cd /home/daytona/workspace/attachments/4c7c207f-fa4b-490c-929e-094be99fbd08 && python3 -c " import pdfplumber with pdfplumber.open('DNB Diagram Questions 68.pdf') as pdf: for i, page in enumerate(pdf.pages): print(f'--- PAGE {i+1} ---') print(page.extract_text()) "

mkdir -p /home/daytona/workspace/dnb-diagrams && ls /home/daytona/workspace/dnb-diagrams/

mkdir -p /home/daytona/workspace/dnb-diagrams && cat > /home/daytona/workspace/dnb-diagrams/generate_part1.py << 'PYEOF' import matplotlib matplotlib.use('Agg') import matplotlib.pyplot as plt import matplotlib.patches as mpatches import matplotlib.patches as patches from matplotlib.patches import FancyArrowPatch, FancyBboxPatch, Arc, Circle, FancyArrow import numpy as np from matplotlib.backends.backend_pdf import PdfPages import warnings warnings.filterwarnings('ignore') # Global style - clean, hand-draw friendly plt.rcParams['font.family'] = 'DejaVu Sans' plt.rcParams['axes.spines.top'] = False plt.rcParams['axes.spines.right'] = False pdf_path = '/home/daytona/workspace/dnb-diagrams/DNB_Diagrams_Part1.pdf' def section_title_page(pdf, title, color='#1a3a5c'): fig, ax = plt.subplots(figsize=(11.7, 8.3)) fig.patch.set_facecolor('#f0f4f8') ax.set_xlim(0,10); ax.set_ylim(0,10); ax.axis('off') ax.add_patch(FancyBboxPatch((0.3,3.5),(9.4,3.5), boxstyle="round,pad=0.3", facecolor=color, edgecolor='white', linewidth=3)) ax.text(5,5.8, title, ha='center', va='center', fontsize=28, fontweight='bold', color='white', wrap=True) ax.text(5,1.5, 'DNB Anaesthesiology — Diagram Question Bank 2021–2025', ha='center', va='center', fontsize=13, color='#555') ax.text(5,0.8, 'Hand-drawable annotated diagrams from standard textbooks', ha='center', va='center', fontsize=11, color='#888', style='italic') pdf.savefig(fig, bbox_inches='tight'); plt.close(fig) with PdfPages(pdf_path) as pdf: # ── COVER PAGE ────────────────────────────────────────────────────────── fig, ax = plt.subplots(figsize=(11.7, 8.3)) fig.patch.set_facecolor('#0d1b2a') ax.set_xlim(0,10); ax.set_ylim(0,10); ax.axis('off') ax.add_patch(FancyBboxPatch((0.2,0.2),(9.6,9.6), boxstyle="round,pad=0.2", facecolor='none', edgecolor='#4fc3f7', linewidth=3)) ax.text(5,8.2,'DNB ANAESTHESIOLOGY',ha='center',fontsize=26,fontweight='bold',color='#4fc3f7') ax.text(5,7.2,'DIAGRAM QUESTION BANK',ha='center',fontsize=22,fontweight='bold',color='white') ax.text(5,6.3,'2021 – 2025',ha='center',fontsize=18,color='#b0bec5') ax.add_patch(plt.Rectangle((1,5.5),8,0.08,color='#4fc3f7')) ax.text(5,4.8,'68 High-Yield Topics',ha='center',fontsize=20,fontweight='bold',color='#ffcc02') ax.text(5,4.0,'Annotated • Easy to Draw • From Standard Books',ha='center',fontsize=14,color='#b0bec5') ax.text(5,3.0,'✦ Respiratory ✦ Airway & Circuits ✦ Regional Anaesthesia',ha='center',fontsize=12,color='#80cbc4') ax.text(5,2.4,'✦ Cardiovascular ✦ Equipment ✦ Pharmacology',ha='center',fontsize=12,color='#80cbc4') ax.text(5,1.2,'Verified from 10 exam sessions | AIDAA / Morgan & Mikhail / Miller / Barash', ha='center',fontsize=10,color='#607d8b',style='italic') pdf.savefig(fig, bbox_inches='tight'); plt.close(fig) # ════════════════════════════════════════════════════════════════════════ # SECTION 1: RESPIRATORY SYSTEM # ════════════════════════════════════════════════════════════════════════ section_title_page(pdf, 'SECTION 1\nRESPIRATORY SYSTEM\n(Topics 1–8)', color='#1565c0') # ── TOPIC 1: Oxygen Dissociation Curve ────────────────────────────────── fig, ax = plt.subplots(figsize=(11.7, 8.3)) fig.patch.set_facecolor('#fffde7') ax.set_xlim(0,100); ax.set_ylim(0,105) ax.set_xlabel('PO₂ (mmHg)', fontsize=12, fontweight='bold') ax.set_ylabel('SaO₂ (%)', fontsize=12, fontweight='bold') ax.set_title('TOPIC 1 | Oxygen-Haemoglobin Dissociation Curve\n[5x — Bohr Effect • P50 • Haldane • Shifts]', fontsize=13, fontweight='bold', color='#1a237e', pad=10) # Normal sigmoid po2 = np.linspace(0,100,300) def hb_sat(po2, p50=27): n=2.7 return 100*(po2**n)/(po2**n + p50**n) sat_normal = hb_sat(po2, 27) sat_right = hb_sat(po2, 35) sat_left = hb_sat(po2, 19) ax.plot(po2, sat_normal, 'b-', lw=3, label='Normal (P50=27 mmHg)') ax.plot(po2, sat_right, 'r--', lw=2.5, label='Right shift (P50↑=35)') ax.plot(po2, sat_left, 'g--', lw=2.5, label='Left shift (P50↓=19)') # P50 markers ax.axvline(27, color='blue', alpha=0.4, lw=1.5, linestyle=':') ax.axhline(50, color='blue', alpha=0.4, lw=1.5, linestyle=':') ax.plot(27,50,'bo',ms=8) ax.annotate('P50 = 27 mmHg\n(Normal)', xy=(27,50), xytext=(35,38), fontsize=9, color='blue', arrowprops=dict(arrowstyle='->', color='blue', lw=1.5)) # Key points ax.plot(40,75,'ko',ms=7); ax.annotate('Mixed venous\nPvO₂=40, SvO₂=75%', xy=(40,75),xytext=(45,62),fontsize=8.5, arrowprops=dict(arrowstyle='->',lw=1.2)) ax.plot(100,97.5,'bs',ms=7); ax.annotate('Arterial\nPaO₂=100, SaO₂=97.5%', xy=(100,97.5),xytext=(70,88),fontsize=8.5, arrowprops=dict(arrowstyle='->',lw=1.2)) ax.plot(60,89,'r^',ms=7); ax.annotate('Critical point\n60 mmHg → 90%', xy=(60,89),xytext=(62,78),fontsize=8.5,color='darkred', arrowprops=dict(arrowstyle='->',lw=1.2,color='darkred')) # Shift boxes right_causes = '→ Right shift (↑P50):\n• ↑Temp • ↑CO₂ • ↑H⁺ (↓pH)\n• ↑2,3-DPG • Exercise\n= Bohr Effect — releases O₂' left_causes = '← Left shift (↓P50):\n• ↓Temp • ↓CO₂ • ↓H⁺ (↑pH)\n• ↓2,3-DPG • HbF • CO\n= ↑O₂ affinity — binds O₂' ax.text(55,20, right_causes, fontsize=8.5, color='darkred', bbox=dict(boxstyle='round', facecolor='#ffe0e0', alpha=0.8)) ax.text(1,68, left_causes, fontsize=8.5, color='darkgreen', bbox=dict(boxstyle='round', facecolor='#e0ffe0', alpha=0.8)) # Haldane effect note ax.text(1,5,'Haldane Effect: deoxyHb binds CO₂ 3.5× more than oxyHb → venous CO₂ transport ↑', fontsize=9, style='italic', color='#555', bbox=dict(boxstyle='round', facecolor='#e3f2fd', alpha=0.7)) ax.legend(loc='upper left', fontsize=9, framealpha=0.8) ax.grid(True, alpha=0.3) ax.set_xticks([0,20,40,60,80,100]); ax.set_yticks([0,25,50,75,90,100]) ax.text(98,2,'Source: West\'s Respiratory Physiology',ha='right',fontsize=8,color='#888',style='italic') plt.tight_layout() pdf.savefig(fig, bbox_inches='tight'); plt.close(fig) # ── TOPIC 2: ACLS Algorithms ───────────────────────────────────────────── fig, ax = plt.subplots(figsize=(11.7, 8.3)) fig.patch.set_facecolor('#fce4ec') ax.set_xlim(0,12); ax.set_ylim(0,10); ax.axis('off') ax.set_title('TOPIC 2 | ACLS Algorithm — VF/pVT + PEA/Asystole\n[5x — CCLS / Indian Resuscitation Council 2019]', fontsize=13, fontweight='bold', color='#880e4f', pad=8) def flowbox(ax, x, y, w, h, text, fc='#ffffff', ec='#333', fs=8.5, bold=False): ax.add_patch(FancyBboxPatch((x-w/2, y-h/2), w, h, boxstyle='round,pad=0.1', facecolor=fc, edgecolor=ec, lw=1.8)) ax.text(x, y, text, ha='center', va='center', fontsize=fs, fontweight='bold' if bold else 'normal', wrap=True, multialignment='center') def arrow_down(ax, x, y1, y2, color='#333'): ax.annotate('', xy=(x, y2), xytext=(x, y1), arrowprops=dict(arrowstyle='->', color=color, lw=2)) # VF/pVT column ax.text(3.2, 9.5, 'VF / pVT', ha='center', fontsize=12, fontweight='bold', color='#c62828') flowbox(ax, 3.2, 8.8, 3.0, 0.7, 'Unresponsive / No breathing\nCall for help — start CPR', '#ffcdd2','#c62828',8,True) arrow_down(ax, 3.2, 8.45, 7.85, '#c62828') flowbox(ax, 3.2, 7.55, 3.0, 0.6, 'Attach defibrillator\nCheck rhythm', '#ef9a9a','#c62828',8.5,True) ax.text(3.2, 7.05, 'SHOCKABLE?', ha='center', fontsize=9, fontweight='bold', color='#c62828') arrow_down(ax, 3.2, 7.0, 6.45, '#c62828') flowbox(ax, 3.2, 6.15, 3.0, 0.6, '⚡ SHOCK — 200J biphasic\nResume CPR immediately 2 min', '#e53935','#b71c1c',9,True) arrow_down(ax, 3.2, 5.85, 5.35, '#c62828') flowbox(ax, 3.2, 5.05, 3.0, 0.6, 'Adrenaline 1mg IV q3-5min\n(After 2nd shock)', '#ffcdd2','#c62828',8.5) arrow_down(ax, 3.2, 4.75, 4.25, '#c62828') flowbox(ax, 3.2, 3.95, 3.0, 0.6, 'Amiodarone 300mg IV\n(3rd shock — refractory VF)', '#ef9a9a','#c62828',8.5) arrow_down(ax, 3.2, 3.65, 3.15, '#c62828') flowbox(ax, 3.2, 2.85, 3.0, 0.6, 'Treat reversible causes\n4 Hs & 4 Ts', '#fff9c4','#f9a825',8.5) # PEA/Asystole column ax.text(8.8, 9.5, 'PEA / ASYSTOLE', ha='center', fontsize=12, fontweight='bold', color='#1565c0') flowbox(ax, 8.8, 8.8, 3.0, 0.7, 'Unresponsive / No breathing\nCall for help — start CPR', '#bbdefb','#1565c0',8,True) arrow_down(ax, 8.8, 8.45, 7.85, '#1565c0') flowbox(ax, 8.8, 7.55, 3.0, 0.6, 'Attach defibrillator\nCheck rhythm', '#90caf9','#1565c0',8.5,True) ax.text(8.8, 7.05, 'NON-SHOCKABLE', ha='center', fontsize=9, fontweight='bold', color='#1565c0') arrow_down(ax, 8.8, 7.0, 6.45, '#1565c0') flowbox(ax, 8.8, 6.15, 3.0, 0.6, 'CPR 30:2 — High quality\nMinimise interruptions', '#1565c0','#0d47a1',9,True) arrow_down(ax, 8.8, 5.85, 5.35, '#1565c0') flowbox(ax, 8.8, 5.05, 3.0, 0.6, 'Adrenaline 1mg IV ASAP\nthen q3-5min', '#bbdefb','#1565c0',8.5) arrow_down(ax, 8.8, 4.75, 4.25, '#1565c0') flowbox(ax, 8.8, 3.95, 3.0, 0.6, 'Recheck rhythm every 2 min\nROSC? → post-arrest care', '#e3f2fd','#1565c0',8.5) arrow_down(ax, 8.8, 3.65, 3.15, '#1565c0') flowbox(ax, 8.8, 2.85, 3.0, 0.6, 'Treat reversible causes\n4 Hs & 4 Ts', '#fff9c4','#f9a825',8.5) # 4Hs 4Ts box ht_text = '4 Hs: Hypoxia • Hypovolaemia • Hypo/Hyperkalaemia • Hypothermia\n4 Ts: Tension PTX • Tamponade • Toxins • Thrombosis (PE/coronary)' ax.text(6, 1.9, ht_text, ha='center', va='center', fontsize=9, bbox=dict(boxstyle='round', facecolor='#fff9c4', edgecolor='#f9a825', lw=2), multialignment='center') ax.text(6, 1.0, 'Source: Indian Resuscitation Council / AHA ACLS 2020', ha='center', fontsize=8.5, color='#888', style='italic') plt.tight_layout() pdf.savefig(fig, bbox_inches='tight'); plt.close(fig) # ── TOPIC 3: Flow-Volume Loops ─────────────────────────────────────────── fig, axes = plt.subplots(1,3, figsize=(11.7, 7)) fig.patch.set_facecolor('#e8f5e9') fig.suptitle('TOPIC 3 | Flow-Volume Loops — Normal • COPD (Obstructive) • Restrictive\n[4x — Spirometry Standard]', fontsize=13, fontweight='bold', color='#1b5e20') patterns = [ ('NORMAL', '#2e7d32', [1,2.5,3.5,3.8,4,3.5,2,0,-1,-2.5,-3,-3.5,-3.8,-4],[1,1.5,2,2.5,3,3.5,4,4,3.5,3,2.5,2,1.5,1]), ('COPD\n(Obstructive)', '#b71c1c', [0.8,1.8,2.2,2.5,2.4,1.8,1,0,-0.8,-1.5,-2,-2.5],[0.8,1.2,1.7,2.2,2.6,3.0,3.4,3.4,3,2.5,2,1.7,1.3,1]), ('RESTRICTIVE','#0d47a1', [0.7,1.8,2.4,2.5,2.3,1.5,0,-0.7,-1.5,-2,-2.4,-2.5],[0.7,1.1,1.5,1.9,2.3,2.7,2.8,2.8,2.4,2,1.6,1.3,1,0.7]), ] loop_data = [ # (FVC, PEF, shape description) # Normal {'fvc':5.0,'fev1':4.0,'pef':10,'expiry_x':np.array([0,0.5,1,1.5,2,2.5,3,3.5,4,4.5,5]), 'expiry_y':np.array([0,9,9.5,9,8,6.5,5,3.5,2,1,0]), 'inspiry_x':np.array([0,0.5,1,1.5,2,2.5,3,3.5,4,4.5,5]), 'inspiry_y':np.array([0,-3,-4.5,-5.5,-6,-6.5,-6.5,-6,-5,-3.5,0]), 'color':'#2e7d32','title':'NORMAL','note':'FVC=5L FEV1=4L\nFEV1/FVC=80%\nPEF normal'}, {'fvc':4.0,'fev1':2.0,'pef':6,'expiry_x':np.array([0,0.5,1,2,3,4]), 'expiry_y':np.array([0,5.5,5,3.5,1.5,0]), 'inspiry_x':np.array([0,0.5,1,2,3,4]), 'inspiry_y':np.array([0,-3,-4,-5.5,-4.5,0]), 'color':'#b71c1c','title':'COPD (Obstructive)','note':'FVC↓ FEV1↓↓\nFEV1/FVC <70%\nScooped-out concave\nexpiratory limb'}, {'fvc':3.0,'fev1':2.5,'pef':8,'expiry_x':np.array([0,0.3,0.8,1.5,2.5,3]), 'expiry_y':np.array([0,8.5,9,7,3,0]), 'inspiry_x':np.array([0,0.3,0.8,1.5,2.5,3]), 'inspiry_y':np.array([0,-3,-5,-6.5,-5.5,0]), 'color':'#0d47a1','title':'RESTRICTIVE','note':'FVC↓↓ FEV1↓\nFEV1/FVC >80%\nSmall but tall loop'}, ] for i, (ax, ld) in enumerate(zip(axes, loop_data)): ax.set_xlim(-0.3, 5.5); ax.set_ylim(-8, 12) ax.axhline(0, color='black', lw=1.5) ax.plot(ld['expiry_x'], ld['expiry_y'], color=ld['color'], lw=3) ax.plot(ld['inspiry_x'], ld['inspiry_y'], color=ld['color'], lw=3, linestyle='--') ax.fill_between(ld['expiry_x'], ld['expiry_y'], 0, alpha=0.15, color=ld['color']) ax.fill_between(ld['inspiry_x'], ld['inspiry_y'], 0, alpha=0.15, color=ld['color']) ax.set_title(ld['title'], fontsize=12, fontweight='bold', color=ld['color']) ax.set_xlabel('Volume (L)', fontsize=10) if i==0: ax.set_ylabel('Flow (L/s)', fontsize=10) ax.text(0.05, 0.98, ld['note'], transform=ax.transAxes, va='top', fontsize=8.5, bbox=dict(facecolor='white', alpha=0.85, boxstyle='round')) ax.text(0.5, 0.52, 'EXPIRATION →', transform=ax.transAxes, ha='center', fontsize=8, color=ld['color']) ax.text(0.5, 0.35, '← INSPIRATION', transform=ax.transAxes, ha='center', fontsize=8, color=ld['color'], style='italic') ax.spines['top'].set_visible(False); ax.spines['right'].set_visible(False) fig.text(0.5, 0.01, 'Source: West\'s Respiratory Physiology • Nunn\'s Applied Respiratory Physiology', ha='center', fontsize=9, color='#555', style='italic') plt.tight_layout() pdf.savefig(fig, bbox_inches='tight'); plt.close(fig) # ── TOPIC 4: Oxygen Cascade ────────────────────────────────────────────── fig, ax = plt.subplots(figsize=(11.7, 8.3)) fig.patch.set_facecolor('#e3f2fd') ax.set_xlim(-0.5, 7); ax.set_ylim(0, 180) ax.set_title('TOPIC 4 | Oxygen Cascade — Atmospheric → Mitochondria\n[3x — A-a Gradient • Pasteur Point]', fontsize=13, fontweight='bold', color='#0d47a1', pad=10) steps = [ ('Atmosphere', 159, '#4fc3f7'), ('Trachea\n(humidified)', 149, '#29b6f6'), ('Alveolar\n(PAO₂)', 100, '#039be5'), ('Arterial\n(PaO₂)', 95, '#0288d1'), ('Venous\n(PvO₂)', 40, '#0277bd'), ('Intracellular', 20, '#01579b'), ('Mitochondria', 5, '#1a237e'), ] xpos = np.arange(len(steps)) colors_bar = [s[2] for s in steps] vals = [s[1] for s in steps] bars = ax.bar(xpos, vals, color=colors_bar, width=0.6, edgecolor='white', linewidth=2, zorder=3) for i,(b,s) in