Human Anatomy at Colby

We made the paper!

January 31, 2013 · Comments Off on We made the paper!

Check it out! We made The Morning Sentinel.

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Grand Rounds: Cancer and Mental Illness

February 1, 2017 · Comments Off on Grand Rounds: Cancer and Mental Illness

Grand Rounds Presentation from Amy Bruce, Sandra Ntare, Charlee Manigat

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Lauren Shirley: My Experience in BI265j

February 24, 2015 · Comments Off on Lauren Shirley: My Experience in BI265j

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Anatomy and physiology form the cornerstone of medicine. Without A&P, medicine as a field would fail to exist. Thus, as a premed student, I saw it as my duty to take A&P to give myself a solid background for my other medical interests and the internships I hope to pursue. After working in a cadaver lab for several summers where I completed dissections of many different joints, I imagined that I had a fairly solid background in anatomy. Additionally, my experience as an EMT and the basic anatomy and bodily processes I had learned as part of my training should make this easy. Right?? Boy was I wrong.

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The musculoskeletal anatomy that I had mastered in my lab before was approximately two hours of lecture in a month-long class. My imagination had certainly underestimated the breadth of the class and the many different topics that would be covered. While my previous experiences definitely helped me a little, they gave me nowhere near the advantage I imagined.

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I was most challenged by the pace of the class. As we conquered a new body system each day, in both its anatomy and its physiology, there was little time to absorb the details of each system. Rather, the class served as an overview of many main components and processes within the body. We covered everything from the skeletal framework of the body to the minute electrical conduction pathways in the heart, and none of it really got half the time it deserved. However, this class did give me a new appreciation of the miracle of the human body and its myriad evolutionary advantages. I cannot even comprehend the different evolutionary events that would have had to occur for it to reach its current state.

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Organs we take for granted, such as the eye or ear, give us a plethora of information about the world around us. While I knew the basic function and makeup of these organs before the class, I had no idea about their underlying intricacies. I was fascinated by the different components that makeup our vision. While the rods in our eyes give us “night vision,” it lacks the color and “high definition” quality that cones provide. While these components appear in different densities in different places on the retina, the brain is able to take in all of the information, which synapses through the optical nerve to create a coherent image of our surroundings. It was information such as this that I learned in the class which gave me a new appreciation for the human body and its physiology.

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While this class definitely pushed me to learn a maximum of information in a minimum of time, I really ended up enjoying the Anatomy and Physiology class and would highly recommend it to any other students who are considering taking it for Jan Plan in the future. However, my advice to these students would be this: you get out of the class what you put in to it. Your interest and effort is key to your success in and enjoyment of the class.

 

 

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Allison O’Connor: My Overall Experience in BI265J

February 24, 2015 · Comments Off on Allison O’Connor: My Overall Experience in BI265J

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This January 2015, I had the opportunity to take Anatomy and Physiology with Dr. Klepach. The human body and the way it functions has always intrigued me, but Anatomy and Physiology was not offered at my high school, so I never had the opportunity to explore this interest in a formal classroom setting. So, the JanPlan A&P class presented me with the perfect opportunity to explore my interests and officially learn about the human body and the reasons behind why it functions the way that it does. This class was even more important, since I am planning to pursue a career in medicine, and I think that basic background knowledge of human anatomy and physiology is imperative for future success in medical school and beyond.

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For most of my life I have been pretty confident that I wanted to pursue a career in medicine and when I got to Colby I was very certain of the fact that I was going to take the pre-requisites necessary for medical school so that I could go on to med school right after Colby. Over the past few semesters I took many of the pre-med classes along with and EMT course. Classes at Colby were a little bit of a rude awakening for me, and I did not perform as well as I was used to, despite putting in more effort than I had in high school. Because of this my confidence was shaken. This along with a variety of personal setbacks and health issues prompted me to question my decision to pursue a career in medicine. Coming into this JanPlan I felt like I had a lot to figure out regarding my plans for the future. I was very excited for this class because of my aforementioned interest in anatomy and the functioning of the human body, but I was also anxious since this class had a reputation for being incredibly challenging and a lot of work. I found that the rumors about Anatomy and Physiology were true, however I enjoyed every minute of the course and definitely learned way more than I could have ever anticipated-not just about anatomy, but also about myself and the way I learn as well as stress-management techniques. Dr. Klepach created a classroom environment that took the focus off of grades and switched the focus to actually learning the material while maintaining a healthy lifestyle (eating three balanced meals a day, getting eight hours of sleep each night and trying to manage our stress levels). It is often too easy to get caught up in the grades that you get on an exam or to stress about the final grade that you receive in a class and in all of this worrying about the end result you forget to enjoy the learning along the way. I also have always struggled with managing my stress levels and don’t always get as much sleep as I should on a given night. The classroom environment that Dr. K created for A&P this JanPlan really gave me the space to focus on changing my habits and remind myself of how much I love learning when I am not worried about grades.

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Anatomy and Physiology was one of the most engaging, interesting and challenging courses that I have taken at Colby thus far, and the course helped me rediscover my awe and amazement toward the human body and reconfirmed for me that I want to pursue a career in medicine. I consider myself incredibly lucky to have spent the month of January learning about the human body, learning about myself and creating habits that will serve me well in the rest of my Colby career and beyond.

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Rachel Bird: Flipped Classroom

February 24, 2015 · Comments Off on Rachel Bird: Flipped Classroom

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When I showed up to the first day of my Introduction to Human Anatomy and Physiology JanPlan class, the professor, Dr. Klepach, told us that, for the first week (and maybe longer), we wouldn’t be having a typical lecture-style class. Instead, we were expected to watch podcasts of the following day’s lesson and come up with questions to go over with our classmates. Then, during the lecture block, we would be doing activities and having discussions about the material we had reviewed the night before. After lecture, we would go to the lab for 90 minutes to review anatomical structures and study histological slides in preparation for our lab practicals. As a student athlete with two jobs on campus, having an additional hour and a half of podcasts to watch outside of class, in addition to the homework and studying that was already expected of me, was pretty overwhelming. An average day for me started at 5:45am, when I woke up for morning practice, and then I was either at work, class, practice, or reviewing for the next day’s lecture until I crashed in my bed at night. However, as taxing as the first week of JanPlan was for me, the flipped classroom experiment definitely did pay off in some ways.

For one, it allowed my classmates and me to do fun, interactive activities during lecture block, instead of just sitting listening to a professor talk. One day, during a lecture block devoted to neuron firing and cell physiology, we split into groups and acted out the different types of graded and action potentials. Understanding the electrochemical gradient was a lot easier when I could see my classmates passing through a doorway to achieve an even number of students on each side!

