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90 Cards in this Set
- Front
- Back
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carcinomas of breast arise from what? |
epithelial cells of the lactiferous ducts in mammary gland lobules |
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lymphedema |
excess fluid in lymph nodes. |
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peau d'orange |
lymphedema causing puffy skin between dimpled pores and orangelike appearance |
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subareolar breast cancer |
retraction of the nipple |
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HOw does breast cancer typically spread/ |
lymphatic vessels, lymphogenic metastasis |
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most common site of metastasis of breast cancer |
axillary lymph nodes (most drainage from breast) |
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Which veins can cancer spread from the breast? |
posterior intercostal veins draining into azygos/hemiazygos system of veins |
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What movement is clinical sign of advanced cancer of the breast? |
retromammry space invaded by cancer cells and attached to pectoral fascia causing breast to ELEVATE when muscle contracts |
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mammorgraphy |
detects breast masses, large jagged density is carcinoma, skin thickened over tumor |
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simple mastectomy |
breast removed downt to retromammary space |
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radical mastectomy |
more extesnive surgical procedure, involving removal of breast, pectoral muscles, fat, fascia and many lymph nodes |
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lumpectomy/quadrantectomy |
only tumor and surrounding tissues followed by radiation therapy |
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gynecomastia |
breast hypertrophy in males after puberty - imbalance between estrogenic and androgenic hormones or from change in metabolism of sex hormones by the liver - suprarenal or testicular cancers - 40% of males with Klinefelters |
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necessary for staging and determining appropriate treatment of a cancer |
excision and pathologic analysis of axillary lymph nodes |
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axillary node dissection risks |
long thoracic nerve (results i nwinged scapula) |
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paralysis of serratus anterior caused by |
injury to long thoracic nerve |
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effect of paralysis of serratus anterior |
medial border of the scapula moves laterally and posteriorly away from the thoracic wall (wing) upper limb may not be able to be abducted above horizontal position |
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winged scapula |
medial border and inferior angle of scapula pull markedly away from posterior thoracic wall |
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Compression of third part of artery |
when profuse bleeding occurs (stab or bullet wounds) |
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How do you compress axillary artery at its origin ? |
Downward pressure in angle btw clavicle and inferior attachment of SCM |
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Where does the aneurysm of axillary artery occur? |
first part |
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Effects of anuerysm of axillary artery |
compress trunks of brachial plexus, pain and anesthesia in areas of skin supplied by effected nerves |
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axillary vein dangers |
air entering proximal part and producing air emboli in blood |
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laminectomy |
surgical excision of one or more spinous processes and the adjacent supporting vertebral laminae |
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When are laminectomies done? |
gain access to vertebral canal, (provides posterior exposure to spinal cord, and roots of specific spinal nerves. |
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Why are cervical vertebrae less tightly interlocked than others? |
more horizontally oriented articular facets |
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Why can cervical dislocations occur without damaging the spinal cord? |
large vertebral canal in cervical region |
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facet jumping |
locking of articular processes, (lack of this causes cervical vertebrae to slip back into place) |
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What happens during a severe dislocation + fracture of a cervical vertebrae that doesn't have facet jumping. |
Damage to the spinal cord is not clearly seen on radiograph MRI must be done |
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What is the result of vertical forces compressing lateral masses of C1? |
fracture of one or both of anterior or posterior arches |
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Jefferson or burst fracture |
rupture of the transverse ligament |
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What part of the axis is most commonly injured? |
vertebral arch (fracture) |
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traumatic spondylolysis of C2 |
fracture of the column formed by superior and inferior articular processes of axis - pars interarticularis |
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hangman's fracture |
traumatic spondylolysis of C2 |
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lumbar spinal stenosis |
narrow vertebral foramen in one or more lumbar vertebrae - hereditary - can make one more vulnerable to disc bulging |
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Treatment of lumbar stenosis |
decompressive laminectomy |
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cervical rib |
developmental costal of C7 (becomes part of transverse process that lies anterior to transverse foramen) becomes abnormally large - may elevate and place pressure on subclavian artery or inferior trunk of brachial plexus - may cause thoracic outlet syndrome |
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sacrococcygeal ligament |
- closes sacral hiatus - pierced by filum terminale - deep to ligament = epidural space |
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caudal epidural anesthesia |
local anesthetic agent injected into fat of sacral canal - sacral hiatus is often route - median sacral crest are landmarks for hiatus |
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injury of coccyx |
dislocation of sacrococcygeal joint, fracture - can occur during childbirth -may cause coccygodynia |
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spina bifida occulta |
neural arches of L5 and/or S1 fail to develop normally and fuse posterior to the vertebral canal - TUFT OF HAIR |
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spina bifida cystica |
one or more vertebral arches fail to develop compltely - herniation of meninges and or spinal cord - neurological systems (meningomyelocele) - most severe - neural tube defects |
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common cause of lower back pain and lower limb pain |
herniation or protrusion of gelatinous nucleous pulposus into or through annulus fibrosus |
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What direction do herniations occur? |
posteriolaterally - spinal nerve roots cause symptomatic |
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acute pain of herniated disc |
localized back pain resulting from pressure on longitudinal elements and periphery of annulus fibrosus |
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chronic pain from herniated disc |
compression of spinal nerve roots |
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most common location of lumbar disc protrusions |
