Lower Limb - High-Yield NEET PG Notes

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pres.title = "Lower Limb Anatomy - NEET PG MCQ Patterns";
pres.author = "Orris";

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// ═══════════════════════════════════════════════════════════════════
//  SLIDES
// ═══════════════════════════════════════════════════════════════════

// ── SLIDE 1: TITLE ─────────────────────────────────────────────────
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  sl.addText("ANATOMY", { x: 0.7, y: 1.9, w: 8.8, h: 0.85, fontSize: 52, bold: true, color: C.teal, charSpacing: 4 });
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// ── SLIDE 2: TABLE OF CONTENTS ─────────────────────────────────────
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    { num: "03", title: "Femoral Triangle & Adductor Canal", icon: "▲" },
    { num: "04", title: "Vessels & Blood Supply", icon: "♥" },
    { num: "05", title: "Clinical Nerve Injuries (MCQ Goldmine)", icon: "★" },
    { num: "06", title: "Dermatomes & Reflexes", icon: "◉" },
    { num: "07", title: "Practice MCQs with Explanations", icon: "✎" },
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// ── SLIDE 3: SECTION 1 HEADER ──────────────────────────────────────
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// ── SLIDE 4: BONES & COMPARTMENTS ─────────────────────────────────
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    "Largest bone in the body",
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    "Coxa valga: angle > 135°",
    "Greater trochanter → Glut. med & min",
    "Lesser trochanter → Iliopsoas insertion",
    "Medial circumflex femoral a. → head of femur supply",
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  "Tarsal Bones (7) — Mnemonic",
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// ── SLIDE 5: LEG COMPARTMENTS TABLE ───────────────────────────────
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    ["Lateral", "Fibularis longus & brevis", "Superficial fibular", "Eversion, weak plantarflex."],
    ["Post. Superficial", "Gastrocnemius, Soleus", "Tibial", "Plantarflexion"],
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// ── SLIDE 6: SECTION 2 HEADER ──────────────────────────────────────
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// ── SLIDE 7: LUMBAR PLEXUS TABLE ──────────────────────────────────
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    ["Obturator", "L2-L4", "All medial compartment (adductors)", "Medial upper thigh"],
    ["Lat. cutaneous n. of thigh", "L2-L3", "None (purely sensory)", "Lateral thigh"],
    ["Ilio-inguinal", "L1", "None", "Medial upper thigh + perineum"],
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// ── SLIDE 8: SACRAL PLEXUS TABLE ──────────────────────────────────
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    ["Superior gluteal", "L4-S1", "Glut. med, min, TFL", "Exits ABOVE piriformis"],
    ["Inferior gluteal", "L5-S2", "Gluteus maximus only", "Exits below piriformis"],
    ["Post. cut. n. of thigh", "S1-S3", "None", "Posterior thigh sensation"],
    ["Tibial (sciatic br.)", "L4-S3 ant.", "Post. thigh + leg + sole", "Ankle jerk S1-S2"],
    ["Common fibular (sciatic br.)", "L4-S2 post.", "Ant. & lat. compartments of leg", "Foot drop if injured"],
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// ── SLIDE 9: SECTION 3 HEADER ──────────────────────────────────────
sectionSlide(pres, "03", "Femoral Triangle & Adductor Canal", "A favourite MCQ topic");

// ── SLIDE 10: FEMORAL TRIANGLE ────────────────────────────────────
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    sl.addText(n.detail, { x: 5.95, y: by + 0.28, w: 3.65, h: 0.45, fontSize: 10.5, color: C.gray });
  });

  // Femoral hernia note
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  sl.addText("• Passes through femoral canal (medial femoral sheath)\n• Inferior and lateral to pubic tubercle\n• More common in women; high risk of strangulation", { x: 0.65, y: 4.35, w: 3.9, h: 0.95, fontSize: 11, color: C.navy });
}

// ── SLIDE 11: SECTION 4 HEADER ─────────────────────────────────────
sectionSlide(pres, "04", "Vessels & Blood Supply", "Femoral → Popliteal → Tibial arteries");

// ── SLIDE 12: VESSELS TABLE ───────────────────────────────────────
tableSlide(pres, "MAJOR VESSELS OF THE LOWER LIMB",
  ["Vessel", "Origin", "Key Clinical Point"],
  [
    ["Femoral artery", "External iliac (below ing. lig.)", "Palpable at mid-inguinal point; continues as popliteal via adductor hiatus"],
    ["Profunda femoris", "Femoral a. (2-3 cm below ing. lig.)", "Main supply to thigh; gives medial & lateral circumflex femoral aa."],
    ["Medial circumflex femoral a.", "Profunda femoris", "★ Main blood supply to head of femur — at risk in femoral neck fractures"],
    ["Great saphenous vein", "Dorsal venous arch of foot", "Longest vein in body; passes anterior to medial malleolus; drains → femoral vein"],
    ["Popliteal artery", "Femoral a. (at adductor hiatus)", "Deepest structure in popliteal fossa (closest to bone). AVN order"],
    ["Anterior tibial a.", "Popliteal", "Becomes dorsalis pedis at ankle — palpable on dorsum of foot"],
    ["Posterior tibial a.", "Popliteal", "Palpable posterior to medial malleolus; gives fibular (peroneal) a."],
  ],
  C.teal
);

