Anterior Chest Wall Flashcards
Distal to left subclavian artery & Ligamentum arteriosum
⬆️ BP to upper extremities & ⬇️ femoral artery pulses
Collateral circulation:
- internal thoracic artery –> intercostal artery –> superior epigastric artery –> inferior epigastric artery –> external iliac artery
- these arteries become dilated –> rib notching in dilatation of intercostals artery
Postductual coarctation of aorta
Insertion of central venous catheter
Access to SVC & right side of the heart to monitor BP, long-term parenteral feeding, administer drugs
Internal jugular vein & subclavian vein usually
Complications: puncture of subclavian artery, pneumothorax, hemothorax, trauma to the trunks of brachial plexus, arrhythmia, venous thrombosis, erosion of catheter through SVC, tricuspid valve damage, infection
Less common, proximal to ductus arteriosus, blood reached the lower part of the body aneurysm of the aorta
- felt by palpitation the trachea at sternal notch (T2)
Preductal coarctation
From deceleration
Aorta tears just distal to the left subclavian artery through tunica intima & media
Aortic disruption
Knife wound above the clavicle may damage the ff structures
Subclavian artery
Brachial plexus, lower trunk –> loss of hand movement (ulnar nerve), sensory loss over medial aspect arm, forearm & last 2 digits (C8 & T1 dermatomes)
Cervical pleura & apex of the lung –> open pneumothorax, collapse of the lung
Projection of diaphragm on the chest wall
Central tendon
- posterior to xiphoidsternal joint
Right dome
- arches superiorly to upper border of rib 5, MCL
Left dome
- arches superiorly to lower border of rib 5, MCL
Cause: anomalous cervical rib –> compresses lower trunk of brachial plexus, subclavian artery or both
Thoracic outlet syndrome
Located behind the clavicle
Surrounded by pleura, lymph ducts & phrenic nerve
Complications: pneumothorax, lymph leakage & diaphragm paralysis
Scalene lymph node biopsy
