Consequences Of Chronic Cough

Question 1

What is a Pneumothorax?

Answer 1

Air in the pleural cavity

Question 2

What counts as a small pneumothorax?

Answer 2

Anything under 2cm

Question 3

What is a large pneumothorax?

Answer 3

Anything greater than 2cm

Question 4

How does a pneumothorax occcur?

Answer 4

Penetrating injury to the parietal pleura or rupture to the visceral pleura.

Question 5

What happens tonight h lung after a pneumothorax has occurred?

Answer 5

The vaccine is lost and the elastic tissue of the lung recoils towards the lung root.

Question 6

How is a pneumothorax diagnosed?

Answer 6

Taking a history
Examination
CXR investigation

Question 7

What would be found during the examination if there was a pneumothorax?

Answer 7

Reduced ipsilateral chest expansion and breath sounds. Along with hyper resonance on percussion.

Question 8

What would be seen on the CXR of someone with a pneumothorax?

Answer 8

Absent lung markings peripherally as well as a visible lung edge.

Question 9

What happens during a tension pneumothorax?

Answer 9

As the amount of air in the pleural space increases, the lung collapses towards the route.
Eventually the air build up puts pressure on the mediastinal structures.

Question 10

What is seen in a mediastinal shift as a result of a tension pneumothorax?

Answer 10

Tracheal deviation away from side of unilateral tension pneumothorax.
Hypotension and SPV is compressed which reduces the venous return to the heart.

Question 11

How should a tension pneumothorax be managed?

Answer 11

Needle aspiration (thoracentisis)
Siting of a chest drain

Question 12

For both needle aspiration and chest drain where should they be placed and what do the go through.

Answer 12

4th and 5th intercostal space through the midaxillary line.

Goes through skin, superficial/deep fascia, 3 layers of intercostal muscles as well as the parietal pleura.

Question 13

Where is the safe triangle?

Answer 13

Anterior border of latisimus Doris, posterior border of pec maj.
the axial line is superior to the nipple.

Question 14

Where should the needle be entered?

Answer 14

Middle of intercostal space between the intercostal and collateral NVB

Question 15

What is the emergency management of a pneumothorax?

Answer 15

Inserting a large gauge cannula in to the pleural cavity via the 2nd or 3rd intercostal space in the mid clavicular line.

Question 16

What 2 factors are important in hernia development?

Answer 16

Weakness in structure

Increased pressure on one side of that part of wall

Question 17

Where are the weaknesses in the diaphragm likely to result in hernia?

Answer 17

Attachments at the Xiphoid
The posterior attachments
The oesophageal hiatus

Question 18

What is a para-oesophageal hiatus hernia?

Answer 18

Herniated pet of the stomach moves up through the oesophageal hiatus to become parallel to the oesophagus in the chest.

Question 19

What is a sliding hiatus hernia?

Answer 19

The herniated pet of the stomach slides through the oesophageal hiatus into the chest with the gastro-oesophageal junction.

Question 20

Where is the inguinal region?

Answer 20

Runs from ASIS and pubic tubercle.

Question 21

What do the inguinal ligaments make up?

Answer 21

The inferior borders of the external oblique aponeurosis.

Question 22

What are the inguinal canals?

Answer 22

4cm long tubes made from the medial halves of the floors of the inguinal canals.

Question 23

Where is the enterence to the inguinal canal?

Answer 23

The deep ring

Question 24

Where is the exit of the inguinal canal?

Answer 24

The superficial ring

Question 25

Where is the v shaped defect?

Answer 25

The external oblique aponeurosis lying superolateral to public tubercle

Question 26

Where is the deep ring located?

Answer 26

Superior to the midpoint of the inguinal canal

Question 27

Where does an inguinal hernia occur?

Answer 27

From the medial half of the inguinal region.

Can be unilateral or bilateral.

Question 28

What is the weakness from the inguinal hernia a result of?

Answer 28

The presence of the inguinal canal in the inguinal part of the anterolateral abdominal wall