oh blog post

i hope i could figure out how to make my post view better. easy to read on.

a football game

sekadar luahan fikiran sblm sambung kerja yg melambak tu. ..... >>> di kedai makan, waktu malam. tersiar d televisyen, perlawanan bola sepak team A vs team B. siaran mcm ni mmg kurang menarik perhatian. tambah lagi dgn babak2 kecederaan- yg mungkin bagi ku melengahkan masa dan membazir peluang. bukan bingkas bangun, tp sibuk mengaduh kesakitan. bukan sekali dua, tp sepanjang perlawanan. >>> um, bila direnung kembali, perlawanan tu seakan gambaran kehidupanku. usah tgk orang lain, pandang diri sendiri dulu. mmg sama. 2 pasukan dijadualkan berentap. 90 minit. ada gol sbg matlamat, utk dirembat sebanyak mungkin. ada persaingan utk menang dlm masa yg ditetapkan, masing2 ada peluang utk membuat sendiri jaringan, masing2 ada peranan utk pastikan dpt buat jaringan. >>> situasi 1- kedua2 team mcm nak x nak aje main. skit2 jatuh. x pe kalo nak jatuh, tp cepat2 la bgun. mamcam nak minta simpati pun ada. teragak2 nak buat serangan. strategi nak serang pun mcm x diatur dulu sebelum perlawanan. err, bukan ke specialty korang ke game ni? patutnya siang mlm kena pkir mcm mana nak maju n terus cemerlang dlm specialty sendiri. >>> situasi 2- walaupun team C adalah pasukan gergasi bola sepak n terkenal dgn strategi dan kemahiran mereka, team D (pasukan yg x ternama) tetap tak gentar. x tunjuk takut. x beralasan. team D tetap bermati2 an utk pertahankan gol. tetap cuba menyerang. cepat2 bangun bila tersungkur. tetap berlari dan teruskan mencari peluang. 90 minit shja masa yg diberi, apa nak jadi, jadi lah, asalkan setiap saat tiada yg sia2. jurulatih dan pemain laksanakan satu demi satu strategi, tapi semua x berjaya nmpaknya. akhirnya tumpas di tangan pasukan gergasi itu. mmg kalah teruk. walaupun nmpak air mata kesedihan tu, tp jauh dalam hati, mereka puas. puas dgn BERUSAHA, BERSUNGGUH-SUNGGUH. >>> secara jujurnya, saya hormat dan ingin menjadi seperti pasukan yg kuat semangat itu. kini mungkin diriku seperti situasi yg pertama (lemah, beralasan) tp aku berazam insyaallah, utk menjadi yg kedua. itu lebih bermaruah, lebih bermakna, dan lebih memberi makna. >>> wallahualam.

paediatrics 5th year

29 August 2012 (tomorrow) will be my end of posting examination ^_^ bismillahirrahmanirrahim... i want to do my VERY BEST in my final year, insyaallah..

http://aia.i4u.us/islam.shtml

auscultation of heart

4 areas: - aortic - pulmonary - tricuspid - mitral

http://www.stethographics.com/heart/main/sites.htm

pattern of resp muscles use

um, for the pattern of respiratory muscle use: Normally, the diaphragm does all the work of inspiration and the abdomen will move outward along with the chest wall as the diaphragm descends (Figure 35.3). Inward inspiratory motion of the abdomen is termed abdominal paradox and suggests diaphragmatic dysfunction (Figure 35.4). Inward inspiratory motion of the chest wall is suggestive of a decrease in lung compliance. Placing the palms of the hands on the chest and abdomen may help confirm the visual impression. Active use of the abdominal musculature during expiration is distinctly abnormal. Look to see if the strap muscles of the neck, the scalenes, and the sternocleidomastoids are contracting during inspiration causing an upward motion of the entire chest.

Use of accessory muscles is suggestive of increased inspiratory work of breathing. Extreme increases in inspiratory work of breathing may be reflected in accentuated swings of pleural pressure. Negative pleural pressure may be manifested by inspiratory retraction of the suprasternal or supraclavicular notches or the intercostal spaces. In the presence of notch retraction, pulsus paradoxus is frequently present and should always be measured.

http://clinicalmethods.blogspot.com/2011/08/chapter-35-overview-of-pulmonary-system.html, Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990; http://soundersleep.com/musclesOfRespiration.php

paradoxical thoracoabdominal breathing

we learnt that there will be a paradoxical thoracoabdominal breathing in a life threathening asthma (respiratory arrest eminent). this might help me a bit.

Figure 35.3Normal inspiration Descent of the diaphragm raises intra-abdominal pressure moving the abdomen outwards along with chest expansion. The sternum moves outward.

Figure 35.4Abnormal inspiratory findings In the hyperinflated patient with obstructive lung diseases the flattened diaphragm pulls in the lower ribs at end-inspiration (Hoover's sign). The sternum is pulled cephalad by the action of the strap muscles of the neck. The abdomen may be retracted by the passive transmission of intrathoracic pressure across the dysfunctional diaphragm.

http://clinicalmethods.blogspot.com/2011/08/chapter-35-overview-of-pulmonary-system.html, Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990