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58 Cards in this Set

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  • Back
an endoscope, used to examine the mediastinum and conduct minor surgery, inserted through a small inceision at the root of the neck, just superior to the jugular notch, anterior to trachea
use a mediastinoscope to view or biopsy mediastinal lymph nodes
Widening of mediastinum with reference to mediastinal subdivisions
usually viewed with chest radiographs, often observed after trauma resulting from a head-on collision which produces hemorrhaging into the medistinum from lacerated great vessels, can also be caused by malignant lymphoma which enlarges mediastinal lymph nodes, also associated with congestive heart failure
surgical significance of the transverse pericardial sinus
after the pericardial sac is opened anteriorly, a finger can be passed through the transverse pericardial sinus posterior to the aorta and pulmonary trunk, surgeons can clamp these arteries and stop or divert the circulation of blood here
inflammation of the pericardium, usually causes chest pain, friction of the roughened surfaces sounds like th rustle of silk when listening with a stethoscope over the left sternal border and upper ribs
pericardial effusion
passage of fluid from pericardial capillaries into the pericardial cavity, or an accumulation of pus, usually occurs with congestive heart failure
congestive heart failure
a heart that fails to pump out blood at the same rate that it receives it (fails to maintain blood circulation
cardiac tamponade
heart compression, occurs from reducing expansion of the heart, limiting the amount of blood the heart can receive thus reducing cardiac output, is potentially lethal bec. the heart is compressed and circulation fails, can also occur from having blood in the pericardial cavity resulting from perforation of a weakened area from a heart attack or stab wounds
drainage of fluid from the pericardial cavity, used to relieve cardiac tamponade, done by inserting a wide-bore needle through the left 5th or 6th ICS near the sternum (the bare area of the pericardium), or by entering the infrasternal angle and passing superoposteriorly
positional abnormalities of the heart
caused by abnormal folding of the embryonic heart, causes dextrocardia
position of heart is reversed, where the apex of the heart is to the right instead of left, mirror images of the great vessels as well
percussion of the heart
percussion (density and size of heart), tested by creating vibrations by tapping the chest while listening and feeling for differences in soundwave conduction, performed at the 3rd-5th ICS
atrial septal defects (ASD)
congenital, incomplete closure of the oval foramen, these small openings cause no hemodynamic abnormalities
-clinically significant, allow oxygenated blood from the lungs to be shunted from the left atrium through the ASD into the right atrium, causing enlargement of the right atrium and ventricle and dilation of the pulmonary trunk, leads to hypertrophy of the right atrium and ventricle
ventricular septal defects (VSD)
occur on the membranous part, but can also occur on the muscular part of the IVS, rank first on all cardiac defects, causes a left to right shunt of blood through the defect, INC pulmonary blood flow, which causes hypertension and maybe ardiace failure (bec. of higher pressure on left side)
clots, can become dislodged and enter the peripheral arteries
occlusion of an artery supplying the brain
cerebrovascular accident (CVA)
which may affect vision, cogntion, or motor function of parts of the body controlled by the damaged area of the brain
stenosis (valvular heart disease)
narrowing, failure of a vlave to open fully, slowing blood flow from a chamber, cause INC workload on heart
insufficiency (valvular heart disease)
failure of the valve to close completely, usually owing to nodule formation on the cusps so that the edges do not meet or align
audible vibrations caused by turbulence
superficial vibratory sensations, may be felt on the skin over an area of turbulence
valve replacement
mitral valve insufficiency (mitral valve prolapse)
insufficient valve with one or both leaflets extending back into the left atrium during systole, produces murmur, chest pain and fatigue
pulmonary valve stenosis
valve cusps are fused, with narrow central opening, conus arteriosus is underdeveloped in infundibular type, produce a restriction of right ventricular outflow, hypertrophy of right ventricle
pulmonary valve incompetence
incomplete closure of pulmonary cusps, heart murmur
aortic valve stenosis
most frequent valve abnormality, result of degenerative calcification, left ventricular hypertrophy
aortic valve insufficiency
results in aortic regurgitation, producing a heart murmur and a collapsing pulse (forcible impulse that rapidly diminishes)
coronary artery disease (CAD)
is one of the leading causes of death, result in a reduced blood supply to the vital myocardial tissue
rendered virtually bloodless, occurs from an occlusion in a major artery
pathological tissue death
