Randoms: Walthard Cell Nest and Forceys Granules

Walthard cell rest/nests, is a small cyst usually found in the serosa of fallopian tube. Grossly, they present as cream nodules measuring around 1-2 mm. Microscopically, the epithelial lining of the cyst has a "coffee-bean" nucleus.

Image from Wikipedia.

Image from Wikipedia.

Significance: Walthard Cell Nest is associated with Brenner Tumor.


Fordyce granules are sebaceous glands found in the area of the body where they are not expected to be there (e.g. oral cavity, lip vermillion, etc). Ectopic sebaceous gland is good description for it.

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Of slides: When you look at a picture, don't look for something that you want to see. Look at what the picture wants you to see. :) Else, you will miss a lot of things and just be limited on what you expect of the world. 

How to Approach a Slide

Treat your slide like your patient. You do physical examination on it. You have to do it in an organized manner.

1. Know the patient profile: age, sex, diagnosis, pertinent history. Most clinicians treat a pathologist like a lab test like CBC or electrolytes. They do biopsy and they send it to the lab for "testing". But actually they are referring to you because they want your expertise on the "physical examination" of a previous body part from a patient. Why are they referring to you? Based on the information shared by the clinician, think of your differentials.

2. Gross specimen. Examine. Is the specimen in fragments? Mass? What is the color? How's the surface? The consistency? Check the cut surface. Capsule? Measure it! Or.. is it too thin? Describe :D. Is the cut surface solid? cystic? gelatinous? hemorrhagic? Narrow down your differentials once you see the specimen.

Once you have the slide..
3. Naked eye slide exam: 1x or no magnification. Examine the specimen just by looking at the slide.

4. ARCHITECTURE. Scan the slide. Think of it like you're looking from the bird's eyeview. What's happening in this slide?

• Contained? Encapsulated?
• War? Inflammation?
• Recent
1. Early immune soldiers = Neutrophils
2. Immune soldiers run to the battle site = Vascular congestion
3. Extravasation of the fluids brought by the soldiers’ transport to the site = Edema
4. Blood vessel pathway is destroyed allowing fibrinogen to pass through  = Fibrinous exudates
5. Tissue damage
• Long-time
1. Long term immune soliders = Lymphocytes, macrophages, plasma cells, eosinophils
2. Developed more pathways over time = Increased vascularity
3. Already had time to fix destruted areas = Fibrosis (attempts to heal)
4. Prolonged damage = Tissue destruction
• Insanity? Invasion? Disorganized?
• Needy of supply? Vascular?
• Etc etc.

5. CYTOLOGY. Once you appreciate the architecture, check for the abnormal parts. Zoom in and see. What are the types of cells involved? What is the background? (Myxoid: pinkish with some cells floating on its sea. Mucoid: pinkish with some glandular structures floating.) Never scan the slide using low-power or high-power or you might miss a lot of things.

• Who! Who are the characters? Cell differentials depending on the shape, how they are grouped and their background.

a.   Polygonal? Round?

b.   Spindle-shape?

The Spindle Cells. Use their shape to get a clue of what these cells could probably be.

c.   Squamoid?

d.   Glands?

e.  Myxoid background?

• .    What do they want?! What’s happening in the minds of these characters? Jump to high power.

a. Nucleus

                                          i.      Reactive changes = prominent nucleolus

                                          ii.      Hyperchromatic = busy mind/nucleus

                                          iii.      Enlarged nucleus

b. Cytoplasm: clear? pink? blue? foamy?

         Hydropic degeneration = Reversible 

                 - RNA gives the blue tint and with cellular damage, the ribosomes are reduced

                                               - loss of staining due to swelling of membraned organelles

                                               - swelling of mitochondria and ER adds more pallor

                                               - more swelling: waterlogged cell  à vacuolation

                      

c.      Nucleus-cytoplasm ratio = High in basal skin layer, lower if more mature (except in atrophic prostate)

d.       Mitosis – cell giving birth to another cell

e.      Vacuole? Grainy? 

f.      Etc etc. 

Read read Molavi (Practice of Surgical Pathology). :D. Practice!

(Based on MCA's advice).


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Randoms:
For hemorrhoids, don't only check the rectal and the anal mucosa. Check for the viral cytopathic effect -- check for koilocytes. :D.

