nota 1

(entry kali ni bosan, panjang dan tak menarik langsung!!!!)

apabila exam final menghampiri, simptom-simptom pelik mula melanda..
daripada terus taip mengarut, baik buat nota (salin nota)


ANATOMY (Thorax)

The heart is supplied by the Right and Left Coronary Artery.

Right Coronary Artery

Origin : Anterior Aortic Sinus
Course :
Passes between pulmonary tunk and right auricle..then passes in the anterior part of coronary groove till the inferior border of the heart..then it runs in the posterior part of the coronary groove where it ends by anastomosing with circumflex branch of the Left Coronary Artery.

Branches :

- Sinoatrial (SA) nodal artery – supplies the SA node of 65% of people
- Right Conus artery – supplies the infandibulum (conus arteriosus) of the right ventricle
- Right Marginal artery – supplies the right ventricle
- Arterial and Ventricular branches to both atria and right ventricle
- Posterior Interventricular Artery – passes along the post interventicular groove accompanied by the middle cardiac artery. It supplies Atrioventricular (AV) node in 80% of people, both ventricles and post 1/3 of ventricular septum.

Left Coronary Artery

Origin : Posterior Aortic Sinus
Course :
Passes between pulmonary trunk and left auricle..on reaching the coronary groove, it gives the Anterior Interventricular Artery and continues as the Circumflex Artery

Anterior Interventricular Artery

It descends in the anterior interventricular groove accompanied by Great Cardiac Vein down to the apex of the heart where it anastomoses with Posterior Interventricular Artery (br of Rt Coronary At).

It supplies the infandibulum and the right ventricle through the conus artery, both ventricles and anterior 2/3 of ventricular septum

Circumflex Artery

It is the continuation of Left Coronary Artery. It curves around left border of the heart and runs in the posterior part of coronary groove where it anastomoses with the Right Coronary Artery.

Branches :

- Sinoatrial (SA) Nodal Artery in 35% of the people
- Left Marginal Artery in 90% of the people. It supplies the left ventricle.
- Atrioventricular (AV) Nodal Atery in 20% of the people.
- Atrial and Ventricular branches to the left atrium and left ventricle.

Clinical notes:

Occlusion of these arteries wil lead to…

(a) Gradual occlusion : Angina Pectoris ( condition of suffocating constricting retrosternal cardiac pain). Its pain is referred to an area of skin over the middle of the sternum and the medial side of arm and forearm.(sakit kat dada secara mengejut lah senang cakap)
(b) Sudden occlusion : Lead to cardiac infarction (scar formation resulls of death for the area of the cardiac muscle)
(c) Thrombosis of large artery if not treated at once : sudden death (pergi tak kembali orang cakap)

Treatment for preventing occlusion : catheter or coronary stent

sila perihatin dengan sakit di bahagian jantung!!

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PYSCHOLOGY

The Doctor Patient Relationship. (ngeee)

Social relationships

Perhaps patient has just met her doctor, within the seconds, she tells the doctor very intimate personal details about her health. And within a minute, she is prepared to remove it clothes and submit to a physical examination.

senang citer, hubungan doctor pesakit ni berlaku dalam tempoh yang sekejap, tak perlu pergi dating dating ke (haram alaik), chatting ke, tengok gambar ke tapi sekadar cukup di bilik pemeriksaan kesihatan di klinik mahupun hospital. Adapun diingatkan bahawa perhubungan yang terbina dengan baik antara doctor dan pesakit bole memberi kesan yang positif terhadap kesihatan pesakit. Dan pesakit perlulah mengetahui hak-hak mereka (common sense) semasa di rawat oleh doctor agar tidak berlaku seperti ini (klik saya)

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BIOCHEMISTRY (Metabolism of Purine and Pyrimidine Nucleotides)

Gout (hyperuricemia)

It is caused by elevated uric acid concentrations in blood (hyperuricaemia) and in urine (uricosuria). It is due to metabolic abnormalities lead to overproduction of purine nucleotide by de novo pathway. Hyperuricaemia is defined as increased serum uric acid concentration more than 7 mg % (male) and 6 mg % (female).

Increased uric acid forms insoluble urate crystals (tophii) which can precipitate in the joint resulting in arthritis (gout) as well as in the kidney tubules resulting in renal dysfunction.

Gout is effectively treated by
(a) Allopurinol drug : inhibit xanthine oxidase enzyme which is needed to produce uric acid
(b) Probenicid drug : drug which increases uric acid secretion
(c) Colchicine and non steroidal anti inflammatory drug : prevent acute attacks in gout’s patients
(d) Avoid eating food rich in nucleotides and nucleic acids such as liver

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PHYSIOLOGY (Reproduction)

Placenta

Hormones secreted by the placenta
1. Human Chorionic Gonadothropin (hCG)
2. Human Chorionic Somatomammotropin (hCS)
3. Estrogen
4. Progesterone
5. Relaxin

hCG hormone

- prolong life span of corpus luteum
- testosterone secretion of male embryo
- steroid synthesis in fetal adrenals
- responsible for morning sickness liker vormitting (alaa macam dalam cerita2 tu, asal pregnant muntah, asal muntah pregnant)
- responsible for the sign of pregnancy (nak tau mengandung ke tak, through this hormone lah kia check kut urine)

hCS

- it decrease glucose utilization by the mother by decreasing insulin sensitivity. So glucose is available for the fetus
- lipolytic action for alternative source of energy

Placental Estrogen

- stimulate growth of myometrium
- enlargement of breast and growth of ductal system
- enlargement of external genitalia
- relaxation of pelvic ligaments

Placental Progesterone

- suppressing myometrium contraction to prevent spontaneous abortion
- development of embryo
- promote storage of nutrient for nutrition of the embryo
- prepare the breast for lactation by developing the mammary acinar and alveolar system


Ok, baca dan HAFAL.
Aku memang tade kerja buat nota (salin nota) ni.
Kalau ada tak paham, sila google sendiri ok!
Huhuhu