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23 Cards in this Set
- Front
- Back
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How much pleural fluid is in each pleural space? |
About 10mL |
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Coupling of the visceral and parietal pleura is accomplished by what features? |
-Negative pressure in the pleural space -pleural fluid in the pleural space |
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What are blebs and bullae and what are they caused by? |
Blebs and bullae are small air filled blisters caused by leakage of air from lungs. Bullae are blebs bigger than 2cm |
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Why could blebs and bullae cause problems? |
Bursting of blebs or bullae can puncture the visceral pleura of the lungs and result in air filling into the pleural space. This can cause a pneumothroax |
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Why is a persons lungs accessed after coming off a positive pressure ventilator? |
Positive pressure ventilators can cause bursting of blebs or bullae and result in a pneumothrorax |
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Where is the insertion point for a needle thoracostomy? When would a needle thoracostomy be preformed? |
2nd ICS and Midclavicular line Only in an emergency |
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How can damage to the neck cause a pneumothorax? |
The cupola of the neck (cervical pleura) could be punctured |
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What are the boundaries of the 'safe triangle'? |
Lateral border of pec major Anterior border of latissimus dorsi Apex below the axilla lower rib of 5th ICS |
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What is another name for a chest tube? |
Thoracostomy tube |
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Where should a chest tube be inserted? |
The 4th ICS within the safe triangle anterior axillary line |
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Why is a chest tube sometimes inserted in the 2nd ICS? |
When a patient is lying down, the lowest point in the pleural cavity is in line with the 2nd ICS |
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At what region should you insert something through the ribs? Why? |
On the superior aspect of the lower rib of the ICS due to thw neurovascular bundle running along the inferior aspect of each rib |
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For what reasons would you preform a thoracocentesis? |
For diagnostic and therapeutic reasons. |
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Which rib should you never insert anything into and why? |
-Below the ninth rib -The costodiaphragmatic recess is thinest here and puncture of the liver (right) or stomach and/or spleen on left is likely |
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During a thoracocentesis, where should you insert a needle/tube? |
- 1-2 ribs below the level of the fluid - between 5-10cm lateral from spinous processes - 1-2cm inferior to scapula |
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Asymmetrical doming of the diaphragm is normal why? On what side is the diaphragm higher (more superior) ? |
The liver and stomach which lie either side of the inferior diaphragm differ in size. The liver, on the right is bigger and hence the dome on the right will be more superior than the dome caused by the stomach and spleen on the left |
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How is it that in certain situations the left diaphragm cant contract but the right side can? |
Innervation of left and right phrenic nerves mean the left and right diaphragm can contract if there is damge to the opposite nerve |
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What are the -anterior -lateral -posterior attachments of the diaphragm? |
-Xiphoid process -Costal margins -Tendinous arches to spine and transverse processes |
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The median arcuate ligament is formed by what? Where do these attach onto? |
-The tendinous arches of the left and right crus -Right crus = vertebral bodies L1 + L3 -Left crus = vertebral bodies L1 + L2 |
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What muscles pass by the arches formed by the medial arcuate and lateral arcuate ligaments? |
-Medial arcuate = psoas major -Lateral arcuate = quadratus lumborum |
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The aorta pass through what? At what vertebral level? |
-The median arcuate ligament -T12 |
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How can a defective eosophageal hiatus result in under developement of the lungs in the feotus? |
A diaphramatic hernia could allow the stomach to enter the thoracic cavity, impeding on the lungs |
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What arteries supply the diaphragm? |
-Musculophrenic and pericardiocophrenic -Superior phrenic artery -Inferior phrenic artery |