LTO Student License

Pumunta ako ng LTO sa East Avenue para sa aking student licenseWirdo lang na tapos na 'ko magdriving school bago ko pa nakuha ang ID ko, haha.

Sa pagkuha ng Student License, kailangang magdala ng NSO Birth Certificate at photocopy nito. Magtanong na lang sa guwardiya kung saan banda pupunta. Napakaraming guwardiya sa LTO. :D. (Kaso ang bilis nila magsalita, nakatatlong tanong pa ako bago ako nakarating sa building para student license kasi nahiya akong ipaulit yung sinabi nung ibang mga guard..)

Pag nando'n na sa building na 'yon. Sabihin ninyo sa information/guard na for Student License kayo para ituro niya kung saan ang pila. Sa Step 1, ipepresent ang NSO birth certificate at photocopy, tapos bibigyan kayo ng form na sasagutan ang ng number kung pang-ilan sa pila. Tingnan niyo kung pang-ilan kayo, nakadisplay siya sa harap ng window para sa student license. Kung may 100 pa ang layo, may isang oras ka pa para magliwaliw. Kaya wag bulukin ang sarili sa loob ng LTO. Haha. Sa kaso ko, 10 AM ako dumating, mga 11:45 pa ako natawag. Mga 105 ang layo ko sa pila. Namasyal muna ako at gumawa ng iba pang mga bagay, at pagbalik ko, malapit na ako sa pila. :D

Ibibigay ang form at NSO (+ copy) sa window. Susunod ay kukunan na ng litrato at pipirma na para sa ID. Mula sa parte na ito, mahirap na umalis, dahil tatawagin na mismo ang pangalan niyo. Kailangang nandoon lang kayo at naghihintay. Pagkatapos ng picture, bayad naman. Hantayan uli at kailangang tawagin muna ang pangalan. Pagkatapos ng bayaran, maghintay uli para sa releasing ng ID. Inabot ako ng kulang-kulang tatlong oras sa parte na ito. Kaya dapat medyo handa sa mapagkakalibangan. 3G, games, libro, o kung anumang ibang p'wedeng gawin. Sa kaso ko, nanood ako ng tao, naglaro ng kaunti sa selpown at nagdrowing nang nagdrowing.

Bila kong napasalamatang mahilig akong magdrowing dahil mula pala pagkabata e lagi na 'kong sinasalba ng drowing sa posibleng pagkabagot. :D

Hapi kuha ng student license! :D

Parada sa isipang walang magawa

Ugh

Sana hanggang n years mula ngayon!

Littman Classic II S.E. Rainbow

Yay! My cousin gave me a gift for passing the board exam. :D A new stethoscope! I'm not an clinician but of course I will use it! :D Very exciting to receive gifts via package! Haha.

Rainbow! Hihi.

Rainbow on the inside. XD

It is a Littman Classic II with Rainbow Finish Chestpiece. I think it's artistic and it fits my eclectic personality. Haha. :D. It also has a green tube which makes it more unique (compared to black).

I have a Cardio III stethoscope which was also given to me as a gift. I have used it to thousands of patients and it has maximized its use after monitoring sooo many patients in the ward. It's cool because its bell can be converted to a pediatric steth. Of course, it's also very sensitive when listening to murmurs. What's also good about it is that it's heavy. So when people borrow it, they tend to return it immediately. xD. However, since it's heavy... it's .. heavy.

What I like about the Classic steths is that they are lightweight :D. As a pathology resident, I will just use my stethoscope to screen patients in the Blood Bank. I might do some medical missions too. Hopefully, I can keep my new stethoscope new, lol. :D

DIY: Key Holder

Because most of the people here at home always forget where they put their car keys, I decided to make a key holder.

Materials:
Scrap wood (free: found it outside)
Pencil and eraser (free: found it in my drawer)
Ruler (free: found it in my toolbox)
Markers (free: found them in my cabinet)

Uh, question mark thing. I don't know what it's called. I bought it in Handyman for ~40 pesos.

I started by measuring the wood and dividing it to equal areas depending on how I want it. I then drew my design.

Montero = Monty!
Pajero = Pajie!
Captiva = Capty!
Tucson = Tucsy!
JAC = JAC
... = Tamiya!

I aligned and put the hooks to see if the car drawings will be affected.

I used ordinary markers to outline the sketch I made.

