Anatomy 3 - Consequences of a Chronic Cough Flashcards
What lobe of what lung do foreign bodies tend to be inhaled into in the upright patient?
The inferior lobe of the right lung (right bronchus has a larger diameter, more vertical orientation and a shorter length)
What is the name of the internal aspect of the tracheal birfurcation?
Carina
What is a pneumothorax?
The presence of air in the pleural cavity causing the lung to collapse
What are 3 types of pneumothoraxes with explanation?
Spontaneous = no apparent cause (in an otherwise healthy person)Traumatic = result of an injury Tension = breach in the lung surface acts as a one way valve allowing air to move into the pleural cavity during inhalation but preventing it from moving out during exhalation
What is a bulla?
A thin-walled air-filled space within the lung, arising congenitally or in emphysema
What size is a small pneumothorax?
Less than 2cm
What happens when a small amount of air enters the pleural cavity (either due to a penetrating injury to the parietal pleura or due to rupture of the visceral pleura) leading to the lung collapsing?
The vacuum is lost and the elastic lung tissue recoils towards the lung root (if only a small pneumothorax there will only be a
Examination findings when a pneumothorax is present? (3)
Reduced ipsilateral chest expansion and breath soundsHyper-resonance on percussion
What are the 2 features of a pneumothorax on a chest x-ray?
Absent lung markings peripherally and lung edge invisible
What does the build up of air in the pleural cavity eventually lead to in a tension pneumothorax?
Pleural cavity applies pressure (tension) to the mediastinal structures eventually causing mediastinal shift compressing the heart and left lung
What happens to the trachea in a tension pneumothorax?
Tracheal deviation away from he side of a unilateral tension pneumothorax
Why does a tension pneumothorax lead to hypotension?
SVC compression reduces venous return to the heart leading to hypotension
What is the treatment of a large pneumothorax?
Needle aspiration (thoracentesis)sitting of a chest drain
Why is the a chest drain inserted in the 4th or 5th intercostal space midaxillary line?
This is the “safe traingle” - anterior border of latissimus dorsi and the posterior border of the pectoralis major
When carrying out thoracentesis, where should you aim to place the needle?
Just above the rib below in order to keep away from the NVB
Emergency management of a tension pneumothorax?
Insert a large gauge cannula (grey/orange) into the pleural cavity via the 2nd or 3rd intercostal space in the midclavicular line on the side of the tension pneumothorax
What is the most likely consequence of a chronic cough?
Herniae
What are the 2 factors usually required for the development of a hernia?
Weakness of one structure (usually a part of the body wall)Increased pressure on one side of the part of the wall (e.g. chronic cough)