Another benefit to the flipped classroom is that I went into class each day feeling far more prepared and ready to learn. In a fast-paced, content-heavy course like Anatomy and Physiology, it definitely helped me to be able to come to lecture already prepared with questions from the lecture. Given that we were trying to fit a full-length college anatomy class into only three and a half weeks of JanPlan, it was really important to be prepared for class and stay on top of the material. The recorded lectures were helpful in this way because if I missed something while taking notes or needed more review on a topic, I could just pause of rewind the video to the section I wanted to watch again. However, the fact that the lectures were recorded meant that I couldn’t raise my hand to ask the professor a question when it occurred to me, and I would need to wait until the next day for clarification, usually when the topic was no longer fresh in my mind.

As interesting as the flipped classroom experiment was, I was glad when the class voted to return to a normal lecture style for the remaining weeks of JanPlan. Not only did a standard lecture structure allow me more time for athletics and my job, I also felt less stressed about trying to find a 90 minute or longer block of time where I could watch the lectures. Luckily, the PDFs of the lecture slides, and all of the podcasts, were still available through the class website, so if I missed something in class I was able to go back after and review. Although I think that a flipped classroom would probably work better during the regular semester, as opposed to JanPlan, which is already hectic, it was definitely an interesting experiment that forced me to work on budgeting my time and planning out my day so that I could fit in all my commitments.

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Alexandria Lucas: Meeting with High School Anatomy Students

February 24, 2015 · Comments Off on Alexandria Lucas: Meeting with High School Anatomy Students

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In high school, I never had an opportunity similar to this one in which I was able to visit a college science class and interact so directly with the college students and the material they are learning. Not only did they get to come and visit, but they were able to dissect a pig’s heart and we were there to help them do it! I do not know what have been a cooler fieldtrip in high school than this one.

It was very interesting and engaging because as we walked around and took them through the lab exam we had just taken, they could identify some of the anatomy and share knowledge about things we may not have learned because they too were currently in an anatomy class. In addition, it was helpful to be in the teaching role as we described and identified the anatomy on the different models. I think this truly works as a way to understand and learn the material better, and is not often a position that us college students are in. This particular lab test was on the heart, eye, ear, and the brain.

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After taking them around our lab exam, we went downstairs to dissect the pigs’ hearts. Each group had their own heart to dissect, and it was both an opportunity for the students to learn about some of the anatomy we had just reviewed as well as to explore whatever pieces of the heart they found intriguing further. Some groups dove right into ripping apart the heart, while others took more reserved action and precise cutting to open the heart.

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The purpose of this field trip was initially supposed to be meeting with the students to help them come up with ideas for the Maine Math and Science Alliance Science Fair. Because of our current class, we brainstormed ideas that directly related to anatomy and physiology, such as do different styles of music have an effect on the heart rate, or do different color filters of light effect pupil dilation in similar or varying ways.

Perhaps my favorite part of the day, which was the only unplanned part as it happened, was answering questions the group of students I was showing around had on college science classes, premed requirements, college class schedules, and more. Before I came to Colby, I truly had no idea what college was like, and needless to say I also had no idea how classes, lectures, exams, etc. operated. They were very curious about what a typical day looks like and what is different about high school classes versus college classes, and the two biggest things I shared were that exams make up very large portion of your grade particularly in science class, for very infrequently do you have daily homework assignments that significantly contribute to your grade like in high school. I also shared the much greater need for independent learning and studying in college, for it is your responsibility to make sure you understand the material covered in class during lecture and to study outside of class if you don’t. It was fun to be able to reflect on the time I have had here at Colby so far and share my learning and knowledge with students who will soon be headed off to college themselves.

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Mayra Arroyo: A Healthier and Happier Me

February 24, 2015 · Comments Off on Mayra Arroyo: A Healthier and Happier Me

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During the 4 weeks of class I learned so much. Not only anatomy, but I also learned a lot about my lifestyle choices and my study habits. Before taking this class, I had never really thought about how the choices I made affected my learning and my health. One clear example is the number of hours I sleep. I was used to sleeping at 12 am or later and snoozing for an hour every morning. After sleeping at 10 or 11 pm every night and waking up 6 or 7 am, I was able to see a difference in my energy levels through out the day. I did not have to take naps during the day and I also did not have to drink coffee to stay awake during the day. This allowed me to be extremely productive and be fully concentrated on what I was doing.

Another example is eating breakfast. I was used to waking up too late and not having enough time to go to breakfast. With my new sleeping habit I was able to go to breakfast every morning. I was the most proud of this new eating habit, not because I started it, but because I was able to continue it the whole month without quitting.

The last lifestyle change I made occurred the last week of class after watching “Sugar: The Bitter Truth”. I started to remove all juice from my meals. I have always known that soda is extremely bad for a person’s health, but I wrongly assumed that juice was not as bad. After watching this video I learned that juice is equally as harmful, and have stopped drinking it. Although I have not been prefect and have had juice, I am much more conscious about drinking water instead of juice at every meal. I also learned from this video that many of the things that we eat today contain fructose, even things that most people would not even think, such as baby formula. This was absolutely shocking and horrifying. I have started to look at the labels of food in hopes to reduce my consumption of fructose. I know these small changes will make a huge difference to health.

This class not only helped me become a healthier individual, but it has helped me become a better student. One way is that I am now a more organized. I have started to make lists in ranking of importance of things I need to accomplish each day. This has not only helped me be more organized, but it has also helped me to prioritize. This was significant for this class, because there was a lot of material. I had to focus on the most important ideas concepts, because it was impossible to study every single topic thoroughly. Although these changes may seem minor, they are not because this is the start I needed in order to become better and healthier student. I plan to continue these new habits during the spring semester and beyond.

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Laurel Edington: MMSA Mentoring Session

February 24, 2015 · Comments Off on Laurel Edington: MMSA Mentoring Session

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One of my favorite parts of this month was mentoring high school students involved in the Maine Math and Science Alliance. Each grand rounds group was paired with two high school students. The two girls my group worked with were named Shea-Lynn and Cierra. Shea is a home-schooled junior and Cierra is a sophomore at Dover-Foxcroft. The plan for the day was to show them around the lab, talk to them about anatomy and physiology, and help them come up with ideas for a science fair project.

Before the students arrived, we took our second lab practical and then walked around talking about the answers to the exam so that we could show the high school students what we have been learning over the past week.

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IMG_5584            When they arrived and we were in our groups, we went through the entire exam with them. We all looked at the models and slides, explained the answers to each question, and explained the functions of each anatomical structure. This was great because it reinforced the material. Over the past few days I had been trying to memorize all of the structures of the neurons/spinal cord/brain, eyes and ears, and the cardiovascular system. By explaining the structures and functions to Shea and Cierra, it helped me to learn and understand the material even more.

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After the lab tour, each group dissected another pig heart since there were some hearts left over from the week before. I was really excited that I was able to be involved in a dissection on this day because I wasn’t able to be in class when we did the dissections the week before. Shea and Cierra, although a little timid at first, dove right in and were able to find the aortic and pulmonary valves very quickly. They did the of the dissection while we instructed and did a little demonstrating.

