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CPR I > CPR Test 1 > Flashcards

CPR Test 1 Flashcards

1
Q

Which are the most commonly fractured ribs?

A

middle ribs, anterior to costal angle

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2
Q

supernumerary ribs

A

extra ribs in cervical or lumbar region

TOS/ issues w brachial plexus and subclavian A or asymptomatic

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3
Q

Dislocation of ribs

A

dislocation at the Sternocostal joint

sternum and costocartliage

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4
Q

separation of ribs

A

separation at the Costochondral joint

rib and costocartilage

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5
Q

Thoracentesis

Bw what ribs?

A

pleural cavity fluid sample taken w hypodermic needle in between intercoastal nv bundle and collateral branches

ribs 9 and 10, midaxillary

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6
Q

Where do you insert a chest tub?

A

bw 5 and 6th rib

removes large amt of air, fluid, blood or pus from pleural cavity with collapsed lung/ emergency

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7
Q

thoroscopy

A

visualization/biopsy with thoracoscope inside pleural cavity

intercostal spaces 1-3

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8
Q

gastroschisis

A

protrusion of viscera to right of umbilical cord
amniotic fluid (saltly) = bad for GI
bowel is uncovered and floating in ^^
failure of lateral folds to pull gut in

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9
Q

congenital epigastric hernia

A

midline bulge covered w skin and subcut. tissue

bw xiphoid process and umbilicus

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10
Q

congenital diaphragmatic hernia

A

posterolateral defect
viscera bulge into pleural cavity that delay lung growth
on left side
failure for myoblast to partially or fully infiltrate pericardiopertioneal canal

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11
Q

Lung cancer can involve what nerves due to proximity?

A

Phrenic N., Vagus N. and Recurrent Laryngeal N.

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12
Q

treatment for lung cancer?

A

removal of a Lung (Pneumonectomy), a lobe of a lung (Lobectomy) or a specific Bronchopulmonary Segment (Segmentectomy) through a procedure called Lung Resection

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13
Q

Pleuritis

A

inflammation of the Pleura producing a roughness on the lungs making breathing difficult.
friction! sometimes can adhere parietal and visceral
sharp pain (ie w walking upstairs), deeper and increased breathing

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14
Q

pulmonary collapse

A

enough air enters the Pleural Cavity to break the surface tension between the two layers of Pleura
lung elasticity causes them to collapse

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15
Q

Pneumothorax

A

thoracic wall wound or rupture of pulmonary lesion of PC

causes entry/build up of air/pressure into the Pleural Cavity, results in a collapse of the lung

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16
Q

Hydrothorax

A

excess fluid in the Pleural Cavity, usually the result of fluid escape into the Pleural Cavity, or Pleural Effusion.

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17
Q

Hemothorax

A

blood in pleural cavity

cut of intercostal vessel/internal thoracic vessel

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18
Q

bronchial asthma

A

widespread narrowing of the airways produced by contraction of smooth muscle, edema of the mucosa and mucus in the lumen of the Bronchi and Bronchioles

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19
Q

Bronchoscopy

A

insertion of a Bronchoscope into the trachea to visualize the Main Bronchi.

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20
Q

laryngeal atresia

A

failure of recanalization of larynx
CHAOS syndrome (obstruction of upper fetal airway)
airways dilated, lung enlarged, filled w fluid
diaphragm flattened/inverted, fetal ascites/hydrops

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21
Q

tracheoesophageal fistual

A

connection bw trachea and esophagus (most common LRT)
failed foregut endoderm to proliferate rapidly
cant swallow, drools, regurgitation, GI reflux
polyhydramnios

associated with esophageal atresia

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22
Q

pulmonary agenesis

A 
unilateral agenesis (lack lung, lobe, bronchi)
resp bud fail to split into bronchial buds
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23
Q

oligohydramnios

A

insufficient amniotic fluid production, severe retards lung devlp
assoc w renal agenesis/failure

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24
Q

pulmonary hypoplasia

A

restriction of fetal thorax (uterine pressure)
affects stretch recpt and lung growth
decreased hydraulic pressure on lungs

higher risk of oligohydramnios <26 weeks

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25
Q

resp distress syndrome

A 
rapid labored breaking 
surfactant deficiency (lung underinflated)
tachy/nasal flaring, suprasternal/intercostal/subcostal retractions, grunts/cyanosis
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26
Q

congenital lung cysts

A

fluid or air filled
bronchial develp. disturbance
wheezing, cyanosis, diff breathing

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27
Q

bronchospasm

A

constriction of smooth m in bronchioles

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28
Q

emphysema

A

perm enlargement of air spaces distal to term bronchiole, narrowing of bronchioles, destruction of alveolar walls
loss of gas exchange bc decrease SA
dyspnea, cough, wt loss

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29
Q

PNA

A

inflamed lung tissue, filled w WBC (neutrophils), rbc, fibrin
big capillaries w lots rbcs
looks red/firm/heavy
fever chills, cough, decreased breath sounds, crackles in lungs

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30
Q

What is abnormal bv/lymphatic capillary growth via vasculogenesis called?

A

Angiomas
ex: capillary hemangioma (lots caps), cavernous hemangioma (lots venous sinuses)

form from mesenchyme, regress on their own
common in head and neck

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31
Q

What is called to have a right sided L ventricle?

