Anatomical Pathological consequences of chronic cough

Question 1

What can stimulate sensory receptors in the mucosa of the respiratory tree?

Answer 1

inflammatory mediators
irritant chemicals
build up of mucous
certain drugs

Question 2

In the upright postition, which bronchi are inhaled foreign bodies most likely to go down?

Answer 2

right - most likely to get stuck in inferior lobe of right lung

Question 3

What is the name of the internal aspect of the trachea bifurcation?

Answer 3

Carina

Question 4

What can cause a pneumothorax?

Answer 4

penetrating injury to the parietal pleura or rupture of the visceral pleura

Question 5

How is pneumothorax diagnosed?

Answer 5

• clinical history
• reduced ipsilateral chest expansion
• reduced ipsilateral breath sounds
• hyper-resonance on percussion
• absent lung markings on CXR

Question 6

What can a tension pneumothorax cause?

Answer 6

Mediastinal shift away from the side of the pneumothorax

Question 7

How should a large pneumothorax be treated?

Answer 7

Use needle aspiration and a chest drain into the 4th or 5th intercostal space midaxillary line- in the safe triangle

Question 8

What is the “safe triangle”?

Answer 8

bordered by posterior border of pectoralis major, anterior border of latissimus dorsi, and the axial line superior to the nipple

Question 9

What is the emergency management of a tension pneumothorax?

Answer 9

Insert large orange/grey cannula into 2/3rd ICS midclavicular line of affected side

Question 10

What are the 2 kinds of hiatus hernia?

Answer 10

paraoesophageal and sliding

Question 11

Where are the inguinal ligaments?

Answer 11

attach between ASIS and pubic tubercle

Question 12

How is the inguinal canal formed?

Answer 12

the inguinal canal is formed embryologically during the passage of the testes or the round ligament of the uterus into the perineum

Question 13

In the adult what does the inguinal canal contain?

Answer 13

spermatic cord or round ligament of the uterus

Question 14

What do the inguinal ligaments contribute to?

Answer 14

medial haves form the floor of the inguinal canal and they are also the inferior borders of the external oblique aponeuroses

Question 15

where do the inguinal canals run between?

Answer 15

a deep ring (entrance - superior to the midpoint of the inguinal ligament) and a superficial ring (exit)

Question 16

What is the superficial ring?

Answer 16

a v shaped defect in the external oblique aponeurosis that lies superolateral to the pubic tubercle

Question 17

What is the name of the cord that helps guide the testes?

Answer 17

gubernaculum

Question 18

What is the processus vaginalis?

Answer 18

an outpouching of parietal perioneum

Question 19

What is internal spermatic fascia?

Answer 19

a covering of transversalis fascia

Question 20

What is the cremasteric fascia?

Answer 20

a covering of skeletal muscle fibres from the internal oblique onto the fascia covering the testes

Question 21

What is the external spermatic fascia?

Answer 21

a covering of external oblique aponeurosis

Question 22

What does the spermatic cord contain?

Answer 22

• Vas deferens
• Testicular artery
• Panpiniform plexus of vein
• Autonomic nerves to vas deferens and arterioles
• Genitofemoral nerve
• Lymphatics that drain from the testis

Question 23

Where does the round ligament of the uterus pass through?

Answer 23

inguinal canals into labium majus

Question 24

If it is an indirect hernia, will it reappear?

Answer 24

No

Question 25

where does a direct inguinal hernia go?

Answer 25

through hesselbach’s triangle: inguinal ligament inferiorly, inferior epigastric vessels laterally, rectus abdominis medially

Question 26

where does an indirect inguinal hernia go?

Answer 26

• passes through inguinal canal via deep ring, lateral to inferior epigastric artery and vein