PA school human anatomy vs. undergraduate human anatomy.

[stuffbud]

I am currently taking undergraduate human anatomy before my first semester of PA school starting early May. What are some specific differences between PA school anatomy and undergraduate anatomy that I will encounter? In my undergrad anatomy we cover histology slides, basic functions of muscles/organs, and the more "prominent" blood vessels and nerves. A few random things we didn't cover include: lumbosacral plexus, ear, origin/insertions of the muscles. 

[FfIghter23]

PA school anatomy was def more intense. Yes, you need to know all innervations, origins & insertions, blood supplies, etc...

 

Pick up a Netters anatomy book and flip through it as you will be using and dissecting appx 90% of the book. 

As a PA you may have a patient w/ a shoulder problem w/ weakness. You have to distinguish: 1) is it shoulder related or neck related? 2) What muscles? 3) What spinal levels?... then you go into surgery w/ your ortho doc and you need to know where the major blood supplies are located, where the nerves are, where to cut and where not to cut... you don't want to screw that up ;)

[EMEDPA]

more clinical correlations in PA school anatomy. I did both and between the 2 had a great experience covering all the major A+P issues.

[Z PA-C]

Do you have cadavers in your undergrad anatomy? If not, that will be a huge difference!! Seeing things on the cadavers can be quite different then staring at a picture or diagram as there can be a lot of anatomical variation between different people (especially when it comes to nerves and vessels). Also I found that in my undergrad anatomy we learned anatomy by a system based approach (ie one week was bones, then muscles, then nerves) whereas in PA school we learned everything by region (head, arm, inguinal, foot, etc). I found that learning the anatomy by region really helped me appreciate anatomical relationships along with the associated clinical correlates.

[UGoLong]

We started with a cadaver for each team of 4-5 students. When we finished, it was reduced to rubble. So was my mind from all of the memorization and attempts to pick out little pinned features in other cadavers during tests.  In addition to "what is this?" test questions included things like "what nerve ennervates this structure"

 

Nothing like my undergrad anatomy class.

[EMEDPA]

Ugo- my experience was just the opposite- I had a great undergrad cadaver dissection class with poor physiology component(taught by a marine biologist), but when I got to pa school the physiology was great(taught by md, phd anatomist), but the dissection was only prosections done by the medstudents , which we could view and discuss.

nothing like getting dirty and doing the dissections yourself!

[stuffbud]

Do you have cadavers in your undergrad anatomy? If not, that will be a huge difference!! Seeing things on the cadavers can be quite different then staring at a picture or diagram as there can be a lot of anatomical variation between different people (especially when it comes to nerves and vessels). Also I found that in my undergrad anatomy we learned anatomy by a system based approach (ie one week was bones, then muscles, then nerves) whereas in PA school we learned everything by region (head, arm, inguinal, foot, etc). I found that learning the anatomy by region really helped me appreciate anatomical relationships along with the associated clinical correlates.

Yes we have a cadaver which is quite awesome, however, we don't do the dissections!

[stuffbud]

PA school anatomy was def more intense. Yes, you need to know all innervations, origins & insertions, blood supplies, etc...

 

Pick up a Netters anatomy book and flip through it as you will be using and dissecting appx 90% of the book. 

 

As a PA you may have a patient w/ a shoulder problem w/ weakness. You have to distinguish: 1) is it shoulder related or neck related? 2) What muscles? 3) What spinal levels?... then you go into surgery w/ your ortho doc and you need to know where the major blood supplies are located, where the nerves are, where to cut and where not to cut... you don't want to screw that up ;)

90% of a Netter's anatomy book is daunting as I have just received my textbook for this summer and have been looking at it. However, I look forward to the challenge of the course and I appreciate the information you have provided me!

[UGoLong]

I'm not sure, but this might be one of the pros of not going to a PA program at an institution that also has a medical school. Our's didn't so no prosection. Probably some cons too I suppose.