enumerate(zip(bars,steps)): ax.text(i, s[1]+3, f'{s[1]} mmHg', ha='center', fontsize=10, fontweight='bold', color='#1a237e') ax.text(i, -8, s[0], ha='center', va='top', fontsize=8.5, fontweight='bold', multialignment='center') # A-a gradient annotation ax.annotate('', xy=(3, 95), xytext=(2, 100), arrowprops=dict(arrowstyle='<->', color='red', lw=2)) ax.text(2.5, 108, 'A-a gradient\n= PAO₂−PaO₂\nNormal <15 mmHg\n(young)', ha='center', fontsize=9, color='darkred', bbox=dict(facecolor='#ffe0e0', alpha=0.85, boxstyle='round')) # Pasteur point ax.axhline(1, color='purple', lw=2, linestyle='--') ax.text(0.2, 5, 'Pasteur Point ≈ 1 mmHg\n(minimum O₂ for aerobic metabolism)', fontsize=9, color='purple', bbox=dict(facecolor='#f3e5f5', alpha=0.8, boxstyle='round')) # Drop annotations ax.annotate('Water vapour\n47 mmHg', xy=(1, 149), xytext=(1.8, 160), fontsize=8.5, arrowprops=dict(arrowstyle='->', lw=1.5)) ax.annotate('CO₂ ≈ 40 mmHg\nVentilation effect', xy=(2, 100), xytext=(3.2, 125), fontsize=8.5, arrowprops=dict(arrowstyle='->', lw=1.5)) ax.annotate('Shunt / V/Q\nmismatch', xy=(3, 95), xytext=(4, 115), fontsize=8.5, arrowprops=dict(arrowstyle='->', lw=1.5), color='darkred') ax.annotate('O₂ extraction\nby tissues', xy=(4, 40), xytext=(4.8, 65), fontsize=8.5, arrowprops=dict(arrowstyle='->', lw=1.5)) ax.set_ylabel('PO₂ (mmHg)', fontsize=11, fontweight='bold') ax.set_xticks([]); ax.grid(axis='y', alpha=0.3, zorder=0) ax.text(6.5, 5, 'Source: West\'s\nRespiratory\nPhysiology', ha='center', fontsize=8, color='#888', style='italic') plt.tight_layout() pdf.savefig(fig, bbox_inches='tight'); plt.close(fig) # ── TOPIC 5: V/Q West's Zones ──────────────────────────────────────────── fig, axes = plt.subplots(1,2, figsize=(11.7, 8.3)) fig.patch.set_facecolor('#e8f5e9') fig.suptitle("TOPIC 5 | West's Zones of the Lung — V/Q Distribution\n[3x — Blood Flow & Ventilation Gradients]", fontsize=13, fontweight='bold', color='#1b5e20') ax = axes[0] ax.set_xlim(0,10); ax.set_ylim(0,12); ax.axis('off') # Lung outline lung_x = [3,2,1.5,1.5,2,3,4,5,5,4.5,4,3.5,3] lung_y = [1,2,4,7,10,11,10,10,7,4,2,1.5,1] ax.fill(lung_x, lung_y, color='#e8f5e9', edgecolor='#2e7d32', lw=2.5) ax.text(5.5, 10.5, 'APEX', fontsize=9, fontweight='bold', color='#555') ax.text(5.5, 1.5, 'BASE', fontsize=9, fontweight='bold', color='#555') # Zones zones = [ (9.0, '#ef5350', 'ZONE 1\n(Apex)\nPA > Pa > Pv\nBlood flow = 0\nVentilated but\nnot perfused\n(Dead space)\nV/Q = ∞'), (6.0, '#ff9800', 'ZONE 2\n(Middle)\nPa > PA > Pv\nIntermittent flow\nStarling resistor\nV/Q = normal ~1'), (3.0, '#4caf50', 'ZONE 3\n(Base)\nPa > Pv > PA\nContinuous flow\nBest perfusion\nV/Q < 1 (shunt)'), ] zone_colors = ['#ffcdd2','#ffe0b2','#c8e6c9'] for zi,(y,color,text) in enumerate(zones): ax.add_patch(plt.Rectangle((1.4, y-1.5), 3, 2.8, facecolor=zone_colors[zi], edgecolor=color, lw=2, alpha=0.7)) ax.text(2.9, y, text, ha='center', va='center', fontsize=7.5, fontweight='bold' if zi==0 else 'normal', multialignment='center') # Pressure labels ax.text(0.2, 6, '↑', fontsize=18, color='#1565c0') ax.text(0.2, 5, 'Height', fontsize=8, color='#1565c0') ax.text(5.5, 9, 'PA = Alveolar pressure', fontsize=8, color='#c62828') ax.text(5.5, 8.4, 'Pa = Arterial pressure', fontsize=8, color='#1565c0') ax.text(5.5, 7.8, 'Pv = Venous pressure', fontsize=8, color='#2e7d32') ax = axes[1] ax.set_xlim(0, 12); ax.set_ylim(0, 12) ax.set_title('Flow & Ventilation Gradients\n(per unit lung volume)', fontsize=11, fontweight='bold') heights = np.linspace(1, 11, 100) blood_flow = 5 * np.exp(-0.25 * (heights - 1)) ventilation = 2.5 * np.exp(-0.12 * (heights - 1)) + 1 vq_ratio = ventilation / (blood_flow + 0.01) ax.plot(blood_flow, heights, 'r-', lw=3, label='Blood Flow') ax.plot(ventilation, heights, 'b-', lw=3, label='Ventilation') ax.plot(vq_ratio*1.5, heights, 'g--', lw=2.5, label='V/Q Ratio (×1.5 scaled)') ax.axhline(9, color='#888', lw=1, linestyle=':'); ax.text(9.5, 9.2, 'Zone 1', fontsize=9) ax.axhline(5.5, color='#888', lw=1, linestyle=':'); ax.text(9.5, 5.7, 'Zone 2', fontsize=9) ax.axhline(2.5, color='#888', lw=1, linestyle=':'); ax.text(9.5, 2.7, 'Zone 3', fontsize=9) ax.set_xlabel('Relative flow/ventilation', fontsize=10) ax.set_ylabel('↑ Apex Height Base ↓', fontsize=10) ax.legend(fontsize=9, loc='upper right') ax.grid(alpha=0.3) ax.spines['top'].set_visible(False); ax.spines['right'].set_visible(False) ax.text(0.5, -0.12, 'At apex: V/Q high (dead space) | At base: V/Q low (shunt tendency)', transform=ax.transAxes, ha='center', fontsize=9, color='#333', bbox=dict(facecolor='#f9fbe7', alpha=0.9, boxstyle='round')) fig.text(0.5, 0.01, 'Source: West\'s Respiratory Physiology, 10th edition', ha='center', fontsize=9, color='#555', style='italic') plt.tight_layout() pdf.savefig(fig, bbox_inches='tight'); plt.close(fig) # ── TOPIC 6: CO2 Transport ─────────────────────────────────────────────── fig, ax = plt.subplots(figsize=(11.7, 8.3)) fig.patch.set_facecolor('#f3e5f5') ax.set_xlim(0,12); ax.set_ylim(0,10); ax.axis('off') ax.set_title('TOPIC 6 | CO₂ Transport in Blood — 3 Pathways + Chloride Shift\n[2x — Haldane Effect]', fontsize=13, fontweight='bold', color='#4a148c', pad=8) # 3 pathway boxes paths = [ (2, 7.5, 'DISSOLVED\n(5%)', '#ce93d8', '#4a148c', 'CO₂ dissolved in plasma\nFick\'s law\n0.03 mmol/L/mmHg'), (6, 7.5, 'CARBAMINO\n(5%)', '#ba68c8', '#4a148c', 'CO₂ + Hb-NH₂ →\nHb-NH-COOH\nMore in deoxyHb\n→ Haldane effect'), (10, 7.5, 'BICARBONATE\n(90%)', '#9c27b0', '#4a148c', 'CO₂ + H₂O →\nH₂CO₃ → H⁺ + HCO₃⁻\nCarbonic anhydrase\n(in RBC)\nHCO₃⁻ → plasma'), ] for x,y,title,fc,ec,note in paths: ax.add_patch(FancyBboxPatch((x-1.6,y-0.7),3.2,1.6,boxstyle='round,pad=0.15', facecolor=fc,edgecolor=ec,lw=2,alpha=0.8)) ax.text(x, y+0.25, title, ha='center', fontsize=11, fontweight='bold', color='white') ax.text(x, y-1.5, note, ha='center', fontsize=8.5, multialignment='center', bbox=dict(facecolor='#f3e5f5', alpha=0.9, boxstyle='round')) # RBC diagram (central) rbc = plt.Circle((6, 3.8), 1.8, color='#ef9a9a', alpha=0.5) ax.add_patch(rbc) ax.text(6, 3.8, 'RBC', ha='center', fontsize=14, fontweight='bold', color='#b71c1c') ax.text(6, 3.2, 'Carbonic\nAnhydrase', ha='center', fontsize=8.5, color='#880e4f') # Chloride shift ax.annotate('', xy=(8.2,3.8), xytext=(7.8,3.8), arrowprops=dict(arrowstyle='->', color='blue', lw=2)) ax.text(9.0, 4.2, 'HCO₃⁻ → plasma', fontsize=9, color='blue') ax.annotate('', xy=(7.8,3.4), xytext=(8.2,3.4), arrowprops=dict(arrowstyle='->', color='green', lw=2)) ax.text(9.0, 3.3, 'Cl⁻ → RBC\n(CHLORIDE SHIFT\n= Hamburger shift)', fontsize=9, color='darkgreen', bbox=dict(facecolor='#e8f5e9', alpha=0.9, boxstyle='round')) # Haldane effect ax.add_patch(FancyBboxPatch((0.3,0.5),5,1.2,boxstyle='round,pad=0.15', facecolor='#ede7f6',edgecolor='#7b1fa2',lw=2)) ax.text(2.8, 1.1, 'HALDANE EFFECT: Deoxygenated Hb carries 3.5× more CO₂\n' 'than oxyHb → venous blood carries more CO₂\n' 'Clinically: O₂ therapy can ↑ PaCO₂ in COPD (Haldane effect)', ha='center', va='center', fontsize=8.5, multialignment='center') ax.add_patch(FancyBboxPatch((6.2,0.5),5.5,1.2,boxstyle='round,pad=0.15', facecolor='#fff3e0',edgecolor='#e65100',lw=2)) ax.text(9.0, 1.1, 'CO₂ Transport Summary:\nArterial PCO₂ = 40 mmHg\nVenous PCO₂ = 46 mmHg\nA-V diff = 6 mmHg\n→ 200 mL CO₂/min excreted', ha='center', va='center', fontsize=8.5, multialignment='center') ax.text(6, 0.2, 'Source: West\'s Respiratory Physiology • Ganong\'s Review of Medical Physiology', ha='center', fontsize=8.5, color='#888', style='italic') plt.tight_layout() pdf.savefig(fig, bbox_inches='tight'); plt.close(fig) # ── TOPIC 7: Laryngeal Nerve Innervation ───────────────────────────────── fig, axes = plt.subplots(1,2, figsize=(11.7, 8.3)) fig.patch.set_facecolor('#e0f2f1') fig.suptitle('TOPIC 7 | Laryngeal Nerve Innervation — SLN / RLN + Cord Positions\n[2x — RLN Palsy Clinical]', fontsize=13, fontweight='bold', color='#004d40') ax = axes[0] ax.set_xlim(0,10); ax.set_ylim(0,12); ax.axis('off') ax.set_title('Nerve Supply', fontsize=11, fontweight='bold', color='#004d40') # Vagus nerve trunk ax.add_patch(plt.Rectangle((4.5,9),1,2.5,color='#80cbc4',ec='#004d40',lw=2)) ax.text(5,10.5,'VAGUS\n(CN X)',ha='center',fontsize=9,fontweight='bold') # SLN ax.annotate('',xy=(2,7.5),xytext=(4.5,9),arrowprops=dict(arrowstyle='->',lw=2,color='#00695c')) ax.add_patch(FancyBboxPatch((0.2,6.2),3.8,1.3,boxstyle='round',facecolor='#b2dfdb',ec='#00695c',lw=2)) ax.text(2.1,6.85,'SLN — Superior Laryngeal Nerve',ha='center',fontsize=8.5,fontweight='bold',color='#004d40') ax.text(0.5,5.5,'Internal branch: Sensory\nabove vocal cords\n(mucosa)',fontsize=8, bbox=dict(facecolor='#e0f2f1',alpha=0.9,boxstyle='round')) ax.text(0.5,3.8,'External branch: Motor\nCricothyroid muscle\n(pitch control)',fontsize=8, bbox=dict(facecolor='#e0f2f1',alpha=0.9,boxstyle='round')) # RLN ax.annotate('',xy=(7.5,7),xytext=(5.5,9),arrowprops=dict(arrowstyle='->',lw=2,color='#c62828')) ax.add_patch(FancyBboxPatch((6.2,5.7),3.5,1.3,boxstyle='round',facecolor='#ffcdd2',ec='#c62828',lw=2)) ax.text(8,6.35,'RLN — Recurrent\nLaryngeal Nerve',ha='center',fontsize=8.5,fontweight='bold',color='#c62828') ax.text(6.2,4.8,'Motor: All intrinsic\nlaryngeal muscles\n(EXCEPT cricothyroid)',fontsize=8, bbox=dict(facecolor='#fff5f5',alpha=0.9,boxstyle='round')) ax.text(6.2,3.2,'Sensory: Below\nvocal cords\n(subglottic)',fontsize=8, bbox=dict(facecolor='#fff5f5',alpha=0.9,boxstyle='round')) ax.text(6.2,1.8,'L-RLN: loops under\naortic arch\nR-RLN: loops under\nsubclavian artery',fontsize=7.5, bbox=dict(facecolor='#ffebee',alpha=0.9,boxstyle='round'),color='#c62828') ax = axes[1] ax.set_xlim(0,10); ax.set_ylim(0,10); ax.axis('off') ax.set_title('RLN Palsy — Cord Positions', fontsize=11, fontweight='bold', color='#004d40') positions = [ (2.5, 7.5, 'NORMAL', 'Paramedian during\nphonation', '#2196f3', 0.3), (7.5, 7.5, 'UNILATERAL\nRLN PALSY', 'Cadaveric position\n(paramedian/lateral)\nHoarseness\nAspirates', '#ff5722', 0.45), (2.5, 2.5, 'BILATERAL\nRLN PALSY', 'Both cords\nparamedian\nStridor!\nEmergency trach', '#c62828', 0.5), (7.5, 2.5, 'SLN PALSY', 'Median position\n(cricothyroid weak)\nBreathy voice\nPitch loss', '#9c27b0', 0.3), ] for x,y,title,note,color,gap in positions: # Draw vocal cords (V shape) for side in [-1,1]: g = gap*side ax.plot([x, x+side*1.2],[y+0.5, y-0.3], color=color, lw=3) ax.add_patch(plt.Circle((x, y), 0.15, color=color, alpha=0.5)) ax.text(x, y+1.2, title, ha='center', fontsize=8.5, fontweight='bold', color=color, multialignment='center') ax.text(x, y-1.2, note, ha='center', fontsize=7.5, multialignment='center', bbox=dict(facecolor='white', alpha=0.8, boxstyle='round')) fig.text(0.5, 0.01, 'Source: Snell\'s Clinical Anatomy • Kaplan\'s Anaesthesia', ha='center', fontsize=9, color='#555', style='italic') plt.tight_layout() pdf.savefig(fig, bbox_inches='tight'); plt.close(fig) # ── TOPIC 8: BVM Self-Inflating Bag ───────────────────────────────────── fig, ax = plt.subplots(figsize=(11.7, 8.3)) fig.patch.set_facecolor('#fff8e1') ax.set_xlim(0,14); ax.set_ylim(0,10); ax.axis('off') ax.set_title('TOPIC 8 | BVM — Self-Inflating Bag Components + FiO₂ Values\n[1x — Bag-Valve-Mask]', fontsize=13, fontweight='bold', color='#e65100', pad=8) # Mask mask = patches.Ellipse((1.5,5),1.8,3.5,color='#90caf9',alpha=0.8,ec='#1565c0',lw=2.5) ax.add_patch(mask) ax.text(1.5,5,'MASK',ha='center',fontsize=9,fontweight='bold',color='#0d47a1') # One-way valve (patient side) ax.add_patch(FancyBboxPatch((2.8,4.3),1.4,1.4,boxstyle='round',facecolor='#ffcc02',ec='#e65100',lw=2)) ax.text(3.5,5.0,'Non-\nrebreath\nvalve',ha='center',fontsize=7.5) ax.annotate('',xy=(2.8,5),xytext=(2.3,5),arrowprops=dict(arrowstyle='->',lw=2)) # Self-inflating bag bag = patches.Ellipse((6.5,5),4,3.5,color='#a5d6a7',alpha=0.8,ec='#2e7d32',lw=2.5) ax.add_patch(bag) ax.text(6.5,5.3,'SELF-INFLATING\nBAG',ha='center',fontsize=10,fontweight='bold',color='#1b5e20') ax.text(6.5,4.5,'(~1600 mL adult)',ha='center',fontsize=8.5,color='#1b5e20') ax.annotate('',xy=(4.2,5),xytext=(3.9,5+0.001),arrowprops=dict(arrowstyle='->',lw=2)) # Air inlet valve ax.add_patch(FancyBboxPatch((8.9,4.3),1.4,1.4,boxstyle='round',facecolor='#ffe082',ec='#f9a825',lw=2)) ax.text(9.6,5.0,'Air\ninlet\nvalve',ha='center',fontsize=7.5) # O2 inlet ax.annotate('',xy=(9.6,4.3),xytext=(9.6,3),arrowprops=dict(arrowstyle='->',lw=2,color='blue')) ax.text(9.6,2.7,'O₂ Inlet\n10-15 L/min',ha='center',fontsize=9,color='blue') # Reservoir bag reservoir = patches.Ellipse((12,5),2.5,3,color='#b39ddb',alpha=0.8,ec='#4527a0',lw=2.5) ax.add_patch(reservoir) ax.text(12,5.2,'RESERVOIR\nBAG',ha='center',fontsize=9,fontweight='bold',color='#311b92') ax.text(12,4.5,'(~2500 mL)',ha='center',fontsize=8,color='#311b92') ax.annotate('',xy=(10.3,5),xytext=(11,5),arrowprops=dict(arrowstyle='<-',lw=2)) # FiO2 table fio2_data = [ ('Without O₂', 'Room air', '0.21 (21%)'), ('O₂ without reservoir', '10-15 L/min', '0.40-0.60 (40-60%)'), ('O₂ with reservoir', '10-15 L/min', '0.85-1.0 (85-100%)'), ] ax.add_patch(FancyBboxPatch((0.2,0.3),13.5,2.5,boxstyle='round',facecolor='#fff9c4',ec='#f9a825',lw=2)) ax.text(7,2.6,'FiO₂ DELIVERED', ha='center', fontsize=10, fontweight='bold') headers = ['Condition', 'O₂ Flow', 'FiO₂'] for j,h in enumerate(headers): ax.text(1+j*4.5, 2.2, h, fontsize=9, fontweight='bold', color='#555') for i,(cond,flow,fio2) in enumerate(fio2_data): y = 1.7 - i*0.45 ax.text(1,y,cond,fontsize=8.5); ax.text(5.5,y,flow,fontsize=8.5); ax.text(10,y,fio2,fontsize=8.5,fontweight='bold',color='#1565c0') ax.text(7,0.1,'Source: Morgan & Mikhail\'s Clinical Anaesthesiology, 6th Ed.', ha='center',fontsize=8.5,color='#888',style='italic') plt.tight_layout() pdf.savefig(fig, bbox_inches='tight'); plt.close(fig) print("Part 1 done — Respiratory System (Topics 1-8)") PYEOF python3 /home/daytona/workspace/dnb-diagrams/generate_part1.py

