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Respiratory Anatomy & Disease Mechanisms > Consequences of chronic coughing (ANATOMY) > Flashcards

Consequences of chronic coughing (ANATOMY) Flashcards

1
Q

What is a pneumothorax?

A

Air in the pleural cavity

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2
Q

How can dynamic airway compression in asthma lead to a pneumothorax?

A

Expiration is difficult and the build-up of air trapped in alveoli can lead to rupture of lung & visceral pleura

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3
Q

By which mechanism is a pneumothorax developed?

A

Penetrating injury to parietal pleura or rupture of visceral pleura > loss of vacuum > elastic recoil of lungs towards lung root > pneumothorax

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4
Q

What classifies a small pneumothorax?

A

<2 cm between lungs and parietal pleura

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5
Q

What classifies a large pneumothorax?

A

> 2 cm between lungs and parietal pleura

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6
Q

How is a pneumothorax diagnosed by examination?

A

Reduced ipsilateral chest expansion
Reduced ipsilateral breath sounds
Hyper-resonance on percussion

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7
Q

How can a pneumothorax be diagnosed by investigation via a CXR?

A

Absent lung markings peripherally

Visible lung edge

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8
Q

How does a tension pneumothorax develop?

A

Torn pleura creating a one-way valve allowing air to enter pleural cavity on inspiration but not expiration

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9
Q

What consequence can follow a tension pneumothorax?

A

Mediastinal shift

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10
Q

How can mediastinal shift, and therefore a tension pneumothorax, be diagnosed?

A

Deviation of the trachea - palpable on jugular notch

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11
Q

What is the consequence of mediastinal shift?

A

SVC compression reduces venous return to the heart causing hypotension

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12
Q

How is a large pneumothorax managed (2)?

A 
Needle aspiration (thoracentesis)
Siting of chest drain
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13
Q

Where should the needle enter to relieve a large pneumothorax?

A

4th or 5th intercostal space in the mid-axilliary line

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14
Q

Why do you have to perform a thoracentesis absolutely centred in the intercostal space?

A

To avoid intercostal neuromuscular bundle

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15
Q

What are the borders of the SAFE TRIANGLE for a thoracentesis?

A

Anterior border of latissimus doors
Posterior border of pectoralis major
Axial line superior to nipple

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16
Q

How would you emergency manage a tension pneumothorax?

A

Insert large gauge cannula into pleural cavity via 2nd or 3rd intercostal space in the mid-clavicular line on the side of the tension pneumothorax

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17
Q

What is a hernia?

A

Any structure passing through another (i.e. ending up in the wrong place)

18
Q

What is required for a hernia to develop?

A

Weakness of one structure (normal/congenital/surgical scar) + increased pressure on one side of that part of the wall

19
Q

Why can a chronic cough cause a hernia?

A

Regular increase in intra-abdonimal pressure on diaphragm, anterolateral abdominal walls (including inguinal region + femoral triangle)

20
Q

Where do diaphragmatic hernia tend to develop?

A

Xiphoid attachment
Posterior attachments
Oesophageal hiatus

21
Q

What distinguishes a paraoesophagheal hiatus hernia?

A

herniated pert of stomach passes through oesophageal hiatus to become parallel to the oesophagus in the chest - Gastro-oesophageal junction doesn’t move

22
Q

What distinguishes a sliding hiatus hernia?

A

Herniated part of the stomach slides through oesophageal hiatus into the chest with the gastro-oesophageal junction

23
Q

Where do inguinal hernias occur?

A

Uni-/bilateral

Medial halves of inguinal region

24
Q

What weakness and which pressure cause inguinal hernias?

A 
Weakness = presence of inguinal canal 
Pressure = intra-abdominal
25
Q

What can cause an inguinal hernia?

A

Chronic cough or constipation
Occupational heavy lifting
Athletic effort

26
Q

Where is the inguinal canal?

A

Between deep ring and superficial ring

27
Q

Where is the inguinal region?

A

between anterior superior iliac spine and pubic tubercle

28
Q

What guides the testicle from its origin point in the abdomen down through the abdominal wall into the scrotum?

A

The gubernaculum

29
Q

How does the testicle descend from the abdomen to the scrotum?

A

Testicle starts to push into transversalis fascia (drags some with its) > bypasses transverse abdominus > crosses internal oblique (drags some with) > passes through superficial ring of pubic tubercle > passes through superficial fascia (drags some with)

30
Q

What does the layer of transversals fascia become known as when covering the testis?

A

Internal spermatic fascia

31
Q

What does superficial fascia become known as later on when it covers the testis?

A

External spermatic fascia (covering of external oblique aponeurosis)

32
Q

What does the internal oblique become known as later on when it covers the testis?

A

Cremasteric fascia

33
Q

The structures that the testes dragged with it become known as the ____

A

spermatic cord

34
Q

Small part of peritoneum remained in scrotum after descending of testis becomes known as the ______

A

tunica vaginalis

35
Q

The point between the deep & superficial is the _____

A

inguinal canal

36
Q

The deep ring is where the the testes pushed into the ________

A

transversals fascia

37
Q

The superficial rings is where the testes pushed into the _______ of the scrotum

A

superficial fascia

38
Q

What does the spermatic cord contain?

A

Vas deferens
Tsticular artery
Pampiniform plexus

39
Q

What is the function of the venous pampiniform plexus in the testes?

A

Venous drainage

40
Q

What is the function of the testicular vein?

A

Testicular perfusion

41
Q

What is the function of the vas deferens?

A

Transports sperm

42
Q

What are the boundaries of the femoral canal?

A 
Anterior =  inguinal ligament 
Medial = lacunar ligament 
Lateral = femoral vein
Posterior = pectinate ligament

Respiratory Anatomy & Disease Mechanisms (13 decks)

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