 

 

 

Sent from my iPad using Tapatalk HD

[EMEDPA]

apparently programs with DPT students on campus often have the PA students looking at their prosections as well.

overall, having a hospital down the hall from the lecture halls had a lot of advantages first year when we had to interview pts, do exams, etc.

[whoRyou]

... I had a great undergrad cadaver dissection class with poom physiology component(taught by a marine biologist)

E: What is or who is 'Poom' physiology?

[EMEDPA]

who- that would be a typo...poor physiology

[whoRyou]

who- that would be a typo...poor physiology

LOL as I was waiting for your answer I thought you were referring to an author? editor? see here http://anatomyacademyonline.blogspot.com/ Additional research conducted by Poon (2013) looked at using blended instruction from an institutional point of view. Poon was able to summarize the benefits and challenges to using blended learning, which I have reproduced below (Poon, 2013, p. 276)

[CStep]

We started with a cadaver for each team of 4-5 students. When we finished, it was reduced to rubble. So was my mind from all of the memorization and attempts to pick out little pinned features in other cadavers during tests.  In addition to "what is this?" test questions included things like "what nerve ennervates this structure"

 

Nothing like my undergrad anatomy class.

Whoa...you're anatomy questions were that easy? 

 

None of our anatomy test questions were single stage questions...everything is two stage or tertiary questions.  Undergrad anatomy didn't even compare to PA school anatomy, an example question looked like this:

 

The arteries that course parallel to the base of the renal pyramid within the substance of the cortex are:

lobar arteries

interlobar arteries

intralobular arteries

arcuate arteries

peritubular capillaries

[Guest JMPA]

 

Whoa...you're anatomy questions were that easy? 

 

None of our anatomy test questions were single stage questions...everything is two stage or tertiary questions.  Undergrad anatomy didn't even compare to PA school anatomy, an example question looked like this:

 

The arteries that course parallel to the base of the renal pyramid within the substance of the cortex are:

lobar arteries

interlobar arteries

intralobular arteries

arcuate arteries

peritubular capillaries

 

at least you had multiple choice, I had mostly fill in. was good times though

[Nitsua805]

 

Whoa...you're anatomy questions were that easy? 

 

None of our anatomy test questions were single stage questions...everything is two stage or tertiary questions.  Undergrad anatomy didn't even compare to PA school anatomy, an example question looked like this:

 

The arteries that course parallel to the base of the renal pyramid within the substance of the cortex are:

lobar arteries

interlobar arteries

intralobular arteries

arcuate arteries

peritubular capillaries

 

Agreed

 

We started with a cadaver for each team of 4-5 students. When we finished, it was reduced to rubble. So was my mind from all of the memorization and attempts to pick out little pinned features in other cadavers during tests.  In addition to "what is this?" test questions included things like "what nerve ennervates this structure"

 

Nothing like my undergrad anatomy class.

Yeah, I'm quite confused. I know I'm posting in a dead thread, but I want to understand what you are saying. Are you saying that your post grad anatomy class was much more difficult than your undergrad given the type of questions such as "what is this," and "what nerve innervates this structure"? And that type of testing was more difficult than under grad? I'm currently working towards becoming a PA; however, at the moment, I'm only at a city college (santa barbara city college), and the anatomy class I am currently taking is much more comprehensive and detailed than those questions. If that is what upper divisional anatomy looks like, then I feel much more confidant with moving forward.

[TPA16]

This is on my quiz tomorrow: I have had a test every day this week so I have had from 7pm today til 1pm tomorrow to memorize all of this. NOTE: I have pretty good time management, there is no way I could have studied for this earlier. Expect similar time frames when you're in PA school. I was an anatomy TA in undergrad and earned an A in the course and as a TA. On my past 3 anatomy tests I have scored 88,81,83. I have studied arguable the same amount for anatomy in undergrad compared to PA school. Anatomy in PA school is just more specific and detailed as you can see with how many subsections of the Neck there are. I do not need to know insertions of muscles thankfully. anatomy tests usually include 3-3.5x this much information as shown below

 

Neck

·       Anterior triangle – SCM, mandible, midline.