cat > /home/daytona/workspace/dnb-diagrams/respiratory.py << 'PYEOF' import matplotlib matplotlib.use('Agg') import matplotlib.pyplot as plt import matplotlib.patches as mpatches import numpy as np from matplotlib.patches import FancyBboxPatch, FancyArrowPatch, Ellipse, Circle, Rectangle from matplotlib.backends.backend_pdf import PdfPages import warnings warnings.filterwarnings('ignore') plt.rcParams['font.family'] = 'DejaVu Sans' def add_source(ax, text, x=0.5, y=-0.08): ax.text(x, y, text, transform=ax.transAxes, ha='center', fontsize=7.5, color='#666', style='italic') def fbox(ax, x, y, w, h, text, fc='white', ec='#333', fs=9, bold=False, ta='center'): ax.add_patch(FancyBboxPatch((x-w/2, y-h/2), w, h, boxstyle='round,pad=0.08', facecolor=fc, edgecolor=ec, lw=1.8)) ax.text(x, y, text, ha=ta, va='center', fontsize=fs, fontweight='bold' if bold else 'normal', multialignment='center') pdf_path = '/home/daytona/workspace/dnb-diagrams/DNB_Respiratory_System.pdf' with PdfPages(pdf_path) as pdf: # ── COVER ─────────────────────────────────────────────────────────────── fig, ax = plt.subplots(figsize=(11.7, 8.3)) fig.patch.set_facecolor('#e3f2fd') ax.set_xlim(0,10); ax.set_ylim(0,10); ax.axis('off') ax.add_patch(FancyBboxPatch((0.3,0.3), 9.4, 9.4, boxstyle='round,pad=0.2', facecolor='#1565c0', edgecolor='#4fc3f7', lw=4)) ax.text(5, 8.0, 'DNB ANAESTHESIOLOGY', ha='center', fontsize=22, fontweight='bold', color='#4fc3f7') ax.text(5, 7.0, 'DIAGRAM QUESTION BANK', ha='center', fontsize=18, fontweight='bold', color='white') ax.text(5, 5.8, 'SECTION 1', ha='center', fontsize=28, fontweight='bold', color='#ffcc02') ax.text(5, 4.8, 'RESPIRATORY SYSTEM', ha='center', fontsize=22, fontweight='bold', color='white') ax.text(5, 3.8, 'Topics 1–8 | 8 High-Yield Diagrams', ha='center', fontsize=14, color='#b0bec5') topics = [ '1. O₂ Dissociation Curve (5x)', '2. ACLS Algorithms (5x)', '3. Flow-Volume Loops (4x)', '4. Oxygen Cascade (3x)', '5. V/Q West\'s Zones (3x)', '6. CO₂ Transport (2x)', '7. Laryngeal Nerve Innervation (2x)', '8. BVM Self-Inflating Bag (1x)', ] for i, t in enumerate(topics): ax.text(5, 3.0 - i*0.3, t, ha='center', fontsize=10, color='#e3f2fd') ax.text(5, 0.5, 'Hand-drawable • Annotated • From Standard Textbooks', ha='center', fontsize=10, color='#90caf9', style='italic') pdf.savefig(fig, bbox_inches='tight'); plt.close(fig) # ══════════════════════════════════════════════════════ # TOPIC 1 — Oxygen Dissociation Curve # ══════════════════════════════════════════════════════ fig, ax = plt.subplots(figsize=(11.7, 8.3)) fig.patch.set_facecolor('#fffde7') ax.set_xlim(0, 105); ax.set_ylim(-5, 110) ax.set_xlabel('PO₂ (mmHg)', fontsize=12, fontweight='bold') ax.set_ylabel('Haemoglobin Saturation SaO₂ (%)', fontsize=12, fontweight='bold') ax.set_title('TOPIC 1 | Oxygen–Haemoglobin Dissociation Curve\n' '[5x — P50 • Bohr Effect • Haldane Effect • Right/Left Shifts]', fontsize=13, fontweight='bold', color='#1a237e', pad=10) po2 = np.linspace(0, 100, 400) def sat(po2, p50=27, n=2.7): return 100 * po2**n / (po2**n + p50**n) ax.plot(po2, sat(po2, 27), 'b-', lw=3.5, label='Normal P50 = 27 mmHg', zorder=5) ax.plot(po2, sat(po2, 35), 'r--', lw=2.5, label='Right shift P50 = 35 mmHg') ax.plot(po2, sat(po2, 19), 'g--', lw=2.5, label='Left shift P50 = 19 mmHg') # dotted guides for p,s,c in [(27,50,'blue'),(40,75,'gray'),(60,90,'orange'),(100,97.5,'blue')]: ax.plot([0,p],[s,s], color=c, lw=1, linestyle=':', alpha=0.6) ax.plot([p,p],[0,s], color=c, lw=1, linestyle=':', alpha=0.6) ax.plot(27,50,'bo',ms=9, zorder=6) ax.annotate('P50 = 27 mmHg\n50% saturation',xy=(27,50),xytext=(10,38), fontsize=9,color='#1a237e',fontweight='bold', arrowprops=dict(arrowstyle='->',color='blue',lw=1.8)) ax.plot(40,75,'ks',ms=8, zorder=6) ax.annotate('Mixed venous\nPvO₂=40, SvO₂=75%',xy=(40,75),xytext=(45,58),fontsize=9, arrowprops=dict(arrowstyle='->',lw=1.5)) ax.plot(60,sat(60,27),'r^',ms=8,zorder=6) ax.annotate('Critical point\n60 mmHg → ~90%\nBelow = rapid ↓SaO₂', xy=(60,sat(60,27)),xytext=(62,78),fontsize=9,color='darkred', arrowprops=dict(arrowstyle='->',color='darkred',lw=1.5)) ax.plot(100,97.5,'b*',ms=12,zorder=6) ax.annotate('Arterial\nPaO₂=100, SaO₂=97.5%',xy=(100,97.5),xytext=(72,90),fontsize=9, arrowprops=dict(arrowstyle='->',lw=1.5)) ax.text(58,25, '→ RIGHT SHIFT (↑P50) — O₂ released:\n' ' • ↑ Temperature\n • ↑ CO₂ (↑ PCO₂)\n' ' • ↑ H⁺ (↓ pH) = BOHR EFFECT\n' ' • ↑ 2,3-DPG\n • Exercise / Acidosis', fontsize=9, color='#c62828', bbox=dict(boxstyle='round', facecolor='#ffe8e8', alpha=0.9, ec='#c62828')) ax.text(2,62, '← LEFT SHIFT (↓P50) — O₂ held:\n' ' • ↓ Temperature\n • ↓ CO₂ (↓ PCO₂)\n' ' • ↓ H⁺ (↑ pH)\n • ↓ 2,3-DPG\n' ' • HbF • CO • MetHb', fontsize=9, color='#2e7d32', bbox=dict(boxstyle='round', facecolor='#e8f5e9', alpha=0.9, ec='#2e7d32')) ax.text(2, -4, 'HALDANE EFFECT: Deoxygenated Hb binds CO₂ 3.5× more than oxyHb → ' 'venous blood carries more CO₂ | ' 'Clinically: O₂ therapy can ↑ PaCO₂ in COPD', fontsize=8.5, style='italic', color='#37474f', bbox=dict(boxstyle='round', facecolor='#e3f2fd', alpha=0.8)) ax.legend(loc='upper left', fontsize=10, framealpha=0.9) ax.grid(True, alpha=0.25) ax.set_xticks(range(0,110,10)); ax.set_yticks(range(0,110,10)) ax.spines['top'].set_visible(False); ax.spines['right'].set_visible(False) add_source(ax,'Source: West\'s Respiratory Physiology, 10th Ed. • Nunn\'s Applied Respiratory Physiology') plt.tight_layout() pdf.savefig(fig, bbox_inches='tight'); plt.close(fig) # ══════════════════════════════════════════════════════ # TOPIC 2 — ACLS Algorithms # ══════════════════════════════════════════════════════ fig, ax = plt.subplots(figsize=(11.7, 8.3)) fig.patch.set_facecolor('#fce4ec') ax.set_xlim(0, 14); ax.set_ylim(0, 10); ax.axis('off') ax.set_title('TOPIC 2 | ACLS Algorithms — VF/pVT vs PEA/Asystole\n' '[5x — CCLS / Indian Resuscitation Council 2019]', fontsize=13, fontweight='bold', color='#880e4f', pad=8) def flow_box(ax, cx, cy, w, h, txt, fc, ec, fs=8.5): ax.add_patch(FancyBboxPatch((cx-w/2,cy-h/2),w,h, boxstyle='round,pad=0.08',facecolor=fc,edgecolor=ec,lw=2)) ax.text(cx,cy,txt,ha='center',va='center',fontsize=fs, multialignment='center',fontweight='bold') def arr(ax,x,y1,y2,c='#333'): ax.annotate('',xy=(x,y2),xytext=(x,y1), arrowprops=dict(arrowstyle='-|>',color=c,lw=2.2, mutation_scale=18)) # --- VF column (left) --- col1 = 3.5 ax.text(col1,9.6,'⚡ VF / pVT',ha='center',fontsize=13,fontweight='bold',color='#c62828') flow_box(ax,col1,8.95,5.5,0.75,'No pulse / Unresponsive → Call for help\nStart CPR 30:2 • High quality', '#ffcdd2','#c62828',8) arr(ax,col1,8.57,8.07,'#c62828') flow_box(ax,col1,7.7,5.5,0.65,'Attach defibrillator → Analyse rhythm', '#ef9a9a','#c62828',8.5) ax.text(col1,7.2,'▼ SHOCKABLE ▼',ha='center',fontsize=9,fontweight='bold',color='#c62828') arr(ax,col1,7.15,6.65,'#c62828') flow_box(ax,col1,6.3,5.5,0.65,'⚡ SHOCK — 200 J biphasic\nResume CPR immediately × 2 min', '#e53935','#b71c1c',9) arr(ax,col1,5.97,5.47,'#c62828') flow_box(ax,col1,5.1,5.5,0.65,'IV/IO access • Adrenaline 1 mg q3–5 min\n(give after 2nd shock)', '#ffcdd2','#c62828',8.5) arr(ax,col1,4.77,4.27,'#c62828') flow_box(ax,col1,3.9,5.5,0.65,'Amiodarone 300 mg IV bolus\n(Refractory VF after 3rd shock)', '#ef9a9a','#c62828',8.5) arr(ax,col1,3.57,3.07,'#c62828') flow_box(ax,col1,2.7,5.5,0.65,'Recheck rhythm every 2 min\nROSC? → Post-resuscitation care', '#fff9c4','#f57f17',8.5) # --- PEA column (right) --- col2 = 10.5 ax.text(col2,9.6,'💉 PEA / Asystole',ha='center',fontsize=13,fontweight='bold',color='#1565c0') flow_box(ax,col2,8.95,5.5,0.75,'No pulse / Unresponsive → Call for help\nStart CPR 30:2 • High quality', '#bbdefb','#1565c0',8) arr(ax,col2,8.57,8.07,'#1565c0') flow_box(ax,col2,7.7,5.5,0.65,'Attach defibrillator → Analyse rhythm', '#90caf9','#1565c0',8.5) ax.text(col2,7.2,'▼ NON-SHOCKABLE ▼',ha='center',fontsize=9,fontweight='bold',color='#1565c0') arr(ax,col2,7.15,6.65,'#1565c0') flow_box(ax,col2,6.3,5.5,0.65,'Continue CPR 30:2\nMinimise interruptions < 5 sec', '#1565c0','#0d47a1',9) arr(ax,col2,5.97,5.47,'#1565c0') flow_box(ax,col2,5.1,5.5,0.65,'IV/IO access • Adrenaline 1 mg ASAP\nthen q3–5 min', '#bbdefb','#1565c0',8.5) arr(ax,col2,4.77,4.27,'#1565c0') flow_box(ax,col2,3.9,5.5,0.65,'No Amiodarone for PEA/Asystole\nAdrenaline alone', '#e3f2fd','#1565c0',8.5) arr(ax,col2,3.57,3.07,'#1565c0') flow_box(ax,col2,2.7,5.5,0.65,'Recheck rhythm every 2 min\nROSC? → Post-resuscitation care', '#fff9c4','#f57f17',8.5) # --- 4Hs 4Ts --- ax.add_patch(FancyBboxPatch((0.3,0.25),13.4,1.9, boxstyle='round,pad=0.1',facecolor='#fff9c4', edgecolor='#f57f17',lw=2.5)) ax.text(7,1.85,'REVERSIBLE CAUSES — 4 Hs & 4 Ts', ha='center',fontsize=11,fontweight='bold',color='#e65100') ax.text(3.5,1.2,'4 Hs:\nHypoxia • Hypovolaemia\nHypo/Hyperkalaemia • Hypothermia', ha='center',fontsize=9,multialignment='center') ax.text(10.5,1.2,'4 Ts:\nTension Pneumothorax • Tamponade\nToxins • Thrombosis (PE/MI)', ha='center',fontsize=9,multialignment='center') ax.text(7,0.08,'Source: Indian Resuscitation Council 2019 • AHA ACLS 2020', ha='center',fontsize=8,color='#666',style='italic') pdf.savefig(fig, bbox_inches='tight'); plt.close(fig) # ══════════════════════════════════════════════════════ # TOPIC 3 — Flow-Volume Loops # ══════════════════════════════════════════════════════ fig, axes = plt.subplots(1,3,figsize=(11.7,7.5)) fig.patch.set_facecolor('#e8f5e9') fig.suptitle('TOPIC 3 | Flow–Volume Loops\n' 'Normal • Obstructive (COPD) • Restrictive [4x]', fontsize=13,fontweight='bold',color='#1b5e20',y=0.99) loops = [ dict(title='NORMAL',color='#1565c0', ex_v=[0,0.5,1,2,3,4,5], ex_f=[0,10,9.5,8,6,3,0], in_f=[0,-4,-5,-6.5,-6.5,-5,-0], fvc=5.0,fev1=4.0,ratio=80, note='FVC = 5 L\nFEV₁ = 4 L\nFEV₁/FVC = 80%\nSmooth convex shape'), dict(title='OBSTRUCTIVE\n(COPD)',color='#c62828', ex_v=[0,0.5,1,2,3,4], ex_f=[0,6,5.5,3.5,1.5,0], in_f=[0,-3.5,-4.5,-5.5,-5,-0], fvc=4.0,fev1=1.8,ratio=45, note='FVC ↓ FEV₁ ↓↓\nFEV₁/FVC < 70%\nScooped concave\nexpiratory limb\nSlowed emptying'), dict(title='RESTRICTIVE',color='#2e7d32', ex_v=[0,0.3,0.8,1.5,2.5,3], ex_f=[0,9,9.5,8,4,0], in_f=[0,-3.5,-5.5,-6.5,-5.5,-0], fvc=3.0,fev1=2.7,ratio=90, note='FVC ↓↓ FEV₁ ↓\nFEV₁/FVC > 80%\nTall narrow loop\nReduced lung vol\n(fibrosis/obesity)'), ] for ax, ld in zip(axes, loops): ex_v = np.array(ld['ex_v']); ex_f = np.array(ld['ex_f']) in_v = np.array(ld['ex_v']); in_f = np.array(ld['in_f']) max_v = max(ex_v)+0.5 ax.set_xlim(-0.3, max_v); ax.set_ylim(-9, 13) ax.axhline(0,color='black',lw=1.5) ax.axvline(0,color='black',lw=1,linestyle=':',alpha=0.4) from scipy.interpolate import make_interp_spline if len(ex_v)>3: xs = np.linspace(0, max(ex_v), 200) ex_smooth = make_interp_spline(ex_v,ex_f,k=3)(xs) in_smooth = make_interp_spline(in_v,in_f,k=3)(xs) ax.plot(xs, ex_smooth, color=ld['color'], lw=3.5, label='Expiration') ax.plot(xs, in_smooth, color=ld['color'], lw=3.5, linestyle='--', label='Inspiration') ax.fill_between(xs, ex_smooth, 0, alpha=0.12, color=ld['color']) ax.fill_between(xs, in_smooth, 0, alpha=0.12, color=ld['color']) # PEF marker pef_x = ex_v[np.argmax(ex_f)] ax.annotate('PEF', xy=(pef_x, max(ex_f)), xytext=(pef_x+0.3, max(ex_f)+1), fontsize=8, color=ld['color'], arrowprops=dict(arrowstyle='->', lw=1.2, color=ld['color'])) ax.set_title(ld['title'], fontsize=12, fontweight='bold', color=ld['color']) ax.set_xlabel('Volume (L)', fontsize=10) if ax == axes[0]: ax.set_ylabel('Flow (L/s)', fontsize=10) ax.text(0.02, 0.98, ld['note'], transform=ax.transAxes, va='top', fontsize=8.5, bbox=dict(facecolor='white',alpha=0.9,boxstyle='round', ec=ld['color'])) ax.text(0.5, 0.55, 'EXPIRATION →', transform=ax.transAxes, ha='center', fontsize=8, color=ld['color']) ax.text(0.5, 0.38, '← INSPIRATION', transform=ax.transAxes, ha='center', fontsize=8, color=ld['color'], style='italic') ax.spines['top'].set_visible(False); ax.spines['right'].set_visible(False) ax.grid(alpha=0.2) fig.text(0.5,0.01,'Source: West\'s Respiratory Physiology • Stoelting\'s Pharmacology & Physiology', ha='center',fontsize=9,color='#555',style='italic') plt.tight_layout(rect=[0,0.03,1,0.97]) pdf.savefig(fig,bbox_inches='tight'); plt.close(fig) # ══════════════════════════════════════════════════════ # TOPIC 4 — Oxygen Cascade # ══════════════════════════════════════════════════════ fig, ax = plt.subplots(figsize=(11.7, 8.3)) fig.patch.set_facecolor('#e3f2fd') ax.set_xlim(-0.5, 7.5); ax.set_ylim(-15, 185) ax.set_title('TOPIC 4 | Oxygen Cascade — Atmospheric → Mitochondria\n' '[3x — A-a Gradient • Pasteur Point • Alveolar Gas Equation]', fontsize=13, fontweight='bold', color='#0d47a1', pad=10) steps = [ ('Atmosphere', 159, '#4fc3f7', 'FiO₂ = 0.21\nPB = 760 mmHg\nPO₂ = 0.21×760'), ('Trachea\n(humidified)', 149, '#29b6f6', 'Water vapour\n47 mmHg\n149 = 0.21×(760-47)'), ('Alveolar\n(PAO₂)', 100, '#039be5', 'Alveolar gas eqn:\nPAO₂ = FiO₂(PB-47) - PaCO₂/RQ\n= 150 - 40/0.8 = 100'), ('Arterial\n(PaO₂)', 95, '#0288d1', 'A-a gradient\n= PAO₂ - PaO₂\nNormal < 15 mmHg\n(due to V/Q mismatch\n+ shunt + diffusion)'), ('Venous\n(PvO₂)', 40, '#0277bd', 'O₂ extraction\nby tissues\nNormal CaO₂-CvO₂\n= 5 mL/dL'), ('Intracellular', 20, '#01579b', 'Dependent on\nmitochondrial\nactivity & demand'), ('Mitochondria', 