Cranial Nerves

This weeks dissection finally came to a head, literally. We sawed into the skull to remove the most important and complex organ in the body.

The Brain

It was likely the most fascinating dissection yet and breaking the brain into its parts and functions has been no simple task. With a test slated early this week, we are feverishly cramming as much information, as humanly possible, into our own heads.

Specifically, the cranial nerves pose a threat to a decent grade. In an effort to help the student who has to learn them too, I have included resources that I found to be beneficial. These include memory aides, mnemonics, charts, and more. If you have suggestions of your own, please post them in the comments to share.

Cranial Nerves

• David Darling online encyclopedia - includes great links to individual nerves
  
• Chart including nerve components, functions, and pathways
• Extensive list of mnemonics
• Easy memorization technique for the nerve components (shown below) by a former student

"Great Virginia, Sweet Virginia, G Veg Save! SSA does two and eight."

The "G Veg Save" part confused me at first – obviously it helps you remember to list GVE, but then you continue onto the next line so you can finish spelling "Veg", giving you a lonely G. So you finish that line with a "SA", then put "SVE" on the line after that, so that you (sort of) spell "SAVE." Giving you:

GVA –
SVA –
GVE –
GSA –
SVE –
SSA – II & VIII

Now, which cranial nerves have a whole bunch of components in them? VII, IX, and X, right? So fill in the list like this, leaving spaces as indicated – the GVA list is complete and doesn’t need a space:

GVA – VII, IX, X
SVA – ___, VII, IX, X
GVE – ___, VII, IX, X
GSA – ___, VII, IX, X
SVE – ___, VII, IX, X
SSA – II & VIII

Now, start counting in odd numbers to fill in the spaces (you’ll use V twice, otherwise you’d be listing VII twice for SVE. So your list looks like this now:

GVA – VII, IX, X
SVA – _I_, VII, IX, X
GVE – _III_, VII, IX, X
GSA – _V_, VII, IX, X
SVE – _V_, VII, IX, X
SSA – II & VIII

Add XI to the SVE list, because it belongs there.

GVA – VII, IX, X
SVA – _I_, VII, IX, X
GVE – _III_, VII, IX, X
GSA – _V_, VII, IX, X
SVE – _V_, VII, IX, X, XI
SSA – II & VIII

So what’s missing? Of course, GSE! And for GSE, list the cranial nerves that don’t show up anywhere else in the lists, plus III.

GVA – VII, IX, X
SVA – _I_, VII, IX, X
GVE – _III_, VII, IX, X
GSA – _V_, VII, IX, X
SVE – _V_, VII, IX, X, XI
SSA – II & VIII
GSE – III, IV, VI, XII

Best of luck to all those who have to endure this complicated study. For more enlightening materials discussing the brain, consider these books.

Upon Further Examination

To fully investigate all aspects of my experience, I'd like to welcome my wife as a guest blogger for this week's post. Consideration of those friends and family members who are affected by my decision to attend medical school is important - especially since I'm married.

Willow

Thanks for the invitation, Josh. Here's my two cents on, Life as a Medical Student's Wife:

I was fortunate Josh knew he wanted to pursue medical school when I met him six years ago. Witnessing the satisfaction he received from previous involvement in the field has been crucial in helping me to be continually encouraging throughout the constant requirements and expectations that school demands. Although I'm not the one sitting in front of a book every night trying to soak in endless pages of information, medical school for me has been equally demanding of my time- and lack of time- with my husband. It has been crucial that I involve myself in my own career, community and personal interests as diligently as he is involved with school. Without my own schedule, having a husband in medical school would never work for me.

Moving to a new location, regardless of the field of study you are entering, always integrates a period of transition. Fortunately my career moved with me, so I did not have to find a new job, but socially it has been difficult to find women in the Las Vegas area who are not solely interested in clubbing on the strip, shopping or eating out for entertainment. Since I work from home as a designer for a company out of state, the ability to connect with women in the work field is difficult. So, I started teaching yoga at a gym and have found many interesting people from all walks of life congregate for fitness. Having an additional social outlet outside of my marriage has been integral in keeping my personal sanity during medical school.