I used colored markers to color the letters. I wanted to color the cars too but I don't have the available colors to do it. I put the hooks after. :)

Simple and funny, haha. Doesn't look good but it does its purpose, haha. My mistake is I wasn't able to put enough space for the keys.

Make sure that your key holder is located in a secure place. You don't want robbers to enter your house and get all your car keys.

Pathology

Okey, excited na ako. Natanggap ako sa patho. Gusto kong simulan nang tama ang buhay ko, haha. Pero syempre, di ibig sabihin ay di ko na gagawin ang mga gusto ko. Sobrang saya ko nang dumating ang padala ni T na Arduino. Ang saya-saya. Kung interesado ka sa electronics at programming at wala ka pang karanasan, mahusay na start ang Arduino Uno. :D. Tapos s'yempre gusto ko pa ring tapusin ang computer science na course sa edX at matutunan ang Python. :)

Excited na rin ako gumawa ng research sa pathology. Gusto ko paglaruan ang computational pathology. Tingin ko napaka-interesante. Gusto ko ring ipasok ang electronics sa research. Hindi ko alam kung alin ang feasible pero nakakatuwa na may mga possibilities.

Pero s'yempre, nakakatakot kung gaano katarik ang learning curve na kailangan para maging pathologist. Pero interesting talaga. :D. Sana naman!

Owel papel. :)

Coffee Collection!

My favorite blend is Kapeng Bailen from Gen. Emilio Aguinaldo, Cavite. It is a blend of Liberica, Excelsa and Robusta. Next is Pahimis Blend of Cafe Amadeo from Amadeo, Cavite which is a blend of Arabica, Robusta and Liberica.

I am excited to try Kape de Kalinga from Tabuk, Kalinga. I read somewhere that Kalinga coffee is purely Robusta, so it's interesting. I'm also excited to give Arabica another chance to beat my favor to Liberica (Barako). :D. One of my pure Arabica coffee is from Sweden and the other one from Hawaii.

If only I know how to taste coffee the proper way, haha. I want to review each of them. XD. Poshycharot. XD.

Driving Lessons Day 4

Kapag liliko sa kanan, hintayin na pumantay ang side mirror sa first third ng corner ng island
Ikabig sa kabila ang manibela kapag mga 10 degrees mula sa gitna ng kalsada.



Kapag 15 kph na, 2nd gear.

Driving Lessons Day 3

Wala naman, nagdrive lang kami papuntang Fairview.

Turning???
1. Start ang pagliko kapag kapantay na ang kanto ng island
2. Lumiko kapag kalahati na ng kotse ang lumagpas sa island

Pagbaba ng gear
1. Kunwari nasa 3
2. Neutral, konting break.
3. Neutral, lower gear.

Driving Lessons Day 2

Mukhang medyo malungkot si Kuya B ngayong araw. @_@.. Heniwey, para sa Day 2!

Parking facing the wall

Parking pwet facing the wall

Position ng paa brake at gas

Unang Pagkakataon

Ang daming kakaiba para sa akin ang nangyari sa araw na ito. Parang semi-pasko sa dami ng regalo. Mas marami pa nga yata kaysa sa karaniwang pasko.

Bago ako umalis ng bahay, unang pagkakataon ko na gawin ang basic-kuno-na-paghuhugas-ng-mukha. Matrabaho sa totoo lang. Pero tumatanda na ako at ayaw kong hayaan na lang ang araw na patandain ang mukha ko nang ganoon na lang xD. Kaya't nakapagfacial scrub ako (yehees, third day na), nakapagtoner (yoown, second day!) at first time na maglagay ng sunscreen moisturizer sa mukha. Hahaha. Arti.

Hmn.. tapos, sinimulan ko ang araw na ito sa driving school. Unang pagkakataon ko magpark ng paurong. Hindi pa mahusay, pero kahit papaano nasimulan na.

Nagkita kami ni Joy Ann. Pumunta kami sa Chocolate Kiss at unang pagkakataon naming matikman ang Dayap Cake. Napakatamis.. pero.. uh.. Parang marshmallow na tinunaw. Pero okey naman.

Naglakad kami at kumain sa Happy Thai. Unang pagkakataon kong kumain ng Thai Pad at ng Milk Tea. Masarap ang Thai Pad nila. Masarap din ang milk tea, kinailangan ko nga lang dagdagan ng medyo maraming tubig. Gano'n pala ang lasa ng milk tea. Parang tea... na may milk.

