We started our second semester bright and early on Monday morning...and then proceeded to have an ice day today and a delayed opening already on the books for tomorrow. The whole doing-nothing thing is great, but at this point I'm just ready to get back to a schedule. We started our anatomy lab dissections yesterday (large animal this time!), and diving into a goat, horse, and cow is much sloppier than with cats and dogs. Definitely wearing my rubber boots to lab this semester! Other than that we had a brief intro to cardiovascular physiology in the morning and embryology in the afternoon - nothing too taxing. Overall the semester looks like a lot of fun with comparative anatomy, physiology (cardio, pulmonary, renal, gastrointestinal), virology, embryology, behavior, immunology, and more production medicine on the docket.
Christmas break was great between seeing family and friends, spending lots of time with the boy, and shadowing back at the home vet hospital for a few days. It was a really weird transition to not be in a classroom each day or be studying in my apartment each night. Vet school goes quickly but you really do feel as though you've been there forever after only a few days.
I also came back to Raleigh in time to work with the neurology department in the teaching hospital for a week. LOVED it! I'm really having the very serious problem of falling in love with some aspect of every new bit of vet med I encounter. It's not helping the whole "figure out what I want to do with my life" issue. Once again, the senior clinicians and residents were amazing and the fourth-year students were so helpful and great to learn from.
Some of the top things I learned in neurology that week?
1) Neurologists get to actually perform surgery in addition to handling non-invasive cases! Totally did not know that those procedures aren't done by the hospital surgeons. I got to scrub in and watch several hemilaminectomies performed by the neuro residents. These involved slowly drilling away the vertebral bone covering the spinal cord and removing the herniated vertebral disc out of a tiny surgical window. Super delicate work!
2) Use of an MRI is commonly used in a full neuro work-up (yes, even in animals). The imagery is absolutely amazing, and the use of different contrasting agents or exposures lets the physician visualize different things on different views. The use of a single contrasting agent allowed us to perfectly see a hemorrhagic brain lesion in a seizing dog!
3) "Grand mal" is kind of an outdated way to describe seizures. Who knew!
4) Phenobarbital and bromide, the two main drugs of choice for a lot of neurological conditions, are both over 100 years old and still going strong.
5) Neuro sees a lot of dachsunds. A loooot. The breed has vertebral discs that actually calcify by a young age, so instead of being springy and jelly-like and normal, they get hard and brittle and kind of unhappy. Then they like to slip out into the vertebral canal and put pressure on the spinal cord rather than staying where they belong. About 25% of the breed actually develops clinical signs from a herniated disc during their lifespan!
6) Orthostatic tremors are tremors that occur only when the patient is standing still and disappear when prone or moving.
7) I actually probably should remember all of those cranial nerves from anatomy - testing their function is one of the first steps of a neurological exam! Poor functioning of a nerve could indicate a brain lesion in a specific location.
8) Both cancer and an infectious process (like meningoencephalitis) can show up on an MRI in a similar way. At that point, performing a spinal tap to remove and then study cerebrospinal fluid (CSF) is a good diagnostic tool.
9) Loss of deep pain requires a very traumatic and complete lesion or injury and is associated with a much poorer prognosis for the patient.
10) Isolating where a neurological problem is occurring is very much like a puzzle or mystery. Is it peripheral or central? Brain or spinal cord? Complete or unilateral? Which vertebrae? Which part of the brain? Which nerve? You have to use observation, tests, and sometimes a little diagnostic imaging to find the problem and only after it's found can you think about fixing it. Pretty cool!
Tonight my goal is to get some paper reading done and finish my research proposal write-up for my summer work. I've been putting it off out of sheer Christmas laziness, but that is definitely not an excuse anymore!
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