5, '#0d47a1', 'Critical PO₂\n= 1 mmHg\n(Pasteur point)'), ] bar_w = 0.55 xpos = np.arange(len(steps)) for i,(name,val,col,note) in enumerate(steps): ax.bar(i, val, width=bar_w, color=col, edgecolor='white', lw=2, zorder=3) ax.text(i, val+4, f'{val}', ha='center', fontsize=11, fontweight='bold', color='#1a237e') ax.text(i, -3, name, ha='center', va='top', fontsize=8.5, fontweight='bold', multialignment='center') # Note below bar ax.text(i, val/2, note, ha='center', va='center', fontsize=7, color='white', multialignment='center', bbox=dict(facecolor='none', alpha=0)) # A-a gradient bracket ax.annotate('', xy=(3, 95), xytext=(2, 100), arrowprops=dict(arrowstyle='<->', color='red', lw=2.5)) ax.text(2.5, 115, 'A-a gradient\nNormal < 15 mmHg', ha='center', fontsize=9, color='darkred', fontweight='bold', bbox=dict(boxstyle='round', facecolor='#ffe8e8', alpha=0.9, ec='red')) # Pasteur point line ax.axhline(1, color='purple', lw=2.5, linestyle='--', zorder=4) ax.text(0.1, 6, 'Pasteur Point ≈ 1 mmHg\n(min PO₂ for aerobic metabolism)', fontsize=8.5, color='purple', bbox=dict(boxstyle='round', facecolor='#f3e5f5', alpha=0.9, ec='purple')) # Drop arrows showing losses losses = [(0.5, 10, 'Water\nvapour\n47 mmHg'), (1.5, 49, 'Alveolar\nCO₂\n(CO₂/RQ)'), (3.5, 55, 'V/Q mismatch\nShunt\nDiffusion'), (4.5, 55, 'O₂ extraction\nby tissues')] for xm, dy, txt in losses: mid = xm ax.annotate('', xy=(mid+0.5, steps[int(mid+0.5)][1]), xytext=(mid+0.5, steps[int(mid)][1]), arrowprops=dict(arrowstyle='->', color='#555', lw=1.5)) ax.set_ylabel('PO₂ (mmHg)', fontsize=11, fontweight='bold') ax.set_xticks([]) ax.grid(axis='y', alpha=0.25, zorder=0) ax.spines['top'].set_visible(False); ax.spines['right'].set_visible(False) add_source(ax, "Source: West's Respiratory Physiology • Miller's Anaesthesia, 8th Ed.") plt.tight_layout() pdf.savefig(fig, bbox_inches='tight'); plt.close(fig) # ══════════════════════════════════════════════════════ # TOPIC 5 — V/Q West's Zones # ══════════════════════════════════════════════════════ fig, (ax1, ax2) = plt.subplots(1, 2, figsize=(11.7, 8.3)) fig.patch.set_facecolor('#e8f5e9') fig.suptitle("TOPIC 5 | West's Zones of the Lung — V/Q Distribution\n" "[3x — Blood Flow & Ventilation Gradients • Shunt • Dead Space]", fontsize=13, fontweight='bold', color='#1b5e20') ax1.set_xlim(0,10); ax1.set_ylim(0,12); ax1.axis('off') # Lung outline (simple) import matplotlib.path as mpath lung_patch_x = [3.5,2.5,2,1.8,2,2.5,3.5,4.5,5,4.8,4.5,4,3.5] lung_patch_y = [1,2,4,6.5,9,11,11.5,11,9,6.5,4,2,1] ax1.fill(lung_patch_x, lung_patch_y, color='#f1f8e9', ec='#388e3c', lw=3, zorder=2) zone_info = [ (9.5, '#ef5350', '#ffcdd2', 'ZONE 1 (Apex)', 'PA > Pa > Pv\nBlood flow = 0\nAlveolar dead space\nV/Q = ∞\n(Rare — hypovolaemia)'), (6.5, '#ff9800', '#ffe0b2', 'ZONE 2 (Middle)', 'Pa > PA > Pv\nIntermittent/pulsatile flow\nStarling resistor behaviour\nV/Q ≈ 1 (normal)'), (3.0, '#43a047', '#c8e6c9', 'ZONE 3 (Base)', 'Pa > Pv > PA\nContinuous flow\nBest perfusion\nV/Q < 1\n(shunt tendency)'), ] for y_pos, ec_col, fc_col, title, note in zone_info: ax1.add_patch(FancyBboxPatch((1.6, y_pos-1.6), 3.1, 3.1, boxstyle='round,pad=0.1', facecolor=fc_col, edgecolor=ec_col, lw=2, alpha=0.8, zorder=3)) ax1.text(3.15, y_pos+0.4, title, ha='center', fontsize=8.5, fontweight='bold', color=ec_col) ax1.text(3.15, y_pos-0.4, note, ha='center', fontsize=7.5, multialignment='center', color='#333') ax1.text(5.8, 11, 'PA = Alveolar pressure', fontsize=8.5, color='#b71c1c') ax1.text(5.8, 10.4, 'Pa = Pulmonary arterial pressure', fontsize=8.5, color='#1565c0') ax1.text(5.8, 9.8, 'Pv = Pulmonary venous pressure', fontsize=8.5, color='#2e7d32') ax1.text(5.8, 9.0, 'Gravity ↓ → Pa & Pv increase\ndownward (1 cmH₂O/cm height)', fontsize=8.5, bbox=dict(facecolor='#f9fbe7', alpha=0.9, boxstyle='round')) ax1.text(5.8, 7.2, '→ Zone 4 (extreme base):\nInterstitial pressure > Pa\nSeen in pulmonary oedema', fontsize=8.5, color='#6a1b9a', bbox=dict(facecolor='#ede7f6', alpha=0.9, boxstyle='round')) ax1.text(0.5, 6.5, '↑\nA\nP\nE\nX', fontsize=9, ha='center', color='#555', fontweight='bold') ax1.text(0.5, 2.5, '↓\nB\nA\nS\nE', fontsize=9, ha='center', color='#555', fontweight='bold') ax1.set_title('Zones in Upright Lung', fontsize=11, fontweight='bold', color='#1b5e20') # Graph ax2.set_xlim(0, 12); ax2.set_ylim(0, 12) heights = np.linspace(0.5, 11, 100) blood_flow = 5.5 * np.exp(-0.28 * (heights - 0.5)) ventilation = 1.8 + 2.0 * np.exp(-0.15 * (heights - 0.5)) vq = ventilation / (blood_flow + 0.01) ax2.plot(blood_flow, heights, 'r-', lw=3, label='Blood flow (Q)') ax2.plot(ventilation, heights, 'b-', lw=3, label='Ventilation (V)') ax2.plot(np.clip(vq*1.2,0,11.5), heights, 'g--', lw=2.5, label='V/Q ratio (scaled)') ax2.axhline(8.5, color='#ef5350', lw=1.5, linestyle=':', alpha=0.7) ax2.axhline(5.0, color='#ff9800', lw=1.5, linestyle=':', alpha=0.7) ax2.axhline(2.0, color='#43a047', lw=1.5, linestyle=':', alpha=0.7) ax2.text(10.5, 8.7, 'Zone 1', fontsize=9, color='#ef5350') ax2.text(10.5, 5.2, 'Zone 2', fontsize=9, color='#ff9800') ax2.text(10.5, 2.2, 'Zone 3', fontsize=9, color='#43a047') ax2.set_xlabel('Relative flow / ventilation (arbitrary units)', fontsize=9) ax2.set_ylabel('Height from base → APEX', fontsize=10) ax2.set_title('Flow & Ventilation vs Height', fontsize=11, fontweight='bold', color='#1b5e20') ax2.legend(fontsize=9, loc='upper right') ax2.grid(alpha=0.2) ax2.spines['top'].set_visible(False); ax2.spines['right'].set_visible(False) ax2.text(0.5, -0.1, 'At apex: V/Q = 3.3 (dead space effect) | Overall mean V/Q = 0.8\n' 'At base: V/Q = 0.6 (shunt-like effect)', transform=ax2.transAxes, ha='center', fontsize=9, bbox=dict(facecolor='#f9fbe7', alpha=0.9, boxstyle='round')) fig.text(0.5, 0.01, "Source: West's Respiratory Physiology, 10th Ed. • Nunn's Applied Respiratory Physiology", ha='center', fontsize=9, color='#555', style='italic') plt.tight_layout(rect=[0,0.03,1,0.97]) pdf.savefig(fig, bbox_inches='tight'); plt.close(fig) # ══════════════════════════════════════════════════════ # TOPIC 6 — CO2 Transport # ══════════════════════════════════════════════════════ fig, ax = plt.subplots(figsize=(11.7, 8.3)) fig.patch.set_facecolor('#f3e5f5') ax.set_xlim(0,14); ax.set_ylim(0,10); ax.axis('off') ax.set_title('TOPIC 6 | CO₂ Transport in Blood — 3 Pathways + Chloride Shift\n' '[2x — Haldane Effect • Henderson–Hasselbalch]', fontsize=13, fontweight='bold', color='#4a148c', pad=8) # 3 pathway boxes path_data = [ (2.5, 8.0, 'DISSOLVED\n5%', '#ce93d8', '#6a1b9a', 'CO₂ dissolved in plasma\n0.03 × PCO₂ mmol/L\n(Fick\'s law)'), (7.0, 8.0, 'BICARBONATE\n90%', '#7b1fa2', '#4a148c', 'CO₂ + H₂O → H₂CO₃\n→ H⁺ + HCO₃⁻\nCarbonic anhydrase\n(inside RBC)\nHCO₃⁻ exits to plasma\nCl⁻ enters RBC\n= CHLORIDE SHIFT\n(Hamburger phenomenon)'), (11.5, 8.0, 'CARBAMINO\n5%', '#9c27b0', '#4a148c', 'CO₂ + Hb-NH₂ →\nHb-NHCOO⁻ + H⁺\nPrimarily on\ndeoxyhaemoglobin\n= Haldane Effect'), ] for x,y,title,fc,ec,note in path_data: ax.add_patch(FancyBboxPatch((x-1.7,y-0.5),3.4,1.1, boxstyle='round,pad=0.1',facecolor=fc,edgecolor=ec,lw=2.5)) ax.text(x,y,title,ha='center',fontsize=11,fontweight='bold',color='white') ax.text(x,y-2.0,note,ha='center',fontsize=8.5,multialignment='center', bbox=dict(facecolor='#f8f0ff',alpha=0.95,boxstyle='round',ec=ec)) ax.annotate('',xy=(x,y-0.5),xytext=(x,y-0.9), arrowprops=dict(arrowstyle='-|>',lw=2,color=ec,mutation_scale=15)) # RBC central rbc_circ = Ellipse((7.0, 4.5), 4.5, 2.5, color='#ffcdd2', alpha=0.7, ec='#c62828', lw=3) ax.add_patch(rbc_circ) ax.text(7.0, 4.8, 'RED BLOOD CELL', ha='center', fontsize=12, fontweight='bold', color='#b71c1c') ax.text(7.0, 4.2, 'Carbonic Anhydrase', ha='center', fontsize=9.5, color='#880e4f') # Chloride shift arrows ax.annotate('HCO₃⁻ → out to plasma', xy=(9.5,4.8), xytext=(10.5,5.6), fontsize=9, color='blue', arrowprops=dict(arrowstyle='->', color='blue', lw=2)) ax.annotate('Cl⁻ → in to RBC', xy=(9.5,4.2), xytext=(10.5,3.4), fontsize=9, color='darkgreen', arrowprops=dict(arrowstyle='->', color='darkgreen', lw=2)) # Haldane effect box ax.add_patch(FancyBboxPatch((0.3,0.3),6.2,1.8, boxstyle='round,pad=0.1',facecolor='#ede7f6',ec='#7b1fa2',lw=2)) ax.text(3.4,1.2,'HALDANE EFFECT:\nDeoxyHb carries 3.5× more CO₂ than OxyHb\n' 'Reason: deoxyHb is a better H⁺ buffer (forms carbamino)\n' 'Clinical: O₂ therapy ↑ PaCO₂ in COPD patients', ha='center',va='center',fontsize=8.5,multialignment='center') # Numbers box ax.add_patch(FancyBboxPatch((7.2,0.3),6.5,1.8, boxstyle='round,pad=0.1',facecolor='#fff3e0',ec='#e65100',lw=2)) ax.text(10.45,1.2,'CO₂ VALUES:\nArterial PCO₂ = 40 mmHg | Venous PCO₂ = 46 mmHg\n' 'A-V difference = 6 mmHg\nCO₂ produced at rest = 200 mL/min (RQ = 0.8)\n' 'Total CO₂ in blood ≈ 50 mL/dL', ha='center',va='center',fontsize=8.5,multialignment='center') ax.text(7,0.05,'Source: Ganong\'s Review of Medical Physiology • West\'s Respiratory Physiology', ha='center',fontsize=8,color='#777',style='italic') pdf.savefig(fig, bbox_inches='tight'); plt.close(fig) # ══════════════════════════════════════════════════════ # TOPIC 7 — Laryngeal Nerve Innervation # ══════════════════════════════════════════════════════ fig, (ax1, ax2) = plt.subplots(1, 2, figsize=(11.7, 8.3)) fig.patch.set_facecolor('#e0f7fa') fig.suptitle('TOPIC 7 | Laryngeal Nerve Innervation — SLN & RLN + Cord Positions in Palsy\n' '[2x — RLN Palsy Clinical Presentations]', fontsize=13, fontweight='bold', color='#006064') ax1.set_xlim(0,10); ax1.set_ylim(0,12); ax1.axis('off') ax1.set_title('Nerve Anatomy', fontsize=11, fontweight='bold', color='#006064') # Vagus ax1.add_patch(FancyBboxPatch((3.8,9.8),2.4,1.4,boxstyle='round', facecolor='#b2ebf2',ec='#00838f',lw=2.5)) ax1.text(5,10.5,'VAGUS (CN X)',ha='center',fontsize=10,fontweight='bold',color='#006064') # SLN ax1.annotate('',xy=(2.0,8.3),xytext=(4.0,9.8), arrowprops=dict(arrowstyle='-|>',lw=2.5,color='#00838f',mutation_scale=16)) ax1.add_patch(FancyBboxPatch((0.2,6.8),4.0,1.4,boxstyle='round', facecolor='#b2dfdb',ec='#00695c',lw=2.5)) ax1.text(2.2,7.5,'SLN\nSuperior Laryngeal N.',ha='center',fontsize=9,fontweight='bold',color='#004d40') ax1.add_patch(FancyBboxPatch((0.2,4.9),1.8,1.6,boxstyle='round', facecolor='#e0f2f1',ec='#00695c',lw=1.5)) ax1.text(1.1,5.7,'Internal\nbranch\n(Sensory)\nAbove cords\nMucosa/epiglottis', ha='center',fontsize=8,multialignment='center') ax1.add_patch(FancyBboxPatch((2.2,4.9),2.0,1.6,boxstyle='round', facecolor='#e0f2f1',ec='#00695c',lw=1.5)) ax1.text(3.2,5.7,'External\nbranch\n(Motor)\nCricothyroid only\n(pitch control)', ha='center',fontsize=8,multialignment='center') # RLN ax1.annotate('',xy=(7.5,8.3),xytext=(6.0,9.8), arrowprops=dict(arrowstyle='-|>',lw=2.5,color='#c62828',mutation_scale=16)) ax1.add_patch(FancyBboxPatch((5.8,6.8),4.0,1.4,boxstyle='round', facecolor='#ffcdd2',ec='#c62828',lw=2.5)) ax1.text(7.8,7.5,'RLN\nRecurrent Laryngeal N.',ha='center',fontsize=9,fontweight='bold',color='#b71c1c') ax1.add_patch(FancyBboxPatch((5.8,4.9),3.8,1.6,boxstyle='round', facecolor='#fff5f5',ec='#c62828',lw=1.5)) ax1.text(6.7,5.7,'Motor: ALL intrinsic laryngeal\nmuscles EXCEPT cricothyroid\nSensory: subglottic mucosa\n' 'L-RLN: loops under aortic arch\nR-RLN: loops under subclavian', ha='center',fontsize=7.8,multialignment='center') ax1.add_patch(FancyBboxPatch((0.2,0.3),9.6,4.3,boxstyle='round', facecolor='#e0f7fa',ec='#00838f',lw=1.5)) ax1.text(5,4.3,'SUMMARY TABLE',ha='center',fontsize=9.5,fontweight='bold',color='#006064') rows = [('Nerve','Motor to','Sensory from'), ('SLN external','Cricothyroid','—'), ('SLN internal','—','Supraglottis'), ('RLN','All intrinsic (except CT)','Subglottis'), ('RLN palsy','Hoarseness/stridor','Aspiration risk')] for i,row in enumerate(rows): y = 3.8 - i*0.65 bold = (i==0) for j,cell in enumerate(row): ax1.text(0.5+j*3.2, y, cell, fontsize=8 if not bold else 8.5, fontweight='bold' if bold else 'normal', color='#006064' if bold else '#333') ax2.set_xlim(0,10); ax2.set_ylim(0,10); ax2.axis('off') ax2.set_title('Vocal Cord Positions in Palsy', fontsize=11, fontweight='bold', color='#006064') cord_configs = [ (2.5, 8.0, 'NORMAL', '#1565c0', 0.3, 0.35, 'Phonation: paramedian\nAbduction: lateral\nNormal voice'), (7.5, 8.0, 'UNILATERAL RLN PALSY', '#c62828', 0.5, 0.55, 'Cadaveric position\n(paramedian/lateral)\nHoarseness\nBreathy voice\nAspiration risk'), (2.5, 3.5, 'BILATERAL RLN PALSY', '#880e4f', 0.12, 0.12, 'Both cords near midline\nStridor (EMERGENCY!)