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Anatomy > Clinical Correlations- Exam 3 > Flashcards

Clinical Correlations- Exam 3 Flashcards

1
Q

Simple Rib Fracture

A

Affects Ribs 4-10

  • Blunt or penetrating trauma to chest wall
  • Angle of Rib is prone to fracture

Treatment is pain control and respiratory care

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2
Q

Thoracic Outlet Syndrome

A

Positional, intermittent compression of the Brachial Plexus and/or Subclavian Artery or Vein

Costoclavicular Syndrome:
-Clavicle compressing vessels from the neck

Scalenes-Anticus Syndrome:
-Scalene muscles compressing vessels from the neck

Hyperabduction Syndrome:
-Pectoralis minor compressing vessels from the neck

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3
Q

Neurogenic Thoracic Outlet Syndrome

A
  • Most common type of TOS
  • Compression of the Brachial Plexus
  • Pain, numbness, weakness
  • Treated with Physical Therapy
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4
Q

Venous Thoracic Outlet Syndrome

A
  • Compression of the Subclavian Vein
  • Extremity swelling, Deep Vein Thrombosis
  • Treated with Thrombolysis and surgery
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5
Q

Arterial Thoracic Outlet Syndrome

A
  • Compression of the Subclavian Artery
  • Pain with exertion, thromboembolism
  • Treated with surgery
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6
Q

Paralyzed Diaphragm

A
  • Lesion or compression of the Phrenic Nerve
  • Diaphragm will rise on inspiration instead of depress due to unopposed pressure from abdominal viscera
  • Rises on same side as Phrenic injury
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7
Q

Pulmonary Collapse

A

Penetration through thoracic wall and parietal pleura admitting air and causing lung to collapse

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8
Q

Secondary Atelectasis

A

Penetrating wound through Parietal Pleura breaking the tension that holds the Parietal and Visceral Pleura together causing the lung to collapse

  • Can be seen on x-ray during inspiration
  • Diaphragm elevates, organs shift in the mediastinum
  • Lung appears whiter and surrounding space is darker
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9
Q

Open Pneumothorax

A

Clean wound that allows air to enter & exit the cavity

  • Mediastinal shift on inspiration that corrects itself on expiration
  • Chest pain, shortness of breath, cyanosis
  • Unilateral diminished breath sounds

Treatment includes:

  • Occlusive dressing
  • Tube thoracostomy
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10
Q

Tension Pneumothorax

A

Wound where air enters but cannot exit thoracic cavity

  • Mediastinal shift cannot fix itself putting pressure on opposite lung decreasing ventilation
  • Pressure increases with each breath

Treatment includes:

  • Needle thoracostomy
  • Tube thoracostomy
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11
Q

Tube Thoracostomy

A

Incision in thoracic cavity to insert a chest tube for drainage of fluid or air

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12
Q

Thoracocentesis

A

Inserting a needle in thoracic cavity to remove fluid from the costodiaphragmatic recess

-Insert needle below the 9th rib in the mid-axillary space angled upwards to avoid the diaphragm

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13
Q

Bronchoscopy

A

Using an endoscope to view the interior of the tracheobronchial tree for:

  • Abnormalities/growths
  • Foreign objects
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14
Q

Transverse Pericardial Sinus

A

Space behind Aorta and Pulmonary Trunk crossing in front of the Superior Vena Cava

-Space allows cardiac surgeons to clamp the Aorta

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15
Q

Cardiac Tamponade

A

Fluid accumulation between the Visceral and Parietal layers of the pericardium
-Puts pressure on the Heart as it beats because fibrous Pericardial Sac will not expand

Treated with Pericardiocentesis

  • Insert needle at 5th or 6th intercostal space at the left sternal border
  • Insert needle at the infrasternal angle
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16
Q

Mitral Valve Prolapse

A

Improper closure of the Mitral valve causing regurgitation during ventricular contraction

-Affects 1 in 20 people (mostly young females)

Characterized by:

  • Chest pain
  • Fatigue
  • Characteristic murmur
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17
Q

