Skills lab - Pathological heart sounds

yo!! long time no see you, blog!

anyway, nk post pasal something yg MEDICibberish....
ok, psl bunyi jantung N + pathologic.

First, the positions of stethoscope we're gonna put on the chest.
We have 7 positions.

1. Second right intercostal space
2. Lower left sternum
3. Second left intercostal space
4. Third left intercostal space
5. Fourth left intercostal space
6. Apex
7. Medial of pulmonal valve

(It's the blue dots)




Tips for my exam tomorrow? xD
Frequent place of pathological heart beats.
1, 3, 2, 6

Sounds, place and diseases

• Systolic murmur | 1,3,4,5 | Aortic stenosis  
• Systolic murmur | 3, 7 | Pulmonal stenosis 
• Diastolic murmur (with opening snap) | 6 | Mitral stenosis 
• Holosystolic | 2, 6 | Tricuspid, Mitral Insufficiency (but the one i heard has no 'dup' sound in it)
• Midsystolic | 2, 6 | Mitral Insufficiency
• Gallop | 2, 6 | Decompensatio cordis
• Holosystolic | 4,5 | Ventricular septal defect (VSD)

Anyway, just first listen to position 1 first, if it's abnormal, listen to 3 --> it could means Systolic murmur AS (the only one that abnormality is at position 1.

If 1 is normal, go straight to position 2, if it's hard to listen at # 2, go to #6. There's too many abnormality that can be at position 2, 6 --> Holosystolic, midsystolic, gallop.

If #2 is normal, and # 6 is abnormal --> only diastolic murmur (with opening snap) It sound like a rushing sounds. The end of the first heart beat kinda overlaps with the second heart beat.

Then if 1, 3, 2, 6 are normal, listen to 4, 5, abnormality at 4, 5 --> holosystolic murmur of VSD

Anyway, we should be able to distinguish the sounds. My doctors said NOT to remember just the position of the heart sounds. But this way, I think I could make it simple since the exam time is pretty short like 1 mins only.

The tricky part is how to distinguish the sounds of systolic murmur AS and midsystolic murmur. If it's me, I'll say that midsystolic sounds if heavier than systolic murmur and like holosystolic murmur with "dub".
If systolic murmur AS - krrrrteb (it sounds crispy)
If midsystolic murmur - grrrrdub (it sounds heavy and bold)

For systolic murmur PS and holosystolic murmur.
They both sounds like a wind. If I were to say, I heard that systolic murmur sounds like a heavy wind and holosystolic sounds like a wind in the desert? It has no gap between murmur and heart sounds while systolic PS kinda stop after the heart sound before the murmur starts again.

For holosystolic MI/TI and holosystolic VSD
All I can say is that it's slower in pace and heavier than the holosystolic MI/TI. Sounds more like a dying heart, slow and waiting for death.

Sorry if I'm wrong cuz that's what I heard from my skills lab.
Just wanna do well in my exam. >_<

Personality quiz.... results

This would be my first post of something different from the usual post. hehhee~

I got this from someone's journal. Nampak cm menarik so I give it a try.
Here if korg nk try
Seriously, rasa mcm penah buat je quiz ni dlu but that was long time ago so I expect the result has changed.

Results:

Your view on yourself:
Other people find you very interesting, but you are really hiding your true self. Your friends love you because you are a good listener. They'll probably still love you if you learn to be yourself with them.
Really? Well I just want to blend in with ppl. So xde confidence in showing myself. I'm paranoid okay.. Tapi mmg b'harap bley show my true self more.. Not if they throwing that "not interested' face to me.

The type of girlfriend/boyfriend you are looking for:
You like serious, smart and determined people. You don't judge a book by its cover, so good-looking people aren't necessarily your style. This makes you an attractive person in many people's eyes.
Serious YES, smart YES, determined YES.. but good looking pn YES!! Itu penting ekceli.. hahaha!

Your readiness to commit to a relationship:
You prefer to get to know a person very well before deciding whether you will commit to the relationship.
Currently not ready. Still xjmpe Mr Can-accept-me-as-i-am. Yes, better to get to know each other first..

The seriousness of your love:
Your have very sensible tactics when approaching the opposite sex. In many ways people find your straightforwardness attractive, so you will find yourself with plenty of dates.
Wow.. urm.. speechless. Sensible tactics? hahaha!! Plenty of dates.. no! XD


Your views on education
Education is less important than the real world out there, away from the classroom. Deep inside you want to start working, earning money and living on your own.
Xske study! Xske real life gak! I wish I could stay longer in my dream tapi nanti org ckp xb'pijak kt dunia nyata.. well whatever. Tp bosan la g kelas, xmenarik minat lgsg. 
Yes, start working and live my own life the way I want!  

The right job for you:
You're a practical person and will choose a secure job with a steady income. Knowing what you like to do is important. Find a regular job doing just that and you'll be set for life.
Since I don't like have to JUST READ, I prefer doing. Macam math or art or latihan.. just read is boring.. Bukak buku je mata tutup. gaaahhh!
If I know my current interest before I choose my path, I wonder if things would be different. 


How do you view success:
You are afraid of failure and scared to have a go at the career you would like to have in case you don't succeed. Don't give up when you haven't yet even started! Be courageous.
This is so true! Ini yg org ckp, walk on the safe side. First, bcuz I don't want to be interviewed. hahaah!! 

What are you most afraid of:
You are afraid of things that you cannot control. Sometimes you show your anger to cover up how you feel.
I can't control myself and my feeling. and my sleeping time. Emo tu mmg slalu.. not to cover how I feel but I really don't know what I feel.

Who is your true self:
You are full of energy and confidence. You are unpredictable, with moods changing as quickly as an ocean. You might occasionally be calm and still, but never for long.
Energy and confidence? Lately sgt kurang.. Unpredictable YES.. Mood swing, ALWAYS!! quickly as an ocean? right. I used to be very calm and still but not for longer I guess..

Personality quiz sgt menarik. Help me to find myself.. Kadang2 rasa confused. Dulu slalu sgt kuar masuk bilik kaunseling sbb sgt b'masalah.

Okay I'm out.