Haha!

Binigyan ako ni Joy Ann ng mga regalo. Ang saya-saya. Unang pagkakataon kong magkaroon ng concealer! Woot!! At ang lupit, may liquid eyeliner pa!! Shushal!! Parehong di ko pa nasusubukang gumamit ng pareho!

At dahil mabait siya, binigyan niya ako ng mga pasalubong galing Hong Kong!! Unang pagkakataon kong makakita ng ng fish sausage!! At may.. uh.. parang nakarolyo na kakaibang pagkain. Hindi ko maalala ang pangalan. Pero unang pagkakataon din!! :D

Pagkauwi ko, dumating na ang ilan sa mga packages na inorder ko sa internet. Woot!! May close-up filter na ako!! Unang pagkakataon kong makakita at gamitin!! Unang "macro" ko na mga shots!!

At ang pinaka-pinaka-pinaka-pinaka malupit sa lahat! Dumating ang regalo ni Thomas!!!! Sooooooooooooooooooooooooooooobraaaaaaaaaaaaaaaaaaaaaaaaaang astig, di ko kinakaya, hahahahahhahahaha. Nakakaiyak nga e. Electronic kit!! Grabe. Maliit pa lang ako, gusto ko na talaga matuto nito. Tas may pangmeasure pa ng kuryente na kasama. Arduino Uno at kung anu-ano pa. Hahaha. Sinubukan ko nang magbasa, pero.. uh, naghugas muna ako ng pinggan at pinakain si Jackie at naglinis ng bahay at maliligo muna ako. Hahaha! Sobrang excited na ako. ^________________________________^. Pero ayaw ko na munang pag-usapan at sabihin kay Thomas, wahahahahahahaha. Nakakahiya. XD. Kapag maayos na siguro 'yong nagawa ko. :D.

Sobrang excited na ako. :D


Pati yung make-up na bigay ni Joy Ann, gusto ko paglaruan, wahahahah.


... haaay. Bukas, malalaman ko na kung natanggap ako sa Patho. Bukas rin ako iinterviewihin ng Briton. Nakakatakot.

Nakakatakot. Nakakatakot.



Sana hindi ganito ang araw na ito para sa paghahanda bukas. Sabi nila, pagkatapos ng kasiyahan, may kalungkutan. Pero.. wala naman yata sa logic 'yon. Relative naman ang saya at lungkot.


Pagkatapos ng bukas. Malalaman ko.


:D. Sa Sabado, baka may eat-all-you-can sa Maginhawa, p'wede!! :D

Driving Lessons Day 1

Pagkabayad namin sa driving school, napasabak na agad ako sa driving lessons. Uh.. Isusulat ko lang dito sa blog ang ilan sa naalala ko para hindi ko makalimutan. Kung mali ang pagkakaalala ko.. uh.. e di hindi ko naalala, haha. xD.

Una! : Ang ginagawa pagkapasok sa kotse.
1. Umupo at siguraduhin na abot ng tarsals ang clutch.
2. Ikabit ang seatbelt.
3. Ilagay sa neutral ang kambyo
4. Apak clutch. Ikot susi. (Dapat mapaandar ang sasakyan sa loob ng 3 seconds. -- Ignition. Kapag nag-iignite ng matagal. Depende sa model kung aapakan ang clutch sa ignition).

Pagpapaandar!
1. Sagad clutch, lagay sa 1.
2. Release clutch slowly. Pag kumagat na, release.

Change gear!
1. Sagad clutch, lagay sa x.
2. 3-second-release. (Kapag nag-rerelease dapat ang binti ang gumagalaw, hindi lang ang paa)
3. Bitaw kapag kumagat na.

Half Brake!
1. Sagad clutch
2. Dahan-dahang brake.

Full brake!
1. Sagad clutch
2. Dahan-dahang brake.

Slight brake..
1. Dahan-dahang brake -- no clutch.

Ways para mag slowdown
> Pindot clutch habang tinintimpla
> Release accelerator
> Kaunting brake

Parallel Parking
1. Tabihan ang kotseng nasa harap. Side-by-side sa side mirror. Mga half meter away.
2. Sagarin sa kanan ang manibela.
3. Clutch. Reverse. Slowly release. Hanggang kalahati na ng kotse ang nakabariga sa pwet ng tinabihang kotse.
4. Straight ang manibela.
5. Clutch. Reverse. Slowly release.
6. Sagaring ang manibela sa kaliwa.
7. Clutch. 1. Slowly release.
6. Siguraduhin na may space sa harap para kapag umalis ang nasa likuran at may tumutok na bago. Makakaalis ka pa rin dahil may sapat na space sa harap.

