Identify the Structure... Ready BEEEEP!

I can't remember the last exam that I've been excited for. A fourth of our class stood outside the doors to the Anatomy lab, apprehensive for our first "practical exam." Armed only with a pen and clipboard, this exam wouldn't be multiple choice. An anatomical structure would be "pinned," and you either knew it, or you didn't. Dr. Kernick and Dr. Gilliland split the class in half and led us into the room, single-file and in two lines. We walked next to our buddy, like elementary school children on a field trip. Through the double doors awaited 20 bodies arranged in a horseshoe, each tagged with different muscles, nerves, veins, arteries, or other anatomical structure. Stepping into the lab, we left our buddy and each found a station. 40 structures, 40 students. Each body had 2 structures to identify. I began in the middle of the room, on the superior medial interior aspect of the horseshoe (there's a little anatomy humor... in English, I was at the top of the horseshoe). We would have 60 seconds to identify the body part and write it down on our answer sheet before time was up. A countdown on a television ticked off the seconds before a piercing BEEEEP! From there we moved clockwise around the room, until we ended up where we began. Once that minute was up, we couldn't go back to look at the body. The exam would be over. I began at #26.

"Once you've identified the structure, legibly write your answer on the answer sheet. If you finish early, wait til the minute is over before moving to the next body."

I looked at #26 the moment I stopped next to the body. The man was lying on his back, with towels covering his arms legs and face. His chest was exposed. Earlier in the class, we had made an incision down his chest and abdomen, beginning at the sternal notch, down past the navel. From there, we made three horizontal cuts from the midline to the midaxillary line laterally: one near the sternal notch, one at the bottom, and one about halfway between. We slowly pealed the layers of skin, fat, and fascia laterally, exposing the thick muscles of the chest. Delicately we exposed the muscles of the scapula, anterior shoulder, and chest. The instructions for #26 simply read, "Identify the Structure." With the skin pealed back, I could see the large pectoralis major. But it too was reflected, and a smaller muscle just underneath lay atop the rib cage with a tiny little pin in it. I wrote the answer for #26 even before the exam began. Pectoralis minor.

"Remember, spelling doesn't count, but we aren't going to guess at your answer."

Good. I can't spell "zygapophysial joint" anyways. Actually I think it's an "e" at the end there, not an "i," but I had to look it up on wikipedia to correct myself.

"Any questions? No? Good. Let's start the countdown. 3, 2, 1, BEEEEEEP."

I used that first minute to take a deep breath. I took the paper exam about an hour earlier, and I thought it was actually pretty tough (it certainly wasn't as easy as the practice exam, surprise surprise). On the multiple choice test, it is not simply identification. A question might ask about what nerve innervates the muscle that allows the arm to abduct and extend from 90 degrees to 180 (serratus anterior). Or if the thumb can no longer oppose, but can still be involved in flexion, extension, and adduction, what muscle no longer has motor function? (Opponens pollicis). But there was no time limit per question, and I could always flip back to a question later, looking through the rest of the test for help. Not here. 60 seconds. That's all I get before I have to give up and move on. So I took another deep breath.

Looking around the room, most of my fellow classmates showed similar eagerness, first structure already identified. Others had their nose about an inch away from the flesh, making absolutely sure of their answer or looking for some insertion or origin. Some were trying to peer across the body to see which structure the classmate across the body had to identify. As the time ticked down, I looked up at the Amit across from me. BEEEP. With a quick wink we parted in opposite directions. #27. Easy. Radial nerve. BEEEP. #28. Cross-section. Serratus anterior. BEEEP. Rest stop. Another deep breath.

There were three stations around the room designated "rest stops." Here, you get a minute off to collect your thoughts, finish scribbling any notes you need to, and take a break. I would have rather had one of these towards the end (before the test, I was about as impatient as a ten year old Christmas morning). Slowly but surely I made it around the room in one full loop, with only one structure I had literally no idea what it was (Damn you Netter's flashcards for not identifying the inferior glenohumeral tuberosity!).

"Pens down and pass in your answers. Congratulations! You just finished your first anatomy practical."

And that's why I love Anatomy.