RESPIRATORY SYSTEM 1.Heart valvue disorders and murmurs.. REMEMBER: hARD ASS MRS.

MSDoctor hARD - Aortic Regurgitation is DIASTOLIC ASS - Aortic Stenosis is SYSTOLIC MRS - Mitral Regurgitation is SYSTOLIC MSD - Mitral Stenosis is DIASTOLIC 2.Myocardial infarction Many many thanks to Karun Kumar for sending his self made mnemonics on MI. Pleas e note that he has included some hindi mnemonics in this post. Definition (CAP) Evidence of myocardial necrosis with any 1 of the following: Cardiac biomarkers (pref. Troponins) showing sudden rise or fall Sudden unexpected cardiac death involving cardiac Arrest Pathological findings of acute MI

Signs of MI (windows VISTA) Vagal activation (vomiting, bradycardia) Impaired myocard. Func. (s1,s2 soft; hypotension; inc. JVP; Oliguria; Cold, clam my skin) Sympathetic activation (Pallor, sweating, tachycardia) Tissue damage (Low grade fever) A complication (MR / VSD producing pansystolic murmur Enzymes elevated in MI (TALC - talcum powder) Troponin T/I AST LDH CK-MB Complications of MI Immediate (RAILgaadi) a) RV infarction b) Arrythmias (VT, AF, VF) - may also be due to I.v. Xylocaine overdose c) LHF Early (PSVT ka MELA laga hua hai !!) a) Pericarditis b) Sudden death c) VSD d) Thromboembolic complications (Pulmonary, Arterial) e) MR (Papillary muscle dysfunction or rupture) f) LV free wall rupture (Pericardial tamponade)

g) Arterial compl. (same as mentioned in d) ) Late (PADS) a) Psychological reaction (DADDA- Denial, Acceptance, Dependency, Depression, Ad justment - this is from earliest change to last) b) Arrythmias (ventricular like VF, VT) c) Dressler s syndrome (Autoimmune phenomenon characterized by fever, pericarditis , pleuritis, pneumonitis) d) Shoulder (Frozen shoulder) Pain n stiffness of left shoulder

3.Rheumatic fever : Major criteria CASES Carditis, Arthritis (migratory), Subcut nodules, Erythema marginatum, Syndenhams chorea Minor criteria 4PA Pyrexia, prolonged PR, past Hx, positive (ie ?)ESR/CRP, Arthralgia Occlusive arterial disease 6Ps Pain, pallor, pulseless, parasthesia. Paralysis, perishing with cold Splinter haemorrhages TRIP SAM Trauma, RA, Infective Endo, PAN SLE / Sepsis, Anaemia (profound), Malignancy (haematological) ST elevation ELEVATION Electrolytes, LBBB, Early Repolarization, Ventricular hypertrophy, Aneurysm, Tre atment (eg pericardiocentesis), Injury (AMI, contusion), Osborne waves (hypothermia), Non-o cclusive vasospasm (prinzmetal s) SVT Causes SNAP Sinus tachy, nodal tachy, a fib, paroxysmal atrial tachy Symptoms of aortic stenosis ASD Angina 2 years } Syncope 1 year } prognosis Dyspnoea 6/12 } Endocrinology 4.Cardiology 2 LVF, Management of FOAM Frusemide 40mg iv, Oxygen, Atrovent (& Ventolin) nebs, Morphine 2.5 - 5 mg Mitral Stenosis, Complications PASTRI Pulm ?BP, A fib, Systemic embolism, Tricuspid regurg, Right heart failure, Infec tive endocarditis Myocardial infarct, complications ABCDE x2

Arrhythmias / Aneurysm Bradycardia / ?BP Cardiac failure / cardiac tamponade Dresslers / Death! Embolism / Extra (VSD, pap muscle rupture) Pericarditis DRUMSTICX Dresslers, Rh fever / RA, Uraemia, MI, SLE, Trauma, Idiopathic, Coxsackie, X-ray Postural Hypotension HANDI Hypovolaemia / hypopituitarism, Addisons, Neuropathy (autonomic), Drugs (vasodil ators / TCADs, diuretics, antipsychotics), Idi 5.Cardiology 1 No apex beat DOPES Dextrocardia (don t say this first!), Obesity, Pleural/Pericardial effusion, Emphy sema, Shock. 3rd Heart Sound FIPPY Failure, Incompetence (mitral/tricuspid), Pregnancy/Pill/PE/Pericarditis, Youth 4th Heart Sound SHIT Stenosis (aortic/pulmonary), Hypertension/Heart Block, Ischaemic HD, Tamponade Arrhythmias ARHYTHMIAL 4PC Atrial Myxoma, Rh heart dis, HYpertension, THyrotoxicosis, Mitral valve dis, IHD , ALcohol Pneumonia / PE / Pericardial eff, cardiomyopathy Atrial Fibrillation ARITHMATIC Alcohol, Rh fever, IHD, Thyrotoxicosis, Hypertension, Mitral stenosis / MI / Myx oma (atrial) ASD, Toxins, Idiopathic/Infective endocarditis Cardiomyopathy/Constrictive peric arditis Bradycardia, regular PAD HIM Physiological (athlete, sleep) / paroxysmal, AV block (2II, 3), Drugs (, dig, amiod arone) Hypothyroid / hypothermia, Icteric (severe), MI Dominant R wave in V1 WORD WPW, Old MI, RBBB, Dextrocardia EMD Arrest 4Hs 4Ts

