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Right I'll try and explain a little better.  Mine is a pretty atypical case I admit. 

Basically what I do is load the PDF onto photoshop and then read through each page, using the brush selection tool (not the pen tool, my apologies) to select chunks of text, and then making each one a new layer.  I'm used to doing this quickly in drawing, where I adjust my tools so that 'new layer via cut' and 'select bottom (aka background) layer', can be executed with two quick keystrokes.  TheKeeper, the process you described with holding down shift for a straight line is exactly how I do it.

The reason I choose to do it this way, instead of in a word processor, is for a couple of reasons.  Firstly, I find just dragging chunks of text into place a hell of alot quicker than formatting it Word.  Another reason is that the pages I work with are laid out in a very specific way with a clear structure, and I want to keep my note pages as identical as possible to the real thing so that I can visualise them more easilly in my mind.

It's bizaare, but it happens to work very well.  The only thing that could be better, as I say, is precision, as my hand sometimes slips and I select too much at once.  Hence my question about traction.

Hope this makes things clearer