-       Anterior digastric, posterior digastric, omohyoid – aid in swallowing and speech. Attach to the hyoid bone, mastoid and mandible and help to form the subtriangles within the anterior triangle.

-       Cervical viscera:

§  Pharynx, esophagus – superior part of the digestive tract.

§  Larynx, trachea – superior part of the respiratory tract.

§  Thyroid gland – anterior to respiratory and digestive tracts.

-       Lateral to cervical viscera à vagus nerve, common carotid artery, internal jugular vein, superior end sympathetic trunk.

-       Structures from superior to inferior:

§  Hyoid à thyroid cartilage of larynx à cricoid cartilage à trachea and 1^st tracheal ring à isthmus of thyroid gland.

-       Structures from superficial to deep:

§  Sternohyoids, omohyoids à sternothyroid, thyrohyoid à thyroid cartilage, cricoid cartilage, 1^st tracheal ring, isthmus and thyroid gland, esophagus.

·       4 subtriangles: muscular, submandibular, carotid and submental.

 

-       Carotid triangle – bounded by the omohyoid, posterior belly digastric and SCM.

§  Hypoglossal CN 12 – supplies motor innervations to the tongue and crosses the carotid artery.

§  Carotid sheath – contains the common carotid, internal jugular vein and vagus nerve.

§  Carotid sinus – dilation at either end of the common carotid or beginning of the internal carotid.

§  Internal & external carotids – lie inferior and deep to the hypoglossal nerve.

§  Superior end of sympathetic trunk on medial side of the common carotid.

-       Submandibular triangle – bounded by BOTH digastrics and inferior margin of mandible.

§  Both digastric bellies are connected by a central tendon.

§  Mylohyoid – forms the floor of the mouth and part of the floor of this triangle.

§  Hypoglossal nerve, superficial facial artery and vein cross over submandibular salivary glands.

-       Submental triangle – bordered by midline of the neck and anterior digastrics.

§  Contains mylohyoid and deep to this muscle, the paired geniohyoid muscles.

-       Muscular triangle – superior belly of omohyoid, SCM and midline of neck from hyoid to sternum.

 

 

·       Posterior triangle – SCM, trapezius, clavicle.

-       Nerves visible on floor of triangle:

§  Brachial plexus, subclavian artery and vein – serve upper limbs.

§  Spinal accessory nerve (CN 11) – lies on levitator scapulae and runs through SCM proximally. Innerves the SCM and trapezius.

Ø  Exits skull through jugular foramen with the internal jugular vein.

§  Phrenic nerve (C3,4,5) – lies on anterior scalene.

§  Cervical plexus (C1-C4) – sensory and motor to skin and muscles of the neck.

-       Muscular floor of the triangle (posterior to anterior):

§  Levator scapulae, scalenus posterior, medius and anterior.

§  Roots of the brachial plexus and subclavian artery pass between the middle and anterior scalenes.

 

·       Pharynx – upper end digestive and respiratory tubes that aid in chewing, swallowing, breathing and speaking.

-       Best visualized in mid-sagittal view.

-       Boundaries: base of the skull superiorly, cricoid cartilage inferiorly (C6), vertebral column posteriorly and posterior nasal and oral cavities anteriorly.

 

 

-       Nasal pharynx – most upper, base skull to the soft palate, contains nasal septum and choanae.

§  Inferior boundary includes the hard palate, soft palate and terminates posterior at uvula.

§  Opening of the auditory tube found on the superior lateral nasal pharyngeal wall.

-       Oral pharynx – soft palate to epiglottis, contains uvula, soft palate and base of tongue.

§  Tongue and underlying genohyoid and mylohyoid muscles.

§  Palatoglossal (lateral and anterior) and palatophyngeal (posterior) arches à palatine tonsils lie between these arches.

-       Laryngeal pharynx – epiglottis to cricoid cartilage of larynx, contains glossopepiglottic fold, epiglottis, laryngeal inlet, piriform recess.

-       Posterior wall is made up of constrictor muscles (superior, middle, inferior).

