Atrial fibrillation

Paroxysmal SVT

She has her diagnosis on her shirt😂🍻

The official line in medicine is that the physical exam is important. But what you quickly pick up in the “hidden curriculum”—the values and beliefs of medicine as it’s practiced—is that the physical exam is mostly a waste of time. On rounds in the hospital, as a student or intern, you might proudly describe a murmur you picked up on exam, but it doesn’t take long to realize that it’s only the report of the “echo” (shorthand for echocardiogram —an ultrasound of the heart) that anyone pays attention to. And because the physical exam is not valued, you soon learn not to pay attention to it and all further learning stops—replaced by the kind of learning you know those who are in charge will value. What did the newest high-tech test say? What is the most current research on a particular therapy? These are the questions physicians are now being trained to ask—not the more traditional questions, such as, What did you see when you looked at the patient? What did you feel? What did you hear?

- Every patient tells a story

Neurological lesions above the red nucleus (intercollicular line in the midbrain) tend to cause decortication and lesions below, decerebration.

Decorticate vs decerebrate posturing

There are at least 3 tracts and 1 nucleus that have the name "arcuate" in them.

As for "Lemniscus," you have 2 of them.

Arcuate fasciculus: connects Broca's with Wernicke's area.

Internal Arcuate tract: connects the dorsal column nuclei with the thalamus.

Anterior/posterior External Arcuate tract: connects the dorsal column nuclei with the pons & the cerebellum.

Arcuate nucleus: I don't even know where that is

Medial Lemniscus: the continuation of the internal arcuate tract outside the medulla is named the medial lemniscus. It connects the dorsal column nuclei with the thalamus.

Lateral Lemniscus: connects the auditory nuclei (superior olivary & cochlear) with the inferior colliculi.

Pseudo-hypertrophy

It happens in muscular dystrophy.

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A history lesson & a neuroanatomy lesson