Chest pathology and the critical chest Flashcards
what % of the chest cavity does a normal heart occupy?
approx. 50%
what is the cardiothoracic ratio
A (width of the heart) / B (width of chest cavity)
how many lobes does the right lung have
3- right upper lobe
right middle lobe
right lower lobe
what is the line called that separates the upper and lower lobe (right and left lung)
major fissure
what is the line called that separates the upper and middle lobe (right lung)
minor fissure
how many lobes does the left lung have
2- left upper lobe
left lower lobe
what are the 5 main chest pathologies
1) cardiomegaly
2) heart failure
3) PO/Fluid overload
4) ARDS
5) Lung Cancers
what is the aetiology,causes of cardiomegaly (6 points)
1) Valve disease- MVD/AVD/TVD
2) Hypertension
3) cardiomyopathy
4) CAD
5) Myocarditis
6) Trauma/Surgery
what are the two types of heart valve disease
1) primary aortic or
2) mitral valve disease
what can valves either be (2 answers)
1)stenosed (narrowed)
2incompetent=regurgitation
what two things does heart valve disease cause
increase in pulmonary and right heart pressures
what can heart valve disease lead to
pulmonary oedema
what is the equation for blood pressure
BP= heart rate + systemic vascular resistance (SVR)
what is SVR
systemic vascular resistance
contributing factors for hypertension (8 possible)
1) family history
2) smoking
3) obesity
4) diabetes
5) kidney diseases
6) high alcohol intake
7) lack of exercise
8) certain medicines (steroids)
what can hypertension lead to
heart failure
what is dilated cardiomyopathy
enlarged heart with dilation of all 4 chambers
what is hypertrophic cardiomyopathy
asymmetrical hypertrophy of the ventricular septum (HOCM)
what is restrictive cardiomyopathy
loss of ventricular compliance. Can have normal heart size, but ventricular cavities markedly obliterated by extensive endocardial thickening
4 commons things resulting from cardiomyopathy
1) angina pectoris (chest pain)
2) syncope (fainting)
3) cardiac failure
4) sudden death
what can atherosclerosis leading to myocardial infarction (MI) cause
injury and irreversible damaged to the myocardium
what is myocarditis
an inflammation of the heart muscle
what can cause myocarditis (4 points)
1) viral infection
2) bacterial infection
3) rheumatic fever
4) toxic reaction to a drug
what can myocarditis cause (3 things)
1) damage to the heart muscle
2) the heart’s pumping action
3) a degree of heart failure
what three types of heart failure are there?
1) left ventricular failure
2) right ventricular failure
3) Biventricular failure
what happens with LVF
fluid will build up in the lungs due to congestion of the veins of the lungs-pulmonary oedema
what happens with RVF
general body vein pressure will increase and fluid will accumulate in the body, especially the tissues of the legs and abdominal organs (liver most common)- limb and abdominal oedema
what is biventricular failure and how does it occur
RVF + LVF- also known as congestive cardiac failure (CCF)
Often left heart failure leads to right heart failure, causing biventricular failure
signs and symptoms of LVF (10 possible)
1) orthopnea (SOB)
2) dyspnea/tachypnea
3) restlessness/insomnia
4) cyanosis (bluish colouration)
5) cough
6) tachycardia
7) fatigue
8) weakness
9) anorexia
10) diaphoresis (sweating)
signs and symptoms of RVF(11 possible)
`1)weight gain
2) ascites
3) abdominal distension
4) oedema
5) dilated peripheral veins
6) GI distress-nausea, vomiting, jaundice
7) Hepto/splenomegaly
8) fatigue
9) weakness
10) anorexia
11) diaphoresis (sweating)
what is ARDS
adult/acute respiratory distress syndrome
what are the 3 things of ARDS
1) called ‘shock lung’
2) sudden damage to alveoli- odematous changes
3) usually acutely ill patients- trauma, post surgery, infection
what are the 4 main types of lung cancers
1) small cell
2) non small cell (NSCLC)
3) mesothelioma
4) metastases
what are 4 types of non small cell lung cancers(NSCLC)
1) squamous cell
2) adenocarcinoma
3) large cell
4) bronchoalveolar cell carcinoma
what happens with small cell lung cancer (4 things)
1) strongly associated with smoking
2) very aggressive
3) mets very early
4) central tumour= main bronchus/lobar bronchus
what is the prognosis and treatment of NSCLC
vary depending on stage
what is the best chance of curing NSCLC
surgery for stages 1 or 2
20-25& patients
what are the two forms of treatment for non-surgical candidates with NSCLC
chemotherapy or
radiotherapy
what is the survival rate/ years of survival of stage 1a of NSCLC
82%, 5 year survival
what is the survival rate/ years of survival of stage 4 of NSCLC
10%, 1 year survival
what is mesothelioma
a rare form of cancer, is a disease in which malignant cells are found in the pleura, or peritoneum
what % of cases of mesothelioma have a history of asbestos exposure
70-80%
what are the 6 common metastases from lung cancer
1) Ca Breast
2) Testicular Ca
3) colon
4) sarcoma
5) bladder
6) prostate
what is a main sign of mets
cachexic presentation- loss of weight suddenly
what is pulmonary oedema
build up of fluid in the lungs