L4-L5 or L5-S1 |
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sciatica |
pain in lower back and hip radiating down back of the thigh into the leg - lumbar IV disc that compresses and compromises L5 or S1 component of sciatic nerve |
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Most common fracture of C2 |
at the dens, occurs most often at its junction with the body of the axis - transverse ligament of atlas becomes interposted btw fragments of dens - dens no longer has blood supply |
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hyperextension injury of neck affects? |
posterior parts of vertebrae, crush or compression of vertebral arches and their processes - may radiate pain into back ofneck bc of spinal sensory ganglia |
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severe hyperextension injuries of neck |
anterior longitudinal ligament is severely stretched and may be torn |
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lower back pain |
generally muscular, joint, or fibroskeletal pain |
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kyphosis |
hunchback, increase in thoracic curvature, (posteriorly) - erosion of anterior part of one or more vertebrae |
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lordosis |
- hollow back or sway back, anterior tilting of pelvis - increased extension of lumbar vertebrae - weakened trunk musculature - can result in excessive lumbar lordosis during late pregnancy |
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scoliosis |
abnormal lateral curvature - rotation of vertebrae, spinal processes turn towards cavity |
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myelography |
radiopaque contrast procedure that allows visualization of spinal cord and spinal nerve roots |
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leptomeninges |
arachnoid and piamater - single layer from smesenchyme surrounding embryonic spinal cord |
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lumbar puncture |
withdrawl of CSF from lumbar cistern - evaluating CNS disorders 0 meningitis and diseases of CNS alter CSF |
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transection of spinal cord |
loss in all sensation and voluntary movement inferior to the lesion |
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ischemia of spinal cord |
affect function and can lead to muscle weakness or paralysis - neurons with cell bodies distant from site of ischemia will also die |
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paralysis of platysma symptoms |
skin falls away from neck in slack folds |
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what prevents spread of abscesses caused by tissue destruction? |
investing layer of deep cervical fascia |
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What happens if an infection happens btw the investing fascia and the visceral part of pretracheal fascia? |
it can spread into thoracic cavity anterior to pericardium |
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retropharyngeal abscess |
pus peroforating prevertebral layer of deep cervical fascia and entering retropharyngeal space - symptoms include difficulty swallowing and speaking |
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congenital torticollis |
contraction or shortening of cervical muscles that produces twisting of the neck and slanting of the head - prenatally, injured during difficult birth |
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spasmodic torticollis |
cervical dystonia: bilateral combination of lateral neck nerves - shoulder usually elevated in direction to which side turns |
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subclavian vein puncture |
central line placement - fluids and medications and to measure CVP - thumb on middle of clavicle and index on jugular notch - needle punctures inferior to thumb and medially advanced towards jugular notch til tip enters at right venous angle |
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right cardiac catherization |
puncture of the IJV to introduce catheter into the superior vena cava - very rarely EJV |
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Prominence of external jugular vein |
- internalbarometer - normal range = visible above clavicle for short distance - rise in pressure prominent throughotu course of neck |
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severence of external jugular |
- severed along posterior border lumen is held open by deep cervical fascia and negative intrathoracic pressure will suck air into vein - cyanosis -venous air embolism |
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lesions of spinal accessory nerve |
- unilateral lesion does not produce abnormal position - weakness in turning head to opposite side - weakness and atrophy of trapezius |
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unilateral paralysis of trapezius |
inability to elevate and retract shoulder and by difficulty elevating upper limb above horizontal |
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What is drooping of the shoulder a sign of? |
CN Xi injury |
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severence of phrenic nerve |
paralysis of coressponding half of the diaphgragm |
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phrenic nerve block |
short period of paralysis on one side during lung operations, |
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injury to suprascapular nerve |
vulnerable in fractures of middle third of clavicle - losso f lateral rotation of humerus at the glenohumeral joint |
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:) |
:( |
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fracture of clavicle |
sternocleidomastoid muscle elevates medial fragment - end of superiorly directed fragment is prominent - trapezius muscle is unable to hold the lateral fragment up and shoulder drops - lateral fragment may be pulled medially by adductor muscles |
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fracture of scapul |
severe trauma usually associated with fractured ribs, - protruding subcutaneous acromion |
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Injury to Spinal Accessory Nerve |
clinical manifestation is marked ipsilateral weakness |
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injury to thoracodorsal nerve |
vulnerable during surgery to inferior part of the axilla or during mastectomies when axillary tail of breast removed - paralysis = unable to raise trunk with upper limbs as in climbing |
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injury to dorsal scapular |
affects rhomboids - affected side has scapula located farther from midline |
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injury to axillary nerve |
gives shoulder a flattened appearance and produces slight hollow inferior to acromion - atrophy of the deltoid - loss of sensation due to superior lateral cutaneous nerve of the arm |
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arterial anastomosis around scapula |
importance is when ligation of lacerated subclavian or axillary nerve is necessary |
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midhumeral fracture |
- injury of radial nerve, |
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supra-epicondylar fracture |
fracture of the distal part of the humerus, displaced anteriorly or posteriorly - brachialis and triceps tend to pull the distal fragment over proximal fragment |
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injury to the radial nerve |
paralysis of the triceps, brachioradialis, supinator, and extensor of wrist and ringers |
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ligation of the uterine tubes |
surgical method of birth control |
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ectopic tubal pregnancy |
due to collection of pus in uterine tube (pyosalpinx), causes blastocyst to implant in mucosaa |
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