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25 Cards in this Set
- Front
- Back
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simple thoracic cage injuries
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costovertebral dislocation, transverse/oblique/overriding rib fx, chondral fx, costochondral/chondrosternal separation, sternal fx
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complicated thoracic cage injuries
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traumatization of pleura/lung (pneumothorax, contusion, emphysema), multiple rib fx (flail chest), tear of blood vessels (hemothorax), compound fx (missile/puncture wound), injury to heart or great vessels
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thoracic outlet syndrome (TOS)
costoclavicular syndrome |
-compression of NV sturctures due to narrowed thoracic outlet
-symptoms: pain in neck/shoulder, numbness/weakness in arm/hand, diminished radial pulse -risk factors: trauma, postural distortions, heavy lifting/throwing, congential anomalies, working in static positions -tx: phys therapy and/or surgery |
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intercostal nerve block
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-palliation from anesthetizing IC nerve after rib fx
-needle introduced near costal groove - posterior aspecic of thoracic cage @ angle of rib |
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needle decompression
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-needle placed in pleural cavity to remove air (tension pneumothorax)
-needle inserted just superior to rib above collateral branches of rib below but well below IC VAN in costal groove of rib above -preffered sites @ 2/3 IC space, midclavicular or 5 IC space midaxillary |
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anterior mediastinal masses
(thymoma, thyroid mass, teratoma, lymphoma) |
thymoma - thymus tumors (myasthenia gravis)
thyroid - displaces trachea teratoma - all 3 germ cell types lymphoma - Hodgkin's, non-Hodgkin's, primarily mediastinal b-cell tumors symptoms: retrosternal pain, cough, dyspnea, SVC syndrome, choking sensation |
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middle mediastinal masses
(lymph nodes, aortic aneurysm, vascular dilation, cysts) |
lymph - form infections/malignancy
aortic - atherosclerotic, may rupture vascular - enlarged pulmonary artery or cardiomegaly cysts - bronchogenic, pericardial symptoms: retrosternal pain, cough, dyspnia, SVC syndrome, choking sensaiton |
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cardiac tamponade
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"heart compression" - result of collection of blood in pericardial cavity
causes: traume, bleeding from weak muscle after MI or cardiac surgery symptoms: JVD, muffle heart sounds, narrowed difference b/t systolic/diastolic BP tx: pericardiocentesis - drainage of fluid; needle inserted into IC space near sternum |
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breast cancer
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can metasticize via lymph system
"orange peel" appearance of skin due to blocked lymph channels deviation of nipple & dimpling of tissue due to tumor growth pulling on/contracting CT/suspensory ligs risk of mastectomy - damage to long thoracic nerve --> winged scapula |
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coronary artery bypass graft (CABG)
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veins or arteries from elsewhere grafted to coronary arteries to improve blood supply
-great saphenous vein, internal thoracic artery, radial artery |
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L ventricular hypertrophy
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non-tumerous increase in size (no increase in cell #s)
caused by: hypertension, aortic/mitral valvular disease |
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myocardial infarction
(heart attack) |
caused by: coronary artery atherosclerosis & thrombosis
-local ischemia & necrosis of defined myocardial area typically in subendocardium -infarct = necrotic tissue *white-arterial occlusion in heart, spleen, kidney *red-RBCs leaking into necrotic area (lung/GI) *transmural-across entire ventricular wall, endocard to epicard *subendocardial-ltd to interioer 1/3 of ventricular wall -usually LAD |
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auscultatory locations
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aortic - R 2nd IC space
pulmonary - L 2nd IC space tricuspid - lower sternum mitral - L 5th IC space away from sternum |
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valvular heart disease
(aortic/mitral stenosis/regurgitation) |
stenosis - narrowing
regurgitation - insufficiency AS: leads to LV overload/hypertrophy; caused by RHD, calcific stenosis, congentical bicuspid valve AR: caused by congenitally malformed leaflets, RHD, ineffective endocarditis (IE), ankylosing spondylitis, marfan's, aortic root dilation MS: leads to LA dilation; caused by RHD MR: caused by abnormal valve leaflets, rupture of papillaries or chordae, papillary fibrosis, IE, LV enlargement |
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simple pneuomothorax
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trauma to chest wall allowing air to enter pleural cavity collapsing lung
open: air from outside closed: air from lung |
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tension pneumothorax
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air enters pleural cavity and gets trapped --> lung collapsed as potential space in pleaural cavity becomes real space
symptoms: dimished breath sounds, JVD, tracheal deviation to opposite side tx: needle decompression (2nd IC spce, mid clavicular), chest tube (drains blood, 4-5-6 IC space, anterior axillary line) |
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inhaled foreign body
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typically on R side b/c R main bronchus is wider & more vertical
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lung disease
(tuberculosis, anthracosis) |
TB: inhalation of myobacterium tuberculosis --> localized lesions/tubercles which rupture into bronchi
anthracosis: "coal miner's lung"; extensive deposition of black carbon pigment & fibrotic central region of lung |
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chronic obstructive pulmonary disease (COPD)
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chronic bronchitis, asthma, emphysema (permanent enlargement of airspaces & destruction of bronchiole walls by inflammation, decrease elastic recoail of lung makes expiration difficult leading to hypertrophy of IC muscles and barrel chest)
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lung cancer
(squamous cell (bronchogenic) carcinoma, and adenocarcinoma from intrapulmonary bronchi) |
arises from alveolar lining cells of lung parenchyma or epithelium of tracheobroncial tree
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idiopathic pulmonary fibrosis
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chronic restrictive lung disease causing chronic inflammation, fibrosis & need for more pressure to inflate stiffened lungs
leads to hypoxemia & cyanosis caused by environmental/occupation agents men>women |
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pulmonary embolism
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COD in 10-15% of hospitalized patients
thromboemboli originate in deep leg veins b/c of venous stasis, trauma, coag disorders lesser degree w/o infarction: tachypnea, anxiety, dyspnea, vague substernal pressure massive: obstructs vessels & leads to infarction and circulatory collapse |
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posterior mediastinal masses
(neurogenic tumors, esopheal lesions) |
NT: periph nerves or sheath cells
EL: diverticula & tumors symptoms: pain, neuro symptoms, swallowing difficulty |
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subclavian venous line
(landmarks & risks) |
landmarks: 1/2 way out to clavicle & 2 finger breadths above sternal notch
risks: lung injury (pneumothorax), subclavian art injury, brachial plexus injury |
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ER thoracotomy
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L 5th IC space to open pericard longitudinally
avoid phrenic nerve fix cardiax injuries clamp pulm hilum cross clamp airota |
