🦾 Upper Limb - FMGE Last Revision Points

from reportlab.lib.pagesizes import A4
from reportlab.lib import colors
from reportlab.lib.units import cm
from reportlab.platypus import (
    SimpleDocTemplate, Paragraph, Spacer, Table, TableStyle,
    HRFlowable, KeepTogether
)
from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle
from reportlab.lib.enums import TA_CENTER, TA_LEFT
from reportlab.platypus import PageBreak

OUTPUT = "/home/daytona/workspace/upper-limb-pdf/Upper_Limb_Nerve_Injuries_Mnemonics.pdf"

doc = SimpleDocTemplate(
    OUTPUT,
    pagesize=A4,
    rightMargin=1.8*cm,
    leftMargin=1.8*cm,
    topMargin=1.5*cm,
    bottomMargin=1.5*cm,
)

styles = getSampleStyleSheet()

# Custom styles
TITLE_STYLE = ParagraphStyle(
    "Title", parent=styles["Title"],
    fontSize=22, textColor=colors.HexColor("#1a237e"),
    spaceAfter=4, alignment=TA_CENTER, fontName="Helvetica-Bold"
)
SUBTITLE_STYLE = ParagraphStyle(
    "Subtitle", parent=styles["Normal"],
    fontSize=11, textColor=colors.HexColor("#5c6bc0"),
    spaceAfter=2, alignment=TA_CENTER, fontName="Helvetica"
)
SECTION_STYLE = ParagraphStyle(
    "Section", parent=styles["Normal"],
    fontSize=13, textColor=colors.white,
    fontName="Helvetica-Bold", alignment=TA_LEFT,
    leftIndent=6, spaceAfter=2, spaceBefore=6
)
BODY_STYLE = ParagraphStyle(
    "Body", parent=styles["Normal"],
    fontSize=9.5, textColor=colors.HexColor("#212121"),
    fontName="Helvetica", leading=14, spaceAfter=2
)
MNEMONIC_STYLE = ParagraphStyle(
    "Mnemonic", parent=styles["Normal"],
    fontSize=10.5, textColor=colors.HexColor("#b71c1c"),
    fontName="Helvetica-Bold", leading=14, spaceAfter=2,
    leftIndent=8
)
NOTE_STYLE = ParagraphStyle(
    "Note", parent=styles["Normal"],
    fontSize=9, textColor=colors.HexColor("#4a148c"),
    fontName="Helvetica-Oblique", leading=13, spaceAfter=2,
    leftIndent=8
)
FOOTER_STYLE = ParagraphStyle(
    "Footer", parent=styles["Normal"],
    fontSize=8, textColor=colors.grey,
    alignment=TA_CENTER
)

def section_header(text, bg=colors.HexColor("#1a237e")):
    data = [[Paragraph(text, SECTION_STYLE)]]
    t = Table(data, colWidths=[doc.width])
    t.setStyle(TableStyle([
        ("BACKGROUND", (0,0), (-1,-1), bg),
        ("ROWBACKGROUNDS", (0,0), (-1,-1), [bg]),
        ("TOPPADDING", (0,0), (-1,-1), 5),
        ("BOTTOMPADDING", (0,0), (-1,-1), 5),
        ("LEFTPADDING", (0,0), (-1,-1), 10),
    ]))
    return t

def mini_header(text):
    data = [[Paragraph(f"<b>{text}</b>", ParagraphStyle(
        "mini", parent=styles["Normal"],
        fontSize=10.5, textColor=colors.white,
        fontName="Helvetica-Bold", leftIndent=4
    ))]]
    t = Table(data, colWidths=[doc.width])
    t.setStyle(TableStyle([
        ("BACKGROUND", (0,0), (-1,-1), colors.HexColor("#3949ab")),
        ("TOPPADDING", (0,0), (-1,-1), 4),
        ("BOTTOMPADDING", (0,0), (-1,-1), 4),
        ("LEFTPADDING", (0,0), (-1,-1), 8),
    ]))
    return t

