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Medical Mnemonics

Christopher Holmes

12 April 2000


Medical Mnemonics

Christopher Holmes,
The University of Tokyo Faculty of Medicine


Mnemonics:
Methods of memorization

Definition of mnemonic
Any device for aiding the memory.


Structure
Memorization relies on linkage (multiplying associations between ideas) using one or more elements:
Meaning
Symbolism
Personal significance


Meaning

Narrative (stories)

A cannibal ate a dozen people, including an ailing stock market analyst.


One Ate Twelve,
Ill Dow Jones expert included!

(This helps to remember the 1, 8, and 12-foot lengths of the Ileum, Duodenum, and Jejunum, the first three parts of the digestive system after the stomach.)


Symbolism

e.g.: for days of the week:
Sun for Sunday, moon for Monday, wedding for Wednesday, frying pan for Friday


Personal significance

Emotional impact, "shock value," mixture of sensory information
(smelly cheese, rotten meat, sarcastic grin)


Familiarity

Order

Repetition


Order
Arbitrary (rote, random)
Numerical
Alphabetical
Logical
Chronological
Morphological


P-Q-R-S-T

Mnemonic used when eliciting an HPI (history of present illness) and exploring symptoms


P--palliative or provocative factors affecting the pain
Q--quality of pain (burning, stabbing, aching, etc.)
R--region of body affected
S--severity of pain (usually 1-10 scale)
T--timing of pain (e.g. -- after meals, in the morning, etc.)


Logical

Chronological

Morphological
Small to large
Top to bottom
Left to right


Form of mnemonic

Gesture

Substitution

Sound

Others

Gestures
(pointing, tying a string around the finger, etc.)

Door locking, train safety checks

Reminders to perform non-routine activities

Substitution

"ray-gun" for Reagan

"fair-tribe-bun" for vertreiben in German

豚寝る (pig-sleep) for トンネル in Japanese


Sound

Rhyme, rhythm, alliteration



"i before e except after c"

(i.e., pierce, brief, belief, grief, etc.,
but receive, receipt, deceive, etc.)




Thirty days hath September
April, June, and November;
All the rest have thirty-one,
Except February, which has twenty-eight
(Except in Leap years, when it has twenty-nine).


My improved version --


Thirty days has September
April, June, and November;
All the rest have thirty-one. (But wait!
Doesn't February have twenty-eight?
-- True, but not always, for
Leap years give it one day more.)
(C) Christopher Holmes 2000


Other methods
Current
Timers
Personal digital assistants (PDAs): Palm Pilot, Zaurus
Flash cards, quiz-constructor software, dictionary servers
Assistants (nomenclators)
Expert systems
Future
Personal computer applications

Applications of Mnemonics
in Medicine
Anatomical and functional features
Nomenclature
Associations among parts
Associations between parts and their functions
Processes, phases

Procedures
Diagnosis
Surgery/anesthesia
Emergency medicine

Anatomical nomenclature

Organ system names
(circulatory, immune, nervous, reproduction, respiratory, urinary, muscle, digestive, integumentary, endocrine):

I MURDER, INC., or

Sir: I'm nervous about reproducing with the rest. Uri must dig into the end, or

Sir: I'm nervously reproducing the rest, but Uri must dig in. End.

The tricuspid valve is in
The Right Inside part of the heart.

The mitraL valve is on the Left.

Types of white blood cell (Lymphocytes, Neutrophils, Basophils, Eosinophils, and Monocytes):

Lying Nude in Basement Early Monday

The 5 sphincters in the alimentary canal
(Anal, Pyloric, Lower Esophageal, Oddi's, and Ileocecum):

APE OIL, or

An Odd Pile Lowers the Ileocecum


The layers of the epidermis
(from the outside inwards)
(stratum) (Corneum, Lucidum, Granulosum, Spinosum, Basale):

Cora Lucille's Granny Spins Baskets.


Cranial bones
(Ethmoid, Parietal, Temporal, Occipital, Frontal, Sphenoid):

Ethel, the Parakeet, is Temporarily Occupied in Front of the Sphinx.


The cranial sutures
(Sagittal, Lambdoid, Squamous and Coronal):

Saggy Lambs Squash the Coroner.


Parts of the eye (Sclera, Choroid layer, Retina and Vitreous humor (SCRV) + Eyeballs + Outer layer):

SCREW your eyes out.


Parts of the middle ear
(tympanic membrane, ossicles, eustachian tube, oval and round windows):

Tim Observed Eunice's Tub from two Windows.

Connections/associations among parts
Centrioles are useful organelles which play a key role in cell division, namely pulling the chromosomes apart. Centrioles are ropes made of nine groups of three fibres, a 9+3 arrangement.
How to remember this? Count the number of letters in "centriole" (9), then count the syllables (3).



The stomach and omentum (which lies over the stomach) share the letters OM.

The parts of the forebrain:
C+D+E=F
(Cerebrum + Diencephalon = Forebrain)


Four types of glial cells
(ependymal, astrocytes, oligodendrocytes, microglia):
Every Asshole Owes Money.
Associations between systems/organs/parts and their functions

The PERITONEUM
holds a PERson's Intestines To NEarest wall.



B Cells
Bite virus
T Cells
Torpedo sick cells.


The eight functions of blood
(Oxygen, Carbon dioxide, Food, Heat, Waste, Hormones, Disease, and Clotting):

Old Charlie Foster Hates Women Having Dull Clothes, or

Waste Ox Cart Food Disease makes Clot in Heated Whore.


