S2 Week4: Musculoskeletal Exam, Gait Analysis, and Pharmacology!
This week started off with our first musculoskeletal exam! We had a written exam in the morning and the afternoon finished off with a lab practical. This exam was a fun way to evaluate everything that we had learned during the past three weeks! This was also our first official lab practical in the anatomy lab and it was an experience to say the least. This exam was set up in a maze-like fashion were there were roughly 38 numbered stations spaced throughout the room. Each student started on a different station and every 60 seconds a buzzer would go off. At the sound of the buzzer we would rotate to the next question until we ended at our starting station and then the exam was finished. At the end of the exam we had a few quick minutes to return to any of the questions incase we missed anything the first time around. This was unlike any exam I had taken in the past but was a fun way to put my knowledge to the test!
Monday finished off with some hot yoga to decompress and some quality time with Churro!
Tuesday began with a fun lecture on bone neoplasia. It was interesting to learn about the different types of cancers that can affect the skeletal system and how they may present in our patients. One disease that we learned a lot about was osteosarcoma. Osteosarcoma is a fairly common cancer in medium to large breed dogs and is the most common form of bone neoplasia. It tends to occur "away from the elbow and towards the knee" meaning the proximal humerus, distal radius, proximal tibia and distal femur are commonly affected. This is a gnarly cancer that affects the bone and the scary thing is that by the time the disease is detected, it has often already metastasized to the lungs making the prognosis less than optimal. Early pulmonary metastasis is not always visible on radiographs so a limb amputation will often be performed in hopes of "curing" the patient. Unfortunately, if additional thoracic radiographs are performed a few months later, there will often be clear signs of metastasis. The next lecture was on joint homeostasis followed by one on cartilage and how it responds to injury. The lecture-portion of the day finished off with some information on joint fluid and some key things to look for cytologically. That afternoon concluded with an equine blood collection lab. This was a fun way to practice collecting blood from horses and we also got to try some intramuscular injections. That afternoon finished off with a nice swim and a walk with Churro!
Wednesday started off with a fun lecture on small animal gait analysis. This lecture incorporated a plethora of videos of animals walking, running, and jumping to demonstrate subtle things to look for while examining their mobility. The remaining morning lectures were focused on identifying the imaging features of common joint diseases and neoplasia. This was a nice supplement to the lecture that we had Tuesday morning and was a way to understand what neoplasia looks like on radiographs.
That afternoon began with a lab on the histology of bone, cartilage, and joint development. We were able to look through various slides and understand the progression and maturation of different tissues along with the components that they are made of. After that lab we transitioned into a discussion on joint clinical pathology. This discussion was meant to build off of the joint fluid lecture from the day before. We were presented with two cases and had an hour to formulate some sort of diagnosis based on the patient's history and joint fluid cytology. This definitely helped cement the information from the other day and it was a fun way to apply the prior knowledge!
Thursday started off with another lecture on bone neoplasia and then transitioned into a lecture on inflammatory bone disease. After learning about the mechanism behind different inflammatory bone diseases we had an imaging lecture that helped us learn how to identify specific features that may indicate the disease process is of some inflammatory origin. The final lecture of the morning was on equine gait analysis. This lecture followed a similar format to that of the small animal gait analysis lecture and it was fun to see how lameness presents among different species. This lecture was also filled with a plethora of videos demonstrating animals with varying lamenesses. It was fun watching the videos and trying to identify what limb(s) were affected. That afternoon we had an anatomy lab that focused on joint anatomy. There were multiple samples available for us to handle and it was super interesting to feel the ligaments, tendons, meniscus, and cartilage. After learning about joints all week, this was a great way to bring that knowledge to life and truly see how everything works together to allow movement.
Friday started off with two awesome pharmacology lectures. These lectures were focused on medications that are commonly used to treat diseases that affect the bones and joints. We discussed non-steroidal anti-inflammatory drugs, monoclonal antibodies and bisphosphonates.
Here is some additional information on how those drugs work and some examples of when you may use them in practice.
Non-Steroidal Anti-Inflammatory Drugs (Carprofen, Meloxicam, Flunixin Meglumine): These drugs are cyclooxygenase inhibitors. Inhibiting cyclooxygenase inhibits the production of prostaglandins and thromboxane which are associated with pain. Some. NSAIDS are selective for COX-2, while others inhibit both COX-1 and COX-2. COX-2 selectivity helps reduce the potential side effects of these drugs since COX-1 plays a role in normal biologically important functions. These drugs are often used to treat pain and inflammation.
Monoclonal Antibodies (Solencia, Librela): These drugs target Nerve Growth Factor which is elevated in response to a noxious stimulus. These drug molecules bind to a receptor called TrkA which prevents Nerve Growth Factor from binding and thus inhibits it from producing a response.
Bisphosphonates (Zoledronic Acid): These are anti-resorptive drugs that prevent osteoclasts from binding to bone and induces apoptosis (cell death) of osteoclasts. Osteoclasts are the cells in the bone that resorb bone so inhibiting them helps prevent bone loss. This drug is commonly used in animals with bone tumors or osteoporosis.
Friday was a short day class-wise and we were done after the pharmacology lectures. I took advantage of the free afternoon and went for a nice long bike ride. The weather was a little wild and I got a little downpour action roughly half-way through the ride but by the end there was a double rainbow and the sky was clear which made the wet middle miles totally worth it! I was also finishing my ride right around the same time that a lot of the schools were getting out and it was fun to see everyone walk outside and take pictures of the rainbow or point it out to their friends. Little things like that remind me of just how beautiful life is and while we are all so different, at our core we all enjoy the beautiful things in life and want to share them with others.
That evening I met two of my undergrad triathlon team friends for dinner! One of them moved to Davis after undergrad for a job and another one was touring the school and looking at one of their graduate programs! It was awesome to catch up and hear about all the exciting things that are happening in their lives!
Saturday started off with a fun run with Churro and a hot yoga session. The afternoon was filled with studying and getting some things done around the house. Sunday also involved quality time with Churro, a long wet walk and some studying!
Quote of the week: “Hopefully you found the test reasonable if not super fun!” -Dr. Murphy
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