// ── SLIDE 13: SECTION 5 HEADER ─────────────────────────────────────
sectionSlide(pres, "05", "Clinical Nerve Injuries", "MCQ Goldmine — 3-4 Questions Every Exam");

// ── SLIDE 14: NERVE INJURIES TABLE ────────────────────────────────
tableSlide(pres, "NERVE INJURY PATTERNS — HIGH YIELD",
  ["Nerve", "Site of Injury", "Deformity / Sign", "Gait"],
  [
    ["Common fibular (peroneal)", "Neck of fibula", "FOOT DROP (loss of dorsiflexion + eversion)", "High-stepping (steppage) gait"],
    ["Superior gluteal", "Misplaced IM injection / hip surgery", "Trendelenburg sign (pelvis drops contralat.)", "Waddling (Trendelenburg) gait"],
    ["Femoral nerve", "Femoral triangle / inguinal region", "Loss of knee extension; absent knee jerk", "Knee locked in hyperextension"],
    ["Obturator nerve", "Childbirth / pelvic surgery", "Weak adduction; medial thigh sensory loss", "Usually normal gait"],
    ["Sciatic nerve", "Misplaced IM injection (wrong quadrant)", "Weak knee flex. + all below-knee muscles", "Variable"],
    ["Lat. cut. n. of thigh", "Under inguinal lig. near ASIS", "Meralgia paresthetica (burning lat. thigh)", "Normal (sensory only)"],
  ],
  C.red
);

// ── SLIDE 15: NERVE INJURIES BULLETS ──────────────────────────────
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  const cards = [
    { title: "Common Fibular N.", color: C.red, points: ["Wraps around NECK OF FIBULA", "Foot drop = dorsiflexion lost", "Eversion lost (lateral compart.)", "Sensory: lateral leg + dorsum foot", "Causes: fracture, tight cast, bed rest"] },
    { title: "Superior Gluteal N.", color: "1A6B3A", points: ["L4–S1; exits ABOVE piriformis", "Trendelenburg sign on standing", "Muscles: glut. med, min, TFL", "Cause: incorrect IM injection", "Safe site: upper outer quadrant"] },
    { title: "Meralgia Paresthetica", color: C.purple, points: ["Lat. cut. n. of thigh (L2–L3)", "Purely sensory — no motor loss", "Burning/tingling lateral thigh", "Entrapment near ASIS under ing. lig.", "Risk: obesity, pregnancy, tight belts"] },
    { title: "Sciatic N. Injury", color: "8B4513", points: ["L4–S3 | exits below piriformis", "Fibular division more vulnerable", "Misplaced IM → upper outer quadrant safe", "Complete: all below-knee weakness", "Partial often mimics fibular palsy"] },
  ];

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// ── SLIDE 16: SECTION 6 HEADER ─────────────────────────────────────
sectionSlide(pres, "06", "Dermatomes & Reflexes", "1-2 MCQs guaranteed");

// ── SLIDE 17: DERMATOMES + REFLEXES ───────────────────────────────
contentSlide2Col(pres, "DERMATOMES & REFLEXES",
  "Dermatome Map",
  [
    "L1 → Inguinal / groin region",
    "L2 → Anterior upper thigh",
    "L3 → Anterior lower thigh / knee",
    "L4 → Medial leg + medial dorsum foot",
    "L5 → Lateral leg + dorsum foot + great toe",
    "S1 → Sole + lateral foot + little toe",
    "S2 → Posterior thigh",
    "S3-S4 → Perineum",
  ],
  "Reflexes",
  [
    "Knee jerk (patellar reflex) → L3-L4 (Femoral n.)",
    "Ankle jerk (Achilles reflex) → S1-S2 (Tibial n.)",
    "Plantar reflex (Babinski) → S1-S2 (Tibial n.)",
    "Cremasteric reflex → L1-L2 (Genitofemoral n.)",
    "★ L4 lesion: absent knee jerk",
    "★ S1 lesion: absent ankle jerk",
    "★ L5 lesion: foot drop, reflexes intact",
  ],
  C.purple
);

// ── SLIDE 18: SECTION 7 HEADER ─────────────────────────────────────
sectionSlide(pres, "07", "Practice MCQs", "NEET PG Pattern Questions");