Hypothermia, Hypo & hyper-electrolytes, Hypovolaemia, Hypoxia Toxic (including drugs), Trauma, Tamponade, Tension pneumothorax JVP MOP HAIR Multiple wave form, Occludable, Postural changes Hepatojugular reflex, Above (fills from), Impalpable, Respiratory changes 6.Auscultatory areas Thanks to anonymous reader for correcting a major error in this post. Auscultatory areas starting from left 2nd intercostal space: Remember: All Patients Take Medicines Aortic - Pulmonary - Tricuspid - Mitral Note: Only Aortic area is on right ; Remember that All stands for aortic area - read a s Aortic ll (Second) ; Because it's in 2nd IC space ! If you want to remember the other intercostal spaces where the auscultatory area s on left are situated just remember " Lot no.245 " - Left 2, 4, 5 IC spaces in that order for Pulmonary, Tricuspid, Mitral in that order of All Patients Take M edicine. Confusion buster: Please note that Aorta arises from left ventricle, but auscult atory area is on right side. Note the same problem with Pulmonary artery. 7.Congenital heart disease producing cyanosis They all begin with 'T' : Tetrology of Fallot Transposition of great vessels Truncus arteriosis Tricuspid atresia Total pulmonary anomalous venous return

8.Lung development: Phases Submitted by neema_neetha on Fri, 11/12/2009 - 22:03 in Embryology Respiratory system "Every Premature Child Takes Air" Embryonic period Pseudoglandular period Canalicular period Terminal sac period Alveolar period 9.Hemoglobin and Myoglobin-Binding sites,strengths Submitted by akp_osler on Sat, 25/10/2008 - 19:09 in Physiology Respiratory system "ABC" of glycosylated Hb (Hb1c):Glucose binds to Amino terminal of Beta Chain. "HbF binds Forcefully": HbF binds oxygen more forcefully than HbA, so Oxy-Hb dis sociation curve shifts to left. Stored blood is SOS: Stored blood Hb binds to Oxygen Strongly because of decreas e in 2,3 BPG. 2,3 BPG binding site is BBC: BPG binds to

10.Oxygen-haemoglobin dissociation curve: Causes of shift to right Submitted by abrakadavra on Fri, 25/07/2008 - 20:17 in Physiology Respiratory system CADET, face Right! CO2 Acid 2,3-DPG(aka 2,3-BPG) Exercise Temperature 11.Nerve supply of diaphragm: C three,four and Five, keeps diaphragm alive Phrenic nerve (C3-5) supplies diaphragm. Irritation of diaphragm may cause refer red pain on shoulder because phrenic nerve and supraclavicular nerve have same r oot value i.e. C3-5. Opening of Diaphragm: Voice of America (VOA 8,10,12) Venacaval opening lies in the central tendon of diaphragm at the level of T8 Oesophageal opening lies in the muscular part of diaphragm at the level of T10 Aortic opening lies at the lower border of T12 Components of median nasal septum (medial wall of nasal cavity): VPN (virtual private network) of RS 100 V = P = N = one R = S = Vomer Perpendicular plate of ethmoid Nasal spine of frontal bone; Nasal crests of nasal, palatine and maxillary b Rostrum of sphenoid Septal cartilage, Septal process of inferior nasal cartilage

Bronchopulmonary segments of Lung: A PALM Seed MakeS Another Little Palm From superior to inferior: Apical Posterior Anterior Lateral Medial Superior Medial basal Anterior basal Lateral basal Posterior basal Parts of Larynx (Voicebox) in sagittal section: 3 Vs Vestibular fold Ventricle (Sinus) Vocal fold Pleura surface markings: All the even ribs, in order: 2,4,6,8,10,12 show its route

Rib Rib Rib Rib Rib Rib

2: sharp angle inferiorly 4: the left pleura does a lateral shift to accommodate heart (cardiac notch) 6: both diverge laterally 8: midclavicular line 10: midaxillary line 12: the back

Contents of Superior Mediastinum: PVT Left BATTLE P = Phrenic nerve V = Vagus nerve T = Thoracic duct Left = Left recurrent laryngeal nerve B = Brachiocephalic veins A = Arch of aorta and its 3 branches T = Thymus T = Trachea L = Lymph nodes E = Esophagus The 3 branches of Arch of Aorta ABCs of Aortic Arch A B C S = = = = Aortic arch Brachiocephalic trunk Left common carodtid artery Left subclavian artery

Contents of posterior mediastinum: 4 birds: esophaGOOSE (esophagus) vaGOOSE nerve (vagus) azyGOOSE vein (azygos) thoracic DUCK (duct) Popularity: 5% 12.