def colored_table(headers, rows, col_widths, header_bg=colors.HexColor("#3949ab")):
    data = [[Paragraph(f"<b>{h}</b>", ParagraphStyle(
        "th", parent=styles["Normal"], fontSize=9,
        textColor=colors.white, fontName="Helvetica-Bold", alignment=TA_CENTER
    )) for h in headers]]
    for i, row in enumerate(rows):
        data.append([Paragraph(str(cell), ParagraphStyle(
            "td", parent=styles["Normal"], fontSize=9,
            textColor=colors.HexColor("#212121"), fontName="Helvetica",
            alignment=TA_LEFT, leading=13
        )) for cell in row])
    t = Table(data, colWidths=col_widths)
    style = [
        ("BACKGROUND", (0,0), (-1,0), header_bg),
        ("ROWBACKGROUNDS", (0,1), (-1,-1), [colors.HexColor("#e8eaf6"), colors.white]),
        ("GRID", (0,0), (-1,-1), 0.5, colors.HexColor("#c5cae9")),
        ("TOPPADDING", (0,0), (-1,-1), 5),
        ("BOTTOMPADDING", (0,0), (-1,-1), 5),
        ("LEFTPADDING", (0,0), (-1,-1), 6),
        ("RIGHTPADDING", (0,0), (-1,-1), 4),
        ("VALIGN", (0,0), (-1,-1), "MIDDLE"),
    ]
    t.setStyle(TableStyle(style))
    return t

def highlight_box(text, bg=colors.HexColor("#fff9c4"), border=colors.HexColor("#f57f17")):
    data = [[Paragraph(text, ParagraphStyle(
        "hb", parent=styles["Normal"], fontSize=9.5,
        textColor=colors.HexColor("#212121"), fontName="Helvetica",
        leading=14, leftIndent=4
    ))]]
    t = Table(data, colWidths=[doc.width])
    t.setStyle(TableStyle([
        ("BACKGROUND", (0,0), (-1,-1), bg),
        ("BOX", (0,0), (-1,-1), 1.2, border),
        ("TOPPADDING", (0,0), (-1,-1), 6),
        ("BOTTOMPADDING", (0,0), (-1,-1), 6),
        ("LEFTPADDING", (0,0), (-1,-1), 10),
    ]))
    return t

story = []

# ─── COVER ───────────────────────────────────────────────────────────────────
story.append(Spacer(1, 1.2*cm))
story.append(Paragraph("Upper Limb Nerve Injuries", TITLE_STYLE))
story.append(Paragraph("Mnemonics &amp; High-Yield Revision Summary", SUBTITLE_STYLE))
story.append(Paragraph("For FMGE / NEET PG / USMLE Step 1", ParagraphStyle(
    "sub2", parent=styles["Normal"], fontSize=10, textColor=colors.HexColor("#7986cb"),
    alignment=TA_CENTER, spaceAfter=4
)))
story.append(HRFlowable(width="100%", thickness=2, color=colors.HexColor("#1a237e"), spaceAfter=10))
story.append(Spacer(1, 0.3*cm))

# ─── SECTION 1: BRACHIAL PLEXUS ──────────────────────────────────────────────
story.append(section_header("1.  BRACHIAL PLEXUS  -  ROOTS, TRUNKS, CORDS"))
story.append(Spacer(1, 0.2*cm))

story.append(Paragraph('<b>Roots:</b> C5, C6, C7, C8, T1', BODY_STYLE))
story.append(Paragraph(
    '<b>Mnemonic (Roots):</b> "My Tea Comes From Cuba" (C5-C6-C7-C8-T1)',
    MNEMONIC_STYLE
))
story.append(Spacer(1, 0.15*cm))

trunk_rows = [
    ["Upper Trunk", "C5 + C6", "Suprascapular n., Nerve to subclavius"],
    ["Middle Trunk", "C7 only", "No named branch"],
    ["Lower Trunk", "C8 + T1", "—"],
]
story.append(colored_table(
    ["Trunk", "Formation", "Key Branch"],
    trunk_rows,
    [5.5*cm, 4.5*cm, 8.2*cm]
))
story.append(Spacer(1, 0.2*cm))

story.append(highlight_box(
    "<b>Cord Mnemonic - MLP</b>: Medial cord = C8,T1 (Ulnar + medial cutaneous nerves) | "
    "Lateral cord = C5,C6,C7 (Musculocutaneous + Lateral root of Median) | "
    "Posterior cord = all roots (Radial + Axillary)"
))
story.append(Spacer(1, 0.2*cm))

story.append(highlight_box(
    "<b>Flexors vs Extensors Rule:</b><br/>"
    "Anterior divisions → Flexors (Musculocutaneous, Median, Ulnar)<br/>"
    "Posterior divisions → Extensors (Radial, Axillary)",
    bg=colors.HexColor("#e8f5e9"), border=colors.HexColor("#2e7d32")
))
story.append(Spacer(1, 0.3*cm))

