

Good resource you've posted here. I hadn't realized Temple has such good neuroanatomy.

 

[mdeast]

It sounds like everything you've attempted to do so far is passive learning. For many (myself included), neuroanatomy will not stick unless you draw out pathways and cross sections (i.e. active learning). For example, for the cross sections of the brainstem, draw out three levels (one for midbrain, one for pons, one for medulla) using your favorite book or atlas and draw in all the nuclei and tracts that are at each level. Next, test yourself by attempting to draw each cross section of the brain stem from memory without using your books or notes. You'll probably suck at it the first time you try to do it from memory, but keep practicing and you will get the hang of it!

Another good (and maybe faster) option is to go get one of those neuroanatomy workbooks and practice identifying structures. Many of these books have blank cross sections with fill-in-the-blank ID questions. I personally am not a fan of this approach...neuroanatomy was one of those things where the time investment of learning slowly and thoroughly paid off, whereas the tendency with workbooks can be to fly through and look at the answers without really trying.

I personally wouldn't stress about certain aspects of neuroanatomy. Know it well, but don't stress too much about little things For instance, it's rare for them to even give you a brainstem slice on the exam (i.e. you're never going to have to identify nucleus ambiguous on a brainstem slice). USMLE is moving away from having you identify small details and more towards recognition of clinical scenarios. I'd concentrate on knowing basic structures on brain slices and spinal cord slices. And knowing the major tracts and specifically where lesions would be in certain diseases (and what would be the consequence of that lesion). While there can be a lot of neuroanatomy on these exams, it's mainly going to be identifying a clinical context and less about identifying obscure neuroanatomical structures.

 

[Phloston]

I personally wouldn't stress about certain aspects of neuroanatomy. Know it well, but don't stress too much about little things For instance, it's rare for them to even give you a brainstem slice on the exam (i.e. you're never going to have to identify nucleus ambiguous on a brainstem slice). USMLE is moving away from having you identify small details and more towards recognition of clinical scenarios. I'd concentrate on knowing basic structures on brain slices and spinal cord slices. And knowing the major tracts and specifically where lesions would be in certain diseases (and what would be the consequence of that lesion). While there can be a lot of neuroanatomy on these exams, it's mainly going to be identifying a clinical context and less about identifying obscure neuroanatomical structures.

MDeast is right. For example, I just got a question on USMLE Rx with a frontal brain cross-section with an arrow pointing to a structure (which wasn't very clear), then the question was, "bilateral damage to this structure would result in which of the following?" And you could just infer that they were talking about Kluver-Bucy syndrome, even if you weren't 100% that the structure was the amygdala. At the end of the day, we all already know that the USMLE could ask us anything and everything, so of course we could (and very well might) get minutiae questions, but the clinical correlations are likely at least 85% (arbitrary figure, based on my experience with Rx alone) of the questions.

 

[colts]

how were u able to infer that it was the amygdala, were the symptoms given in the question?

 

[Phloston]

how were u able to infer that it was the amygdala, were the symptoms given in the question?

Honestly, there actually wasn't any information given, but I could tell it was in the general location, even though I wasn't 100% sure it was the amygdala. I only inferred it because there's only so many symptom-presentations that are dependent on bilateral lesions, and Kluver-Bucy is one of them. It means you need to know something but not everything. For example, if they were to tell you that a kid's got problems sleeping, then they give you a transverse cross-section with a posterior, mid-line lesion, but you weren't 100% sure what they were pointing to, you could probably infer they're pointing to the pineal gland (secretes melatonin).

 

[ipizzy]

I personally wouldn't stress about certain aspects of neuroanatomy. Know it well, but don't stress too much about little things For instance, it's rare for them to even give you a brainstem slice on the exam (i.e. you're never going to have to identify nucleus ambiguous on a brainstem slice). USMLE is moving away from having you identify small details and more towards recognition of clinical scenarios. I'd concentrate on knowing basic structures on brain slices and spinal cord slices. And knowing the major tracts and specifically where lesions would be in certain diseases (and what would be the consequence of that lesion). While there can be a lot of neuroanatomy on these exams, it's mainly going to be identifying a clinical context and less about identifying obscure neuroanatomical structures.

While I don't disagree than focusing on clinical scenarios is important, we shouldn't discount brainstem since of the various stroke syndromes that seem to show up a ton on qbanks and NBMEs! It is so much easier to identify the location of a lesion based on clinical presentation when you know what things are close together and what artery feeds them than trying to memorize a list of symptoms. I think drawing slices is valuable for almost any part of the brain, since any part of the brain can give you a clinical problem 😉. Since OP has 4 months to study, he can afford to take some time to put things together in a more thorough way if he wants.