Referred pain of the Phrenic Nerve

A

Visceral and somatic sensory neurons synapse on the same neurons in the spinal
-Cannot distinguish messages from the arm/neck and the diaphragm

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18
Q

Coronary Atherosclerosis

A

Lipid deposits in the lining of the coronary arteries eventually resulting in stenosis

Treated with:

  • Atherectomy
  • Medications
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19
Q

Coronary Artery Disease

A

Coronary arteries are blocked or narrowed reducing blood flow to the Heart muscle

Causes angina or myocardial infarction
-Pain signal from Phrenic Nerve

20
Q

Myocardial Infarction

A

Sudden occlusion of a major coronary artery causing myocardium to undergo necrosis

  • Occurs mostly in the LAD (40-50%)
  • Second most in the Right Coronary Artery (30-40%)
  • Third most in the Circumflex Branch (15-20%)
21
Q

Cardiac Arrythmia

A

May occur if part of conducting system is damaged
-Asynchronous contraction of the heart ventricles

Can be corrected with an internal pacemaker

22
Q

Aortic Branch Variations

A

Normal branching (Left Subclavian, Left Common Carotid, and Brachiocephalic Trunk) is observed in only 65% of the population

23
Q

Aortic Coarctation

A

Stenosis of part of the Aorta

  • Can be preductal (infants) or postductal (adults)
  • Causes high pressure in the head and low pressure in the lower limbs

Leads to rib notching
-Rib gets worn down over time due to pulsating artery lying on top of bone

24
Q

DiGeorge Syndrome

A

Congenital immunodeficiency disorder caused by a deletion on Chromosome 22
-Most common cause of congenital thymic aplasia

Characterized by: (CATCH-22)

  • Cardiac Abnormalities
  • Abnormal Facies
  • Thymic Aplasia
  • Cleft Palate
  • Hypocalcemia
  • Deletion on Chromosome 22
25
Q

Liposuction

A

Removal of Camper’s Fascia using suction tube and high vacuum pressure

Considered “botched” when too much is removed leading to an uneven structure of the skin

26
Q

Patent Urachus

A

Urachus is an opening between bladder and umbilicus that should close at birth and become the Median Umbilical Ligament

If left open, bladder infections can occur from opening

Three types:

  • Urachal cyst
  • Urachal sinus
  • Urachal fistula
27
Q

Prune Belly Syndrome

A

Associated with Patent Urachus

Suspected if umbilical cord is enlarged with edema or slow to slough off

Characterized by three main features:

  • Anterior abdominal wall muscles deficient or missing
  • Urinary tract abnormalities
  • Bilateral cryptorchidism (undescended testes)

Believed to be caused by:

  • Urinary tract obstruction
  • Primary mesodermal development defect
28
Q

Variocele

A

Blockage and engorgement of the Pampiniform Venous Plexus
-Scrotum left feeling like a “Bag of worms”

Occur more on the left side because of 90 degree angle from Left Renal Vein to Left Testicular Vein

Can be caused by Nutcracker Syndrome or SMA syndrome

29
Q

Direct Inguinal Hernia

A

Herniation passes MEDIAL to inferior epigastric vessels

  • Busts in to inguinal canal through side wall
  • Only passes through Superficial Inguinal Ring
30
Q

Indirect Inguinal Hernia

A

Herniation passes LATERAL to inferior epigastric vessels

  • Passes through both Deep and Superficial Inguinal Rings
  • More than 2/3 of inguinal hernias
31
Q

Duodenal Ulcers

A
  • Ulceration of duodenal mucosa
  • Typically occurs along posterior aspect of the first part of the duodenum
  • Typically a result of Peptic Ulcer Disease, Chronic H. Pylori infection, smoking, NSAIDs
  • Gastroduodenal artery is most at risk for erosion
32
Q

Portal Hypertension

A

Resistance to portal flow through the liver leading to regurgitation

Due to:

  • Portal vein stenosis (pre-hepatic)
  • Cirrhosis (intrahepatic)
  • Right sided Heart failure (post-hepatic)

Causes:

  • Encephalopathy
  • Ascites
  • Splenomegaly
33
Q

Triangle of Calot

A

Anatomical landmark for locating the Cystic Artery

Borders:

  • Superior: Inferior border of the Liver
  • Medial: Cystic Duct
  • Lateral: Common Hepatic Duct

Contains:

  • Right Hepatic Artery
  • Cystic Artery
  • Lymphatics
34
Q

Cholelithiasis

A

Gallstones formed from insoluble compounds in Bile

Composed of:

  • Cholesterol = Yellow
  • Bilirubin = Black

Causes epigastric pain radiating to inferior shoulder

35
Q

Ligament of Treitz

A

Inferior extension from Diaphragm to Duodenum composed of skeletal and smooth muscle

Landmark for surgical procedures
-Duodenojejunal flexure

Marks tie off point for removing bowel in an autopsy

36
Q

SMA Syndrome

A

When the SMA compresses the Duodenum causing an obstruction in the GI tract
-Can also compress the Left Renal Vein

Can occur after significant weight loss, no extra fat to keep SMA extended

Patient presents with:

  • Nausea
  • Vomiting
  • Early satiety
37
Q

Appendicitis

A

Acute inflammation of the appendix

Begins as vague periumbilical pain progresses to RLQ as inflammation spreads to the mesoappendix

McBurney’s Point

  • Imaginary line from umbilicus to ASIS to palpate appendix
  • If painful when palpating, indicative of appendicitis
38
Q

Psoas Sign

A

Test for appendicitis
-Extension of the right thigh to test for pain (stretching psoas muscle will irritate the mesoappendix eliciting a response)

39
Q

Colon Cancer

A

Adenocarcinoma is most common malignancy of the GI tract

Dietary factors:

  • Low fiber diet
  • High fat and carb intake

Genetic factor:
-APC Gene

40
Q

Colostomy

A

Surgical procedure that fixes the colon to an opening on the skin

  • Done after intestinal surgery or resection
  • Waste passes through opening into collection system\
41
Q

Diverticulosis

A

Mucosa pushes out between weakened muscle fibers in the sigmoid colon making pockets

  • Fecal matter impacts the pockets causing inflammation
  • Pockets can rupture leaving fecal matter in peritoneal cavity causing peritonitis or sepsis
42
Q

Meralgia paresthetica

A

Painful neuropathy of the Lateral Femoral Cutaneous Nerve due to entrapment as it passes through the inguinal ligament

Crossover to thigh is most common site of entrapment

Occurs due to:

  • Pregnancy
  • Tight clothing
  • Obesity
43
Q

Adrenal Insufficiency

A

Adrenal glands don’t produce enough hormone

Can lead to life threatening Adrenal Crisis (especially Tertiary)

  • Low blood pressure, glucose, sodium
  • High blood potassium

Primary (Addison’s Disease)
-Adrenal glands are affected

Secondary
-Pituitary gland is affected

Tertiary

  • Hypothalamus is affected
  • Can be caused by excessive Prednisone usage
44
Q

Polycystic Kidney Disease

A

Multiple clusters of cysts on the kidneys

Can cause kidney to swell:

  • Disrupts function
  • Chronic high blood pressure
  • Kidney infections
  • Renal failure
45
Q

Kidney Stones

A

Form and become located in the Calices of the kidneys, ureters, or urinary bladder

  • If stone is sharp or larger than 3mm, it will distend the ureter and cause severe referred pain in the lumbar and inguinal regions
  • May lead to blood in the urine
46
Q

Ureteric Jets

A

Visualization of normal efflux of urine from distal end of ureter into the bladder

Used to assess obstructive uropathy

47
Q

Incontinence

A

1 in 4 people over 65 have incontinence

Stress Incontinence:

  • Increased abdominal pressure under stress
  • Weak pelvic floor muscles

Urge Incontinence:
-Involuntary contraction of bladder muscles

Overflow Incontinence:
-Blockage of the Urethra

Neurogenic Incontinence:
-Disturbed function of the nervous system

Anatomy (12 decks)

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