December 2012


After a loooong day of anatomy finals, in which we thought of nothing else from 9am to 4:55pm, the semester is blissfully ended. Of course, we start up again in the lab on the 2nd, so it isn’t truly over. However, I’m willing to take whatever reprieve they offer.

As celebration (I’m not sure of what; anatomy is awesome), my buddies and I went out for a rainy night of karaoke. Perhaps it’s a New York thing, but the selection was completely off the wall. Admittedly, I’m not much of an American pop person – I’m more likely to sing Tarkan or AR Rahman in the shower, and maybe some Jonathan Coulton classics – so I usually stick to solids like Iron Maiden, The Who, & Hendrix in public. Amazingly, while this place had a songbook 4″ thick, there was nothing from these guys, or even “Life Goes On.” In fact, the only thing I wound up knowing was “Boy Named Sue.”

I don’t think my friends had ever suffered through a poorly sung Johnny Cash remix before. I should probably apologize.

Just when I thought that med students couldn’t take a joke to save their lives (the immuno jokes come from a guy who swapped the clinic for the lab years ago), Dr. D introduced us to the rich tradition of mnemonics.

There are thousands of essential things to remember for clinical anatomy. It’s not just knowing the names of the bones or the muscles, but understanding the development, the interactions, the variations, and how it can all go wrong. Sometime later we’re supposed to learn how to put this Humpty Dumpty back together again. In the meantime, the mantra is simply “don’t kill the patient.” It helps that this is not a concern relevant to our first patient.

As we go through the process of cramming all of the information into our leaky skulls, it’s useful to have a few phrases handy to jog your memory. The older students and professors pass these down with great zeal and ceremony. I’d love to share them all with you, but all the best ones are extremely dirty. Here are a few of the more drab, socially acceptable examples:

  • C5,6,7 keeps the wings from going to heaven
    • The serratus anterior muscles are what keep your shoulder blades flat against your back. Without them, your shoulder blades would fan out like wings whenever you pushed on anything, hence the term “winged scapula.” It’s also responsible for the alarmingly rippled, triangular chest of the western superhero. Yeah, Batman! They’re innervated by the imaginatively titled “long thoracic nerve,” which arises from the 5th, 6th, and 7th cervical nerves. This is one of the few nerves that actually runs on top of the muscle, so it is very easily damaged. The moral of this story is: don’t get into a knife fight…unless you’re Batman. That armor’s better than kevlar.
  • I ate ten eggs at twelve
    • In order for you to breathe, you have to be able to manipulate the pressure in your lungs. Part of this is done with the muscles that run between your ribs, but most of the work is done by the diaphragm, a big muscle that seals the bottom of your ribcage. However, you can’t have a perfect seal; you still have to get food to your stomach and blood to the lower part of your body! To do this, 3 tubes have to pass through the diaphragm: the esophagus, the aorta (the major artery), and the inferior vena cava (the major vein). They do these at different points relative to the vertebrae, which are numbered. The IVC crosses at the spinal level T8. The esophagus goes through at T10, and the aorta goes through at T12.
    • As a bonus, this is how you get hiccups. The only one of those three structures that passes through the muscular part of the diaphragm is the esophagus (the IVC goes through the tendon, and the aorta kinda sneaks in behind everything, right along the spine). The contractions of the diaphragm and the contractions of your esophagus have to be coordinated so they don’t work at cross-purposes. When they get out of synch, you hiccup.
  • The poo-dendal*
    • I bet you can guess where the pudendal nerve is.

*This is actually a new one this year, courtesy of my friend Raven.