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Describe TR Murmur and VSD murmur in details?
TR Murmur : Characteristic: Holosystolic murmur, loudest at left lower-sternal border and becomes louder with inspiration (Carvallo sign).
VSD Murmur : Characteristic: The murmur of a moderate or large VSD is holosystolic and loudest along the lower left sternal border and is usually accompanied by a thrill. With development of pulmonary NT, the pressure gradient between left and right ventricle diminishes; Hence, the systolic murmur and thrill soften and finally disappear.
Small, muscular VSD may produce prominent high-frequency ejection systolic murmur that end before the end of systole if the contracting septal nucleic loses the defect.
In the setting of acute MI, a pansystolic murmur due to VSD can be differentiated from that due to ruptured papillary muscle:- More than 50 per cent of VSD murmurs are associated with thrill and are loudest medial to apex.- MR murmur very rarely associated with thrill and is loudest lateral to apex.
Extremes of Heat and Cold Deserts are regions of aridity with rainfall of less than 20 cm per year and the soil, though L, fertile, is too porous to retain any water. In summer
nervous system of vertebrates
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