Human Anatomy at Colby

Chris Lee: What I Gained From BI265

February 23rd, 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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Tags: Bi265j · Human Health

Chris Lee: Dissecting a Sheep Heart

February 23rd, 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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Tags: Bi265j · Lab

Grand Rounds: CABG v. PCI Stenting

January 28th, 2015 · Comments Off on Grand Rounds: CABG v. PCI Stenting

CABG vs. Stenting in Multi-vessel Procedures: A Synopsis

Mayra Arroyo, Chris Lee, Ivan Yang

Coronary artery disease is caused by atherosclerosis, or the accumulation of fatty deposits, known as plaque, along the innermost layer of the coronary arteries. There are three main coronary arteries: the right coronary artery, circumflex artery, and the left anterior descending artery.  Atherosclerosis causes the afflicted coronary artery’s wall to thicken and lose elasticity, ultimately narrowing or blocking the artery. This can reduce the oxygen flow to the myocardium. Treatment of coronary artery disease is complex and depends on several factors, but typically comprises of risk factor management, medication, and interventional techniques, such as coronary artery bypass grafting (CABG) and stenting.

Percutaneous Coronary Intervention (PCI) or Stenting is a minimally invasive process in which a doctor inflates a stent (mesh steel tube) with a balloon to open up a clogged artery. This restores normal blood flow. A catheter is inserted through the groin, neck, or arm to move the stent to the affected area.  In recent years, newer types of stents such as drug-eluting stents and biodegradable ones have been developed. Before choosing stenting as a treatment option, one should consider risks involved with stenting such as damage to the vessels or arteries.

CABG is a surgical procedure where a vein or artery (usually from the inner thigh) is used to form a path around a blocked coronary artery. Over the years, there have been changes to the techniques used to carry out CABG. One such example is Totally Endoscopic CABG, which uses a robot equipped with a camera and surgical instruments in its arms. It is important to note that this procedure is highly invasive and risky, which is why it is usually used after more conservative treatments have been attempted.

In the three studies discussed, we compared long-term outcomes of CABG and stenting in multi-vessel disease in diabetics and in combined subgroups by looking at death rates, adverse event rates, and repeat revascularization rates.  Multi-vessel disease is defined as the occlusion of two or more of the three main coronary arteries, and revascularization is a procedure that returns blood flow to a low-oxygen area.

In diabetics, we found that CABG ultimately has better long-term outcomes in multi-vessel treatment.  Primary outcome (death, heart attack, or stroke) rates and all-cause mortality rates were lower in CABG diabetic patients than in diabetic patients who underwent drug-eluting stent procedures.

A study published in 2001 observed the effects that CABG and stent had on patients one year after treatment. The patients’ quality of life (survival and freedom from stroke, heart attack, or repeat revascularization) was examined after one year. It was found that there were no significant differences between the number of CABG and stent patients who did not die or have heart attacks or strokes. However, CABG patients had lower rates of repeat revascularizations than stent patients. In light of this study, it is important to remember that it was conducted in a time before drug-eluting stents and other newer treatment options.

Another study published in January of 2013 found that, compared to CABG patients, a greater percentage of people who underwent PCI with drug-eluting stents underwent repeat revascularization. The study concluded that in people with less complex disease, it is acceptable to undergo PCI. On the other hand, people with multi-vessel problems should choose CABG.

In conclusion, though CABG has proven to have better long-term outcomes than stenting in multi-vessel disease treatment, better studies should be conducted to verify this.   Future studies should include more patients, cover modern CABG and stent techniques, and be extended for several years after revascularization.  For now, it appears that CABG does have an advantage over stenting and drug-eluting stents, mostly due to reduced rates of repeat revascularization.

 

Tags: Grand Rounds