Optic nerve - CN II
It has been quite a long time since the last time I did a proper cranial nerve examination on a patient (i.e. with findings). While waiting for the lecturer to come, my friend and I decided to brush up on our short case examination skills. He suggested cranial nerve examination and volunteered to do it on me. After a while, we realized how terrible our skills were. The flow was not very smooth, and we had slight difficulty in giving instructions to the 'patient'. Hence we came into conclusion that we did not practice enough.
For a short case examination, it won't be more than 10 minutes per case (there will be 3 short cases back to back for the final examination). So, we are supposed to finish examining within 7 minutes (at most) so that there will be discussion where a lot of marks may come from. "The keyword is showmanship," one of my lecturers used to told us. IMHO, CNS examination is the most difficult among all physical examinations of human body system. A lot of instructions needed to be given to the patient in order to elicit the signs. Moreover, we would have to identify where the lesion might possibly be. Which means, dermatomes and myotomes as well as the nerve supply must be remembered. I remember how terrifying Neuroanatomy and Neurophysiology were when we learned them during our second year of Med school.
Whether I like it or not, I would have to practice more so that I can perform the examination properly. A visit or two to the neuromedical and neurosurgical wards might help. My 'bantal' won't help as 'patient' because in CNS examination the patient need to respond accordingly to the instructions given. =)
p.s. For the time being, I would have to be more of exam-oriented because the exam is around the corner. I know, some people believe that it's not good for the career development, but I personally think there's nothing wrong with that. The examination is done to assess whether we are ready to be "released" into the society to serve them. So, I think it OK to be a bit exam-oriented, in sense that to focus more on the common things that may be asked in the examination. Once I've graduated, trust me, I would do a lot more than this to improve my skills and knowledge - keeping updated with the recent developments via journals, attending seminars etc.
Reminder to myself: Prepare the presentation slides for the Case Conference. Tomorrow please visit neuro wards to practice on CNS examination (short cases).
For a short case examination, it won't be more than 10 minutes per case (there will be 3 short cases back to back for the final examination). So, we are supposed to finish examining within 7 minutes (at most) so that there will be discussion where a lot of marks may come from. "The keyword is showmanship," one of my lecturers used to told us. IMHO, CNS examination is the most difficult among all physical examinations of human body system. A lot of instructions needed to be given to the patient in order to elicit the signs. Moreover, we would have to identify where the lesion might possibly be. Which means, dermatomes and myotomes as well as the nerve supply must be remembered. I remember how terrifying Neuroanatomy and Neurophysiology were when we learned them during our second year of Med school.
Whether I like it or not, I would have to practice more so that I can perform the examination properly. A visit or two to the neuromedical and neurosurgical wards might help. My 'bantal' won't help as 'patient' because in CNS examination the patient need to respond accordingly to the instructions given. =)
p.s. For the time being, I would have to be more of exam-oriented because the exam is around the corner. I know, some people believe that it's not good for the career development, but I personally think there's nothing wrong with that. The examination is done to assess whether we are ready to be "released" into the society to serve them. So, I think it OK to be a bit exam-oriented, in sense that to focus more on the common things that may be asked in the examination. Once I've graduated, trust me, I would do a lot more than this to improve my skills and knowledge - keeping updated with the recent developments via journals, attending seminars etc.
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Reminder to myself: Prepare the presentation slides for the Case Conference. Tomorrow please visit neuro wards to practice on CNS examination (short cases).
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