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medicine year 1 and 2 > case 6 > Flashcards

case 6 Flashcards

1
Q

what type of cells are type 1 glomus cells derived from embryologically?

A

nerve cells

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2
Q

what is the sternal notch also called?

A

the jugular notch

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3
Q

what are large cell carcinomas?

A

Epithelial tumours that lack the cytological features of small cell carcinoma and have no glandular or squamous differentiation.

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4
Q

what is the presentation of pneumothorax?

A

Unilateral pleuritic pain with increasing breathlessness and possible cyanosis.

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5
Q

what are the features of pneumothorax on exam?

A

↓ chest expansion
↓/absent breath sounds
Hyper-resonance on percussion

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6
Q

what is one way to treat a pneumothorax? (esp a big one where the patient’s struggling to breathe)

A

chest drain-a small plastic tube may be inserted into the pleural space to remove air-collapsed lung will reinflate as pressure on the lung decreases.

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7
Q

what is the criteria for pulsus paradoxicus?

A

drop in BP of >10mmHg on inspiration

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8
Q

what is frank blood?

A

when a blood vessel bleeds and the same blood is seen outside the body.

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9
Q

what is chylothorax?

A

Presence of lymphatic fluid in the pleural space

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10
Q

what is the annual incidence of PE?

A

around 3-4 per 10,000 people

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11
Q

what are crepitations?

A

crackles

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12
Q

what does GORD stand for?

A

gastro oesophageal reflux disease

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13
Q

why might the trachea deviate to the right?

A

left sided tension pneumothorax
right sided lobar collapse
right sided pneumonectomy
large left sided pleural effusion

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14
Q

what is a pneumonectomy?

A

surgery to remove a lung

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15
Q

what are the examination findings you would expect to find in a patient with a right lower lobe pneumonia?

A

Dullness to percussion right lower zone, crackles right lower zone, increased vocal resonance right lower zone, bronchial breathing

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16
Q

what are the unique symptoms of pancoast tumours?

A

shoulder pain

horners syndrome

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17
Q

What is horners syndrome?

A

unilateral:
ptosis- eyelid drooping
miosis- pupils constricted
anhidrosis - can’t sweat

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18
Q

what is the one bone in the body that isn’t connected to another bone?

A

hyoid bone (at the top of the larynx).

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19
Q

what is a crus?

A

a leg like structure (crus means leg in latin)

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20
Q

how many ribs do we have in total?

A

24

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21
Q

what does costal mean?

A

referring to the ribs

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22
Q

what does chondral refer to?

A

cartilage.

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23
Q

what is the thoracic wall?

A

the structure that surrounds and forms the boundaries of the thoracic cavity.

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24
Q

what are the openings of the thoracic wall?

A

1) superior thoracic aperture

2) inferior thoracic aperture.