§  Glossopharyngeal nerve (CN 9) – passes between superior and middle constrictors and lies on the stylopharyngeus muscle.

-       Structures of the posterior pharynx from superior to inferior:

§  Posterior nasal openings – chonanae.

§  Posterior border of the bony medial pterygoid plate is superior to soft palate.

Ø  Tensor palati muscle lies posterior to this plate.

Ø  Posterior to tensor palati is the levator palate, which arises adjacent to the opening of the auditory tube.

§  Terminal end of soft palate – uvula.

§  Base of the tongue à epiglottis à inlet to larynx à esophagus.

 

-       Conchae – 3 bones lined with mucosa to warm and moisturize air entering the respiratory tract.

·       Larynx – superior end of the respiratory tract, prevents food aspiration and contains vocal cords for phonation.

-       Composed of articulating cartilages controlled by the posterior and lateral cricoarytenoid muscles and cricothyroid muscle.

§  Cricoarytenoid – only abductor of the vocal cords.

-       Cartilages of the larynx à thyroid, cricoid, arytenoids, epiglottics.

-       Motor innervations:

§  Vagus nerve (CN 10)

§  Superior laryngeal nerve

§  Internal and external laryngeal nerve

§  Recurrent laryngeal nerve

Ø  Injury to this nerve during thyroidectomy or anterior neck surgery can result in permanent hoarseness.

 

·       Suboccipital triangle – rectus capitus posterior major, obliqus capitis superior and inferior muscles.

-       Superficial – greater occipital nerve.

-       Floor of triangle – vertebral artery, suboccipital nerves.

-       Posterior – lesser occipital nerve, passes posterior to SCM.

-       Contains SCM, levator scalp, bilateral, atlas, axis, spinal cord, external occipital protuberance, vertebral artery and greater occipital nerve.

 

·       Torticolis (wryneck) – spasmodic contraction or shortening of the neck muscles, producing twisting of the neck with chin up ward and to the opposite side.

-       Caused by injury to SCM or avulsion of the accessory nerve during birth.

-       Unilateral fibrosis occurs in the muscle that cannot lengthen with the growing neck.

·       Eagle’s syndrome – elongation of styloid process or excessive calcification of styloid process or stylophoid ligament.

-       Causes neck, throat or facial pain, dysphagia.

-       Pain likely secondary to compression of the glossopharyngeal nerve that winds around the styloid process as it descends to supply tongue, pharynx and neck.

-       Treatment is styloidectomy.

·       Carotid sinus syncope – temporary loss of consciousness or fainting caused by diminished cerebral blood flow that can occur from massage of carotid sinus à slows HR, vasodilation and decreases BP.

·       Cricothyroidotomy – an emergency procedure to obtain adequate airway access by creating an opening through the cricothyroid membrane.

-       Indications: facial trauma, soft tissue injuries to anterior neck, closing of the airway to due an allergic reaction, traumatic injury to the neck such as an unstable fractured cervical spine, burn inhalation injuries, seriously ill patients with structural abnormalities in the neck or when oral or nasal intubation is not possible.

·       Tracheostomy – elective procedure performed in a hospital on about 10% critically ill patients requiring mechanical ventilation using aseptic protocol.

 

-       Indications: prolonged ventilator based respiratory support (respiratory failure), resection of head and neck tumors involving the larynx, tongue, pharynx and base of the skull or laryngeal stenosis or bilateral vocal cord paralysis.  

[moy505]

 

This is on my quiz tomorrow: I have had a test every day this week so I have had from 7pm today til 1pm tomorrow to memorize all of this. NOTE: I have pretty good time management, there is no way I could have studied for this earlier. Expect similar time frames when you're in PA school. I was an anatomy TA in undergrad and earned an A in the course and as a TA. On my past 3 anatomy tests I have scored 88,81,83. I have studied arguable the same amount for anatomy in undergrad compared to PA school. Anatomy in PA school is just more specific and detailed as you can see with how many subsections of the Neck there are. I do not need to know insertions of muscles thankfully. anatomy tests usually include 3-3.5x this much information as shown below

 

Neck

·       Anterior triangle – SCM, mandible, midline.