\nTracheal intubation /\nTracheostomy needed'), (7.5, 3.5, 'SLN PALSY\n(external branch)', '#2e7d32', 0.35, 0.45, 'Cords at median position\nCricothyroid paralyzed\nLoss of pitch / tension\nBreathy, low-pitched voice'), ] for cx,cy,title,color,gap_ph,gap_ab,note in cord_configs: # Trachea oval background ax2.add_patch(Ellipse((cx,cy),3.0,1.8,color='#f5f5f5',ec='#bdbdbd',lw=1.5,zorder=1)) # Draw cords for sign in [-1,1]: ax2.plot([cx, cx + sign*(0.8+gap_ph)], [cy+0.1, cy-0.5], color=color, lw=3.5, zorder=3) ax2.text(cx, cy+1.3, title, ha='center', fontsize=8.5, fontweight='bold', color=color, multialignment='center') ax2.text(cx, cy-1.5, note, ha='center', fontsize=7.8, multialignment='center', bbox=dict(facecolor='white',alpha=0.9,boxstyle='round',ec=color)) fig.text(0.5,0.01,"Source: Snell's Clinical Anatomy • Stoelting's Anaesthesia • Morgan & Mikhail 6th Ed.", ha='center',fontsize=9,color='#555',style='italic') plt.tight_layout(rect=[0,0.03,1,0.97]) pdf.savefig(fig, bbox_inches='tight'); plt.close(fig) # ══════════════════════════════════════════════════════ # TOPIC 8 — BVM Self-Inflating Bag # ══════════════════════════════════════════════════════ fig, ax = plt.subplots(figsize=(11.7, 8.3)) fig.patch.set_facecolor('#fff8e1') ax.set_xlim(0,14); ax.set_ylim(0,10); ax.axis('off') ax.set_title('TOPIC 8 | BVM — Self-Inflating Bag Components & FiO₂\n' '[1x — Bag-Valve-Mask Assembly]', fontsize=13, fontweight='bold', color='#e65100', pad=8) # MASK mask = Ellipse((1.6,5.5),2.2,4.0,color='#90caf9',alpha=0.85,ec='#1565c0',lw=3) ax.add_patch(mask) ax.text(1.6,5.5,'MASK',ha='center',fontsize=10,fontweight='bold',color='#0d47a1') ax.text(1.6,4.9,'(seal on face)',ha='center',fontsize=8,color='#1565c0') ax.annotate('Anatomical seal\nwith face',xy=(1.6,7.5),xytext=(0.3,8.5),fontsize=8, arrowprops=dict(arrowstyle='->',lw=1.5)) # Non-rebreathing patient valve ax.add_patch(FancyBboxPatch((3.0,4.9),1.8,1.3,boxstyle='round', facecolor='#fff176',ec='#f9a825',lw=2.5)) ax.text(3.9,5.55,'Non-rebreath\nPATIENT\nVALVE',ha='center',fontsize=8,fontweight='bold') ax.annotate('One-way: prevents\nexhaled gas into bag',xy=(3.9,4.9),xytext=(2.8,3.8), fontsize=8,arrowprops=dict(arrowstyle='->',lw=1.3)) ax.annotate('',xy=(3.0,5.5),xytext=(2.7,5.5), arrowprops=dict(arrowstyle='->',lw=2.5,color='#e65100')) # Self-inflating bag bag = Ellipse((7.0,5.5),5.0,3.8,color='#a5d6a7',alpha=0.85,ec='#2e7d32',lw=3) ax.add_patch(bag) ax.text(7.0,5.9,'SELF-INFLATING BAG',ha='center',fontsize=11,fontweight='bold',color='#1b5e20') ax.text(7.0,5.3,'Adult: 1500–1600 mL',ha='center',fontsize=9,color='#1b5e20') ax.text(7.0,4.8,'Paed: 500 mL | Neonatal: 250 mL',ha='center',fontsize=8.5,color='#1b5e20') ax.annotate('',xy=(4.8,5.5),xytext=(4.5,5.5), arrowprops=dict(arrowstyle='->',lw=2.5,color='#2e7d32')) # Air inlet + PEEP valve ax.add_patch(FancyBboxPatch((8.6,4.9),1.8,1.3,boxstyle='round', facecolor='#ffcc80',ec='#ef6c00',lw=2.5)) ax.text(9.5,5.55,'Air inlet\nVALVE\n(+ PEEP)',ha='center',fontsize=8,fontweight='bold') ax.annotate('Opens during\nbag recoil\n(air inlet)',xy=(9.5,4.9),xytext=(10.3,3.9), fontsize=8,arrowprops=dict(arrowstyle='->',lw=1.3)) # O2 inlet ax.annotate('',xy=(9.5,4.9),xytext=(9.5,3.5), arrowprops=dict(arrowstyle='-|>',lw=2.5,color='#1565c0',mutation_scale=15)) ax.text(9.5,3.2,'O₂ Inlet\n10–15 L/min',ha='center',fontsize=9,color='#1565c0',fontweight='bold') # Reservoir bag reservoir = Ellipse((12.3,5.5),2.8,3.5,color='#ce93d8',alpha=0.85,ec='#6a1b9a',lw=3) ax.add_patch(reservoir) ax.text(12.3,5.7,'RESERVOIR\nBAG',ha='center',fontsize=10,fontweight='bold',color='#4a148c') ax.text(12.3,5.0,'~2500 mL',ha='center',fontsize=8.5,color='#4a148c') ax.annotate('Fills with O₂\nbetween squeezes',xy=(12.3,7.3),xytext=(11.0,8.3), fontsize=8,arrowprops=dict(arrowstyle='->',lw=1.3)) ax.annotate('',xy=(10.4,5.5),xytext=(11.0,5.5), arrowprops=dict(arrowstyle='<-',lw=2,color='#6a1b9a')) # FiO2 table ax.add_patch(FancyBboxPatch((0.3,0.2),13.4,2.8,boxstyle='round', facecolor='#fff9c4',ec='#f9a825',lw=2.5)) ax.text(7.0,2.7,'FiO₂ DELIVERED — SUMMARY',ha='center',fontsize=11,fontweight='bold',color='#e65100') headers=[('Configuration','O₂ Flow','FiO₂ Delivered','Clinical Use')] rows=[ ('No O₂, no reservoir','Room air','0.21 (21%)','CPR — air only'), ('O₂, no reservoir bag','10–15 L/min','0.40–0.60 (40–60%)','Basic O₂ therapy'), ('O₂ + reservoir bag','10–15 L/min','0.85–1.00 (85–100%)','Emergency / pre-oxygenation'), ('O₂ + tight seal + reservoir','15 L/min','~1.00 (100%)','Apnoeic oxygenation'), ] col_x = [1.5,5.0,8.5,12.0] for j,h in enumerate(headers[0]): ax.text(col_x[j],2.2,h,fontsize=8.5,fontweight='bold',color='#555',ha='center') for i,row in enumerate(rows): y = 1.75 - i*0.42 for j,cell in enumerate(row): ax.text(col_x[j],y,cell,fontsize=8,ha='center', color='#1565c0' if j==2 else '#333') ax.text(7,0.05,"Source: Morgan & Mikhail's Clinical Anaesthesiology, 6th Ed. • AIDAA Guidelines", ha='center',fontsize=8,color='#777',style='italic') pdf.savefig(fig, bbox_inches='tight'); plt.close(fig) print("SUCCESS — Respiratory PDF written") PYEOF python3 /home/daytona/workspace/dnb-diagrams/respiratory.py

ls -lh /home/daytona/workspace/dnb-diagrams/DNB_Respiratory_System.pdf

cat > /home/daytona/workspace/dnb-diagrams/airway_circuits.py << 'PYEOF' import matplotlib matplotlib.use('Agg') import matplotlib.pyplot as plt import matplotlib.patches as mpatches import numpy as np from matplotlib.patches import FancyBboxPatch, Ellipse, Circle, Rectangle, Arc, FancyArrow from matplotlib.backends.backend_pdf import PdfPages from scipy.interpolate import make_interp_spline import warnings warnings.filterwarnings('ignore') plt.rcParams['font.family'] = 'DejaVu Sans' def fbox(ax, cx, cy, w, h, txt, fc='white', ec='#333', fs=9, bold=False): ax.add_patch(FancyBboxPatch((cx-w/2, cy-h/2), w, h, boxstyle='round,pad=0.08', facecolor=fc, edgecolor=ec, lw=2)) ax.text(cx, cy, txt, ha='center', va='center', fontsize=fs, fontweight='bold' if bold else 'normal', multialignment='center') def arr(ax, x1, y1, x2, y2, c='#333', lw=2.2): ax.annotate('', xy=(x2,y2), xytext=(x1,y1), arrowprops=dict(arrowstyle='-|>', color=c, lw=lw, mutation_scale=16)) def src(fig, text): fig.text(0.5, 0.01, text, ha='center', fontsize=8, color='#666', style='italic') pdf_path = '/home/daytona/workspace/dnb-diagrams/DNB_Airway_Circuits.pdf' with PdfPages(pdf_path) as pdf: # ── COVER ──────────────────────────────────────────────────────────────── fig, ax = plt.subplots(figsize=(11.7, 8.3)) fig.patch.set_facecolor('#e8eaf6') ax.set_xlim(0,10); ax.set_ylim(0,10); ax.axis('off') ax.add_patch(FancyBboxPatch((0.3,0.3), 9.4, 9.4, boxstyle='round,pad=0.2', facecolor='#283593', edgecolor='#7986cb', lw=4)) ax.text(5,8.1,'DNB ANAESTHESIOLOGY', ha='center', fontsize=20, fontweight='bold', color='#7986cb') ax.text(5,7.1,'DIAGRAM QUESTION BANK', ha='center', fontsize=16, fontweight='bold', color='white') ax.text(5,5.9,'SECTION 2', ha='center', fontsize=28, fontweight='bold', color='#ffcc02') ax.text(5,4.9,'AIRWAY & BREATHING CIRCUITS', ha='center', fontsize=18, fontweight='bold', color='white') ax.text(5,4.0,'Topics 9–17 | 9 High-Yield Diagrams', ha='center', fontsize=13, color='#c5cae9') topics = [ '9. Difficult Airway Algorithm — AIDAA (4x)', '10. Mapleson D / Bain\'s Circuit (4x)', '11. Circle System — all components (4x)', '12. NMJ — pre/post-synaptic, drug sites (4x)', '13. Desflurane Vaporiser — Tec 6 mechanism (4x)', '14. Epidural Space — cross-section (4x)', '15. Capnography Waveform — phases + abnormals (3x)', '16. Cormack–Lehane Grading — 4 views (2x)', '17. Spinal Cord Cross-Section — tracts (2x)', ] for i, t in enumerate(topics): ax.text(5, 3.35 - i*0.3, t, ha='center', fontsize=9.5, color='#e8eaf6') ax.text(5,0.5,'Hand-drawable • Annotated • From Standard Textbooks', ha='center', fontsize=10, color='#9fa8da', style='italic') pdf.savefig(fig, bbox_inches='tight'); plt.close(fig) # ══════════════════════════════════════════════════════ # TOPIC 9 — Difficult Airway Algorithm (AIDAA) # ══════════════════════════════════════════════════════ fig, ax = plt.subplots(figsize=(11.7, 8.3)) fig.patch.set_facecolor('#fbe9e7') ax.set_xlim(0,14); ax.set_ylim(0,10); ax.axis('off') ax.set_title('TOPIC 9 | Difficult Airway Algorithm — AIDAA Unanticipated\n' '[4x — Plan A → B → C → D • FONA • Scalpel Cricothyrotomy]', fontsize=12, fontweight='bold', color='#bf360c', pad=8) # Main vertical flow cx = 7.0 fbox(ax,cx,9.3,6,0.65,'UNANTICIPATED DIFFICULT INTUBATION\nGeneral Anaesthesia — patient paralysed', '#ffccbc','#bf360c',9,True) arr(ax,cx,8.97,cx,8.45,'#bf360c') fbox(ax,cx,8.1,6,0.65,'PLAN A — Direct/Video Laryngoscopy\nOptimise: BURP • Head position • Blade change\nMax 3 attempts by experienced provider', '#ffe0b2','#e65100',9) arr(ax,cx,7.77,cx,7.27,'#e65100') ax.text(cx,7.1,'FAILED ↓',ha='center',fontsize=9,color='#c62828',fontweight='bold') arr(ax,cx,6.95,cx,6.45,'#c62828') fbox(ax,cx,6.15,6,0.55,'PLAN B — Supraglottic Airway Device (SAD)\nInsert LMA / i-gel / ProSeal LMA\nAttempt intubation through SAD', '#fff9c4','#f9a825',9) arr(ax,cx,5.87,cx,5.37,'#f9a825') ax.text(cx,5.2,'FAILED ↓',ha='center',fontsize=9,color='#c62828',fontweight='bold') arr(ax,cx,5.05,cx,4.55,'#c62828') fbox(ax,cx,4.25,6,0.55,'PLAN C — Awaken the Patient\nMaintain oxygenation via face mask\nReverse neuromuscular block (Sugammadex)\nConsider awake fibreoptic intubation next time', '#dcedc8','#558b2f',9) arr(ax,cx,3.97,cx,3.47,'#558b2f') ax.text(cx,3.3,'CANNOT INTUBATE, CANNOT OXYGENATE (CICO) ↓', ha='center',fontsize=9,color='#880e4f',fontweight='bold') arr(ax,cx,3.15,cx,2.65,'#880e4f') fbox(ax,cx,2.35,6,0.65,'PLAN D — FONA\n(Front of Neck Access — EMERGENCY!)\nScalpel-Finger-Bougie Cricothyrotomy\nOR Needle cricothyrotomy (temporary)', '#f8bbd0','#880e4f',10,True) # Side annotations # BURP box ax.add_patch(FancyBboxPatch((0.2,6.8),2.8,1.5,boxstyle='round', facecolor='#fff3e0',ec='#e65100',lw=1.5)) ax.text(1.6,7.55,'BURP Manoeuvre:\nBackward Upward\nRightward Pressure\non thyroid cartilage', ha='center',fontsize=8,multialignment='center') # SAD box ax.add_patch(FancyBboxPatch((10.9,5.7),2.9,1.0,boxstyle='round', facecolor='#f9fbe7',ec='#827717',lw=1.5)) ax.text(12.35,6.2,'SAD options:\n1st gen: Classic LMA\n2nd gen: i-gel, ProSeal', ha='center',fontsize=8,multialignment='center') # Scalpel technique ax.add_patch(FancyBboxPatch((0.2,0.3),4.5,1.9,boxstyle='round', facecolor='#fce4ec',ec='#880e4f',lw=2)) ax.text(2.45,1.25,'SCALPEL TECHNIQUE (SAFE):\n1. Palpate cricothyroid membrane\n' '2. Horizontal stab incision\n3. Finger to hold\n' '4. Bougie-guided tube (6.0 cuffed)', ha='center',va='center',fontsize=8,multialignment='center') ax.add_patch(FancyBboxPatch((9.3,0.3),4.5,1.9,boxstyle='round', facecolor='#e8f5e9',ec='#1b5e20',lw=2)) ax.text(11.55,1.25,'CALL FOR HELP AT EVERY STEP\nCommunicate with team\nDeclare CICO early\nDo NOT persist > 3 attempts\nPrevent hypoxic brain injury', ha='center',va='center',fontsize=8,multialignment='center') ax.text(7,0.08,'Source: AIDAA Difficult Airway Management Guidelines 2016 • DAS UK 2015', ha='center',fontsize=8,color='#777',style='italic') pdf.savefig(fig, bbox_inches='tight'); plt.close(fig) # ══════════════════════════════════════════════════════ # TOPIC 10 — Mapleson D / Bain's Circuit # ══════════════════════════════════════════════════════ fig, (ax1,ax2) = plt.subplots(1,2,figsize=(11.7,8.3)) fig.patch.set_facecolor('#e8f5e9') fig.suptitle('TOPIC 10 | Mapleson D / Bain\'s Circuit\n' '[4x — Pethick\'s Test • FGF for SV vs IPPV • Coaxial Arrangement]', fontsize=12,fontweight='bold',color='#1b5e20',y=0.99) # --- All Mapleson circuits schematic --- ax1.set_xlim(0,10); ax1.set_ylim(0,12); ax1.axis('off') ax1.set_title('Mapleson Classification A–F', fontsize=11, fontweight='bold', color='#1b5e20') mapleson = [ ('A (Magill)', 11.0, '#ff8f00', 'FGF at reservoir end\nAPL at patient end\nBest for SV\nFGF = MV (70 mL/kg/min)'), ('B', 9.4, '#ffa000', 'FGF at patient end\nAPL at patient end\nLeast efficient'), ('C', 7.8, '#ffb300', 'Short tube\nFGF at patient end'), ('D (Bain)', 6.2, '#2196f3', 'FGF at patient end\nAPL at reservoir end\nBest for IPPV\nFGF = 70-100 mL/kg/min SV\nFGF = 70 mL/kg/min IPPV'), ('E (Ayre\'s)', 4.6, '#4caf50', 'T-piece\nNo APL, no reservoir\nPaediatric use'), ('F (Jackson-Rees)',3.0,'#9c27b0','T-piece + open reservoir\nPaediatric IPPV/SV\nFGF = 2-3× MV'), ] for name, y, col, note in mapleson: # Tube ax1.add_patch(Rectangle((1, y-0.25), 5.5, 0.5, color=col, alpha=0.6, ec=col, lw=1.5)) # Patient end (left) ax1.add_patch(Circle((1,y), 0.35, color='#ffccbc', ec='#bf360c', lw=2)) ax1.text(1,y,'P',ha='center',va='center',fontsize=8,fontweight='bold',color='#bf360c') # Reservoir (right) reservoir_ellipse = Ellipse((6.8,y),0.8,0.7,color='#b3e5fc',ec='#0288d1',lw=2) ax1.add_patch(reservoir_ellipse) ax1.text(6.8,y,'R',ha='center',va='center',fontsize=8,fontweight='bold',color='#01579b') ax1.text(0.2, y, name, ha='center', va='center', fontsize=8, fontweight='bold', color='#333') ax1.text(7.8, y, note, va='center', fontsize=7, color='#333', bbox=dict(facecolor='white',alpha=0.7,boxstyle='round',pad=0.2)) ax1.text(5, 0.5, 'P = Patient end R = Reservoir bag FGF = Fresh Gas Flow APL = Adjustable Pressure-Limiting valve', ha='center', fontsize=7.5, color='#555', bbox=dict(facecolor='#f1f8e9',alpha=0.9,boxstyle='round')) # --- Bain's Circuit detail --- ax2.set_xlim(0,10); ax2.set_ylim(0,12); ax2.axis('off') ax2.set_title("Bain's Circuit — Coaxial Mapleson D\n(IPPV & Adult Anaesthesia)", fontsize=11, fontweight='bold', color='#1565c0') # Outer tube (expiratory) ax2.add_patch(FancyBboxPatch((0.8,5.0),8.0,1.5,boxstyle='round,pad=0.05', facecolor='#e3f2fd',ec='#1565c0',lw=3)) ax2.text(4.8,6.8,'OUTER TUBE (Expiratory)\nCarries exhaled gases + FGF overflow\nDiameter: 22 mm', ha='center',fontsize=9,color='#1565c0',multialignment='center') # Inner tube (FGF) ax2.add_patch(FancyBboxPatch((1.5,5.4),6.5,0.7,boxstyle='round,pad=0.03', facecolor='#ffeb3b',ec='#f57f17',lw=2.5)) ax2.text(4.75,5.75,'INNER TUBE — FGF delivery (from machine end → patient end)', ha='center',fontsize=8.5,color='#e65100',fontweight='bold') # Patient end ax2.add_patch(Circle((0.5,5.75),0.6,color='#ffccbc',ec='#bf360c',lw=2.5)) ax2.text(0.5,5.75,'Patient',ha='center',va='center',fontsize=7.5,fontweight='bold',color='#bf360c') # Machine end ax2.add_patch(FancyBboxPatch((8.8,4.8),1.0,1.9,boxstyle='round', facecolor='#e8f5e9',ec='#2e7d32',lw=2)) ax2.text(9.3,5.75,'Machine\nend',ha='center',va='center',fontsize=8,fontweight='bold',color='#1b5e20') # APL valve