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The last part of the day (after a quick lunch break) was used to help the students come up with topics for science fair projects based on anatomy and physiology. Cierra’s family owns a farm with over 50 beef cows so she wanted to do a project based on livestock. Together, we all came up with the idea of seeing how different types of food affect the growth of the cows. If she did this project, she was thinking of finding the mass and other size measurements for the cows of different ages and comparing the measurements between the cows that were fed hay and the cows that were fed grain. Shea was interested in determining if different emotions caused changes in blood pressure and heart rate. We talked about having people watch different videos that would cause them to experience different emotions and then she would take heart rate and blood pressure measurements before and after the videos to detect any changes. This day was very rewarding because we were able to reinforce what we have been learning, help high school students become excited about science, and we were able to have a great time.

 

 

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Ivan Yang: My experience in A&P

February 24, 2015 · Comments Off on Ivan Yang: My experience in A&P

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Even though I am a molecular biology major, I had not taken any biology courses in the fall semester, so my advisor highly recommended me to take a biology course for JanPlan. After checking the course listings for January, I decided on a whim to sign up for the Intro to Human Anatomy and Physiology course. Later that week, I met someone who had taken the course last January. She informed me that if I was to take BI265, I would have to be prepared to learn a lot in a small amount of time. There was a wealth of interesting knowledge to be gained from the course, but, she warned, if I was expecting to cruise through JanPlan, I should drop the course. Not sure if I should take her seriously or not, I laughed it off and didn’t think about her words much after that.

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After the first week, I definitely knew that this class was not to be taken lightly. The first week was especially rough because of the flipped lecture setting. Not only did we have to study for daily quizzes and lab exams, but also we had to listen to lecture and lab podcasts for the following day’s lecture and lab sessions. I was completely unprepared, and I was forced to adjust my mentality, my study schedule, and my lifestyle habits. However, while there was a seemingly surreal amount of work involved in the course, the amount of material that I absorbed during the four weeks of JanPlan truly astounded me. In addition, after putting in maximal effort just to learn the basics of human anatomy and physiology, I gained deep respect and admiration for the structure and workings of the human body. I truly came to enjoy the class and the subject, and soon enough I found myself embracing Dr. K’s recommended healthy lifestyle habits.

Beyond learning material through lectures and labs and finding a healthy lifestyle balance between working and resting, I also had many opportunities to do things that I had never done before. For example, for the first time in my life, I had the opportunity to perform a wet dissection of a pig heart. Although I was confused at first due to initial difficulties in matching the neatly-drawn heart schematics in my mind with the real deal in my hands, I thoroughly enjoyed the experience of opening the heart with my own hands, placing my fingers through the valves and blood vessels to see where they connected, and seeing how the real tissues and membranes of the heart correlated with the models in our anatomy lab. In fact, I’m sure I would have enjoyed the experience even more if my partner and I had remembered that there were scalpels available for use in the dissection (we had to cut through a very thick ventricular wall with a very small pair of scissors – if you are taking the class and haven’t done the wet dissection yet, REMEMBER that there are scalpels available for use).

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In sum, BI265 was a welcome and intellectually stimulating challenge. I absorbed a great deal of anatomy and physiology in the last four weeks, worked with wonderful classmates and a great professor, and learned about myself, my study and lifestyle habits, and stress management. I would recommend this class to anyone interested in thinking and in challenging his/her intellectual limits.

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The blood vessel model – my best friend during the weekend before the second lab test.

 

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Ariel Oppong: A Memorable Aspect of Anatomy and Physiology- ART!

February 24, 2015 · Comments Off on Ariel Oppong: A Memorable Aspect of Anatomy and Physiology- ART!

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During the first week of class we made a trip to the Colby Art Musuem. Since the Art museum opened during the summer of 2013 I had only actually participated in one small tour. I feel like a version of myself enjoys art and objectively recognizes its value but a version of myself that is more present on campus does not really have the time or make the efforts to appreciate art. Thus, I was happy we went.

While we were there we completed a scavenger hunt that required our knowledge of different human muscles to find the art pieces that matched with eight different short stories and descriptions. We were allowed to work together or to work in groups of three or less.

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After we completed the scavenger hunt we were asked to find a piece of artwork within the museum and to create our own question/description of the artwork with the central usage of a certain muscle being used by the characters or subjects in the artwork. For my question I decided to make focus on a 1997 piece of artwork called Leader by American artist, Betye Irene Saar. Born in Los Angeles, California in 1926, she has been known to incorporate collage and assemblages into statements of political and social protest.

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In this picture, a strong woman is standing and maintaining the trunk of her body in a firm position. This position represents the woman’s strong presence in the family dynamic of families of this ancestry. Because of the importance of her stance as a symbol for other aspects of her womanhood, I decided to focus my piece on a large muscle that helps the main subject hold that stance: the gluteus Maximus.

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The gluteus maximus is the largest and most superficial of the three-gluteal muscles (including the gluteus medius and the gluteus minimus). The gluteus maximus is proximally attached to the outer surface of the ilium and is distally attached to the superior and lateral surfaces of the greater trochanter of femur. As the largest and strongest muscle in the body, the gluteus maximus is both important in being responsible for the movement of the hip bone and thigh but in also in creating a shape to the human body and creating the appearance of hips. I really enjoyed learning more about Betye Saar, her work, and her work’s impact on general society. At first our student created scavenger hunt questions were supposed to be consolidated into a new list of synopsis for high school students to look at when they came to visit Colby early the following week. However, due to some logistical issue the students were not able to complete the scavenger hunt. Instead of completing a hunt, the high school students completed a heart dissection with us, The day prior to the students’ arrival on campus we had completed an almost trial run like heart dissections on our own in the lab. I enjoyed learning on my own and then showing the high school students different anatomical parts of the heart because it allowed me to see what aspects of the lessons before I was and was not retaining.

 

 

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Calvin Robbins: My Celiac Disease Story

February 24, 2015 · Comments Off on Calvin Robbins: My Celiac Disease Story

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Every year, the BI 265 Jan Plan class holds student run Grand Rounds presentations. A Grand Round presentation is usually done by a doctor and patient (or actor) in front of other doctors to educate them of a surprising finding or elusive diagnosis, thereby helping the doctors in attendance better diagnose the problem in the future. This year a group presented about a man who had Celiac disease but presented as a cardiac patient (check out Ari, Danielle, and Laurel’s Grand Rounds presentation on celiac disease). It inspired me to tell my own story of being diagnosed with Celiac disease.

When I was 10 years old, I started to notice that when I coughed, there were small specks of blood in the mucous. Originally this was dismissed as an issue with dry air, as it was winter at the time, but as time passed, it was recognized as a larger problem.

The obvious assumption was a respiratory issue, so I had X-rays done which showed a very mild case of pneumonia. Soon the Pneumonia was treated but the blood in the mucous remained. Next came a series of blood tests, consultations, more blood tests, MRIs, X-rays, and still more blood tests, of which the only result was slight anemia. Guesses ranged from Acute Interstitial Pneumonia to tuberculosis to cancer, to a stomach ulcer, but every test came back negative. Doctors wanted to do a lung biopsy to check for AIP but my parents elected to wait for the Celiac results as a lung biopsy is invasive, carries a high risk of infection and would have had a long recovery period for an active 10 year old.