three most common sites of coronary artery occlusion
1. anterior IV (LAD) branch of the LCA
2. RCA
3. circumflex branch of the LCA
myocardial infarction (MI)
when an area of myocardium has undergone necrosis
atherosclerotic process of MI
results in lipid accumulations on the internal walls of the coronary arteries, begins during early adulthood and slowly results in stenosis of the lumina of the coronary arteries
myocardial ischemia
insufficient blood supply to the heart, may result in MI
pain that originates in the heart, result of ischemia of the myocardium, narrowed and hardened coronary arteries
coronary bypass graft
done to remove an obstruction of the coronary circulation, commonly use the radial artery, a coronary bypass graft shunts blood form the aorta to a stenotic coronary artery to INC the flow distal to the obstruction (provides a detour around)
coronary angioplasty
pass a catheter into the obstructed coronary artery, when reach obstruction, then inflate balloon pushing the plaque against the wall and INC the size of the vessel, can also use thrombokinase to dissolve the clot
luminal blood
blood from the heart chambers
electrocardiogram (ECG or EKG)
used to amplify and record the passage of impulses over the heart from the SA node
heart block
the ventricles will begin to contract independently at their own rate, atria contract at the normal rate, but the impulse is not transmitted to the ventricles
bundle branch block
damage to one of the bundle branches, excitation passes along the unaffected branch and causes a normally timed systole of that ventricle only, need cardiac pacemaker to INC the ventricular rate of contraction to 70-80 per min.
artifical cardiac pacemaker
inserted subQ, consists of a pulse generator or battery pack, a wire, and an electrode, produces impulses that initiate ventricular contractions at a predetermined rate
cardiopulmonary resuscitation
restore cardiac output and pulmonary ventilation, apply pressure to the thorax over the sternal body
fibrillation of the heart
multiple, rapid, circuitous contractions or twitchings of muscular fibers
atrial fibrillation
normal contractions of the atria are replaced by rapid irregular and uncoordinated twitchings of different parts of the atrial walls, ventricles respond at irregular intervals
ventricular fibrillation
normal contractions of the ventricle replaced by rapid, irregular twitching movements that do not pump
defibrillation of the heart
electric shock may be given to the heart through the thoracic wall causing cessation of all cardiac movements and a few seconds later the heart may begin to
beat more normally
cardiac referred pain
noxious stimuli originating in the heart are perceived by a person as pain arising from a superficial part of the body, the skin on the left upper limb
visceral referred pain
transmitted by visceral afferent fibers accompanying sympathetic fibers and is typically referred to somatic structures or areas such as a limb having afferent fibers with cell bodies in the same spinal ganglion
anginal pain
radiating from the substernal and left pectoral regions to the left shoulder and the medial aspect of the left upper limb
About the thymus
a prominent feature of the superior mediastinum during infancy and childhood, important in the development and maintenance of the immune system, at puberty it begins to diminish in size, at adulthood it is replaced by adipose tissue but still produces T-lymphocytes
localized dilation that may develop bec. of a strong thrust of blood when the left ventricle contracts, will be evident on a chest film as an enlarged ascending aorta, usually complain of chest pain that radiates to the back
right arch of the aorta
formed when the arch of the aorta curves over the root of the right lung and passes inferiorly on the right side
double arch of the aorta
forms a vascular ring around the esophagus and trachea
coartaction of the aorta
arch of the aorta has an abnormal narrowing (stenosis) that diminishes the caliber of the aortic lumen, producing an obstruction to blood flow to the inferior part of the body, commonly found near the site of the ductus or ligamentum areriosum,
injury to the recurrent laryngeal nerves
recurrent laryngeal nerves supply all intrinsic muscles of the larynx, could become involved in a bronchogenic or esophageal carcinoma, enlargement of mediastinal lymph nodes, injury causes change in voice
About the esophagus and its sites of blockage
esophagus descends into the posterior mediastinum, the primary posterior relationship of the base of the heart, there are no constrictions in the walls, but when something is swallowed the arch of the aorta, the left main bronchus and the diaphragm compress its walls, these structures also cause swallowed substances to travel slower when passing through, show where these objects are most likely to lodge
Laceration of the thoracic duct
during an accident or lung surgery, result in lymph escaping into the thoracic cavity at rates ranging from 75 to 200 mL, also possible for lymph to enter the pleural cavity, remove the fluid through thoracentesis or ligate the thoracic duct