Heart Sounds Tutorial

Another free site with wonderful examples of various normal and abnormal heart sounds with matching physiological explanations. The animations are basic but clear. There is also a testing mode to make sure that you got it. Good revision for Year 3 to 5 students.

Interesting Article

Daniel McKean (Year 2 medicine) has forwarded to me this interesting link from the New Yorker. We have much to learn....

Medical Inventions that Failed the Test of Time: Prolonged Bedrest after MI

Just as there have been many history-changing medical discoveries and inventions, there have also been ideas that shone brightly for a time and then, thankfully wilted in the glaring light of the retrospectoscope.

There is an inherent logic to the tradition of advising bedrest, even prolonged bedrest, after myocardial infarction (MI). After all, if a broken leg were to rest in a cast for six weeks, and tuberculous lungs were treated with convalescence in remote sanitoria, did it not follow that the damaged heart should also be rested? By lying still and avoiding physical stress, the ischaemic and tremulous myocardium might recover to beat again.

In this model, popular until the 1960s, the post-infarct patient would lie prone for as long as six weeks, forbidden ('doctor's orders') from attending to their own bathing or even brushing their hair. If urinary retention, DVT or pulmonary embolus should spoil the party, this was the price to be paid. Moves to allow post-MI patients to be nursed sitting out of bed, promoted first in the American Journal of Nursing by Drs Mitchell, Lown and Levine in the 1950s, were seen as radical.

Today, patients who have had a coronary artery bypass graft or new aortic valve are not only out of bed within a few days, but back at home and stumbling to the local gym for rehabilitation.

What a change a few decades makes.

Dr Jon Fogarty

Attention Year 3 Students: Clinical Examination Videos

St. George's Hospital Medical School in London has produced a number of very good videos outlining basic clinical examination.
Cardiovascular System: http://www.youtube.com/watch?v=dp5m2tXHDmA&mode=related&search
Respiratory System: http://www.youtube.com/watch?v=hWGzi5h2UR8&mode=related&search
Abdominal Examination: http://www.youtube.com/watch?v=AktNxbiTO0I&mode=related&search
Thyroid Gland: http://www.youtube.com/watch?v=3EnLqNaRPZM&mode=related&search
Hope you find these useful.