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25
what is the thoracic wall made up of?
thoracic cage intercostal spaces + their contents thoracic muscles
26
how many intercostal spaces on each side?
11
27
what are the 4 stages of physiological respiration?
pulmonary ventilation external gaseous exchange (in alveoli) gas transport internal gas exchange (in capillaries)
28
what do type 1 glomus cells do?
secretory sensory neuronal cells that release neurotransmitter in response to hypoxaemia. the neurotransmitter regulates the rate of firing of carotid body afferent fibres from cranial nerve 9 (glossopharyngeal).
29
COPD is characterised by...
the obstruction of lung airflow which isn't fully reversible.
30
what are the 3 main types of joints?
cartilaginous-connect structures by cartilage fibrous-by fibrous connective tissue synovial-between structures that aren't directly joined but surrounded by a joint capsule containing synovial fluid.
31
what are the 3 classes of joint based on the degree of movement they allow?
synarthrosis-immovable amphiarthrosis-slightly moveable diarthrosis-freely moveable
32
what are the 2 types of cartilaginous joints?
``` primary cartilaginous (synchondrosis)-hyaline cartilage secondary cartilaginous (symphysis)-fibrocartilage ```
33
what is a1 antitrypsin defiency and its relevance?
genetic disorder, a cause of copd | a1 antitrypsin inhibits proteases, without it there is increased action of proteases which leads to copd.
34
what are splanchnic nerves?
paired visceral nerves carrying fibres of the autonomic nervous system and sensory fibres. all sympathetic apart from pelvic (parasympathetic).
35
what makes up the upper respiratory tract?
nose, nasal cavity, pharynx, larynx (larynx sometimes called lower respiratory)
36
what makes up the lower respiratory tract?
trachea, bronchi, lungs
37
what is the trachea held open by?
c shaped cartilage rings
38
what happens to cartilage as you go down the RT?
trachea-c shaped, bronchi, cartilage rings, cartilage reduces as bronchi branch further, no cartilage in bronchioles.
39
what nerves innervate the parietal pleura?
phrenic and intercostal nerves
40
what nerves innervate the visceral pleura?
pulmonary plexus (sympathetic trunk and vagus nerve)
41
what can each of the pleura sense?
parietal- pressure, pain, temperature | visceral-stretch
42
what arteries supply the pleura?
visceral-bronchial | parietal-intercostal
43
about how many degrees is the sternal angle?
163
44
how can you remember what structures are under the sternal angle?
``` RAT PLANT: rib 2 aortic arch tracheal bifurcation pulmonary trunk ligamentum arteriosum azygous vein nerves thoracic duct ```
45
what pattern of breathlessness does pulmonary fibrosis cause?
a slow insidious increase in breathlessness
46
what is it called when u have too many platelets?
thrombocytosis
47
what do you have to remember when testing for lung cancer using a CXR?
they miss 1/5!! if u strongly suspect lung cancer, do a CT.
48
what are the 2 theories underpinning neuronal control of ventilation?
neuronal network theory | pacemaker theory
49
what is pacemaker theory and its support?
pacemaker cells which fire and discharge rhythmically in the brain control ventilation supported by rhythmic firing of cells in pre-botzinger complex.
50
what are some of the cons of pacemaker theory?
if it was correct, how would it respond to metabolic changes? raises issues about how to integrate with other functions like speech-too simple
51
what happens in asbestosis?
breathe in asbestos-can cause scarring and thickening of alveoli-lungs shrink and harden-lower lung capacity-dyspnoea+can cause cough, wheeze, fatigue, chest pain.
52
what are pain receptors called?
nociceptors
53
in obstructive lung disease what happens to the FEV1 and the FVC and the ratio?
both decrease but FEV decreases more | lower FEV1/FVC ratio
54
you're 3x more likely to stop smoking if...
u use a combination of stop smoking treatment and specialist help
55
what are 3 examples of stop smoking treatment?
nicotine replacement therapy eg gums, sprays stop smoking medication eg varenidine (champix-stops pleasurable effects of nicotine on the brain) e cigarettes
56
what is paraneoplastic syndrome?
set of symptoms that occur with cancer due to substances a tumour secretes or to the body's response to the tumour.
57
what is a pancoast tumour?
tumour growth (typically squamous carcinoma) in apical region of lungs. unique set of symptoms.
58
how do you treat tension pneumothorax?
wide bore cannula into 2nd intercostal space at midclavicular line-needle thoracentesis
59
what are the clinical features of tension penumothorax?
``` severe signs and symptoms of respiratory distress and mediastinal shift: tracheal deviation (away from site) tachycardia >135bpm pulsus paradoxicus hypotension increased jvp ```
60
what is pulsus paradoxicus?
abnormally large decrease in stroke volume, bp, and pulse wave amplitude on inspiration.
61
what are some of the causes of haemothorax?
chest trauma, cancer, PE (less common)
62
what is empyema?
presence of pus in the intrapleural space
63
what causes empyema?
it's secondary to an infection-usually pneumonia.
64
what is stridor?
high pitches breathing sound resulting from a narrow or blocked airway heard on inspiration
65
what is FEV1?
measure of how much air a patient can breathe out forcefully in one second.

medicine year 1 and 2 (29 decks)

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