Finally, after about 3 months into an attempted diagnosis, a blood test was performed to test for Celiac Disease. The test was positive. An endoscopy was performed to verify Celiac Disease, as blood tests are not 100% accurate. The doctors discovered an abnormality in the small intestine: the villi were heavily flattened. Given this new insight, and after about a month of a gluten free diet, the blood speckling disappeared.

Celiac Disease is a genetic disease in which the body has an immune reaction to the presence of gluten, a protein found in wheat, rye, and barley. After blood testing it was found that my father and sister, who was asymptomatic, both have Celiac Disease, while my mother does not. From my family you might guess that it is recessive, but the actual inheritance mechanism is still unknown. Worldwide, it is estimated that about 1% of people are diagnosed with Celiac disease while most people with Celiac Disease actually remained undiagnosed.

Sticking with the theme of Grand Rounds, my case was actually presented as a Grand Rounds discussion by Dr. Andrew Filderman once the diagnosis was reached. It is thought that these types of atypical situations go undiagnosed or are improperly diagnosed most of the time they are presented, so spreading information about Celiac Disease is an important step in providing better care to patients.

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Lauren Shirley: BI265J and Personal Health

February 24, 2015 · Comments Off on Lauren Shirley: BI265J and Personal Health

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One interesting aspect of BI265j was the emphasis that Dr. Klepach placed on personal health. On the first day of class, we were given sheets to track our sleep, exercise, stress, and eating habits. Initially, I was overwhelmed with the amount of information to absorb and the sheer scope of the class. Suddenly, I was trying to fit 4 hours of class, three hours of lecture online, sufficient exercise, three square meals and at least eight hours of sleep into a day, not to mention the actual studying part of learning for the class!

The first week was a bit rocky for me: trying to learn to use my time efficiently enough to get everything done while not succumbing to mental exhaustion at the amount of information I was trying to absorb was a challenge to say the least. However, switching back to a traditional classroom environment from the flipped environment was a lifesaver! By eliminating two hours of lecture from my homework load, I had sufficient time to study and exercise. I was able to go to the gym almost every day of the week (when I wasn’t fighting a flu).

I really enjoyed having part of the class be about maintaining our own personal health as a means to more effective learning. By placing an emphasis on exercise, I didn’t feel guilty leaving the library to go the gym for a study break. Instead, I embraced this new lifestyle opportunity and learned to play squash, something I had always wanted to do since coming to college, but had never been able to justify the time to do! Interestingly, I noticed that as I exercised more and put more of an emphasis on my own health rather than on numerical success in class, my stress decreased. I can’t say my quiz grades necessarily improved, but I felt like I was better able to absorb the material that was presented to me and was much happier while I was learning.

Also, by tracking my eating, I noticed that when my stress increased, my cravings for unhealthy foods increased as well. While I am not normally a person that eats a lot of baked goods or sugary foods, I definitely wanted them more when I didn’t exercise as much or get as much fresh air. This made me realize the importance of diet as a result of exercise.

Finally, I really enjoyed making sleep a priority during Jan Plan and received around eight hours of sleep every night on average with the exception of nights I was on duty as an EMT.

Thus, this class really taught me that my exercise habits impact both my stress and my diet, and that when I exercised less, other areas of my life would suffer. I was it metaphorically as similar to instructions for putting on an oxygen mask in a plane: Put on your own mask first before you help those around you. By focusing on my own health, effective learning and success will follow. Also, success is not defined just by numbers academically, but by your quality of life in general and how you feel.

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Danielle Levine: Heart Dissection and MMSA Visit

February 24, 2015 · Comments Off on Danielle Levine: Heart Dissection and MMSA Visit

Danielle Levine (’15, Biology)

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While taking Introduction to Anatomy and Physiology this JanPlan, I was given the opportunity to perform a wet dissection of a pig heart. Having learned about the surface and blood vessel structural features via the study of powerpoint slides, listening to class lectures, and studying plastic models, the wet dissection gave me the opportunity to view the anatomy learned in an actual heart. Studying a list of anatomical features and seeing pictures of them on paper is a very different experience from actually getting one’s hands “dirty” and exploring a real heart and seeing what those structures actually look like.

Besides being able to dissect the heart in lab, one of my favorite activities of the semester was when during the following week we dissected another pig heart with visiting high school students, and were able to show them everything we had learned about the heart the week before. On Martin Luther King Jr. Day, a number of high school students from different schools in Maine visited Colby for the day as part of a collaboration between the Maine Math and Science Alliance and the Colby Goldfarb Center; we were able to show the students around the lab and talk to them about anatomy and physiology, as well as help them with potential science fair project ideas.

That day, our class began with a lab practical that covered the eye, the ear, and the nervous and cardiovascular systems before the high school students arrived; after we finished the exam, we met the high school students who would be spending the day at Colby with us. Each lab group of Colby students partnered with two high school students, my group with Cierra, a sophomore from Dover-Foxcroft, and Shea-Lynn, a home schooled junior. After introducing ourselves, we took the high school students on a tour of our lab, showing them all the different models we use to help us learn about human anatomy. In addition, we went over with them the lab practical exam that we just took, explaining what the answers were (of course, we had an answer key, and we had gone over the answers in class after we had finished the exam), and the physiological significance of the various anatomical structures identified. This was a very enjoyable experience, as not only did it reinforce my knowledge of the material, but it also gave me the opportunity to share that knowledge with these students by teaching them a little bit of anatomy and physiology.

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After the lab tour, we had enough pig hearts left over from the previous week, and so we were able to dissect another pig heart, this time letting the high school students perform the dissection while we helped and taught them about the different structures and features of the heart they were looking at – this teaching was reinforced by the use of pictures and models of the heart.

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After successfully dissecting the heart and exploring its anatomic features (and after lunch), we talked about potential Maine Science Fair project ideas for Cierra and Shea-Lynn; they came up with some interesting topics such as the effect of emotions on heart rate and blood pressure. The day was very rewarding, as it gave me a feeling of competence in that I was able to teach others material I had learned in the course – not to mention, it was also a lot of fun!

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Pictures of two of the heart models we used to study the cardiovascular system and teach the high school students with.