-       Anterior digastric, posterior digastric, omohyoid – aid in swallowing and speech. Attach to the hyoid bone, mastoid and mandible and help to form the subtriangles within the anterior triangle.

-       Cervical viscera:

§  Pharynx, esophagus – superior part of the digestive tract.

§  Larynx, trachea – superior part of the respiratory tract.

§  Thyroid gland – anterior to respiratory and digestive tracts.

-       Lateral to cervical viscera à vagus nerve, common carotid artery, internal jugular vein, superior end sympathetic trunk.

-       Structures from superior to inferior:

§  Hyoid à thyroid cartilage of larynx à cricoid cartilage à trachea and 1^st tracheal ring à isthmus of thyroid gland.

-       Structures from superficial to deep:

§  Sternohyoids, omohyoids à sternothyroid, thyrohyoid à thyroid cartilage, cricoid cartilage, 1^st tracheal ring, isthmus and thyroid gland, esophagus.

·       4 subtriangles: muscular, submandibular, carotid and submental.

 

-       Carotid triangle – bounded by the omohyoid, posterior belly digastric and SCM.

§  Hypoglossal CN 12 – supplies motor innervations to the tongue and crosses the carotid artery.

§  Carotid sheath – contains the common carotid, internal jugular vein and vagus nerve.

§  Carotid sinus – dilation at either end of the common carotid or beginning of the internal carotid.

§  Internal & external carotids – lie inferior and deep to the hypoglossal nerve.

§  Superior end of sympathetic trunk on medial side of the common carotid.

-       Submandibular triangle – bounded by BOTH digastrics and inferior margin of mandible.

§  Both digastric bellies are connected by a central tendon.

§  Mylohyoid – forms the floor of the mouth and part of the floor of this triangle.

§  Hypoglossal nerve, superficial facial artery and vein cross over submandibular salivary glands.

-       Submental triangle – bordered by midline of the neck and anterior digastrics.

§  Contains mylohyoid and deep to this muscle, the paired geniohyoid muscles.

-       Muscular triangle – superior belly of omohyoid, SCM and midline of neck from hyoid to sternum.

 

 

·       Posterior triangle – SCM, trapezius, clavicle.

-       Nerves visible on floor of triangle:

§  Brachial plexus, subclavian artery and vein – serve upper limbs.

§  Spinal accessory nerve (CN 11) – lies on levitator scapulae and runs through SCM proximally. Innerves the SCM and trapezius.

Ø  Exits skull through jugular foramen with the internal jugular vein.

§  Phrenic nerve (C3,4,5) – lies on anterior scalene.

§  Cervical plexus (C1-C4) – sensory and motor to skin and muscles of the neck.

-       Muscular floor of the triangle (posterior to anterior):

§  Levator scapulae, scalenus posterior, medius and anterior.

§  Roots of the brachial plexus and subclavian artery pass between the middle and anterior scalenes.

 

·       Pharynx – upper end digestive and respiratory tubes that aid in chewing, swallowing, breathing and speaking.

-       Best visualized in mid-sagittal view.

-       Boundaries: base of the skull superiorly, cricoid cartilage inferiorly (C6), vertebral column posteriorly and posterior nasal and oral cavities anteriorly.

 

 

-       Nasal pharynx – most upper, base skull to the soft palate, contains nasal septum and choanae.

§  Inferior boundary includes the hard palate, soft palate and terminates posterior at uvula.

§  Opening of the auditory tube found on the superior lateral nasal pharyngeal wall.

-       Oral pharynx – soft palate to epiglottis, contains uvula, soft palate and base of tongue.

§  Tongue and underlying genohyoid and mylohyoid muscles.

§  Palatoglossal (lateral and anterior) and palatophyngeal (posterior) arches à palatine tonsils lie between these arches.