# ─── SECTION 2: NERVE INJURIES TABLE ─────────────────────────────────────────
story.append(section_header("2.  NERVE INJURY SIGNATURES  -  Must-Know Table"))
story.append(Spacer(1, 0.2*cm))

injury_rows = [
    ["Radial\n(C5-C8)", "Spiral groove\n(mid-shaft humerus #)", "Wrist Drop", "Extension wrist+fingers lost; Triceps SPARED", "Saturday night palsy"],
    ["Radial\n(C5-C8)", "Axilla\n(crutch palsy)", "Wrist Drop\n+ Triceps weak", "All extensors lost incl. triceps; Sensory: dorsum hand", "Crutch / Crutch palsy"],
    ["Axillary\n(C5-C6)", "Surgical neck\nhumerus #", "Flat shoulder\n(deltoid atrophy)", "Deltoid + Teres Minor; Badge area numb", "Shoulder dislocation"],
    ["Median\n(C6-T1)", "Carpal Tunnel\n(wrist)", "Ape Hand\n(thenar flat)", "LOAF muscles; Opposition thumb lost", "CTS - night pain, Tinel+, Phalen+"],
    ["Median\n(C6-T1)", "Supracondylar #\n(elbow)", "Hand of Benediction\n(on attempted flex)", "Ant. interosseous branch; FPL, FDP radial, PQ lost", "Most common in children"],
    ["Ulnar\n(C8-T1)", "Medial epicondyle\n(behind elbow)", "Claw Hand\n(4th + 5th fingers)", "Interossei, hypothenar; Sensory: little + ring finger", "Funny bone injury"],
    ["Ulnar\n(C8-T1)", "Wrist\n(Guyon's canal)", "Claw Hand\n(no palm numb)", "Intrinsic muscles only; Palmar branch SPARED", "Cyclist palsy"],
    ["Musculo-\ncutaneous\n(C5-C7)", "Coracobrachialis\npenetration", "Weak elbow flexion", "Biceps, Brachialis, Coracobrachialis; Lat. cutaneous n. forearm", "Uncommon isolated injury"],
    ["Long Thoracic\n(C5-C7)", "Axillary dissection\n/ mastectomy", "Winged Scapula", "Serratus anterior paralysis", "Porter's palsy"],
    ["Dorsal Scapular\n(C5)", "Neck trauma", "Winged Scapula\n(subtle)", "Rhomboids + Levator scapulae", "Scapula doesn't retract"],
]

story.append(colored_table(
    ["Nerve", "Injury Site", "Deformity", "What is Lost", "Clinical Note"],
    injury_rows,
    [2.5*cm, 3.5*cm, 3.5*cm, 5.0*cm, 3.7*cm]
))
story.append(Spacer(1, 0.3*cm))

# ─── SECTION 3: MNEMONICS ────────────────────────────────────────────────────
story.append(section_header("3.  MNEMONICS CHEAT SHEET", bg=colors.HexColor("#4a148c")))
story.append(Spacer(1, 0.2*cm))

mnemonics = [
    ("LOAF (Median nerve hand muscles)",
     "L - Lumbricals 1 &amp; 2\nO - Opponens Pollicis\nA - Abductor Pollicis Brevis\nF - Flexor Pollicis Brevis (superficial head)"),
    ("SITS (Rotator Cuff)",
     "S - Supraspinatus (abduction initiation 0-15°)\nI - Infraspinatus (lateral rotation)\nT - Teres Minor (lateral rotation)\nS - Subscapularis (medial rotation)"),
    ("Cubital Fossa Contents - Lateral to Medial",
     '"Really Be Brave Man"\nR - Radial Nerve | B - Biceps Tendon | B - Brachial Artery | M - Median Nerve'),
    ("Brachial Plexus Roots",
     '"My Tea Comes From Cuba"\nC5 | C6 | C7 | C8 | T1'),
    ("Axillary Artery Branches (Parts 1-2-3 = Branches 1-2-3)",
     "Part 1 (1 branch): Supreme Thoracic\nPart 2 (2 branches): Thoracoacromial, Lateral Thoracic\nPart 3 (3 branches): Subscapular, Ant. Circumflex Humeral, Post. Circumflex Humeral"),
    ("Ulnar vs Median Claw",
     "Ulnar = 4th &amp; 5th finger claw (ulnar paradox: wrist lesion = worse claw)\nMedian = 2nd &amp; 3rd finger claw (hand of benediction = proximal lesion)\nRemember: More proximal injury = Weaker claw (paradox!)"),
    ("Radial Nerve at Different Levels",
     "Axilla injury: Wrist drop + Triceps weakness + Sensory loss arm/forearm/hand\nSpiral groove: Wrist drop, Triceps NORMAL (branch given above groove)\nAnterior Interosseous syndrome: No wrist drop (pure motor, no sensory)"),
    ("Erb's Palsy (C5, C6) vs Klumpke's (C8, T1)",
     "Erb's = Upper trunk | Waiter's tip (arm adducted, medially rotated, elbow extended)\nKlumpke's = Lower trunk | Claw hand + Horner's (if T1 ramus involved = ptosis, miosis, anhidrosis)"),
]