ax2.add_patch(Circle((1.5,4.3),0.55,color='#f8bbd0',ec='#c62828',lw=2)) ax2.text(1.5,4.3,'APL',ha='center',va='center',fontsize=8,fontweight='bold',color='#c62828') ax2.text(1.5,3.5,'APL at patient end\n(exhalation valve)',ha='center',fontsize=8, color='#c62828',multialignment='center') # Reservoir bag reservoir2 = Ellipse((8.5,3.2),1.8,1.4,color='#b3e5fc',ec='#0288d1',lw=2.5) ax2.add_patch(reservoir2) ax2.text(8.5,3.2,'Reservoir\nbag',ha='center',va='center',fontsize=8.5,fontweight='bold',color='#01579b') # FGF requirements table ax2.add_patch(FancyBboxPatch((0.3,0.2),9.4,2.6,boxstyle='round', facecolor='#fff9c4',ec='#f9a825',lw=2)) ax2.text(5.0,2.55,'FGF REQUIREMENTS',ha='center',fontsize=10,fontweight='bold',color='#e65100') fgf_rows = [ ('Mode','FGF Required','Key Point'), ('Spontaneous Ventilation (SV)','70–100 mL/kg/min','2.5–3× minute volume to prevent rebreathing'), ('IPPV (controlled ventilation)','70 mL/kg/min (~4.5 L/min adult)','More efficient — expired gas vented during expiration'), ('Pethick\'s test','Flush O₂ → occlude patient end','Bag should deflate (proves inner tube patent)'), ] col_x2 = [1.3,4.5,8.3] for i,row in enumerate(fgf_rows): y = 2.15 - i*0.57 for j,cell in enumerate(row): ax2.text(col_x2[j], y, cell, fontsize=8 if i>0 else 8.5, fontweight='bold' if i==0 else 'normal', ha='center' if j==1 else 'left', color='#555' if i==0 else '#333') src(fig,'Source: Morgan & Mikhail\'s Clinical Anaesthesiology 6th Ed. • Bain & Spoerel (1972)') plt.tight_layout(rect=[0,0.03,1,0.97]) pdf.savefig(fig, bbox_inches='tight'); plt.close(fig) # ══════════════════════════════════════════════════════ # TOPIC 11 — Circle System # ══════════════════════════════════════════════════════ fig, ax = plt.subplots(figsize=(11.7, 8.3)) fig.patch.set_facecolor('#e3f2fd') ax.set_xlim(0,14); ax.set_ylim(0,10); ax.axis('off') ax.set_title('TOPIC 11 | Circle System — All Components Labelled\n' '[4x — O₂ Analyser Position • CO₂ Absorber • APL Valve • Unidirectional Valves]', fontsize=12,fontweight='bold',color='#0d47a1',pad=8) # Draw circle system as a rectangle loop with components # Inspiratory limb (top) — gas flows LEFT to RIGHT # Expiratory limb (bottom) — gas flows RIGHT to LEFT # Left side = patient connection # Right side = machine components # Top (inspiratory) tube ax.add_patch(Rectangle((2.5,6.8),9,0.5,color='#b3e5fc',ec='#0288d1',lw=2.5,alpha=0.7)) ax.text(7.0,7.35,'INSPIRATORY LIMB →',ha='center',fontsize=9,color='#0288d1',fontweight='bold') # Bottom (expiratory) tube ax.add_patch(Rectangle((2.5,3.5),9,0.5,color='#ffccbc',ec='#e64a19',lw=2.5,alpha=0.7)) ax.text(7.0,3.15,'← EXPIRATORY LIMB',ha='center',fontsize=9,color='#e64a19',fontweight='bold') # Patient Y-piece (left) ax.add_patch(FancyBboxPatch((1.0,4.8),1.5,2.1,boxstyle='round', facecolor='#ffccbc',ec='#bf360c',lw=2.5)) ax.text(1.75,5.85,'Y-PIECE\n&\nPATIENT',ha='center',fontsize=8.5,fontweight='bold',color='#bf360c') # Inspiratory unidirectional valve ax.add_patch(FancyBboxPatch((3.2,6.6),1.6,0.9,boxstyle='round', facecolor='#e8f5e9',ec='#2e7d32',lw=2)) ax.text(4.0,7.05,'→ INSP.\nVALVE',ha='center',fontsize=8,color='#1b5e20',fontweight='bold') ax.text(4.0,6.3,'Unidirectional\n(allows only insp)',ha='center',fontsize=7.5,color='#1b5e20') # Expiratory unidirectional valve ax.add_patch(FancyBboxPatch((3.2,3.3),1.6,0.9,boxstyle='round', facecolor='#fce4ec',ec='#c62828',lw=2)) ax.text(4.0,3.75,'← EXP.\nVALVE',ha='center',fontsize=8,color='#c62828',fontweight='bold') ax.text(4.0,2.9,'Unidirectional\n(allows only exp)',ha='center',fontsize=7.5,color='#c62828') # CO2 Absorber (centre-right of expiratory) ax.add_patch(FancyBboxPatch((6.5,2.8),2.8,1.8,boxstyle='round', facecolor='#e8eaf6',ec='#3949ab',lw=2.5)) ax.text(7.9,3.9,'CO₂ ABSORBER',ha='center',fontsize=9,fontweight='bold',color='#283593') ax.text(7.9,3.5,'Soda lime / Baralyme',ha='center',fontsize=8.5,color='#283593') ax.text(7.9,3.1,'CO₂ + 2NaOH → Na₂CO₃ + H₂O\nIndicator: white→purple (exhausted)', ha='center',fontsize=7.8,color='#333',multialignment='center') # Fresh Gas Inlet ax.add_patch(FancyBboxPatch((9.5,6.5),2.0,1.2,boxstyle='round', facecolor='#fff9c4',ec='#f9a825',lw=2)) ax.text(10.5,7.1,'FGF INLET',ha='center',fontsize=9,fontweight='bold',color='#e65100') ax.text(10.5,6.7,'(between insp valve\n& CO₂ absorber)',ha='center',fontsize=7.8) arr(ax,10.5,6.5,10.5,6.1,'#e65100') # APL Valve ax.add_patch(FancyBboxPatch((9.5,2.8),2.0,1.2,boxstyle='round', facecolor='#f8bbd0',ec='#880e4f',lw=2)) ax.text(10.5,3.4,'APL VALVE',ha='center',fontsize=9,fontweight='bold',color='#880e4f') ax.text(10.5,2.9,'Pop-off valve\n4–6 cmH₂O baseline',ha='center',fontsize=7.8) # Reservoir bag reservoir3 = Ellipse((11.8,5.15),1.6,1.3,color='#b3e5fc',ec='#0288d1',lw=2.5) ax.add_patch(reservoir3) ax.text(11.8,5.15,'RESERVOIR\nBAG\n2–3 L',ha='center',va='center',fontsize=8,fontweight='bold',color='#01579b') # O2 Analyser position label ax.add_patch(FancyBboxPatch((6.2,7.1),2.5,0.8,boxstyle='round', facecolor='#fffde7',ec='#f57f17',lw=2)) ax.text(7.45,7.5,'O₂ ANALYSER',ha='center',fontsize=8.5,fontweight='bold',color='#e65100') ax.text(7.45,7.15,'Position: inspiratory limb\n(most accurate reading)',ha='center',fontsize=7.8,color='#333') # Vaporiser (outside circle — Selectatec block) ax.add_patch(FancyBboxPatch((10.5,0.2),3.2,1.6,boxstyle='round', facecolor='#e0f2f1',ec='#00695c',lw=2)) ax.text(12.1,1.0,'VAPORISER\n(Outside circle)\nVOC = Vaporiser outside circle\nLow-flow safe only if calibrated', ha='center',va='center',fontsize=8,multialignment='center') # Advantage / Disadvantage boxes ax.add_patch(FancyBboxPatch((0.3,0.2),4.8,1.6,boxstyle='round', facecolor='#e8f5e9',ec='#2e7d32',lw=1.5)) ax.text(2.7,1.0,'ADVANTAGES:\n✓ Low FGF possible (rebreathing)\n✓ Conserves heat & moisture\n✓ ↓ Theatre pollution\n✓ ↓ Volatile agent use', ha='center',va='center',fontsize=8,multialignment='center',color='#1b5e20') ax.add_patch(FancyBboxPatch((5.3,0.2),4.8,1.6,boxstyle='round', facecolor='#fff3e0',ec='#e65100',lw=1.5)) ax.text(7.7,1.0,'DISADVANTAGES:\n✗ Complex — component failure\n✗ CO₂ absorber exhaustion\n✗ Compound A (sevoflurane at low flow)\n✗ CO production (desflurane)', ha='center',va='center',fontsize=8,multialignment='center',color='#e65100') ax.text(7,0.05,'Source: Morgan & Mikhail 6th Ed. • Miller\'s Anaesthesia 8th Ed.', ha='center',fontsize=8,color='#666',style='italic') pdf.savefig(fig, bbox_inches='tight'); plt.close(fig) # ══════════════════════════════════════════════════════ # TOPIC 12 — NMJ (Neuromuscular Junction) # ══════════════════════════════════════════════════════ fig, (ax1,ax2) = plt.subplots(1,2,figsize=(11.7,8.3)) fig.patch.set_facecolor('#fce4ec') fig.suptitle('TOPIC 12 | Neuromuscular Junction — Pre/Post-Synaptic Diagram\n' '[4x — AChR Subunits • Drug Sites • NDNMBD vs Suxamethonium]', fontsize=12,fontweight='bold',color='#880e4f',y=0.99) ax1.set_xlim(0,10); ax1.set_ylim(0,12); ax1.axis('off') ax1.set_title('NMJ Structure & Drug Sites', fontsize=11, fontweight='bold', color='#880e4f') # Motor neuron terminal ax1.add_patch(FancyBboxPatch((1.5,9.0),7.0,2.0,boxstyle='round', facecolor='#fff9c4',ec='#f57f17',lw=3)) ax1.text(5.0,10.5,'MOTOR NEURON TERMINAL (Pre-synaptic)', ha='center',fontsize=9.5,fontweight='bold',color='#e65100') # ACh vesicles for x in [2.5,3.5,4.5,5.5,6.5,7.5]: ax1.add_patch(Circle((x,9.5),0.3,color='#fff176',ec='#f9a825',lw=1.5)) ax1.text(x,9.5,'ACh',ha='center',va='center',fontsize=6,fontweight='bold') ax1.text(5.0,9.0,'ACh vesicles (quanta ~7000 molecules each)', ha='center',fontsize=8,color='#555') # Presynaptic nicotinic AChR label ax1.text(1.7,10.0,'Pre-synaptic\nα3β2 nAChR\n(mobilisation)',fontsize=7.5, bbox=dict(facecolor='#ffe082',alpha=0.9,boxstyle='round')) # Synaptic cleft ax1.add_patch(Rectangle((1.5,7.5),7.0,1.3,color='#e0f7fa',ec='#0097a7',lw=2,alpha=0.7)) ax1.text(5.0,8.15,'SYNAPTIC CLEFT (50–100 nm)',ha='center',fontsize=9, fontweight='bold',color='#00695c') ax1.text(5.0,7.7,'Acetylcholinesterase (AChE) here — degrades ACh → Choline + Acetate', ha='center',fontsize=8,color='#333') # Post-synaptic (muscle end-plate) ax1.add_patch(FancyBboxPatch((1.5,5.2),7.0,2.0,boxstyle='round', facecolor='#ffcdd2',ec='#c62828',lw=3)) ax1.text(5.0,6.7,'MUSCLE END-PLATE (Post-synaptic)',ha='center', fontsize=9.5,fontweight='bold',color='#c62828') ax1.text(5.0,6.2,'Nicotinic AChR — α₂βδε (adult) / α₂βδγ (fetal/extrajunctional)', ha='center',fontsize=8.5,color='#333') ax1.text(5.0,5.75,'2 ACh molecules must bind α-subunits → channel opens → Na⁺ influx → EPP → AP', ha='center',fontsize=8,color='#333') ax1.text(5.0,5.35,'Junctional density: ~10,000 AChR/μm²',ha='center',fontsize=8,color='#888') # Drug sites box ax1.add_patch(FancyBboxPatch((0.5,0.3),9.0,4.6,boxstyle='round', facecolor='#e8eaf6',ec='#3949ab',lw=2)) ax1.text(5.0,4.65,'DRUG SITES AT NMJ',ha='center',fontsize=10,fontweight='bold',color='#1a237e') drug_rows = [ ('Drug','Mechanism','Effect'), ('Suxamethonium','Depolarising — mimics ACh, sustained depol','Phase I block → Phase II (train of 4 fade)'), ('Rocuronium/Vecuronium','Competitive antagonist — blocks α-subunits','Non-depolarising (NDNMB) — TOF fade'), ('Neostigmine','Inhibits AChE → ↑ ACh at cleft','Reversal of NDNMB (+ glycopyrrolate)'), ('Sugammadex','Encapsulates rocuronium/vecuronium','Reversal of NDNMB — 2/4/16 mg/kg'), ('Aminoglycosides','Pre-synaptic Ca²⁺ blockade → ↓ ACh release','Potentiate NDNMB'), ] for i,row in enumerate(drug_rows): y = 4.1 - i*0.65 cols2 = [1.0,4.0,7.5] for j,cell in enumerate(row): ax1.text(cols2[j],y,cell,fontsize=7.8 if i>0 else 8, fontweight='bold' if i==0 else 'normal', color='#1a237e' if i==0 else '#333',va='center') # AChR subunit diagram ax2.set_xlim(0,10); ax2.set_ylim(0,12); ax2.axis('off') ax2.set_title('AChR Subunit Structure\n& Clinical Drug Binding', fontsize=11, fontweight='bold', color='#880e4f') # Pentagon receptor penta_x = [5+1.8*np.sin(a) for a in [np.pi/2+i*2*np.pi/5 for i in range(5)]] penta_y = [8.5+1.8*np.cos(a) for a in [np.pi/2+i*2*np.pi/5 for i in range(5)]] penta_patch = plt.Polygon(list(zip(penta_x,penta_y)), facecolor='#ffe0b2',edgecolor='#e65100',lw=3) ax2.add_patch(penta_patch) labels_sub = ['α','α','β','δ','ε'] colors_sub = ['#c62828','#c62828','#1565c0','#2e7d32','#7b1fa2'] for i,(x,y,lbl,c) in enumerate(zip(penta_x,penta_y,labels_sub,colors_sub)): ax2.add_patch(Circle((x,y),0.45,color=c,alpha=0.8,ec='white',lw=2)) ax2.text(x,y,lbl,ha='center',va='center',fontsize=11,fontweight='bold',color='white') ax2.text(5,11.2,'Ion channel (Na⁺/K⁺)',ha='center',fontsize=9,fontweight='bold',color='#01579b') ax2.add_patch(FancyBboxPatch((4.3,6.3),1.4,1.8,boxstyle='round', facecolor='#e3f2fd',ec='#1565c0',lw=1.5,alpha=0.8)) ax2.text(5.0,7.0,'Central\nIon\nChannel',ha='center',fontsize=7.5,color='#0d47a1') ax2.text(0.5,9.5,'2 ACh bind\nα subunits\n(both needed)',fontsize=8,color='#c62828', bbox=dict(facecolor='#ffcdd2',alpha=0.9,boxstyle='round')) ax2.annotate('',xy=(penta_x[0]-0.4,penta_y[0]),xytext=(2.2,9.8), arrowprops=dict(arrowstyle='->',color='#c62828',lw=1.5)) # Comparison table ax2.add_patch(FancyBboxPatch((0.3,0.2),9.4,5.5,boxstyle='round', facecolor='#fce4ec',ec='#880e4f',lw=2)) ax2.text(5.0,5.4,'DEPOLARISING vs NON-DEPOLARISING',ha='center',fontsize=9.5, fontweight='bold',color='#880e4f') cmp_rows = [ ('Feature','Suxamethonium (SCh)','Rocuronium (NDNMB)'), ('Mechanism','Depolarising (mimics ACh)','Competitive blockade'), ('Fasciculations','YES — initial', 'NO'), ('TOF pattern','No fade (Phase I)\nFade at Phase II','TOF fade present'), ('Reversal','Spontaneous (plasma ChE)\nNo specific reversal','Neostigmine or Sugammadex'), ('Clinical use','RSI (fastest onset ~45s)','Routine intubation'), ('Dose','1–2 mg/kg IV','0.6 mg/kg (intubation)'), ] for i,row in enumerate(cmp_rows): y = 4.85 - i*0.6 for j,cell in enumerate(row): ax2.text(0.5+j*3.2, y, cell, fontsize=7.5 if i>0 else 8, fontweight='bold' if i==0 else 'normal', color='#880e4f' if i==0 else '#333', va='center', multialignment='center', ha='center') src(fig,'Source: Miller\'s Anaesthesia 8th Ed. • Stoelting\'s Pharmacology & Physiology 5th Ed.') plt.tight_layout(rect=[0,0.03,1,0.97]) pdf.savefig(fig, bbox_inches='tight'); plt.close(fig) # ══════════════════════════════════════════════════════ # TOPIC 13 — Desflurane Vaporiser (Tec 6) # ══════════════════════════════════════════════════════ fig, (ax1,ax2) = plt.subplots(1,2,figsize=(11.7,8.3)) fig.patch.set_facecolor('#e0f2f1') fig.suptitle('TOPIC 13 | Desflurane Vaporiser — Tec 6 (Heated Pressurised)\n' '[4x — Injection Valve Mechanism • Safety Features • Why Different from Others]', fontsize=12,fontweight='bold',color='#004d40',y=0.99) ax1.set_xlim(0,10); ax1.set_ylim(0,12); ax1.axis('off') ax1.set_title('Tec 6 — Internal Mechanism', fontsize=11, fontweight='bold', color='#00695c') # Heated sump ax1.add_patch(FancyBboxPatch((1.0,1.0),8.0,4.5,boxstyle='round', facecolor='#ffe0b2',ec='#e65100',lw=3)) ax1.text(5.0,4.9,'HEATED SUMP / RESERVOIR',ha='center',fontsize=10,fontweight='bold',color='#bf360c') ax1.text(5.0,4.3,'Heated to 39°C (above boiling point of Desflurane 22.8°C)', ha='center',fontsize=9,color='#333') ax1.text(5.0,3.8,'Maintained at 1.5 atm (1500 mmHg) pressure', ha='center',fontsize=9,color='#c62828',fontweight='bold') ax1.text(5.0,3.3,'→ Desflurane vapour pressure = 1 atm at room temp', ha='center',fontsize=8.5,color='#333') ax1.text(5.0,2.8,'→ Would boil in a standard vaporiser!', ha='center',fontsize=8.5,color='#c62828',style='italic') ax1.text(5.0,2.3,'Liquid desflurane stored here\nElectric heating element