Hanging
1. Clutch. Brake.
2. Slowly release clutch. Once with vibrations, slowly release brake.
3. Gas

Ending
1. Park. Clutch, brake. Clutch, neutral. Hand brake.
2. Turn off ALL equipments.
3. Ikot susi.
4. Lock manibela.
5. Primera

*Angat - right signal light
*Baba - left signal light

"Why don't you get started?"

Kapag alam mo ang gusto mong gawin sa buhay pero nag-qu-quarterlife crisis ka dahil wala ka pang nagagawa kahit isa. Ang dami mo nang "achievements" sa mata ng ibang tao, pero wala ka pa ring naaabot para sa sarili mo.

Bakit di mo simulan dahan-dahan? Bakit di mo simulan ngayon?


Bakit ba wala kang tiwala sa sarili mo? Natatakot ka ba na hindi mo pala kaya ang mga bagay na tanging ginugusto mo? Natatakot ka ba na hindi mo masimulan ng tama?

Bakit di ka ba magsimula? Ngayon?



Playlist para sa. Para sa mga gusto naman, pero hindi pa umuusod. Para sa mga binubulate ang tiyan, gusto daw, pero hindi pa magsimula.

Binubulok mo lang ang sikmura mo. Wala ka lalong magagawa.

Simulan mo na ngayon.


___

Gawa ka na ng iskedyul kung paano mo ilalagay sa pang-araw-araw na buhay mo ang 'buhay' mo.



Hindi tayo nabuhay para mamatay.


Tagay!


<hindi nga pala ako umiinom>

Non-Clinical Physician: Job Hunting

Kung may kakilala sana ako na mag-ga-guide sa 'kin. Ang hirap ng napadpad sa mundong hindi mo trip kung ano ang daloy.

Para sa mga katulad kong doktor na ayaw ng pasyente, anu-ano ba ang mga p'wedeng landas? P'wede bang mabuhay nang normal lang ang gising ang tulog? P'wede bang maging masaya naman?

Haaay.

Research-beybi!! Magkikita rin tayoooooo!! TT_TT

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Kung anu-ano in-applyan ko. Kung anu-ano na rin ang nagrereply.


Gaaahd. Kailangan ko ng guidance. Sarili 30 years from now! Kausapin mo ko!! Purizuuu. T^T

Dermatomes Memory Aid (Cervical and Thoracic)

I don't have a good mnemonic to remember every dermatome, but I have some memory tips to approximate the possible dermatomal level of some parts of the body. If you know the dermatomal level before and after the dermatome which is being asked, you will have a good guess of its level.

Here are my visual memory aids for some of the dermatomes.

C2 - base of the skull
T4 - nipple

C5 - tip of the shoulder
C6 - thumb
T10 - umbilicus

So if we are asked what the dermatomal level of xiphoid process is, we can deduce that it's between T4-T10 because we know that it's below the nipple (T4) and above the umbilicus T10. You can count from the nipple using two fingerbreadths to narrow down the approximation.

C6 - thumb

Using this hand position, count from the thumb to the little finger (C6--> C7 --> C8)

Tricycle Panning

Sinubukang i-edit.

Sa ikalawang araw ng aking paglalakad-lakad kahapon, sinubukan kong mag-aral ng panning. Bale ang panning ay kukuha ka ng litrato ng gumagalaw na bagay. Magfofocus do'n sa bagay na gumagalaw, tapos maiiwan yung background as blur.

Karamihan sa mga kinunan ko ng picture ay tricycle, kasi.. wala lang. Haha. Para dumami ang tricycle pictures sa internet. Hahaha.

Nasa loob lang ako ng village kaya hindi masyadong mabibilis ang mga sasakyan. Pero ang shutter speed ko kapag mga kotse ay 1/60. Kapag tricycle, nasa 1/40.

Ginawa ko nang tirik na tirik ang araw kaya napakainit. XD.