for title, body in mnemonics:
    story.append(mini_header(title))
    for line in body.split("\n"):
        if line.startswith(("L -","O -","A -","F -","S -","I -","T -","R -","B -","M -","P -")):
            story.append(Paragraph(f"&nbsp;&nbsp;&nbsp;&nbsp;{line}", BODY_STYLE))
        elif any(line.startswith(x) for x in ['"', "C5","C6","Part","Ulnar","Median","Axilla","Spiral","Ante","Erb","Klum"]):
            story.append(Paragraph(f"&nbsp;&nbsp;&nbsp;&nbsp;{line}", BODY_STYLE))
        else:
            story.append(Paragraph(line, MNEMONIC_STYLE if line == title else BODY_STYLE))
    story.append(Spacer(1, 0.15*cm))

story.append(Spacer(1, 0.3*cm))

# ─── SECTION 4: QUICK FIRE ───────────────────────────────────────────────────
story.append(section_header("4.  QUICK-FIRE FMGE FACTS", bg=colors.HexColor("#b71c1c")))
story.append(Spacer(1, 0.2*cm))

quick = [
    ("Carpal Tunnel Contents", "Median nerve + 9 tendons (FDS x4, FDP x4, FPL x1). Ulnar nerve is NOT inside."),
    ("Anatomical Snuffbox Floor", "Scaphoid + Trapezium. Radial artery passes through it. Tenderness = Scaphoid fracture."),
    ("Most Common Carpal # ", "Scaphoid (waist most common). Avascular necrosis risk (proximal pole has no direct blood supply)."),
    ("Dupuytren's Contracture", "Palmar fascia fibrosis. Affects ring (4th) and little (5th) finger most. NOT a nerve lesion."),
    ("Winged Scapula - 2 causes", "Long thoracic nerve (serratus anterior) = medial winging. Spinal accessory nerve (trapezius) = lateral winging."),
    ("Painful Arc Syndrome", "60°-120° abduction. Supraspinatus tendon impingement under coracoacromial arch."),
    ("Palmaris Longus", "Most variable muscle; absent in ~15% population. Used for tendon grafts. Innervated by Median nerve."),
    ("Posterior Interosseous Nerve (PIN)", "Deep branch of Radial nerve. Injury = Finger/thumb drop, NO wrist drop, NO sensory loss."),
    ("Guyon's Canal (Ulnar tunnel)", "Contains: Ulnar nerve + Ulnar artery. Borders: Pisiform (medial), Hook of hamate (lateral), Flexor retinaculum (floor)."),
    ("Ulnar Paradox", "More distal ulnar lesion at wrist = Worse claw (lumbricals also paralyzed). Proximal lesion = milder claw (FDP partially works)."),
]

for fact, detail in quick:
    story.append(Paragraph(
        f"<b><font color='#b71c1c'>▶ {fact}:</font></b>  {detail}",
        BODY_STYLE
    ))
    story.append(Spacer(1, 0.1*cm))

story.append(Spacer(1, 0.3*cm))

# ─── SECTION 5: DERMATOMES ───────────────────────────────────────────────────
story.append(section_header("5.  UPPER LIMB SENSORY / DERMATOME QUICK MAP", bg=colors.HexColor("#1b5e20")))
story.append(Spacer(1, 0.15*cm))

derm_rows = [
    ["C5", "Lateral upper arm (axillary n. - regimental badge area)"],
    ["C6", "Lateral forearm + Thumb + Index (Lateral cutaneous n. forearm / Median n.)"],
    ["C7", "Middle finger (Median nerve)"],
    ["C8", "Ring + Little finger (Ulnar nerve)"],
    ["T1", "Medial forearm (Medial cutaneous nerve of forearm)"],
    ["T2", "Medial upper arm (Intercostobrachial nerve)"],
]
story.append(colored_table(
    ["Root", "Area Supplied"],
    derm_rows,
    [3*cm, 15.2*cm],
    header_bg=colors.HexColor("#2e7d32")
))

story.append(Spacer(1, 0.4*cm))
story.append(HRFlowable(width="100%", thickness=1, color=colors.HexColor("#c5cae9")))
story.append(Spacer(1, 0.1*cm))
story.append(Paragraph(
    "Prepared for FMGE Revision  |  Based on Gray's Anatomy for Students &amp; THIEME Atlas  |  Orris Medical AI",
    FOOTER_STYLE
))

doc.build(story)
print("PDF created:", OUTPUT)