Studies show that the high level of stress endured by medical students may actually hinder one’s cognitive function and learning ability. Not to mention, research reveals that 27 percent of all medical students are depressed, with 11 percent having suicidal thoughts. If the stress and depression are not managed early on, it’s likely that it will carry on into their professional careers, which can potentially lead to early burnout. No matter how many research papers you have to write or exams to study for, the number one thing on your list should be taking care of your mental health so you don’t start exhibiting self-destructive behavior.

Avoid Falling Into a Substance Abuse Trap

Between the pressures of studies and a pile of debt from tuition, it’s not uncommon for a medical student to turn to drugs and alcohol as a coping method. Nearly a third of students report alcohol abuse, with burnout and exhaustion being the main driving factors. There’s also a correlation between the type of abuse with the field of study. For example, resident surgeons tend to abuse alcohol, while those in emergency medicine also abuse benzodiazepines, cocaine, and marijuana. While the following mental health tips can help prevent an addiction, should you find yourself hooked on a substance, it’s a good idea to get treated at a facility that specifically caters to medical professionals—even if you’re still a student. Aside from the obvious reasons, it’s important to immediately address your addiction. If it continues into your professional practice, you run the risk of having your license revoked.

Take Regular Breathers

Chaining yourself to your desk isn’t going to do anything for your mental health. Schedule regular breaks throughout the day/night. Even a 30-second micro-break can increase your productivity by 13 percent, and a 15-second break from staring at your computer screen can reduce fatigue by 50 percent.

Plan Healthy Meals

Going down a junk food spiral is only going to decrease your energy and make you feel irritable, especially if you start to put on unnecessary weight. It takes little effort to open a bag of pre-washed greens and top it with a piece of lean, pre-cooked meat (think a rotisserie chicken) or can/pouch of tuna. Keep regular snacks like fruit, veggie sticks and hummus, nuts, string cheese, etc., to help curb hunger (or nerve) pangs without intaking a lot of calories.

Get Enough Sleep

While it’s going to be necessary from time to time, don’t make a regular habit of burning the midnight oil to squeeze in some extra study time because it’s only apt to hurt you in the long run. It’s been proven that lack of sleep can affect short-term and long-term memory and cause mood swings, weight gain, high blood pressure, and a risk for diabetes and heart disease. Institute time management and organizational skills like placing timed tasks in your iPhone with reminders to keep you on track.

Give Yourself a Confidence Boost

Don’t get so caught up in your studies that you forget to give yourself some props for all the hard work you’re doing. Institute confidence-boosting techniques, such as keeping a gratitude journal, being prepared as often as possible, turning a negative thought into a positive one, changing your body language, and staying away from negative people and situations.

Don’t Forget About Other Aspects of Your Life

Keep up with hobbies and personal relationships as best as you can. Retaining some semblance of balance in your life is liable to have a positive effect on your mental health, plus it can be helpful to get support from someone who’s not in your world.

Being in the medical field is a rewarding career, but in order to enjoy it to its fullest, you’ve got to make sure you’re taking care of yourself along the way. Try to see the forest through the trees in the most stressful of situations. Remember that in order to take care of others, you have to make sure you’re in good physical and mental health, too.

The heart pumps a volume of blood into the lungs which after getting oxygenated is transported back to heart. This oxygenated blood is then pumped out of the heart and into the aorta and subsequently into the systemic circulation. As a consequence, at any given time the lungs (pulmonary vasculature) contain around 500ml of blood, thereby allowing them to function as a reservoir of the blood. This reservoir volume is increased by 500 ml when the person is in the supine or lying down position. This is because in supine position there’s an increased venous return (due to the effect of gravity) to the right heart from the peripheries and therefore more blood accumulates in the central parts of body. Upon standing up, this extra 500ml of blood gets redistributed under the effect of gravity, to the now more dependent parts of the body which includes the peripheral tissues and the lower extremities.

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The division of vasculature in the pulmonary circuit is somewhat different from that in the systemic circulation. The arteries in the pulmonary circuit divide in a binary fashion, thereby following the pattern of division of the airways. The veins too exhibit a pattern similar to the arterioles and the bronchioles, thereby finally converging into forming one large pulmonary vein. These pulmonary veins transport the oxygenated blood back to the heart.

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NODAL ACTION POTENTIAL VS. VENTRICULAR ACTION POTENTIAL

The nodal tissues and the Purkinje fibers exhibit automaticity in their properties as they are able to undergo spontaneous depolarizations. In other words, these tissues do not require the need of an external stimulus or a trigger to undergo depolarization. This is in contrast to ventricular fibers that do not show automaticity. The reason behind this phenomenon can be explained as follow:

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  • The resting membrane potential (RMP) of nodal tissues is less negative than the RMP of ventricular fibers. This allows the nodal tissue channels to operate in a semi-activated state even during the resting phase of the action potential. The comparatively more negative ventricular fibers do not show this property and hence, are not easily activated by low voltage impulses.

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Nitric Oxide is called an endothelium derived relaxing factor (EDRF) as it is released by the endothelium of the blood vessel. EDRF cause relaxation of the vascular smooth muscle, and as a result cause vasodilation of the blood vessel. The following factors contribute to the release of nitric oxide from the endothelium:

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  1. Blood travelling at high velocity causes a shearing effect on the wall of the blood vessels. As the endothelial cells endure a drag force produced due to friction. This results in a mechanical trigger which stimulates release of nitric oxide.

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TYPES OF CHANNELS AND CONCENTRATIONS OF VARIOUS IONS

  1. Sodium Channels: The concentration of sodium ions outside the cell membrane is greater than that inside the cell. Therefore, there is a passive movement of sodium ions into the cell as the channels open. The sodium channels are voltage gated as they undergo conformational change in response to differences in potential across the membrane. The sodium channels have two types of gates that control the passage of sodium ions; the ‘H’ gate and the ‘M’ gate. At resting stage, the M gate is closed and the H gate is open. Upon stimulation by an action potential, the M gate opens and the channels become active, allowing sodium ions to travel into the cell. This opening of the channels is limited by time. After a fraction of a second, the H gates close spontaneously rendering the channels inactive. The sodium channels enter a refractory period during which they cannot be activated no matter how strong is the stimulus. At the same time, the M gate closes as well. As soon as the refractory period ends, the H channels open and the sodium channels are restored to their initial inactive state. The M gates remain closed till the arrival of the next action potential and the cycle is repeated.

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Different states of the fast sodium channels and relative conformational states of the H and M gates are summarized in the table below:

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Resistance can be integrated into two types of circuits; parallel and serial circuit.

Series Circuit

The heart is placed in series with the pulmonary vasculature and as well as the rest of the body. It pumps blood to the lungs, from where the blood travels back to the left side of the heart. The left heart pumps blood to the rest of the body after which the blood is returned back to the right heart. Therefore, the pulmonary and systemic circuits are connected in series via two pumps, which are the right heart and left heart respectively.

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Calculating Resistance in Series

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