Ang hirap lang talaga mag-street photography dahil ang awkward. Haha. Nakakahiya na nakatingin ang mga tao na pinipicturan. Wala naman silang consent na pipicturan ko sila, kaya ang laking dilemma pa rin. Pero 'pag may mga nasasama na tao sa mga pictures natin sa public areas, hindi rin naman natin hinihingi ang consent nila hindi ba? @_@.. Sa balita, kapag may navivideo na mga tao, hindi na rin nila pinapaalam na nakasali sila sa maipapalabas sa TV. Dahil nasa public area, kaya public din ang litrato nila? Ethical ba 'yon? Ah, ewan. >_< Ang safe na lang siguro na p'wede kong gawin ay gamitin sa maayos na paraan ang mga letratong nakukuha ko. 'Wag pagkakitaan at 'wag pagkatuwaan ang mga tao.

AwkwardDahil prime lens ang gamit ko, kung gaano kalayo sa paningin ko ang subject,
halos gano'n din kalayo ang nakikita ko sa camera. :S

Kaya ayun, medyo problema dahil walang zoom in ang camera ko. Pero kung may zoom in ka, kaunting distansya lang at okey na. Mahirap lang kung sakaling medyo mahaba ang lente dahil pansinin sa kalsada. Ingat-ingat sa holdap. XD.
______

Steps kung paano ko ginawa ang panning (Nikon):
1. I-set sa Auto-focus continuous (AF-C) - dahil gumagalaw ang mga sasakyan! :D
2. Shutter speed priority
3. Kapag dumaan ang gumagalaw na bagay.. Sundan! XD.
4. Check ang image and adjust to taste ang shutter speed.

Ito ang pinanood ko bago 'ko sinubukan ang panning. Malinaw at basic pagpapaliwanag ni Gavin Hoey.

Narito pa ang mga panning pesyurs na nakuha ko. Wala na munang edit-edit. Ahehehe. (Kaya dapat talaga, kung paano natin kinukuha 'yong litrato, 'yon na halos yung mismong gusto nating itsura. Para wala nang edit! At para lagi tayong nagsastrive for perfection, haha. Charot.)

Axillary Artery Memory Aid (HelpHippo)

I highly recommend the mnemonic by HelpHippo in remembering the branches of the axillary artery. I used this mnemonic when I was cramming for anatomy. Hope this helps. :)

There are other memory aids from HelpHippo that you may find useful. Check their channel. :)

Naked RNA Memory Aid (Tagalog)

Sa PLE August 2015, hindi high-yield ang tanong na "which of the following is a single stranded chorlaNA, which one is naked chukchakNA? which one is enveloped?" et cetera, et cetera. Pero may mnemonic ako para matandaan ang naked RNA at mga dapat matandaan sa mga naked RNA. 

Nakapaskil sa pintuan ng kuwarto ko habang naghahanda sa boards

Naked = Hubad. 

"Hubad ang PUTS"

P - wet: Diarrhea. Most common cause of viral diarrhea in adults and in children - Norvo and Rota

U - tak: Aseptic meningitis. Three groups causing aseptic meningitis. Think of hand, foot and echo (Ang random ng echo, haha. Basta, echo!) 

• Coxsackie - HAND, foot and mouth disease
• Polio - FOOT (madalas nating makita sa lower extremity)
• Echo - ))))))

T - AE: Hep A and E are orofecal transmission, hence, TAE.

S - ipon. Rhinovirus. 

Medyo sabaw, pero maraming must-know ang nasasama sa mnemonic na 'to. Madaling lumabas sa boards ang mga diarrhea, aseptic meningitis, orofecally na transmission ng Hep. 

No'ng August 2015 na PLE, parang may naalala akong may nadaanan about aseptic meningitis. Sa boards kasi hindi nila directly tinatanong ang mga facts. Pamigay na 'yon kapag masyadong straight to the point. Ang style nila, dapat alam mo na 'yong mga facts. Tapos assuming na alam mo nga, magbibigay sila ng mga tanong -- p'wedeng situational, p'wedeng theoretical. Gusto nilang nag-iisip ang mga kumukuha ng boards. More of analysis ang exam kaysa recall. Pero hindi ibig sabihin walang recall. Mapapa-recall ka na lang habang nag-aanalyze, haha. Kailangang INTINDIHING mabuti ang mga konsepto. 

Kung may mali, comment na lang. Sana makatulong.