-       Laryngeal pharynx – epiglottis to cricoid cartilage of larynx, contains glossopepiglottic fold, epiglottis, laryngeal inlet, piriform recess.

-       Posterior wall is made up of constrictor muscles (superior, middle, inferior).

§  Glossopharyngeal nerve (CN 9) – passes between superior and middle constrictors and lies on the stylopharyngeus muscle.

-       Structures of the posterior pharynx from superior to inferior:

§  Posterior nasal openings – chonanae.

§  Posterior border of the bony medial pterygoid plate is superior to soft palate.

Ø  Tensor palati muscle lies posterior to this plate.

Ø  Posterior to tensor palati is the levator palate, which arises adjacent to the opening of the auditory tube.

§  Terminal end of soft palate – uvula.

§  Base of the tongue à epiglottis à inlet to larynx à esophagus.

 

-       Conchae – 3 bones lined with mucosa to warm and moisturize air entering the respiratory tract.

·       Larynx – superior end of the respiratory tract, prevents food aspiration and contains vocal cords for phonation.

-       Composed of articulating cartilages controlled by the posterior and lateral cricoarytenoid muscles and cricothyroid muscle.

§  Cricoarytenoid – only abductor of the vocal cords.

-       Cartilages of the larynx à thyroid, cricoid, arytenoids, epiglottics.

-       Motor innervations:

§  Vagus nerve (CN 10)

§  Superior laryngeal nerve

§  Internal and external laryngeal nerve

§  Recurrent laryngeal nerve

Ø  Injury to this nerve during thyroidectomy or anterior neck surgery can result in permanent hoarseness.

 

·       Suboccipital triangle – rectus capitus posterior major, obliqus capitis superior and inferior muscles.

-       Superficial – greater occipital nerve.

-       Floor of triangle – vertebral artery, suboccipital nerves.

-       Posterior – lesser occipital nerve, passes posterior to SCM.

-       Contains SCM, levator scalp, bilateral, atlas, axis, spinal cord, external occipital protuberance, vertebral artery and greater occipital nerve.

 

·       Torticolis (wryneck) – spasmodic contraction or shortening of the neck muscles, producing twisting of the neck with chin up ward and to the opposite side.

-       Caused by injury to SCM or avulsion of the accessory nerve during birth.

-       Unilateral fibrosis occurs in the muscle that cannot lengthen with the growing neck.

·       Eagle’s syndrome – elongation of styloid process or excessive calcification of styloid process or stylophoid ligament.

-       Causes neck, throat or facial pain, dysphagia.

-       Pain likely secondary to compression of the glossopharyngeal nerve that winds around the styloid process as it descends to supply tongue, pharynx and neck.

-       Treatment is styloidectomy.

·       Carotid sinus syncope – temporary loss of consciousness or fainting caused by diminished cerebral blood flow that can occur from massage of carotid sinus à slows HR, vasodilation and decreases BP.

·       Cricothyroidotomy – an emergency procedure to obtain adequate airway access by creating an opening through the cricothyroid membrane.

-       Indications: facial trauma, soft tissue injuries to anterior neck, closing of the airway to due an allergic reaction, traumatic injury to the neck such as an unstable fractured cervical spine, burn inhalation injuries, seriously ill patients with structural abnormalities in the neck or when oral or nasal intubation is not possible.

·       Tracheostomy – elective procedure performed in a hospital on about 10% critically ill patients requiring mechanical ventilation using aseptic protocol.

 

-       Indications: prolonged ventilator based respiratory support (respiratory failure), resection of head and neck tumors involving the larynx, tongue, pharynx and base of the skull or laryngeal stenosis or bilateral vocal cord paralysis.  

 

Sent you a PM!

[db_pavnp]

This is on my quiz tomorrow: 

 

Man, this all looks painfully low yield.

[JDayBFL]

Man, this all looks painfully low yield.

Anatomy is the bread and butter of medicine and surgery. It may seem low yield but I have gone back to anatomy too many times to count during clinical medicine.

[db_pavnp]

I do imagine you have referred to "anatomy" too many times to count.