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Anonymous Student: Circumcision

February 23, 2015 · Comments Off on Anonymous Student: Circumcision

 

Dr. Peter Millard recently came in for a talk about HIV and preventative measures in Africa, specifically discussing circumcision and its effects in nations severely affected by HIV within Africa. Dr. Millard actively supports circumcision and has equated the procedure with vaccination. There are serious issues with this claim. Circumcision and vaccines can not be equated. The amount of mental acrobatics it requires to compare a quick needle stick with a 15-minute unanesthetized surgical alteration of the genitals is ridiculous. Unlike vaccinations, botched circumcisions are common. Immunization prevents disease but circumcision is 100% chance of mutilation (Rebecca Grey). Vaccination also does not deprive an individual of any functional body parts. The foreskin is not just skin as Dr. Millard alluded. It is composed of mucous membrane, also called a prepuce, analogous to the eyelid or the inside of the mouth. People designated female at birth have a foreskin equivalent called the clitoral hood which evolved from the same tissue as the foreskin. Circumcision within US history has been tied to various fleeting reasons. The procedure was popularized by Dr. Kellogs during the Victorian era (the same person who co-invented corn flakes) to curb masturbation. He said:

“ The operation should be performed by a surgeon without administering an anæsthetic, as the brief pain attending the operation will have a salutary effect upon the mind, especially if it be connected with the idea of punishment.”

This masturbation hysteria was then replaced by fear of sexually transmitted infections followed by prostate cancer, and now urinary tract infections. Parents believe that circumcision helps with cleanliness, but they do not realize that there is something called a bath or a shower. Taddio et al. performed a meta-analysis observing the pain responses to subsequent vaccinations of circumcised infants and uncircumcised infants. They found that circumcised infants showed a stronger pain response than uncircumcised infants. The trauma of circumcision has lasting effects on these children. This logic of removing a functional body part to prevent disease is the same as selling a car to prevent a car accident (Men’s Health). Safe sex practices are what stops HIV transmission.

Dr. Millard mentioned that circumcision decreased transmission of HIV by 50-60%, but did not mention that a vaccine has essentially a 95% efficacy rate. Vaccination is about immunization, circumcision is not about immunization. The US has the highest HIV transmission of all the westernized countries and the highest circumcision rates. Evidence points to insufficient education about safe sex practices. In 1992, 410,00 cases of chlamydia was reported, 20 years later, 1.3 millions cases were reported. In 2000, there were 31,618 cases of syphilis, 10 years later, 45.834 cases were reported. It seems sex education among the general population is low. Instead, doctors are telling parents to circumcise their children instead of teaching children safe sex practices. Media now takes over where various sitcoms commonly have circumcision as a plot device which actively shames those who are not circumcised. Circumcision has become naturalized and not questioned.

Within the US, infant circumcision is still endorsed and is now supported by the WHO and the CDC which is backed by data from adult circumcisions in African countries performed on “consenting” adults. Infant circumcision forcefully separates the fused foreskin from the glans which results in the tearing of the synechia (the tissue that connects the foreskin to the glans) and keratinization of the affected areas. Circumcision is commonly used as treatment for phimosis, but infants can not get phimosis as their foreskins are not naturally retractable. The loss of protective mucosal membranes and various nerves denies the child of their own bodies and decisions. Before a child can even consent to having sex, they have their bodies permanently altered.

The voluntary medical male circumcision in African countries which is backed by the WHO is packaged with connecting men to health care, access to safe sex education, condoms, HIV testing, counselling services, and links to HIV care and treatment. These incentives behind the procedure drive safe sex practices which prevent HIV transmission. Proper habitual condom-use alone prevents HIV transmission by 95%. Circumcision can not be considered voluntary when access to safe sex tools and practices that prevent HIV are contingent upon this procedure. The institutionalized industry of circumcision is backed by ministers of health, policy makers, program managers, health care providers, and donors (e.g. PEPFAR and the Bill and Melinda Gates Foundation) who fund supporting programs. HIV transmission can also be transmitted through circumcision if the tools are not sterilized. Stopping circumcision means stopping access to health care. Of course the HIV transmission rates decrease when patients are educated on safer sex practices. The studies done in Africa were decided to be unethical after two years, but did not mention the unethical issues behind the actual circumcision itself. Long term follow-up should be required for these patients.

The exporting of circumcision results in growing acceptance of this procedure “in communities, among men and their partners, adolescents and parents” (WHO). Although studies have been done on adult men, the WHO supports influence on adolescents who are not given complete informed consent especially when their parents and the institutions manipulating the conditions favor circumcision. Many nations curtail to the US when it comes to health policies. Circumcision has become tool to normalize and impose Western standards of bodies on peoples that can not fully consent.

Circumcision in African countries are funded by western imperialism which exports this practice outside to different nations only to import the “results” back into their own countries to continue non-consensual practice of genital mutilation. This dangerous cycle impacts bodies in very specific ways to normalize cognitive dissonance. Babies do not have consent over circumcision. Continued practice of circumcision normalizes a dangerous environment for those designated male at birth. Why must this procedure be made by doctors paid to cut off foreskin? The infant has no agency over their bodies. Circumcision is a practice that attempts to manage disease, but does not answer the question of how disease can best be managed. Cultural bias coming from Dr. Millard reflects normative nontherapeutic circumcision sentiments within the US.

 

Sources

  1. https://www.psychologytoday.com/blog/moral-landscapes/201109/more-circumcision-myths-you-may-believe-hygiene-and-stds
  2. http://www.ncbi.nlm.nih.gov/pubmed/9057731
  3. http://pediatrics.aappublications.org/content/early/2013/03/12/peds.2012-2896.full.pdf
  4. http://www.parenting.com/blogs/pop-culture/shawn-parenting/circumcision-vaccine-against-bad-parenting
  5. http://www.cbsnews.com/news/circumcision-rates-declining-health-risks-rising-study-says/
  6. http://www.who.int/hiv/topics/malecircumcision/male-circumcision-info-2014/en/

 

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Rachel Bird: The End of My Gymnastics Career

February 23, 2015 · Comments Off on Rachel Bird: The End of My Gymnastics Career

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I used to be squeamish. I was the kid who’d cover their face during movie fight scenes and feel nauseous at the sight of a bloody hangnail. Then I hurt myself — badly — during gymnastics practice, and I realized that as queasy my innards made me, it was worth it to understand them. When I fell on the trampoline during a routine in April 2012, I shattered my left radius and ulna. The repeated bouncing after the initial fall damaged the soft tissue and left the bones in a compound fracture, puncturing my skin halfway up the forearm. Although the initial reconstructive surgeries were able to salvage some of the bone and repair the structure of my arm, the massive soft tissue damage made my arm swell under the surgical dressings. My fingers grew so puffy with edema that they pressed together, despite the dressing that kept them spread as wide as physically possible. My elbow swelled to the size of my knee, and the staples holding the skin on the inner side of my forearm split open and the wound started oozing.