Scarred Brachial Plexus Dog: Brachial Plexus Memory Aid

This is the easiest way for me to draw the brachial plexus. :o3

I made this diagram to easily remember the brachial plexus. It's also good in remembering some of the conditions due to brachial plexus lesions. The brachial plexus dog is based in First Aid from the USMLE Step 1 2014 (Le, Vikas & Sochat, 2014).

You will notice that brachial plexus in 2D is quite symmetrical, except for the part in the anterior division where it converges to lateral cord. So I got the idea of a scarred dog to easily remember that part. (The scar is drawn using a red pen.)

Here is how the brachial plexus dog works:

Click the image to enlarge

Compare your own brachial plexus dog with Netter's Illustration

Other details:

In naming the root, trunk, division, cord and branches, just be guided by the change in the number of the group nerves. Just count the nerve groups from top to down.

• It starts with 5 roots (ear part). (C5, C6, C7, C8 and T1)
• On the eye part, the 5 group of nerves changed to 3 groups (eye part). trunk (superior, middle, inferior)
• right eye - Waiter's tip - superior
• middle
• left eye - Claw hand - inferior
• After 3 groups, it changed to 6 groups (scar part). division (3 anterior, 3 posterior)
• The nerves converging to the nose is the posterior division.  
• From 6 groups, it went back to 3 groups (nose part). cord 
• nose = posterior cord
• scar above = lateral cord (latigo, lateral ;) )
• medial cord
• This will not work for the branches part anymore. Anyway, it's a must-know that the axillary nerve, the radial nerve, the musculocutaneous nerve, the median nerve and the ulnar nerve are the five terminal branches. 

Some use mnemonics to remember the group of nerves. First Aid suggests "Randy Travis Drinks Cold Beer". You can make your own. Hmn.. like "Red Tadpoles Decay Corpse Brutally", haha or "Rotten Trees Dead Corpse Bulate", hahaha. What I use is just thinking that the brachial plexus starts with roots because... because... brachial plexus will start from.. the nerve roots! Where else?! Then like a tree, it starts from the roots then the trunk. At the end of the tree, there are the branches. DC separated the branch from the trunk.. DC = disconnected, hahaha. Lol. Just use whatever works for you. :D 

This is the poster I made which I put in my room to keep myself familiarized with the brachial plexus.

Leave a comment if you see any mistakes. Thanks. :D



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One of the most scarring part of my medical school is when I was asked to discuss Brachial Plexus in front of consultants, residents, medical interns and clerks. I was chosen by my groupmates to do the job because they thought that I am good with making powerpoint presentations. I do powerpoints, but I rarely present it so it was a bit scary. I tried to study it well, made a very simple powerpoint and prepared a 3D program so I can explain brachial plexus clearly.

But when I started speaking, a consultant told me to stop using Tagalog words OR I should just choose on whether speaking straight Tagalog or straight English. Of course, there is no direct translation for very specific anatomical parts in Tagalog, I had no choice but to speak in English. I told the consultant that I stutter when I speak in English and that I can't express my thoughts clearly in English. And then consultant said, "How will you present your research paper in the international setting if you can't speak English?"

It was very embarrassing. I felt so humiliated. I felt somewhat harassed. I felt that my knowledge on the topic was measured by my ability to speak in English... which I couldn't do well.

PFff. Being in the University of the Philippines, I was disappointed with the consultant. We were not in a communication class. Everyone understands my Taglish. I prepared to do a report which will make everyone understand and remember brachial plexus, not to practice my English-speaking skills. I was not presenting a research paper. I was trying to teach a concept! The university has always promoted the use of the mother tongue to teach, so what's the problem?!?! Aah!! Pff. It's the culture of the medical people -_-. Old skOOl-hierarchy-based-I'm-superior-you're-stupid. And yes, I'm being irrational now. xD.

Anyway, it ended as a mess. I forgot many things. I was asked questions that I couldn't answer. I wasn't able to use the 3D anatomy program. I was stuttering. I was mispronouncing words. I didn't know what to say. Hahahaha. At least the entire report is now over, that is what's important. XD. I told myself that I should be able to publish a Tagalog research paper internationally someday. (I also myself that I should be good in speaking English to avoid that situation again next time. Hahaha.)

Sighs. Medschool. :P

I hope that my brachial plexus dog will save you from that kind of situation, lol. Enjoy.