Thorax Clinical Correlates

Front 1

Thoracic Outlet Syndrome

Back 1

compression of neurovascular structures in the thoracic outlet (space btw clav & 1st rib), causing pain, numbness, tingling, weakness & fatigue in upper limb; caused by a cervical rib

Front 2

Flail chest

Back 2

loss of stability of thoacic cage that occurs when a seg of the anterior or lateral thoracic wall moves freely because of multiple rib fractures

Front 3

Rib Fracture Injuries

Back 3

1st rib - injure brachial plexus, subclavian vessels; middle ribs - pneumothorax and lung/spleen injury; lower rib - tear diaphragm, resulting in diaphragmatic hernia

Front 4

Injury to Trachea

Back 4

may be compressed by an aortic arch anuerysm, goiter, thyroid tumors, causing dyspnea

Front 5

COPD

Back 5

includes chronic bronchitis, emphysema, asthma, bronchiectasis; chronic sough, sputum, sob

Front 6

Bronchiectasis

Back 6

chronic dilation of bronchi and bronchioles resulting from destruction of bronchial elastic and muscular elements which may cause collapse of bronchioles

Front 7

Pleurisy (Pleuritis)

Back 7

inflammation of the pleura with exudation into its cavity, causing the pleural surfaces to be roughened; produces friction & a pleural rub can be heard with the stethescope on respiration

Front 8

Pneumothorax

Back 8

accumulation of air in the pleural cavity causing lung to collapse; causes chest pain & dyspnea; treated by draining pleural air collection by simple aspiration using an intravenous catheter or chest tube thoracostomy

Front 9

Tension pneumothorax

Back 9

a life-threatening pneumothorax in which air enters during inspiration and is trapped during expiration; the resultant increased pressure displaces the mediastinum to the opp side, with consequent cardiopulmonary impairment

Front 10

Pleural effusion

Back 10

abnormal accumulation of excess fluid in the pleural space; two types: transudate (clear watery fluid) and exudate (cloudy viscous fluid)

Front 11

Thoracentesis (peural tap)

Back 11

surgical puncture of the thoracic wall into the pleural cavity for aspiration of fluid; performed at or posterior to the midaxillary line one or two intercostal spaces below the fluid level but not below the ninth intercostal space; ideal site is 7-9 space; needle inserted immediately above the superior margin of a rib to avoid injury to the intercostal neurovascular buncle

Front 12

Pancoast's or superior pulmonary sulcus tumor

Back 12

malignant neoplasm of the lung apex & causes Pancoast's Syndrome; compromises 1) lower trunck bp = severe pain toward shoulder, along medial aspect of arm, atrophy of forearm & hand mm), 2) lesions of cervical symp chain ganglia w Horner's syndrome (ptosis, miosis, anhydrosis)

Front 13

Pulmonary Edema

Back 13

fluid accumulation and swelling in the lungs caused by lung toxins, mitral stenosis, left venticular failure that results in increased pressure in the pulmonary veins; fluid is pushed into alveoli

Front 14

Atelectasis

Back 14

collapse of a lung by blockage of the air passages or by very shallow breathing because of anesthesia or bedrest; caused by mucus secretions that plug the airway, foreign bodies in the airway, tumors that compress or obstruct the airway

Front 15

Pulmonary embolism

Back 15

obstruction of the pulmonary artery or one of its branches by an embolus (air, blood clot, fat, tumor cells), which arises in the deep veins of the lower limbs or in the pelvic veins

Front 16

Lesion of the phrenic nerve

Back 16

may produce complete paralysis of the corresponding half of the diaphragm; accessory phrenic nerve can prevent complete paralysis - it is derived from the 5th cervidal nerve as a branch of the nerve to subclavius

Front 17

Pericarditis

Back 17

inflammation of the pericardium, may results in cardiac tamponade, pericardial effusion, precordial and epigastric pain; causes the pericardial murmur or pericardial friction rub

Front 18

Cardiac tamponade

Back 18

acute compression of the heart; caused by rapid accumulation of fluid/blood in the pericardial cavity; causes compressin of venous return to the heart resulting in decreased diastolic capacity, reduced cardiac output, increased heart rate, increased venous pressure w jugular distension, hepatic enlargement and peripheral edema

Front 19

Pericardial effusion

Back 19

accumulation of fluid in pericardial space

Front 20

Pericardicentesis

Back 20

surgical puncture of pericardial cavity for aspiration of fluid, relieves pressure of fluid on heart; needle inserted through 5th intercostal space left to the sternum

Front 21

mitral valve prolapse

Back 21

valve everts into the left atrium and thus fails to close properly when the left ventricle contracts; may produce chest pain, sob, palpitations, cardiac arrhythmia

Front 22

heart block

Back 22

damage to the conducting system; interferes with the ability of the ventricles to receive the atrial impulses; produces irregular ECG

Front 23

coronary atherosclerosis

Back 23

presence of sclerotic plaques containing cholesterol and lipoid material that impair myocardial blood flow, leading to ischemia and MI

Front 24

aneurysm of the aortic arch

Back 24

a sac formed by dilation of the aortic arch that compresses the left recurrent layngeal nerve, leading to coughing, hoarseness, paralysis of the ipsilateral vocal cord; may cause dysphagia & dyspnea

Front 25

tretralogy of fallot

Back 25

AP septum fails to align properly, PROVe (pulmonary stenosis, right vent hypertrophy, overriding aorta, vent septal defect); characterized by right-to-left shunting of blood and cyanosis

Hint 25

PROVe

Front 26

Atrial septal defect (ASD)

Back 26

patent foramen ovale; shunts blood from left atrium to right atrium and causes hypertrophy of the right atrium, right ventricle, pulmonary trunk

Front 27

Ventricular septal defect (VSD)

Back 27

failure of IV septum to develop, resulting in left-to-right shunting of blood through IV foramen, increases blood flow to the lungs and causes pulmonary hypertension

Front 28

Achalasia of esophagus

Back 28

condition of impaired esophageal contractions because of failure of relaxation of the inferior esophageal sphincter, resulting from degeneration of myenteric (Auerbach's) plexus in the esophagus

Front 29

Coarctation of the aorta

Back 29

aorta is abnormally constricted just inferior to the ductus arteriosus, in which case an adequate collateral circulation develops before birth; causes 1) rib notching & cerebral hemorrhage, 2) tortuous enlarged vessels, 3) elevated bp in radial a, dec in femoral a, 4) femoral pulse occurs after radial pulse;

Front 30

Stellate block

Back 30

injectino of local anesthetic near the stellate ganglion by placing the tip of the needle near the neck of the 1st rib

Front 31

injury to left recurrent laryngeal nerve

Back 31

may be caused by bronchogenic or esophageal carcinoma, enlargement of mediastinal lymph nodes, an anuerysm of the aortic arch, causing respiratory obstruction, hoarseness, inability to speak bc of paralysis of vocal cord