In my Utopian ideals, I believe you should connect with your spouse on a daily basis. Early in our marriage I read it was important to have at least 20 minutes alone everyday with your spouse without interruption in order to maintain a healthy relationship. That usually happened. Since medical school, I have learned to be flexible regarding how, when, and where that connection happens. All the wives I've talked to dread block weeks- I am lucky if I get five minutes of undivided attention. I'm also left doing all of the "chores" on my own, and suddenly I realize just how often Josh really does the dishes. The school let us know up front that the schedule would be demanding, and our relationship has had to adjust to those demands. Having that forewarning has helped us keep the demands in perspective and adjust our needs appropriately. Sometimes this happens more easily than others.

Thanks for sharing Willow, you have been extremely supportive and flexible. To see what she has been up to lately, check out her Fresh Squeeze.

Clinical Corner

Tools of the Trade

Learning clinical skills requires knowing how to use the tools at our disposal. Diagnostic sets that include an otoscope and ophthalmoscope come in many shapes, brands, and styles. Welch-Allyn tends to hold the gold standard in this arena and rightfully so. They guarantee their products to students as long as they are in medical school or residency. With that, the prices don't seem so bad.

Although my wife is greatly supportive of my endeavors, she still has a hard time swallowing how this small package of tools can be so costly. Thanks for sitting patiently as I used my new equipment to practice my exams, did I mention how great your eardrums look?

Financial Pill Popping

With a new year comes new policy that may have significant change in how future physicians practice medicine. The Pharmaceutical Research and Manufacturers of America (PhRMA) has adopted a new code of conduct that goes into effect January 2009.

Prescription

Making drugs to fill prescriptions is a difficult task requiring years of research, money, and physicians who will prescribe them. A large sum of money is used to buy cheap pens, "free" lunches, or even more lavish gifts that entice clinicians to write a prescription for the latest wonder drug.

PhRMA has revised their code of conduct to put an end to the handouts among their distributing members. Freebies would otherwise raise the ethical question, "is my doctor prescribing this for my best interest or theirs?" Since handouts cost money, drug companies have to increase the cost to the consumer to pay for them. Why not spend the money to produce better pharmaceuticals through well funded research using the money allocated to the 'perks' column in the budget?

Medical students and practicing physicians alike will have to adjust to drug reps without cheesy stationary and edible giveaways. Perhaps the students will be fortunate to never know this ethical dilemma. Although the code attempts to curb the compensations, pharmaceuticals still remain a business that will get money in its pockets any way it can.

Clinical Corner

Blood Donation

After years of putting it off, I finally donated my blood to help the cause and it just so happens to be the National Blood Donation Month. It cost me one hour, one pint of blood and a couple signatures. In return I received one hole in the arm, a purple bandage wrap and the opportunity to help treat and potentially save the life of a patient as a medical student. Blood banks are often in great need of donors as so many patients require transfusions. If you are looking for a great way to serve, consider donating blood and helping those in need.

Semester Two

The vacation is over and it's time to get back to work. Our semester looks to be packed with all sorts of fun.



New Year

With the new year, of course I would like to say that my resolution to study late into the night every night and stay on top of things is fitting. I know myself better than that. Although I intend to be diligent, the faculty at Touro University have also scheduled quite the load this time around.

We will finish our anatomy studies which will be replaced with neuroscience. From the second year students we hear great things about this course's difficulty. I'm sure it will show up here in some form of stress relief. Histology, physiology, OMM and physical diagnosis will continue to be a part of the curriculum throughout the remainder of our first year experience. To top things off they have included a medical jurisprudence course. Don't ask me how, but apparently this semester has less credit hours than the previous.

Being ill for the greater part of the holidays may have put a damper on things, but my recreational side could not be deprived. After all, I live in Fabulous Las Vegas and had to take advantage of the time away from school. Had I purchased all the needed books and equipment at the begining of the year, there is a good chance I wouldn't have even thought of school over break. In the meantime I am enjoying the remaining hours of my vacation. I hope you have a great and happy new year.