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Eventually, the doctors diagnosed me with compartment syndrome, a condition that is common in crush injuries, but not frequently found in the type of break I had. Because of all the damage to the muscle tissue, my arm had swelled so much that the blood vessels were squeezed almost shut, preventing oxygen from getting to the nerves and muscles in my hand. Unfortunately, by the time I was diagnosed with compartment syndrome, the damage had already been done. The typical treatment for compartment syndrome is a WoundVac, which is essentially a vacuum that attaches onto an opening in the dermis and sucks out all the excess fluid before it can cause a problem. However, by the time the nurses had removed my surgical wraps and determined the cause of the swelling and burning sensation in my arm, the swelling had already begun to subside. Initially, the doctors believed that the nerves would be able to regrow, and most of the damage could heal on its own. However, after two months of daily occupational and physical therapy, I still had no sensation in my wrist, palm, or fingers. Even worse, the build-up scar tissue had cemented my fingers into a fist, and I only had roughly 15 degrees of mobility in my elbow and even fewer in my wrist. My hand was so stuck that I was unable to open my hand to trim my fingernails, so they were starting to grow into the skin on my palm. I didn’t even notice until it started bleeding, because I had no functioning pain nerves in my hand. I also had no proprioception, so when I wasn’t looking at my hand, I would have no idea where it was. This led to some funny encounters, because I would all-to-frequently end up with my hand in my food, or touching a stranger’ back!

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After visits to numerous specialists, Dr. Barth, an orthopedic surgeon who specialized in hand and foot injuries suggested an unusual fix. He planned to surgically open up my forearm and scrape the scar tissue off of the joints and tendons in my hand. He would also remove the dead muscle tissue, but leave the muscle bellies (the central portion of a muscle), in the hope that the few remaining muscle fibers would be able to grow. Hopefully, without all the scar tissue blocking blood flow, some of the nerves in my arm would be able to grow back.

Luckily, the surgery was mostly successful, and I was able to open my hand. Less than two weeks after I was discharged from the hospital, I was able to feel deep pressure in my wrist and in parts of my palm! Nerves regrow at approximately five millimeters per day for larger nerves, so as my median nerve inched up my palm, my occupational therapist could track its growth with touch charts and a photocopy of an anatomy textbook. However, so much muscle and tendon was removed, that even though I was slowly able to feel the proximal areas of my fingers, I didn’t have the strength to move them. My arm was so weak that I had to wear a sling for most of the day because I couldn’t support my hand. Even worse, because I couldn’t feel scratches or cuts, two small paper cuts on my fingers got infected.

Dr. Barth proposed another surgery. He wanted to transfer a tendon from my upper arm into my forearm, in the hopes that I could “retrain” my brain to use one tendon for a different purpose. The surgery transferred the brachioradialis tendon and attached it to my extensor pollicis brevis, so when I wanted to move the distal joint of my thumb, I would have to think about bending my elbow. He also transferred the flexor carpi radialis and attached it to the flexor digitorum superficialis, so when I wanted curl or flex my fingers, I would use the muscle that had previously bent my wrist.

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Although the process of recovering from this surgery and relearning how to use my hand to nearly two years, I am now able to type this paper using both hands (admittedly, it’s kind of awkward)! Unfortunately, having blood flow cut off to my nerves for so long had left me with permanent nerve damage, and I deal with chronic nerve pain and pretty limited strength and mobility. However, I can tie my shoes, dress myself and function in a classroom setting in ways that I couldn’t have dreamed of in the months following my accident, and I am so thankful to modern medicine for that!

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Rachel Bird: My Concussion

February 23, 2015 · Comments Off on Rachel Bird: My Concussion

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Let me preface this by saying that I do not know how to ski. However, I’m a decent snowboarder, and I (mistakenly) thought that the two skills were relatively similar. Apparently I’m quite incorrect. The result is that this entire blog post is hearsay. I have absolutely no memory from Saturday, January 17 until Monday, January 19. According to my friends, on Sunday morning, we all got up early to drive up to Sugarloaf mountain to enjoy Colby Ski Weekend, with discounted lift tickets. The morning skiing was decent, but crowded. I was slowly (but surely) figuring out how to ski, and when we stopped for lunch I was feeling pretty confident. After a few successful runs in the afternoon, it was starting to rain, and the slopes had become slick and icy. We decided to do one last run and then head home. Our group got split up on one of the turns, and I ended up going ahead. When I hit a particularly icy patch, my right ski slipped out from under me and I rolled down a hill. I ended up at a fork in the trail and I went right, following a skier in black who I assumed was my friend. At the next fork in the trail, the only options were two different black diamonds, and the woman I had been following was clearly not a fellow novice skier! I reluctantly chose the path to the right and crossed my fingers. Initially, I was doing fine, slaloming side to side and avoiding the smooth icy patches in the center. Then I came on a steep slope and started to lose control. I tried to slow down, but the rain and melting ice didn’t offer any traction for my rental skis. I careened off the trail and down a hill into the woods, banging my skin on a branch and knocking the base of my head against a tree stump. I blacked out.

I woke to an old man in a green jacket poking me with his ski pole, “Are you okay, sweetheart?”

“Yeah, I’m fine, just give me a second.”

I crawled out of the woods and adjusted my goggles on my too-big rental helmet. I clamped my skis back on and gingerly slid the rest of the way down the mountain to the lodge. I mechanically returned my skis, boots, and helmet, and returned to our picnic table to change into dry clothes. I felt fine — a little drained, but that’s understandable after a long day at the mountain. As we waited for the shuttle to take us back to the parking lot, sleet and rain pelted down. The shuttle finally showed up, but on the way to the parking lot, my head started to pound. I blinked the snow out of my eyes, but my vision stayed blurry.

“Hey Chris — I think I’m seeing double.”

My boyfriend’s face swam in front of me, his mouth splitting into two identical sets of lips and then merging back into one.

“Do you feel okay?” Michaela’s voice piped up from my periphery, her head smearing into an unidentifiable mass.

“Um… I don’t know. I think I hit my head pretty hard when I fell.”

“We’ll get you to the health center when we get back to campus.”

“Ok.”

The shuttle pulled up to the parking lot, and I slouched into the backseat of Tenzin’s car. The sleet kept pouring down as we inched down the steep road. I slumped over on Chris’ shoulder, but he kept shaking me awake.

“Rachel, I really don’t think you should go to sleep yet, you might have a concussion.”

Then the car swerved and Tenzon overcorrected and the wheels slid and the road curved and we were in a snow bank. My head whipped forward and hit the seat in front of me with a resounding thump. Tenzin and Katie climbed out the front doors to survey the damage. The car was fine, but we were clearly stuck in the snow on the side of the road. Luckily, an ambulance happened to be passing by and the EMTs pulled over to see how we were doing.

“We’re all fine, but our friend is in the back seat, and we think she’s got a concussion.”

I crawled out of the back window, and stumbled over the the ambulance. The EMTs chattered between themselves, and apparently reached some consensus, because I was loaded into the back of the ambulance and barraged with questions.

“What year is it? What’s your name? Who is the president? Where do you live? Do you know your address? Are you taking any medicines?”

“Um. I don’t remember… I’m really sorry. I don’t know… uh… I don’t remember.”

Everything was fuzzy as the EMTs started an IV, and I dry-heaved into a plastic bucket.

“Zofran for the nausea and fluids for dehydration.”