Mitosis versus meiosis:

Mitosis takes the cell and Makes It Two;
Meiosis divides the gametes, Making Each Indivisible any further (haploid).


The difference between the two types of reproduction at the cell level:

mITosis makes Identical Twins;
mEioSis makes Egg and sperm.



DNA and RNA are both nucleic acids, but they do different jobs in the cell:

DNA Delivers the blueprint,
RNA Reads it;

also, the transfer RNA (tRNA) molecule is shaped like the letter T.


Six factors triggering smooth muscle contraction
(oxygen, temperature, ions, hormones, stretch, and acid level (pH):

"SHIP TO," or

Office Temp's Eye On Whore Stretching Ass
("Eye On" = ions)



Fovea (the part of the retina most densely packed with cones):

FOr VEry Acute vision.



The eight major hormones from the pituitary gland
(gonadotropic, oxytocin, anti-diuretic, thyroid stimulating, follicle stimulating, luteinizing, adrenocorticotropic, prolactin):

GOAT-FLAP



Hormones of the Anterior Pituitary:

FLAGTOP

F: Follicle stimulating hormone
L: Luteinizing hormone
A: ACTH
G: Growth hormone
T: Thyroid stimulating hormone
O: MSH
P: Prolactin



Ovaries are RIPE with hormones:

relaxin, inhibin, progesterone, estrogen.



Products of the adrenal cortex, going from the outer to the inner layer:

"Salt, sugar, sex; the deeper you go, the sweeter it gets."

(salt = aldosterone, sugar = glucocorticoids, sex = sex hormones)



The sympathetic nervous system:

Fight or Flight

The parasympathetic nervous system:

Rest and Digest

Processes and their phases

The mitotic phases of a cell (Interphase, Prophase, Metaphase, Anaphase, and Telophase, including Cytokinesis and cell Cleavage)

"I Proposed Marriage to Anna by Telephone before I Sighted her Cleavage" or

(for the main phases) "People Meet And Talk."

Procedures
Diagnosis
Steps in diagnosis,
Diagnostic features of disease or condition

Six causes of blood in the urine (Stones, Hematological disorder, Infection, Tumor, Tuberculosis, Trauma):

SHITTT



Cholinergic Crisis-Parasympathetic Stimulation (Salivation, Lacrimation, Urination and Defecation):

SLUD

Rules of thumb

To remember that 50% of cancers arise in three organs (Colon, Lungs, Breast):

College Lunch is Best or
Collegians Love Breasts


Possible causes of back pain:

DISK MASS

D == Degeneration: DJD, Osteoporosis, spondylosis
I == Infection: UTI, PID, Potts, osteomyelitis, prostatitis, Injury/fracture, compression fracture.
S == Spondylitis, ankylosing spondyloarthropathies (rheumatoid arthritis, Reiters, SLE)
K == Kidney stones/infarction/infection (pyelo/abscess)
M == Multiple myeloma, metastasis from breast, prostate, lung, thyroid, kidney CA
A == Aneurysm, abdominal pain referred to the back (see acute abdominal pain)
S == Slipped disk, spondylolisthesis
S == Strain, scoliosis/lordosis, skin: herpes zoster.
Surgery/anesthesiology

Spinal anesthetics
(Lidocaine, Bupivicaine, Procaine, Tetracaine):

Little Boys Prefer Toys.

Emergency medicine

Treatment of Malignant Hyperthermia:

Some Hot Dude Better Give Iced Fluids Fast!!!

S: Stop all triggering agents, give 100% O2
H: Hyperventilate
D: Dantrolene 2.5mg/kg
B: Bicarbonate
G: Glucose and Insulin
I: IV Fluids, Cooling Blanket
F: Fluid Output; Furosemide
F: Tachycardia, be prepared to treat V Tach


What to do in case of syncope:

If the face is red, raise the head.
If the face is pale, raise the tail!





FINIS
addenda

order of events in an epileptic seizure:

the aura, the cry,
the falling, the fit,
the tonus, the clonus,
the pee, and the shit

The Abc's of emergency medicine (order of checking what's wrong with a victim):
A: airway
B: breathing
C: circulation

Mnemonics in Japanese (語呂合わせ):

for the cranial nerves:
かいで見る動く車の三の外顔危懼ノドに迷う副舌下
(臭視動眼)


jibikishonari (from Prof. Kishi)




Other sciences
Geology, geography, meteorology

The names of the Great Lakes spell out HOMES:

Huron, Ontario, Michigan, Erie, Superior

Red sky at morning, sailors take warning;
Red sky at night, sailors delight.

Taxonomy
Linnaeus's system of classification into Kingdom (plant or animal), Phylum (backbone?), Class (mammal?), Order (carnivore?), Family (cat, dog, ape), Genus (orangutan or human), Species and Variety:

King Philip Conquers Our Fifty Grateful States, or

King Phillip's Class Of Family Geniuses Specializes in Variety, or

Kind Phillip's Class Orders Family-sized Gino's Special (Vanilla), or

Keep Perverts Cleverly Occupied, For Gosh Sake!!


And the five Kingdoms
(protoctista, plantae, fungi, monera, animalia):

Protecting Plants is Fun, Mon Ami!
Astronomy

What's up DOC?
(the phases of the moon)

"Oh, Be A Fine Girl, Kiss Me"
(the order of the types of stars)
Mathematics

Value of the first several digits of pi (found by counting the number of letters in each word of the mnemonic):

"See! I have a rhyme assisting
My feeble brain, its tasks resisting" or

"May I have a large container of coffee?"


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