Aims Of Medicine Important Notes:
- Auscultatory Areas
- Clubbing
- Clubbing Definition
- Bulbous enlargement of soft parts of terminal phalanges with both transverse and longitudinal curving of nails
- Clubbing 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
- Clubbing Definition
Read And Learn More: General Medicine Question and Answers
- Clubbing Grading
- Clubbing Grading
- 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
- 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
- Jugular venous pressure
- Different Sounds And Their Significance
- Important Terms
Jugular Venous Pulse
Jugular Venous Pulse is an important sign of cardiovascular disease
Jugular Venous Pulse Procedure:
- Patient is placed in a reclining position at 45° angle with neck muscles relaxed.
- Upper level of pulsation of an internal jugular vein is seen.
Jugular Venous Pulse Significance:
- Fall in pressure during inspiration.
- Rise in pressure in constrictive pericarditis & cardiac tamponade.
Jugular Venous Pulse Waves:
- 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.
- a wave
- 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.
- x wave
Clubbing
Clubbing Definition:
Clubbing is an enlargement of the distal segment of fingers and toes due to an increase in soft tissues.
Clubbing Causes:
- Disorders Of The heart.
- Cyanotic heart disease.
- Subacute bacterial endocarditis
- Disorders Of Lungs.
- Suppuration of lung
- Tumours of lung
- Disorders of GI tract St liver
- Inflammatory bowel disease.
- Cirrhosis of liver.
- Malignancy of liver
- 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.