// ── SLIDES 19–23: MCQs ─────────────────────────────────────────────
mcqSlide(pres, 1,
  "A patient presents with foot drop and loss of sensation over the dorsum of the foot after sustaining a fracture of the proximal fibula. Which nerve is most likely injured?",
  ["Tibial nerve", "Superficial fibular nerve", "Common fibular nerve", "Sciatic nerve"],
  2,
  "The common fibular (peroneal) nerve winds around the neck of the fibula making it extremely vulnerable to injury there. It supplies the anterior and lateral leg compartments responsible for dorsiflexion and eversion. Foot drop = dorsiflexion lost = common fibular nerve injury."
);

mcqSlide(pres, 2,
  "A woman develops weakness of hip abduction and a positive Trendelenburg sign following a difficult childbirth. Which nerve is damaged?",
  ["Inferior gluteal nerve", "Superior gluteal nerve", "Obturator nerve", "Sciatic nerve"],
  1,
  "The superior gluteal nerve (L4–S1) exits the greater sciatic foramen ABOVE piriformis and innervates gluteus medius, gluteus minimus, and TFL. Paralysis causes Trendelenburg sign: when standing on the affected leg, the pelvis drops on the contralateral side."
);

mcqSlide(pres, 3,
  "In the femoral triangle, from lateral to medial, which is the correct order of structures passing under the inguinal ligament?",
  ["Vein, Artery, Nerve", "Nerve, Vein, Artery", "Artery, Nerve, Vein", "Nerve, Artery, Vein (+ lymphatics)"],
  3,
  "The mnemonic NAVY: Nerve (femoral) → Artery (femoral) → Vein (femoral) → lymph(Y)atics — from lateral to medial. The femoral nerve is NOT inside the femoral sheath; only the artery, vein, and lymphatics are enclosed by it."
);

mcqSlide(pres, 4,
  "A 45-year-old obese man complains of burning pain and numbness over the lateral aspect of his thigh. Sensation is intact elsewhere. No motor deficit. Which nerve is involved?",
  ["Femoral nerve", "Obturator nerve", "Lateral cutaneous nerve of thigh", "Posterior cutaneous nerve of thigh"],
  2,
  "Meralgia paresthetica — compression of the lateral cutaneous nerve of thigh (L2–L3) under the inguinal ligament near the ASIS. It is a purely sensory nerve (no motor deficit). Risk factors include obesity, pregnancy, and tight belts. Treatment is conservative."
);

mcqSlide(pres, 5,
  "The main blood supply to the head of the femur is from which artery? This vessel is at risk in femoral neck fractures.",
  ["Obturator artery", "Lateral circumflex femoral artery", "Medial circumflex femoral artery", "Inferior gluteal artery"],
  2,
  "The medial circumflex femoral artery (branch of profunda femoris) is the main supply to the femoral head. In displaced femoral neck fractures, this vessel is torn → avascular necrosis (AVN) of the femoral head. This is why surgical reduction/replacement is urgent."
);

// ── SLIDE 24: SECTION 8 HEADER ─────────────────────────────────────
sectionSlide(pres, "08", "Quick-Fire High-Yield Facts", "Last-minute revision essentials");

// ── SLIDE 25: QUICK FIRE FACTS ────────────────────────────────────
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    ["Largest nerve in the body", "Sciatic nerve (L4–S3)"],
    ["Longest vein in the body", "Great saphenous vein"],
    ["Largest tarsal bone", "Calcaneus"],
    ["Foot drop nerve + site", "Common fibular n. at neck of fibula"],
    ["Trendelenburg sign", "Superior gluteal nerve palsy (L4–S1)"],
    ["Knee jerk root", "L3–L4 (Femoral nerve)"],
    ["Ankle jerk root", "S1–S2 (Tibial nerve)"],
    ["Femoral hernia location", "Inferior & lateral to pubic tubercle"],
    ["Meralgia paresthetica nerve", "Lat. cut. nerve of thigh (L2–L3)"],
    ["Medial circumflex femoral a.", "Main supply to femoral head"],
    ["Nerve unlocking the knee", "Popliteus (via tibial n.)"],
    ["Safe IM injection site", "Upper outer quadrant of gluteal region"],
    ["Nerve above piriformis", "Superior gluteal nerve"],
    ["Nerve(s) below piriformis", "Sciatic, inf. gluteal, post. cut. of thigh"],
  ];

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}

// ── SLIDE 26: FINAL / THANK YOU ────────────────────────────────────
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  sl.addText("ALL THE BEST!", { x: 0.7, y: 1.0, w: 8.5, h: 1.0, fontSize: 54, bold: true, color: C.gold, charSpacing: 3 });
  sl.addText("You've covered the HIGH-YIELD Lower Limb Anatomy for NEET PG", { x: 0.7, y: 2.1, w: 8.5, h: 0.65, fontSize: 17, color: C.white, italic: true });

  const reminders = ["Revise nerve injuries daily", "Practice MCQ patterns", "Use mnemonics (NAVY, etc.)", "Correlate with clinical cases"];
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  sl.addText("Orris Medical Education  •  Lower Limb Anatomy NEET PG", { x: 0.3, y: 5.3, w: 9.4, h: 0.325, fontSize: 10, color: C.white, valign: "middle" });
}

// ── WRITE FILE ─────────────────────────────────────────────────────
pres.writeFile({ fileName: "/home/daytona/workspace/lower-limb-neet/Lower_Limb_NEET_PG.pptx" })
  .then(() => console.log("SUCCESS: Presentation created."))
  .catch(e => console.error("ERROR:", e));

Successfully replaced 1 instance(s) of the string in '/home/daytona/workspace/lower-limb-neet/create_pptx.js'

Successfully replaced 1 instance(s) of the string in '/home/daytona/workspace/lower-limb-neet/create_pptx.js'