Abdominal Wall and Chest Pathology Flashcards
Where do superficial hematomas usually occur?
Rectus sheath
Patient symptoms of a rectus sheath hematoma?
- Ecchymosis (discolouration) of abdominal wall
- Decreased hematocrit
Where is there a lack of posterior rectus sheath?
Below arcuate line
What are abscesses in the abdominal wall usually caused by?
Trauma or post-surgical infections
How are abscesses typically treated?
Antibiotics
What are desmoid tumour also known as?
Aggressive Fibromatosis
What are desmoid tumours often related to?
Pregnancy
What are desmoid tumours made of? Where are they typically located?
Fibrous tissue. Anterior abdominal wall in the muscle, fascia, and aponeuroses
What tumour may have a high recurrence rate after surgery?
Desmoid tumour
SF of desmoid tumour?
- Hypoechoic
- Homogenous
- Some vascularity
- Through transmission
What are endometriomas of the abdominal wall also called?
Chocolate cysts
What pathology can transform into a sarcoma?
Endometriomas
What are the usual causes of endometriomas?
C-section, from the scar
With what pathology will a patient feel pain associated with the menstrual cycle?
Endometrioma
SF of endometriomas of abdominal wall?
- Hypoechoic
- Spiculated
- Solid or cystic
- Vascular
What are the three types of sarcomas?
- Liposarcoma
- Rhabdomyosarcoma
- Fibrosarcoma
High incidence of recurrence and post excision requiring radiation therapy to lower chances of recurrence in what pathology?
Sarcomas
What is known as cancer of the soft tissues?
Sarcoma
What pathology is known as a defect in the abdominal wall where abdominal contents protrude outwards?
Hernia
What is the main component of a hernia?
Fat
What are the most common ventral hernias in children and adults?
Children: Umbilical
Adults: Para-umbilical
What are the most common type of hernia in general?
Groin
What 3 factors contribute to a weakened abdominal wall?
- abnormal collagen metabolism
- pressure overload (obesity, heavy lifting, coughing, smoking, familial tendency or straining)
- Insufficient protein intake
What type of hernias are not considered to be ventral? (2)
Inguinal and diaphragmatic
What is diastasis recti?
Stretching of the linea alba
What is the most common ventral hernia?
Umbilical
Where do epigastric hernias occur?
The widest part of linea alba
Where do spigelian hernias occur?
Along spigelian fascia between rectus muscle and semilunar line - BELOW arcuate line
Do spigelian hernias usually occur above or below arcuate line?
BELOW
Are groin hernias more common in men or women?
Men
Where specifically do groin hernias usually occur?
Ilioinguinal crease
Unilateral hernias are more common on what side of the body?
Right
What 3 categories do groin hernias include?
- Direct
- Indirect
- Femoral
What is the most common groin hernia?
Indirect
What do indirect inguinal hernias protrude through?
A defect in the deep inguinal ring and extending into canal
Where are indirect inguinal hernias located in relation to epigastric vessels?
Laterally
Where are direct inguinal hernias located in relation to epigastric vessels?
Medially
Are femoral hernias more common in men or women?
Women
Where are femoral hernias located?
Medial to the femoral vein and inferior to
the inguinal ligament and usually on the right side
How do you tell if a hernia is reducable on ultrasound?
Use pressure with the probe to see if it gets sucked back into where it came from
How do we measure hernias on ultrasound?
3 planes and the neck (measurement of the break in the abdominal wall)
What are 3 hernia complications?
- Incarceration
- Obstruction
- Strangulation
SF of a strangulated hernia?
- Echogenic
- Loss of peristalsis from bowel
- No vascularity
- Thick walls
- Fluid in herniated sac
What is diaphragmatic paralysis caused by?
Damage to phrenic nerve
Patient symptoms in unilateral diaphragmatic paralysis vs bilateral
Unilateral - difficulty breathing, headaches, fatigue, dyspnea
Bilateral - Severe dyspnea - MEDICAL EMERGENCY
With diaphragmatic paralysis, you may see thickening of the diaphragm during inspiration or expiration?
Inspiration
What is diaphragm eventration?
Lack of muscle in the dome of diaphragm
What may you suspect in the diaphragm when abdominal contents rise up to it?
Eventration
What fetal abnormalities are associated with diaphragm eventration?
Trisomy 13
Trisomy 18
BWS
What abnormality of the diaphragm is a result of increased pressure in the pleural cavity?
Inversion - loss of dome shape and impaired motion
What is the most common type of congenital diaphragmatic hernia?
Bochdalek hernia - defects in the POSTERIOR attachment in the diaphragm
What is pleural effusion also known as?
Hydrothorax - fluid accumulation in pleural cavity
What are the most common causes of pleural effusion? (4)
- Cancer
- Heart failure
- Pneumonia
- PE
What is hemothorax?
Collection of blood in pleural cavity
What is pneumothorax?
Gas or air in the pleural cavity - medical emergency
Why is pneumothorax a medical emergency?
Can cause collapsed lung
What is the normal M-mode “sign” seen on ultrasound for lungs?
Sea shore sign
What is the abnormal M-mode “sign” seen on ultrasound for lungs?
Barcode sign - NO BEACH