4 Thoracic Red flags + systems Flashcards
What are common red flag signs?
- unaffected by spinal movement
- associated symptoms (heart burn)
- Past medical history
- Insideous onset of symptoms
What are risk factors that increase the liklihood of red flags?
- age under 20; over 50
- family history
- past personal history
- sudden, unexpected weight loss/gain
What are some visceral disorders that can be reffered in the thoracic spine?
Describe cardiac pain in the thoracic examination
- Pain form myocardium
- From decreased BF, build up of metabolites in ischemic segment of heart muscles
- Seen as tightness, substernal sensation, or pressure
- easy to point location of pain
- Aggs: exersion pain, heavy meals
- Sitting helps, laying down hurts
What is the presentation of a patient with acute myocardial infarction?
- Intolerable gripping or crushing senation under sternum. Associated diaphoresis (Sweating) and SOB
EMERGENCY ROOM ASAP
What is aortic dissetion and refferal pattern?
- causes mark distention of aortic adventitial coat
- rapid and sudden pain becomes severe
- pain unrelenting (not chaged in any position)
- Patient appears in distress and may be pale or cyanotic
- BP is often normal but distal pulses are frequently decreased or absent
- Similar to heart attach symptoms
- type A: more dissection in ascending (anterior)
- type B: less urgency and less threatening
What is angina pectoris?
- Increased pain with exertion
- regardless of location pain always worsens with exertion and relieved with rest
- Physcian referral ASAP
What is the pain pattern of pericarditis?
- Within epigastrium and left parasternal region
- diaphram irriated pain is at L trap
- acute symptoms = ER
What is mitral valve prolapse?
More common in women then men
- pain is shark or sticking
- Hear mild systolic non injection click, late holostuolic murmur
- pain non exertional and momentarily but lingers minutes to hours
- Pain in Left JAW L ARM L CHEST
More frequent in emotinal stress
What is pericarditis?
Inflammation of pericardium
- secondary to: infection, systemic dreases, tumors, drugs
- Patients present with ,ild to sever chest pain that is aggrivated by cough, respiration, thoracic motion
- Pain releived sitting and forward bending
- Fever chills weakness is common
- tachycardia and cough are variable
Describe common signs of esophageal disorders?
- irritation from foreign bodies, erosion from acid reflux, motility problems
- Gastro esophageal reflux = mild sever burning in epigastric to retro sternal area
- Pain worse at night because supine (stomach acid reflux)
- complains of brackish taste and frequent belching
What is tracheobrachial pain?
- pain from inflammation from teacheobronchial treee
- Refferal to upper portion of sternum and lateral sternum points to major ronchi
- pain with deep breathing and cough
What is pleurisy?
- Parietal pleura contains pain fibers that are conveyed through chest wall through intercostal nerves
- irritation of pleura therby results in chest wall pain
- widening of intercostal space during inspiration stretches inflamemd pleuroa and creates pain
Caused by: pneumonia, pulmonary infarction, injection into pleural space, hematomlocal spread
trauma
Felt in chest wall on site of pleurisy. Central diaphragm reffered to the neck and shoudler
What is a pulmonary embolism?
- lodging of blood clot to vascular tree
- complete: pulmonary infarction leads to consolidation and necrosis of lung
- MEDICAL EMERGENCY
- Thrombus formation occurs at distant site deep venous system or subclavian vein in arm
What are predisposing factors for pulmonary embolism?
- Recent surgery <1 month
- Trauma
- Immobilization
- Cancer
- Pregnancy
- Oral contraceptive
- Advanced age
- Unilateral extremity swelling and chest pain