underneath', ha='center',fontsize=8.5,multialignment='center',color='#555') # Fresh Gas Flow path ax1.add_patch(FancyBboxPatch((0.3,6.5),4.0,1.2,boxstyle='round', facecolor='#e3f2fd',ec='#1565c0',lw=2)) ax1.text(2.3,7.1,'FGF (carrier gas)\nO₂/N₂O/Air enters here', ha='center',fontsize=8.5,color='#0d47a1',multialignment='center') # Injection valve ax1.add_patch(FancyBboxPatch((4.5,5.7),3.0,1.5,boxstyle='round', facecolor='#f3e5f5',ec='#7b1fa2',lw=2.5)) ax1.text(6.0,6.45,'INJECTION VALVE',ha='center',fontsize=9.5,fontweight='bold',color='#4a148c') ax1.text(6.0,5.95,'Differential pressure valve\nInjects desflurane vapour\ninto FGF stream', ha='center',fontsize=8,multialignment='center') arr(ax1,4.3,7.1,4.5,6.5,'#1565c0') arr(ax1,5.0,5.7,5.0,5.5,'#7b1fa2') # Dial / concentration controller ax1.add_patch(Circle((5.0,8.8),0.8,color='#ff8f00',ec='#e65100',lw=2.5)) ax1.text(5.0,8.8,'DIAL\n0–18%',ha='center',va='center',fontsize=8.5,fontweight='bold',color='white') ax1.text(7.0,8.8,'Concentration dial\ncontrols injection\nvalve directly\n→ does NOT vary\nFGF splitting', fontsize=8.5,multialignment='center', bbox=dict(facecolor='#fff9c4',alpha=0.9,boxstyle='round')) ax1.text(0.5,0.3,'Heated to 39°C\nPowered by mains electricity\nAlarm if temp/pressure deviate', fontsize=8,bbox=dict(facecolor='#fce4ec',alpha=0.9,boxstyle='round'),color='#c62828') ax2.set_xlim(0,10); ax2.set_ylim(0,12); ax2.axis('off') ax2.set_title('Why Tec 6 is Different\n& Safety Features', fontsize=11, fontweight='bold', color='#00695c') reason_rows = [ ('WHY DESFLURANE NEEDS TEC 6:', '#bf360c', '#ffccbc'), ('Boiling point = 22.8°C (near room temp)', '#333', '#fff'), ('SVP at 20°C = 669 mmHg (≈ 1 atm!)', '#333', '#fff'), ('Would vaporise unpredictably in standard vaporiser', '#c62828', '#ffe8e8'), ('FGF cooling effect would cause boiling→ ↑↑ concentration', '#c62828', '#ffe8e8'), ('MAC = 6% — needs precise delivery (narrow window)', '#333', '#fff'), ] for i,(text,tc,fc2) in enumerate(reason_rows): y = 11.5 - i*0.7 ax2.add_patch(FancyBboxPatch((0.3,y-0.3),9.4,0.55,boxstyle='round',pad=0.05, facecolor=fc2,ec='#ddd',lw=1)) ax2.text(0.7,y,text,fontsize=8.5,va='center',color=tc, fontweight='bold' if i==0 else 'normal') ax2.text(5,7.1,'SAFETY FEATURES',ha='center',fontsize=11,fontweight='bold',color='#004d40') safety = [ ('✓ Sump heating circuit with thermostat','Prevents temp fluctuation → stable SVP'), ('✓ Pressure-regulating valve (1.5 atm)','Stable vapour delivery independent of FGF'), ('✓ Electronic concentration sensor','Monitors output — alarm if > set value'), ('✓ Agent-specific keyed filler','Cannot fill with wrong agent'), ('✓ Tipping alarm','Alerts if vaporiser tilted > 45°'), ('✓ No output at mains power failure','Fail-safe — defaults to zero'), ] for i,(feat,mech) in enumerate(safety): y = 6.5 - i*0.75 ax2.text(0.4,y,feat,fontsize=8.5,color='#1b5e20',fontweight='bold',va='center') ax2.text(0.4,y-0.35,f' → {mech}',fontsize=8,color='#555',va='center') ax2.add_patch(FancyBboxPatch((0.3,0.2),9.4,1.5,boxstyle='round', facecolor='#e0f7fa',ec='#0097a7',lw=2)) ax2.text(5.0,0.95,'KEY COMPARISON:\nTec 5 / Penlon (halothane/iso/sevo) = unpressurised, unheated, variable bypass\n' 'Tec 6 (desflurane only) = heated sump, pressurised, injection valve\n' 'Aladin cassette (GE machines) = electronic, agent-specific cassette', ha='center',va='center',fontsize=8,multialignment='center') src(fig,'Source: Dorsch & Dorsch Understanding Anaesthesia Equipment 5th Ed. • Miller\'s Anaesthesia 8th Ed.') plt.tight_layout(rect=[0,0.03,1,0.97]) pdf.savefig(fig, bbox_inches='tight'); plt.close(fig) # ══════════════════════════════════════════════════════ # TOPIC 14 — Epidural Space Cross-Section # ══════════════════════════════════════════════════════ fig, (ax1,ax2) = plt.subplots(1,2,figsize=(11.7,8.3)) fig.patch.set_facecolor('#fff8e1') fig.suptitle('TOPIC 14 | Epidural Space — Cross-Section • All Layers • Approaches\n' '[4x — Batson\'s Plexus • Loss of Resistance • Depth • Midline vs Paramedian]', fontsize=11,fontweight='bold',color='#e65100',y=0.99) ax1.set_xlim(0,10); ax1.set_ylim(0,12); ax1.axis('off') ax1.set_title('Layers — Skin to CSF (Cross-Section)', fontsize=11, fontweight='bold', color='#bf360c') layers = [ ('SKIN', 11.3, 0.5, '#ffcc80', '#ef6c00', 'Variable thickness'), ('Subcutaneous fat', 10.7, 0.35, '#ffe0b2', '#ef6c00', ''), ('Supraspinous ligament', 10.2, 0.35, '#a5d6a7', '#2e7d32', 'Connects spinous processes'), ('Interspinous ligament', 9.6, 0.5, '#81c784', '#388e3c', 'Between spinous processes\n(midline only)'), ('Ligamentum Flavum', 8.9, 0.55, '#ffb300', '#f57f17', 'YELLOW ligament\nDense elastic fibres\n= LOR felt HERE\nThickest at L3-L4'), ('EPIDURAL SPACE', 7.8, 0.85, '#ffe0b2', '#e65100', 'Contents:\n• Fat (Batson\'s venous plexus)\n• Lymphatics • Arteries\nDepth: 3.5–5 cm midline\nNegative pressure (LOR/hanging drop)'), ('Dura mater', 6.7, 0.45, '#ef9a9a', '#c62828', 'Outermost meningeal layer\nTough fibrous membrane'), ('Subdural space', 6.2, 0.25, '#f8bbd0', '#c62828', 'Potential space'), ('Arachnoid mater', 5.9, 0.25, '#ce93d8', '#7b1fa2', 'Avascular membrane'), ('Subarachnoid space', 5.3, 0.5, '#b3e5fc', '#0288d1', 'CSF here (spinal block here)\nContains spinal cord/cauda equina'), ('Pia mater', 4.8, 0.25, '#90caf9', '#1565c0', 'Inner layer — on spinal cord surface'), ] for name, y, h, fc, ec, note in layers: ax1.add_patch(FancyBboxPatch((0.5, y-h/2), 5.5, h, boxstyle='round,pad=0.03', facecolor=fc, edgecolor=ec, lw=1.8)) ax1.text(3.25, y, name, ha='center', va='center', fontsize=8.5, fontweight='bold', color=ec) if note: ax1.text(6.2, y, note, va='center', fontsize=7.5, color='#444', multialignment='left') # Needle path ax1.annotate('', xy=(3.25,6.7), xytext=(3.25,11.5), arrowprops=dict(arrowstyle='-|>', color='#1a237e', lw=2.5, mutation_scale=18)) ax1.text(3.25,4.5,'← Needle path\n EPIDURAL stops here\n SPINAL continues\n through dura to CSF', ha='center',fontsize=8.5,color='#1a237e', bbox=dict(facecolor='#e8eaf6',alpha=0.9,boxstyle='round')) ax2.set_xlim(0,10); ax2.set_ylim(0,12); ax2.axis('off') ax2.set_title('Approaches & Clinical Points', fontsize=11, fontweight='bold', color='#bf360c') # Midline vs paramedian ax2.add_patch(FancyBboxPatch((0.3,8.5),4.2,3.2,boxstyle='round', facecolor='#e8f5e9',ec='#2e7d32',lw=2)) ax2.text(2.4,11.4,'MIDLINE APPROACH',ha='center',fontsize=9.5,fontweight='bold',color='#1b5e20') ax2.text(2.4,10.7,'• Needle perpendicular\n• Traverses: skin→SSLig\n →ISLig→LF→epidural\n• Best at L3-L4, L4-L5\n• Easier — fewer passes', ha='center',fontsize=8.5,multialignment='center') ax2.add_patch(FancyBboxPatch((5.5,8.5),4.2,3.2,boxstyle='round', facecolor='#e3f2fd',ec='#1565c0',lw=2)) ax2.text(7.6,11.4,'PARAMEDIAN APPROACH',ha='center',fontsize=9.5,fontweight='bold',color='#0d47a1') ax2.text(7.6,10.7,'• 1 cm lateral to midline\n• Bypasses SSLig & ISLig\n• Directly hits LF\n• Better for thoracic\n• For calcified ligaments', ha='center',fontsize=8.5,multialignment='center') # LOR technique ax2.add_patch(FancyBboxPatch((0.3,5.5),9.4,2.7,boxstyle='round', facecolor='#fff3e0',ec='#ff8f00',lw=2)) ax2.text(5.0,8.0,'LOSS OF RESISTANCE (LOR) TECHNIQUE', ha='center',fontsize=10,fontweight='bold',color='#e65100') ax2.text(5.0,7.5,'Syringe with 2 mL air OR saline attached to Tuohy needle', ha='center',fontsize=9) ax2.text(5.0,7.05,'1. Advance needle through ligaments (resistance felt)',ha='center',fontsize=8.5) ax2.text(5.0,6.65,'2. Continuous pressure on plunger while advancing',ha='center',fontsize=8.5) ax2.text(5.0,6.25,'3. LOR = sudden ease of injection = epidural space entered', ha='center',fontsize=8.5,fontweight='bold',color='#c62828') ax2.text(5.0,5.8,'Hanging drop technique: drop of saline sucked in by negative pressure', ha='center',fontsize=8.5,color='#1565c0') # Key numbers ax2.add_patch(FancyBboxPatch((0.3,2.0),9.4,3.2,boxstyle='round', facecolor='#e8eaf6',ec='#3949ab',lw=2)) ax2.text(5.0,5.0,'KEY NUMBERS & BATSON\'S PLEXUS', ha='center',fontsize=10,fontweight='bold',color='#1a237e') num_rows = [ 'Depth skin → epidural: 3.5–5 cm (average 4 cm midline)', 'Tuohy needle: 16G-18G • 8 cm length • curved Hustead/Huber tip', 'Epidural catheter: threaded 3–4 cm into space', 'Batson\'s plexus: valveless epidural veins → haematogenous spread of tumour', 'Risk: dural puncture (PDPH) • Epidural haematoma • Meningitis', 'Test dose: 3 mL 1.5% lignocaine + 1:200,000 adrenaline (HR↑ if intravascular)', ] for i,row in enumerate(num_rows): ax2.text(0.6, 4.5-i*0.45, f'• {row}', fontsize=8.3, color='#333', va='center') src(fig,'Source: Miller\'s Anaesthesia 8th Ed. • Cousins & Bridenbaugh\'s Neural Blockade 4th Ed.') plt.tight_layout(rect=[0,0.03,1,0.97]) pdf.savefig(fig, bbox_inches='tight'); plt.close(fig) # ══════════════════════════════════════════════════════ # TOPIC 15 — Capnography Waveform # ══════════════════════════════════════════════════════ fig, axes = plt.subplots(2,3,figsize=(11.7,8.3)) fig.patch.set_facecolor('#e8f5e9') fig.suptitle('TOPIC 15 | Capnography — 4 Phases + 5 Abnormal Patterns\n' '[3x — ETCO₂ normal 35–40 mmHg • VAE • Bronchospasm • ROSC • Oesophageal]', fontsize=11,fontweight='bold',color='#1b5e20',y=0.99) # Normal waveform ax = axes[0][0] t = np.linspace(0,4,400) def normal_capno(t): y = np.zeros_like(t) for i,tv in enumerate(t): phase = tv % 1.2 if phase < 0.1: y[i] = 0 elif phase < 0.3: y[i] = (phase-0.1)/0.2 * 38 elif phase < 0.5: y[i] = 38 + (phase-0.3)/0.2 * 2 elif phase < 0.7: y[i] = 40 elif phase < 0.9: y[i] = 40 - (phase-0.7)/0.2 * 40 else: y[i] = 0 return y y_n = normal_capno(t) ax.plot(t,y_n,'g-',lw=2.5) ax.set_ylim(-5,55); ax.set_xlim(0,4) ax.axhline(38,color='gray',lw=1,linestyle=':') ax.text(0.15,3,'A',fontsize=10,fontweight='bold',color='blue') ax.text(0.6,12,'B',fontsize=10,fontweight='bold',color='blue') ax.text(1.1,42,'C',fontsize=10,fontweight='bold',color='blue') ax.text(1.5,42,'D',fontsize=10,fontweight='bold',color='blue') ax.annotate('Phase A-B:\nInsp. baseline (dead space)',xy=(0.15,5),xytext=(0.5,48),fontsize=7, arrowprops=dict(arrowstyle='->',lw=1)) ax.annotate('Phase B-C:\nExpiratory upstroke',xy=(0.6,20),xytext=(0.0,30),fontsize=7, arrowprops=dict(arrowstyle='->',lw=1)) ax.annotate('Phase C-D:\nAlveolar plateau\nETCO₂=35-40',xy=(1.3,40),xytext=(1.8,50),fontsize=7, arrowprops=dict(arrowstyle='->',lw=1)) ax.set_title('NORMAL Capnogram\n(4 phases labelled)',fontsize=9,fontweight='bold',color='#1b5e20') ax.set_ylabel('CO₂ (mmHg)'); ax.grid(alpha=0.2) ax.spines['top'].set_visible(False); ax.spines['right'].set_visible(False) # Oesophageal intubation ax = axes[0][1] t2 = np.linspace(0,4,400) y_oe = np.zeros(400) for i in range(400): phase = t2[i] % 1.0 if 0.2<phase<0.4: y_oe[i] = (phase-0.2)/0.2*8 * max(0,(1-t2[i]/3)) ax.plot(t2,y_oe,'r-',lw=2.5) ax.set_ylim(-5,55); ax.set_xlim(0,4) ax.text(0.5,30,'Diminishing\nwaveforms\n→ fade to zero',fontsize=9,color='red', bbox=dict(facecolor='#ffe8e8',alpha=0.9,boxstyle='round')) ax.set_title('OESOPHAGEAL Intubation\n→ rapidly diminishing waves',fontsize=9,fontweight='bold',color='#c62828') ax.set_ylabel('CO₂ (mmHg)'); ax.grid(alpha=0.2) ax.spines['top'].set_visible(False); ax.spines['right'].set_visible(False) # Rebreathing ax = axes[0][2] def rebreathe_capno(t): y = np.zeros_like(t) for i,tv in enumerate(t): phase = tv % 1.2 if phase < 0.1: y[i] = 8 # elevated baseline elif phase < 0.3: y[i] = 8+(phase-0.1)/0.2*32 elif phase < 0.7: y[i] = 40 elif phase < 0.9: y[i] = 40-(phase-0.7)/0.2*32 else: y[i] = 8 return y y_rb = rebreathe_capno(t) ax.plot(t,y_rb,'m-',lw=2.5) ax.axhline(0,color='gray',lw=1,linestyle=':') ax.set_ylim(-5,55); ax.set_xlim(0,4) ax.annotate('ELEVATED BASELINE\n> 0 mmHg = rebreathing',xy=(0.5,8),xytext=(1.5,25),fontsize=8, color='purple',arrowprops=dict(arrowstyle='->',lw=1.5,color='purple')) ax.set_title('REBREATHING\n(baseline elevated > 0)',fontsize=9,fontweight='bold',color='#7b1fa2') ax.set_ylabel('CO₂ (mmHg)'); ax.grid(alpha=0.2) ax.spines['top'].set_visible(False); ax.spines['right'].set_visible(False) # Bronchospasm - shark fin ax = axes[1][0] def broncho_capno(t): y = np.zeros_like(t) for i,tv in enumerate(t): phase = tv % 1.4 if phase < 0.1: y[i] = 0 elif phase < 0.9: y[i] = (phase-0.1)/0.8*38 # slow rise = shark fin elif phase < 1.1: y[i] = 38-(phase-0.9)/0.2*38 else: y[i] = 0 return y y_br = broncho_capno(t) ax.plot(t,y_br,'darkorange',lw=2.5) ax.set_ylim(-5,55); ax.set_xlim(0,4) ax.text(1.0,25,'SHARK FIN\nwaveform',fontsize=9,color='darkorange',fontweight='bold', bbox=dict(facecolor='#fff3e0',alpha=0.9,boxstyle='round')) ax.text(0.5,48,'Cause: Bronchospasm\nLaryngospasm\nKinking of ET tube',fontsize=8.5, bbox=dict(facecolor='#fff3e0',alpha=0.8,boxstyle='round')) ax.set_title('BRONCHOSPASM\n(Shark fin — slow expiratory upstroke)',fontsize=9,fontweight='bold',color='#e65100') ax.set_ylabel('CO₂ (mmHg)'); ax.set_xlabel('Time →'); ax.grid(alpha=0.2) ax.spines['top'].set_visible(False); ax.spines['right'].set_visible(False) # VAE (Venous Air Embolism) ax = axes[1][1] t3 = np.linspace(0,4,400) y_vae = normal_capno(t3).copy() # Sudden drop then gradually falls drop_idx = 100 for i in range(drop_idx,400): decay = max(0, 1 - (i-drop_idx)/200) y_vae[i] = y_vae[i] * decay ax.plot(t3,y_vae,'b-',lw=2.5) ax.set_ylim(-5,55); ax.set_xlim(0,4) ax.annotate('SUDDEN ↓ ETCO₂\n(air lock in pulm.