Cranial Nerves Revision

Cranial Nerves - Detailed revision cards

Thoracic Spine / Ribs

Annotated diagrams; Technique and Clinical anatomy revision cards  - Thorax

Annotated diagrams; Technique and Clinical anatomy revision cards - Ribs

Annotated differentials textbook -  Chest pain

Visit to the chiropractor

I ran across the road outside BSO, slipped, flew through the air and landed on my coccyx at the feet of two policemen on the pavement. Yes it's true, bizarre and embarrassing! I woke up the next day (Saturday) and couldn't believe I wasn't aching, but saw it as a good reason to visit my chiropractor anyway and approach it critically as a practice visit. It is because of this woman that I chose this career (having found I couldn't study chiropractic in London)! Inspirational as always, no active movements, no soft tissue, lots of different thrusts (always successful) and a good chat. In and out in twenty minutes and feeling fine. Nice job! I want to be her.

Clinic reflection / Theory of technique revision

Today I was overwhelmed by panic, which with hindsight was unnecessary. A patient presented having been referred by us 6 months ago and sent away. She had since had all relevant medical investigations and had brought the results with her, including a recommendation for surgery - which she did not want. It was a complicated history and she was in a lot of pain, but I should not have felt out of my depth at all - but I did. She was quite unwell and was limping. When all the information was digested, it appeared that the most likely explanation for her various symptoms was that her large fibroids were compressing the femoral nerve. It was a frustrating case, as she did not want surgery, because she had suffered through previous surgeries, but it was likely to be the most successful course of action. I felt deeply sorry for her. When I had time to reflect, I realised that in future I should wait until all the information is gathered before I panic - meaning I over reacted to her appearance, initial presentation etc, before finding out that she had been fully screened and had brought the results of imaging. I think I was worried about having to perform several dcp exams under time pressure and being grilled about numerous differentials - and neither situation arose. However, I am glad I have included reviewing dcp procedures in my LPA!

Theory of technique - Q&A CCA prep (Keep it simple)!

SIJ

The many SIJ techniques include some articulations which I NEVER use and seem to forget about most of the time. Now I have them on my little yellow card and I intend to start using them until they become second nature. I'm not doing too well with fourth year technique sadly. My notes are all I've got to go on and they aren't great. Plus whenever I seem to practice something new with colleagues, we all seem to have a totally different idea about what happened in class! For this reason, I am never going to find out what really went on in the technique classes with TA on hip and knee, when I was off sick! I am actually quite disturbed by this.

Annotated diagrams; Technique and Clinical Anatomy revision cards - SIJ

Clinic reflection

12/11 A new patient this week was a dental student with mid back ache due to postural fatigue. She spent hours flexed over patients and had a long upper body. She provided the perfect opportunity to use a seated thoracic articulation technique shown in the obstetrics class. I performed it with the aim of encouraging extension and the patient responded well. I was only too aware of the effects of exam stress and felt that much of this presentation and the patients' brusque, frustrated manner was likely to be because of this. She confirmed this as she left!

I also saw a PhD student with low back ache and was challenged by her insistence on manipulation. I have heard many stories about this happening, but this was my first experience. The patient always had manipulation (in Greece) which "fixed" her and she wanted the same thing here and seemed frustrated by even having to complete the case history first! Fortunately, she was a perfect candidate for manipulation and felt better after a couple of lumbar rolls. I did wonder how she would have reacted if I had decided not to manipulate. Negatively, I expect.

Abdominal Examination

My least familiar examination - still makes me quite nervous if I have to perform one. Really not good enough at this stage, need to practice even more, despite getting some dcp routines signed off lately!

Abdominal Exam Revision Cards

Obstetric elective begins

4/11 My first elective begins. Obstetrics was my first choice and having already had a new mother as a patient this term and having been found lacking, I am looking forward to this subject. It turns out that the techniques we will learn can be used on anyone and the tutor has also promised to help us improve our techniques in general. This sounds too good to be true! This tutor has a great enthusiasm for his subject which is infectious, although he does manage to make pregnancy and birth sound like your worst nightmare and pregnant women sound like alien monstrosities!

Obstetric elective slides - including list of techniques - HURRAH!

Research paper recommended by S.S, written by S.S himself!

Lumbar Spine / Clinic reflection

I successfully performed a rib HVT on a patient this week for the first time, having achieved success on fellow students during my last few attempts. It was a good feeling. I much prefer to use a technique on a patient when I feel I have a good chance of success, whereas I know some of my colleagues perform techniques on a patient as soon as possible for the practice and because it is more likely to work on someone who needs it. I really need to think about this, as maybe it is my friends who have the right idea. At this rate, the course will end and there will be techniques I haven't even tried on patients! That is not where I want to be in June.

We are looking at lumbars in technique now and it is good to revisit this most familiar presentation. There is still so much to learn though it is frightening!

Annotated diagrams, Technique and Clinical anatomy revision cards - Lumbars

Annotated differentials textbook - Low Back Pain