Aims Of Medicine And Clinical Methods Notes and Short Essays

Aims Of Medicine Important Notes:

1. Auscultatory areas
2. Clubbing
   • Definition
     • Bulbous enlargement of soft parts of terminal phalanges with both transverse and longitudinal curving of nails
   • Causes
     • Pulmonary – bronchogenic carcinoma, lung abscess, bronchiectasis
     • Cardiac – infective endocarditis, cyanotic congenital heart disease
     • Alimentary – ulcerative colitis, Crohn’s disease, biliary cirrhosis
     • Endocrine – myxedema, Grave’s disease, acromegaly
     • Miscellaneous – hereditary, heroin addicts
   • Grading
     
     
3. Pseudoclubbing
   • In hyperparathyroidism, excessive bone resorption may result in the disappearance of the terminal phalanges with telescoping of soft tissues and a drumstick appearance of the fingers resembling clubbing
   • However, the curvature of the nail is not present
4. Scliamrotli’s sign
   • Normally when two fingers are held together with nails facing each other, a space is seen at the level of the proximal nail fold
   • This is lost in clubbing
5. Jugular venous pressure
6. Different sounds and their significance
7. Important terms

Aims Of Medicine Short Essays:

Question 1. Jugular venous pulse.

Answer:

Jugular venous pulse

It is an important sign of cardiovascular disease

Jugular venous pulse Procedure:

1. Patient is placed in a reclining position at 45° angle with neck muscles relaxed.
2. Upper level of pulsation of an internal jugular vein is seen.

Read And Learn More: General Medicine Question and Answers

Jugular venous pulse Significance:

1. Fall in pressure during inspiration.
2. Rise in pressure in constrictive pericarditis & cardiac tamponade.

Jugular venous pulse Waves:

1. Positive waves
   • a wave
     • Cause – Atrial contraction.
     • Absent in atrial fibrillation.
     • Prominent in tricuspid stenosis.
   • c wave
     • Small positive wave.
   • v wave
     • Cause: Passive filling of blood from veins into the right atrium.
2. Negative waves
   • x wave
     • Cause: Descent of tricuspid valve.
   • y wave
     • Cause: Rapid flow of blood from right atrium to right ventricle when the tricuspid valve is open.
     • Prominent y wave – seen in tricuspid regurgitation.

Question 2. Clubbing.

Answer:

Clubbing Definition:

It is an enlargement of distal segment of fingers and toes due to an increase in soft tissues.

Clubbing Causes:

1. Disorders of heart.
   • Cyanotic heart disease.
   • Subacute bacterial endocarditis
2. Disorders of lungs.
   • Suppuration of lung
   • Tumours of lung
3. Disorders of GI tract St liver
   • Inflammatory bowel disease.
   • Cirrhosis of liver.
   • Malignancy of liver
4. Hereditary or idiopathic.

VIVA Voce

• The commonest cause of raised JVP is cardiac failure
• White-colored sputum is called mucoid
• Yellowish greenish lotid sputum is called purulent sputum
• Grade 3 clubbing gives nails shape of parrut’s beak.