\ncirculation → ↓ CO\n→ ↓ CO₂ delivery)', xy=(1.2,15),xytext=(1.8,40),fontsize=8,color='blue', arrowprops=dict(arrowstyle='->',lw=1.5,color='blue')) ax.set_title('VAE / PE / Cardiac Arrest\n(sudden ↓ ETCO₂)',fontsize=9,fontweight='bold',color='#0d47a1') ax.set_ylabel('CO₂ (mmHg)'); ax.set_xlabel('Time →'); ax.grid(alpha=0.2) ax.spines['top'].set_visible(False); ax.spines['right'].set_visible(False) # ROSC ax = axes[1][2] t4 = np.linspace(0,4,400) y_rosc = np.zeros(400) for i,tv in enumerate(t4): phase = tv % 1.2 if tv < 2: amp = 10 + tv*5 # CPR — low rising ETCO2 else: amp = 40 + (tv-2)*2 # ROSC — sudden rise if phase < 0.1: y_rosc[i] = 0 elif phase < 0.5: y_rosc[i] = (phase-0.1)/0.4*amp elif phase < 0.7: y_rosc[i] = amp elif phase < 0.9: y_rosc[i] = amp-(phase-0.7)/0.2*amp else: y_rosc[i] = 0 ax.plot(t4,np.clip(y_rosc,0,55),'#00695c',lw=2.5) ax.axvline(2,color='red',lw=2,linestyle='--') ax.text(2.05,45,'ROSC\n→ sudden ↑\nETCO₂',fontsize=9,color='red',fontweight='bold') ax.text(0.5,40,'During CPR:\nETCO₂ 10–20\nPrognosis marker\n< 10 at 20 min → poor', fontsize=8,bbox=dict(facecolor='#e8f5e9',alpha=0.9,boxstyle='round')) ax.set_title('CPR & ROSC\n(ETCO₂ rises suddenly at ROSC)',fontsize=9,fontweight='bold',color='#1b5e20') ax.set_ylabel('CO₂ (mmHg)'); ax.set_xlabel('Time →'); ax.grid(alpha=0.2) ax.spines['top'].set_visible(False); ax.spines['right'].set_visible(False) src(fig,'Source: Ehrenfeld & Cannesson "Monitoring Technologies in Acute Care" • Miller\'s Anaesthesia 8th Ed.') plt.tight_layout(rect=[0,0.03,1,0.97]) pdf.savefig(fig, bbox_inches='tight'); plt.close(fig) # ══════════════════════════════════════════════════════ # TOPIC 16 — Cormack-Lehane Grading # ══════════════════════════════════════════════════════ fig, axes = plt.subplots(1,4,figsize=(11.7,7.5)) fig.patch.set_facecolor('#e8eaf6') fig.suptitle('TOPIC 16 | Cormack–Lehane Grading — Laryngoscopic View\n' '[2x — Grade 1–4 • BURP Manoeuvre • VL = Video Laryngoscopy]', fontsize=12,fontweight='bold',color='#283593',y=0.99) grades = [ ('Grade 1','Full glottis visible\nCords clearly seen', '#43a047','Intubation easy\n~100% success\n1st attempt', [(5,7),(6.5,6),(7,5),(6.5,4),(5,3.5),(3.5,4),(3,5),(3.5,6),(5,7)], [(5,6.5),(5.8,5.8),(6.2,5),(5.8,4.2),(5,3.8),(4.2,4.2),(3.8,5),(4.2,5.8)]), ('Grade 2A/2B','Posterior commissure\n2A: posterior cords\n2B: arytenoids only', '#ff9800','Manageable\nMay need\nBURP/stylet', [(5,7),(6.5,6),(7,5),(6.5,4),(5,3.5),(3.5,4),(3,5),(3.5,6),(5,7)], [(6.0,5.0),(6.5,4.8),(6.2,4.3),(5.5,4.0),(5,4.0)]), ('Grade 3','Only epiglottis visible\nNo glottis seen', '#f4511e','Difficult!\nNeed VL /\nbougie-aided', [(4,8),(5,7.5),(6,8),(6.5,7),(6.5,6),(6,5.5),(5,5.3),(4,5.5),(3.5,6),(3.5,7),(4,8)], None), ('Grade 4','Neither epiglottis\nnor glottis visible', '#c62828','Failed airway\nNeed FONA /\nawake FOI', None,None), ] for ax, (grade,desc,color,action,glottis,cords) in zip(axes,grades): ax.set_xlim(0,10); ax.set_ylim(0,12); ax.axis('off') ax.add_patch(Ellipse((5,6),7,7,color='#b0bec5',alpha=0.2,ec='#607d8b',lw=2)) # Epiglottis (grades 1-3) if glottis: ax.fill(glottis, [v+0.5 for v in [7,6,5,4,3.5,4,5,6,7]], color='#ffccbc', alpha=0.5) ax.add_patch(FancyBboxPatch((3.5,7.0),3.0,1.2,boxstyle='round', facecolor='#ffe0b2',ec='#e65100',lw=2)) ax.text(5.0,7.6,'Epiglottis',ha='center',fontsize=8.5,color='#bf360c',fontweight='bold') # Cords (grades 1-2) if cords: cord_x = [p[0] for p in cords] cord_y = [p[1] for p in cords] ax.fill(cord_x, cord_y, color='#e3f2fd', alpha=0.7, ec='#1565c0', lw=2.5) ax.text(5.0,5.0,'Vocal cords',ha='center',fontsize=8,color='#0d47a1') ax.text(5.0,4.0,'GLOTTIS OPENING',ha='center',fontsize=7.5,fontweight='bold',color='#0d47a1') # Grade 3 — only epiglottis if grade=='Grade 3': ax.text(5.0,4.5,'Glottis\nNOT visible',ha='center',fontsize=9,color='#c62828',fontweight='bold', bbox=dict(facecolor='#ffe8e8',alpha=0.9,boxstyle='round')) # Grade 4 — nothing visible if grade=='Grade 4': ax.text(5.0,6.0,'Soft tissue\nonly\nNo landmarks\nvisible', ha='center',fontsize=10,color='#c62828',fontweight='bold', bbox=dict(facecolor='#ffe8e8',alpha=0.9,boxstyle='round')) ax.text(5.0,10.5,grade,ha='center',fontsize=13,fontweight='bold',color=color) ax.text(5.0,9.5,desc,ha='center',fontsize=8.5,multialignment='center', bbox=dict(facecolor='white',alpha=0.8,boxstyle='round')) ax.text(5.0,1.5,action,ha='center',fontsize=8.5,multialignment='center', bbox=dict(facecolor=color,alpha=0.2,boxstyle='round',ec=color)) # BURP annotation across bottom fig.text(0.5,0.03, 'BURP = Backward Upward Rightward Pressure on thyroid cartilage → improves view by 1–2 grades ' '| VL = Video laryngoscopy (GlideScope / C-MAC) | Source: Cormack & Lehane (1984) • AIDAA Guidelines', ha='center',fontsize=8.5,color='#333',style='italic') plt.tight_layout(rect=[0,0.06,1,0.97]) pdf.savefig(fig, bbox_inches='tight'); plt.close(fig) # ══════════════════════════════════════════════════════ # TOPIC 17 — Spinal Cord Cross-Section # ══════════════════════════════════════════════════════ fig, (ax1,ax2) = plt.subplots(1,2,figsize=(11.7,8.3)) fig.patch.set_facecolor('#fce4ec') fig.suptitle('TOPIC 17 | Spinal Cord Cross-Section — Tracts, Blood Supply, ASA\n' '[2x — Posterior Columns • Corticospinal • Spinothalamic • Brown-Séquard]', fontsize=12,fontweight='bold',color='#880e4f',y=0.99) ax1.set_xlim(0,10); ax1.set_ylim(0,10); ax1.axis('off') ax1.set_title('Spinal Cord Cross-Section & Tracts', fontsize=11, fontweight='bold', color='#880e4f') # Butterfly grey matter grey_H = plt.Polygon([(4,7),(4.5,6.5),(5,6.8),(5.5,6.5),(6,7), (5.8,5),(6,4),(5.5,3.5),(5,3.2),(4.5,3.5),(4,4), (4.2,5),(4,7)], facecolor='#bdbdbd',edgecolor='#616161',lw=2.5,zorder=2) ax1.add_patch(grey_H) # White matter outer oval white = Ellipse((5,5),7.5,7.5,color='#f5f5f5',ec='#9e9e9e',lw=3,zorder=1) ax1.add_patch(white) ax1.add_patch(grey_H) # re-add on top ax1.text(5,5,'GREY\nMATTER',ha='center',va='center',fontsize=8.5, fontweight='bold',color='#424242',zorder=3) # Dorsal horn / ventral horn labels ax1.text(5,6.9,'Dorsal horn',ha='center',fontsize=8,color='#555',zorder=4) ax1.text(5,3.2,'Ventral horn\n(motor neurons)',ha='center',fontsize=8,color='#555',zorder=4,multialignment='center') # Posterior columns (dorsal) ax1.add_patch(FancyBboxPatch((3.8,7.2),2.4,0.8,boxstyle='round',pad=0.05, facecolor='#bbdefb',ec='#1565c0',lw=2,zorder=5)) ax1.text(5.0,7.6,'POSTERIOR COLUMNS\n(Fasciculus gracilis & cuneatus)', ha='center',fontsize=7.8,color='#0d47a1',fontweight='bold') ax1.text(1.5,8.5,'Fine touch, vibration\npropriception\nIpsilateral (same side)\nCrosses in medulla', fontsize=8,bbox=dict(facecolor='#e3f2fd',alpha=0.9,boxstyle='round')) # Lateral corticospinal tract ax1.add_patch(FancyBboxPatch((6.2,5.2),1.5,1.2,boxstyle='round',pad=0.05, facecolor='#c8e6c9',ec='#2e7d32',lw=2,zorder=5)) ax1.text(6.95,5.8,'CST\n(Motor)',ha='center',fontsize=7.5,color='#1b5e20',fontweight='bold') ax1.text(8.0,6.5,'LATERAL\nCORTICOSPINAL TRACT\nVoluntary motor\nIpsilateral (crosses\nat pyramidal decussation)', fontsize=8,multialignment='center', bbox=dict(facecolor='#e8f5e9',alpha=0.9,boxstyle='round')) # Spinothalamic (anterior) ax1.add_patch(FancyBboxPatch((2.5,4.5),1.5,1.2,boxstyle='round',pad=0.05, facecolor='#ffcdd2',ec='#c62828',lw=2,zorder=5)) ax1.text(3.25,5.1,'STT\n(Pain/Temp)',ha='center',fontsize=7.5,color='#b71c1c',fontweight='bold') ax1.text(0.2,3.5,'SPINOTHALAMIC TRACT\nPain & Temperature\nCONTRALATERAL\n(crosses in cord\nwithin 1-2 segments)', fontsize=8,multialignment='center', bbox=dict(facecolor='#ffe8e8',alpha=0.9,boxstyle='round')) # ASA ax1.add_patch(Circle((5.0,8.5),0.3,color='#e53935',ec='#b71c1c',lw=2,zorder=5)) ax1.text(5.0,8.5,'ASA',ha='center',va='center',fontsize=7,fontweight='bold',color='white') ax1.text(5.0,9.5,'Anterior Spinal Artery\n(ASA) — supplies anterior\n2/3 of cord', ha='center',fontsize=8,multialignment='center', bbox=dict(facecolor='#ffe8e8',alpha=0.9,boxstyle='round')) ax2.set_xlim(0,10); ax2.set_ylim(0,12); ax2.axis('off') ax2.set_title('Blood Supply & Clinical Syndromes', fontsize=11, fontweight='bold', color='#880e4f') # Blood supply ax2.add_patch(FancyBboxPatch((0.3,8.5),9.4,3.2,boxstyle='round', facecolor='#fce4ec',ec='#e91e63',lw=2)) ax2.text(5.0,11.4,'SPINAL CORD BLOOD SUPPLY',ha='center',fontsize=10,fontweight='bold',color='#880e4f') bs_rows=[ ('ASA (1 vessel)','Anterior 2/3 cord','Vertebral aa. + radicular aa.'), ('PSA (2 vessels)','Posterior 1/3 cord','Posterior inferior cerebellar aa.'), ('Artery of Adamkiewicz','Enlarges ASA at T8-L2','Critical — damage → anterior cord syndrome'), ('Watershed zone','T4 and L1','Vulnerable to hypotension/aortic surgery'), ] for i,row in enumerate(bs_rows): y = 10.8 - i*0.55 for j,cell in enumerate(row): ax2.text(0.4+j*3.2,y,cell,fontsize=8 if i<len(bs_rows)-1 else 8, color='#880e4f' if j==0 else '#333',va='center') # Cord syndromes ax2.add_patch(FancyBboxPatch((0.3,0.3),9.4,7.9,boxstyle='round', facecolor='#e8eaf6',ec='#3949ab',lw=2)) ax2.text(5.0,8.0,'SPINAL CORD SYNDROMES',ha='center',fontsize=10,fontweight='bold',color='#283593') syndromes=[ ('Complete transection','All modalities lost below level','Trauma, cord compression'), ('Anterior Cord Syndrome','Pain/temp/motor ↓\nVibration/proprioception SPARED', 'ASA occlusion, hyperflexion\nWorst prognosis'), ('Central Cord Syndrome','Arms > Legs weakness\nBladder dysfunction', 'Most common — hyperextension\nCervical spondylosis'), ('Posterior Cord Syndrome','Vibration/proprioception ↓\nPain/temp SPARED', 'PSA occlusion, B12 deficiency\nRare'), ('Brown-Séquard Syndrome','Ipsilateral: motor + proprioception ↓\nContralateral: pain + temp ↓', 'Hemisection — penetrating trauma\nRelatively good prognosis'), ('Cauda Equina Syndrome','LMN signs, saddle anaesthesia\nBowel/bladder incontinence', 'EMERGENCY — disc herniation\nBelow L1-L2'), ] for i,(name,deficit,cause) in enumerate(syndromes): y = 7.2 - i*1.18 ax2.add_patch(FancyBboxPatch((0.4,y-0.4),9.2,1.0,boxstyle='round',pad=0.05, facecolor='white',ec='#7986cb',lw=1.2,alpha=0.8)) ax2.text(0.6,y+0.25,name,fontsize=9,fontweight='bold',color='#1a237e',va='center') ax2.text(0.6,y-0.1,f'Deficit: {deficit}',fontsize=7.8,color='#c62828',va='center') ax2.text(0.6,y-0.35,f'Cause: {cause}',fontsize=7.5,color='#555',va='center') src(fig,"Source: Snell's Clinical Neuroanatomy 8th Ed. • Miller's Anaesthesia 8th Ed.") plt.tight_layout(rect=[0,0.03,1,0.97]) pdf.savefig(fig, bbox_inches='tight'); plt.close(fig) print("SUCCESS — Airway & Circuits PDF written") PYEOF python3 /home/daytona/workspace/dnb-diagrams/airway_circuits.py

sed -i "s/boxstyle='round',pad=0.05/boxstyle='round,pad=0.05'/g" /home/daytona/workspace/dnb-diagrams/airway_circuits.py sed -i "s/boxstyle='round',pad=0.1/boxstyle='round,pad=0.1'/g" /home/daytona/workspace/dnb-diagrams/airway_circuits.py sed -i "s/boxstyle='round',pad=0.15/boxstyle='round,pad=0.15'/g" /home/daytona/workspace/dnb-diagrams/airway_circuits.py sed -i "s/boxstyle='round',pad=0.2/boxstyle='round,pad=0.2'/g" /home/daytona/workspace/dnb-diagrams/airway_circuits.py sed -i "s/boxstyle='round',pad=0.3/boxstyle='round,pad=0.3'/g" /home/daytona/workspace/dnb-diagrams/airway_circuits.py # Also fix boxstyle='round,pad=0.08' patterns that are already correct - skip those grep -n "boxstyle='round'" /home/daytona/workspace/dnb-diagrams/airway_circuits.py | head -20

# Fix all standalone boxstyle='round' in FancyBboxPatch calls by rewriting the file with python python3 << 'EOF' with open('/home/daytona/workspace/dnb-diagrams/airway_circuits.py','r') as f: content = f.read() import re # Fix FancyBboxPatch with boxstyle='round' standalone (no pad in boxstyle) # Pattern: FancyBboxPatch(...) boxstyle='round', -> boxstyle='round,pad=0.08', # But only for FancyBboxPatch lines, not bbox=dict lines lines = content.split('\n') fixed = [] for line in lines: if 'FancyBboxPatch' in line and "boxstyle='round'" in line and 'pad' not in line.split('boxstyle')[1][:15]: line = line.replace("boxstyle='round'", "boxstyle='round,pad=0.08'") fixed.append(line) result = '\n'.join(fixed) with open('/home/daytona/workspace/dnb-diagrams/airway_circuits.py','w') as f: f.write(result) print("Fixed") EOF python3 /home/daytona/workspace/dnb-diagrams/airway_circuits.py

python3 << 'EOF' with open('/home/daytona/workspace/dnb-diagrams/airway_circuits.py','r') as f: content = f.read() # Fix all remaining pad= as keyword arg in FancyBboxPatch by moving into boxstyle string import re # Match: boxstyle='round',pad=0.XX -> boxstyle='round,pad=0.XX' content = re.sub(r"boxstyle='round',\s*pad=([\d.]+)", lambda m: f"boxstyle='round,pad={m.group(1)}'", content) with open('/home/daytona/workspace/dnb-diagrams/airway_circuits.py','w') as f: f.write(content) print("Done") EOF python3 /home/daytona/workspace/dnb-diagrams/airway_circuits.py

python3 << 'EOF' with open('/home/daytona/workspace/dnb-diagrams/airway_circuits.py','r') as f: content = f.read() # Fix the ax.fill call - glottis is a list of (x,y) tuples, need to unpack old = " ax.fill(glottis, [v+0.5 for v in [7,6,5,4,3.5,4,5,6,7]], color='#ffccbc', alpha=0.5)" new = """ if glottis: gx = [p[0] for p in glottis]; gy = [p[1] for p in glottis] ax.fill(gx, gy, color='#ffccbc', alpha=0.5)""" content = content.replace(old, new) with open('/home/daytona/workspace/dnb-diagrams/airway_circuits.py','w') as f: f.write(content) print("Fixed fill call") EOF python3 /home/daytona/workspace/dnb-diagrams/airway_circuits.py

grep -n "ax.fill\|glottis\|cords\|cord_x\|cord_y\|epiglottis\|Epiglottis" /home/daytona/workspace/dnb-diagrams/airway_circuits.py | head -30

~/dnb-diagrams/airway_circuits.py

python3 /home/daytona/workspace/dnb-diagrams/airway_circuits.py

ls -lh /home/daytona/workspace/dnb-diagrams/DNB_Airway_Circuits.pdf