I slumped onto the stretcher and blinked in time with my head’s pounding. Somehow I made it to Farmington Hospital and into a hospital bed, but I was too busy focusing on the peculiar way my forehead was pulsing. More nurses with more questions that I couldn’t quite conjure the answers to, more bright lights and beeping noises that made my head pound, more medical terminology that I was sure I had heard before, but I couldn’t quite place. The tall doctor called for a CAT scan, but I needed to give a urine sample first to prove I wasn’t pregnant, and my head hurt too much to get up and use the bathroom. But I gave the sample, and got the scan, and went back into my hospital bed, and tried not to fall asleep with my eyes open, because I was so damn tired. Hours or maybe seconds passed and the tall doctor sauntered back into the room. My boyfriend jumped up and began badgering him with questions. I took the opportunity to promptly fall asleep while sitting up.

“No internal hemorrhaging, which is good, but she’s got a pretty severe concussion…”

The doctor’s voice trailed off into technicalities, but I was already fast asleep.

 

 

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Laurel Edington: My Experience in Bi265j

February 23, 2015 · Comments Off on Laurel Edington: My Experience in Bi265j

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This January, I was given the opportunity to take the Introduction to Human Anatomy and Physiology janplan class. I’m a senior biology major and have finished all of my major requirements so I didn’t need to take this class, but I’m interested in the material and figured that it would be helpful to be at least familiar with human A&P when I’m eventually in medical school.

During the first week of class, I thought that the workload was too much and I considered dropping the class. Throughout this week, Dr. Klepach kept reinforcing that the first week was the hardest and that he really just wanted us to learn how to deal with a heavy workload and learn the material while still eating three meals a day, working out each week, getting eight hours of sleep each night, and keeping our stress level low. At first, I thought this was insane. How was I possibly supposed to learn all of these bones and muscles and not be stressed?! However, throughout the month, I realized that this was possible. The way the class was set up allowed work to be spread out so that we continued to reinforce the material through quizzes and preparing for lecture and class. By doing this, studying for a bigger exam or working on a bigger project ended up not being as stressful or time consuming as I imagined it would be.

The following weeks were still intense but were more manageable. Although we had quizzes before most lectures, another lab practical, a grand rounds presentation, and a few lab assignments left, Dr. Klepach’s advice of studying to learn the material and not for the grade really helped to make the class less daunting. As a premed student, I’m used to focusing only on the grades I receive and my GPA, but this class made me focus on actually knowing the material. Out of all of the classes I’ve taken at Colby, I’ve learned the most in this class. I don’t think this is because of the sheer amount of material thrown at us and if only a little stuck with us, it would be more information than some classes teach in a semester, but rather that I was actually working to learn the information and not just studying so that I could remember the material only in order to do well on the next test.

I highly recommend this class. I think it’s a great class for any premed student, any biology major, as well as any student who is just interested in anatomy and physiology. We were given so many interesting opportunities that no other class really offers. I can’t think of another biology class that performs any sort of dissection, that teaches the important skill of giving a grand rounds presentation, or that has lectures from specialists such as Dr. Zak Nashed and Dr. Peter Millard. During this month, we learned so much and we only just scratched the surface. I found this class so fascinating and wish that it could have been a semester long, or even a year long, course.

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Chris Lee: What I Gained From BI265

February 23, 2015 · Comments Off on Chris Lee: What I Gained From BI265

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This year I decided to sign up for BI265 (Introduction to Anatomy and Physiology) for my Jan Plan course. Going into it, I had no idea what to expect. I knew from my experiences with high school anatomy that it would require a lot of memorization. Given the fact that the class would only last for a month, I also expected the class to move at a very rapid pace. With these thoughts in mind, I walked into the classroom on the first day, ready to begin my second Jan Plan at Colby.

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On the first day, Dr. Klepach told us that one of his goals in the course was to teach us to maintain healthy lifestyles, despite the rigorous nature of his class. According to him, this would be an important lesson to learn, especially for those of us who entered the health professions field. Maintaining a healthy lifestyle, especially while taking a course like BI265 at first seemed impossible. We were exposed to a lot of information each class and it was not uncommon for us to have quizzes the day after we were introduced to new material. During the first week, I spent nearly all my time outside of class in the library going over lecture notes and stressing over whether or not I had studied enough. I wondered how it was possible to fit in time for sleep, activities outside class, and three meals a day without stressing out. As it turned out, it was possible to achieve all three of these things and succeed in the class. All it took was some self-reflection and time management.

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Self-reflection is an all-around good skill to have. It lets you evaluate where you are in the process of trying to accomplish something and lets you see where your strengths and weaknesses lie. In my case, self-reflection let me see a major weakness in my approach toward the class: my study habits. Usually, my approach to studying would be to re-read my notes until the information sank into my head. For a Jan Plan course, this is inefficient because time is very limited. After an unsuccessful performance on the first lab exam, I sat down and thought about how I was studying. I concluded that I needed to implement a more active style of learning. For instance, when studying the different parts of the eye, heart, and ear, I looked at anatomical models of these organs in addition to looking at the diagrams in my notes. Our lab exams asked us to identify structures on anatomical models, which was why it was more beneficial to study the models in conjunction with diagrams. Being able to self-reflect on my performance in the course helped me make the necessary changes to how I approached the material and improve my performance.

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In addition to self-reflection, time management was another important skill that helped me get through BI265. In order to fit in time for sleep and other activities outside of class, I had to stay focused and be more efficient when it came time to work. Doing this allowed me to be productive while allowing for more time to enjoy myself outside of class. A technique I used to help with time management was setting up an organized schedule. Through this method, I was able to see when I could devote time to study, keep track of deadlines, and plan ahead. I attribute my decrease in stress levels to an improvement in my time management skills. Being more organized helped me get more done sooner so that I was not left with an overwhelming amount of work in the wake of an imminent deadline (which is very stressful situation). While I learned a lot about the cardiovascular, skeletal, digestive, and other body systems in BI265, I also learned the importance of self-reflection and time management. I have no doubt that these two skills will be beneficial to me for the rest of my college career and ultimately the rest of my life.

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Chris Lee: Dissecting a Sheep Heart

February 23, 2015 · Comments Off on Chris Lee: Dissecting a Sheep Heart

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I cut the plastic bag open and was immediately hit with a strong odor. Inside the bag was a sheep’s heart, sitting in a pool of preservative chemicals. Immediately after taking the heart out, I went over to the sink to rinse off the chemicals. I could tell that this was going to be a messy lab. Still, I was excited to do a sheep heart dissection because it was an opportunity for me to see a real heart. For about a week, I had been studying diagrams and models of hearts, but not a real version of the organ itself. The anatomical models we used were helpful in learning where structures of the heart are located, but nothing beats seeing the real thing.

After washing the heart, my lab partner and I located its apex (tip) and figured out where the left and right sides were. It was immediately apparent that not all the structures were intact which was unfortunate (both the inferior and superior vena cava had been cut off). However, we discovered a well-preserved depression known as the foramen ovalis behind the right ventricle that had not been damaged in the preservation process of the heart. The foramen ovalis marks the former sport of the foramen ovale, a hole in the pig fetus’s that helps with blood circulation. After the pig’s birth, the hole is sealed, leaving behind the foramen ovalis.

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Next, we started cutting the heart open. Cutting through the walls of the heart was difficult. The heart’s function, to pump blood throughout the body, requires it to be a tough, durable organ and I was reminded of this as my lab partner and I tried to cut through its walls. Pulling apart an incision on the right side revealed a small chamber with a hole in its lower end covered by three flaps. This was the tricuspid valve, the covering between the hole connecting the right ventricle and right atrium. I stuck my fingers through the valve, pushing my way past the three flaps into the larger space known as the right ventricle and felt around. Brushing against my fingers were the stringy cordae tendinae that connected the flaps of the tricuspid valves to the papillary muscles.

Over on the left side of the heart, we saw structures such as the left atrium, bicuspid valve, and the left ventricle. While making a cut on the left side of the heart, I immediately noticed how much thicker the muscular walls were on this side. Something that occurred to me during this dissection that I never really thought about before was how the heart’s form fit its function. Its thick, muscular walls (particularly on the left side) gave it the necessary power to pump blood to different parts of the body. The cordae tendinae, though somewhat thin and stringy, still felt strong and durable, which was necessary for them to be able to keep the bicuspid and tricuspid valves shut. Even the layout of the heart itself is essential to its function. It contains four chambers linked by a straightforward path that enables deoxygenated blood to enter, get pumped to the lungs to pick up oxygen, return, and then get pumped to other parts of the body. The sheep’s heart dissection was definitely my favorite activity from anatomy class. I enjoyed the hands-on aspect of it and being able to explore the layout and structure of a real heart.

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Laurel Edington: Grand Rounds – Celiac Disease

February 23, 2015 · Comments Off on Laurel Edington: Grand Rounds – Celiac Disease

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During the last week of class, we presented our grand rounds talks that we’ve been working on all semester. This was a great experience because it allowed us to practice giving a grand rounds lecture, which is a common presentation in the medical community. Each group of three picked a topic, which could be a case study or an overview of a disease or medical treatment, and then presented as if they were doctors talking about an interesting patient, new procedure that they’re performing, etc.

This year, the weather didn’t exactly cooperate with us. We were supposed to have a practice session during class on Tuesday and then go to Augusta to present our talks along with Kents Hill students at Maine General. Because of the snow day and horrible driving conditions, neither of these events happened and we had to present our final product with little group practice. Thankfully, my group was able to practice together before the weather was too bad, but practicing during class and at Maine General would have been helpful.

My group decided to present a case study on a 42 year old man with chest and abdominal pain. We found this study through the New England Journal of Medicine and it was used as a hugely teaching moment instead of a typical grand rounds talk. In this case study, the man’s symptoms were textbook for celiac disease but physicians performed a number of tests, including an invasive and non-diagnostic procedure, before even thinking of the possibility of celiac disease. This case study was not used to teach medical students and medical professionals about a rare disease or an interesting case, it was used to enforce the fact that celiac disease is becoming increasingly common and physicians need to be aware of it and perform the simple diagnostic blood test for the disease when a patient comes in presenting characteristic symptoms.

Through this presentation, we learned the difference between celiac disease and non-celiac gluten sensitivity. With celiac disease, there is damage to the intestines and an IgA tissue transglutaminase and IgA endomysial antibody tests can be performed to diagnose the condition, this is not the case with a gluten sensitivity. Both conditions, however, are treated with a strict gluten-free diet. This is becoming a popular new diet in people who don’t suffer from celiac disease or non-celiac gluten sensitivity. People who are using this fad diet and who don’t have celiac disease or a gluten intolerance are at risk for developing new gastrointestingal problems.

This project was a great way to expose us to this sort of presentation since the majority of the class is interested in the medical profession and grand rounds are a common occurrence. This was an especially interesting experience because we were able to present in front of nurses and doctors, which made the experience that much more real. It also reinforced the material we had learned throughout the class because we had to explain the disease based on the anatomy and physiology. I’ve been to multiple grand rounds during my summer internships and I never thought that I would be able to understand a case as well as those doctors, but this experience showed me that I am more than capable and therefore, was an awesome experience.

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Ivan Yang: Musings on the Fetus vs. Mother Battle

February 23, 2015 · Comments Off on Ivan Yang: Musings on the Fetus vs. Mother Battle

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One of the best yet most challenging parts of this course is the sheer volume of knowledge that can be gained in these four weeks. I learned a spectacular amount of information about the human body during the course, giving me a greater appreciation for the ingenuity of evolution and the delicate intricacy of the body’s structures and mechanisms. In addition, Dr. K has a knack for sprinkling little bits of knowledge throughout his lectures that, when given time to soak in, can stimulate a great deal of critical thinking.

For example, when Dr. K lectured on the respiratory system, he briefly mentioned that fetal hemoglobin has higher oxygen saturation than adult hemoglobin does at the same oxygen levels. While this assertion can be explained by the fact that the fetus has higher demand for oxygen and must compete for oxygen in slightly deoxygenated blood, it reminded me of an article I read in a previous biology class on imprinted genes.

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Imprinted genes are genes which are “marked” by the maternal or paternal parent and which are expressed over other versions of the same gene. Mechanisms of imprinted gene expression and evolutionary reasons for their existence are mostly obscure due to their relatively recent discovery. In fact, the existence of imprinted genes was only verified through cloning experiments in the late 80s. Scientists attempting to create a uniparental mouse (a mouse with two paternal or two maternal sets of DNA) found that it was impossible to create a fully-developed uniparental embryo. When the embryo was created from two maternal sets of DNA, its cells were properly organized, but the placenta was insufficient. When the embryo was created from two paternal sets of DNA, it was able to form a very healthy placenta, but the fetus itself was a disorganized mass of cells.

These results flew in the face of Mendelian genetics, which suggested that genes are merely strands of information with no history of origin. To the contrary, genes do, in a sense, remember their parental origins. The studies in the 80s suggested that the expression of certain genes in the paternal genome is responsible for making the placenta, while the expression of certain genes in the maternal genome is responsible for organizing the embryo. One of the first explanations posited that the placenta should be thought of not as a maternal organ designed to support the fetus, but rather as a fetal organ designed to parasitize the mother. While the mother and the fetus both have the common purpose of perpetuating the continued survival of the fetus, they disagree over how much of the mother’s resources should be dedicated to the fetus. In a sense, maternal genes are “selfish” and only the genes necessary to organize the fetus are expressed. Hence, the uniparental mouse embryos made of two maternal sets of DNA were unable to create a sufficient placenta.

This competition for resources between the fetus and the mother, clearly observable through research on imprinted genes, is strikingly similar to the competition for oxygen between the fetus and the mother. As previously mentioned, fetal hemoglobin has a higher oxygen affinity than adult hemoglobin does. To ensure its own survival, it is entirely conceivable that the fetus robs oxygen from the mother’s bloodstream. Perhaps this is but another example of a battle of wills between the fetus and the mother.

 

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