A

ventricular inversion

ventricle folds to the right, outflow tract is on L

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32
Q

What is the name of a total heart reversal? Partial? Right heart, normal GI?

A

heterotaxia
situs inversus - total, every body organ if filled to opposite side, no consequence
situs ambiguous - partial, some organs, issue w/ venous return
r heart, norm gi - visceroatrial heterotaxia (inflow, outflow problems)

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33
Q

What happens when the AV septum fails to fuse?

A

persistent AV canal (agnesis of av valves)

pulmonary hypertension, hard to exercise, SOB, cardiac congestion, endocarditis risk, linked down syndrome

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34
Q

What color does the skin changed to due to low o2 in the blood? symptoms?

A

blue - cyanosis
clubbed fingers, blue fingernail beds/lips, tired, fatigue
from mixing of blood

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35
Q

What is it when you have insufficient shifting of AV septum or cardiac looping? symptoms?

A

Double outlet right ventricle
pulmonary a and aorta exit R ventricle, with VSD

symptoms: cyanosis, breathlessness, murmur, and poor weight gain

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36
Q

Tetralogy of fallot

A

conotruncal ridges off center formation = aorta/pulm trunk are unequal
pulmonary stenosis, aorta overrides where pulmonary a should be, VSD, RV hypertrophies (r to l shunt, cyanosis)

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37
Q

pulmonary valvular atresia

A

pulmonary a is closed off (semilunar valves closed)
patent foramen ovale and ductus arteriosus
Rv hypoplasia

38
Q

aortic valvular stenosis

A

L ventricular hypertrophy = cardiac fail and pulm hypertension
narrowing of aortic valve
male dom, congenital, degenerative, infection (RF)

39
Q

aortic valvular atresia

A

fused valves, hypoplastic LV,

big ductus arteriosus, hypertrophy RV

40
Q

What can start as asymptotic and lead to L ventricular hypertrophy over time from less cusps?

A

bicuspid aortic valve (2 instead of 3)
associated w aortic aneurysms

regurgitation, stenosis

41
Q

tricuspid atresia

A

r AV orfice destroyed
patent foramen ovale, VSD, patent ductus arteriosis, atresia of valve cusps
hypoplastic RV, hypertrophy LV

42
Q

What is underdeveloped/not formed in hypoplastic L ventricle?

A

LV, mitral valve, aortic valve, ascending portion of aorta
acts as univentricular, only using RV (univent)
patent ductus arteriosus and patent foramen ovale (ASD)

43
Q

What can you use for coronary a bypass graft?

A

great saphenous v bc easy dissection from LE, lengthy w no branching or valves, same size
or radial a

44
Q

What is coronary angioplasty do?

A

small ballon catheter flattens plaque against the wall of coronary a to increase the size of lumen for better blood flow

45
Q

What can cause pulmonary embolism? track it runs?

A

blood clot, fat globule, air bubble embolus

a vein on R side of heart to pulmonary A

46
Q

what fills bronchiolar walls during asthma

A

eosinophils, lymphocytes, mast cells

47
Q

atrial septal defect

A

L to R shunting from increased blood to lungs and decreased pulm resistantce after lungs expand

this increased blood to lung, pulm resistance, R vent hypertrophy, CHF, then r to l shunt, cyanosis

90% ostium II (secundum, high atrial septal defect)

48
Q

left to right blood shunt causes?

A

increased work load for R ventricle = hypertrophies, which causes right to left shunts, then cyanosis

49
Q

failure of contruncal ridge formation and fusion is called? caused what else to happen?

A

persistent truncus arteriosus

VSD, mix of blood, pulm congestion, RV hypertrophy, R vent pressure increase, cyanotic cond

50
Q

failed conotruncal ridges to spiral? consequences?

A

transposition of great vessels

pulm a connected to LV, aorta to RV
survives w vsd, asd, patent ductus arteriosus

51
Q

how can pt live with pulmonary valvular atresia?

A

patent ductus arteriosis used to flow of blood from aorta into pulmonary a
patent foramen ovale
transplant if hypoplasia too bad, vsd rv to left and out aorta = univentricular heart (mix of blood)

52
Q

Which lymph nodes are most associated with breast cancer?

A

Axillary Lymph Nodes (include the Pectoral, Interpectoral, Deltopectoral, Supraclavicular and Inferior Deep Cervical Lymph Nodes
also parasternal

53
Q

what is down syndrome (trisomy 21) associated with?

A

failure of atrioventricular septa to form

54
Q

lack of blood to myocardium is caused by? And can lead to?

A

block of coronary A

myocardial infarction

55
Q

building up of lipids on the internal walls of the coronary arteries does what? leading to increase likelihood?

A

decrease the size of the lumen of vessel, can cause embolus and plugging the vessel fully.

coronary atherosclerosis

56
Q

What produces a strangling pain in the chest?

A

angina pectoris

narrow or obstructed coronary arteries that produces ischemia of myocardium

57
Q

cardiac catheterization

A

insert catheter in femoral v
into inferior vena cava
to look at RA, RV, PT, Pulm a

58
Q

what ccan you do if you AV or SA node isnt working?

A

artificial cardiac pacemaker
reg electrical impulse to ventricles via electrodes in large vein to superior vena cava into RA past valve in endocardium of trabecula carnae of RV

59
Q

irregular twitching of atrial cardiac m fibers

A

atrial fibillation

60
Q

irregular twitching of ventricle cardiac m fibers - not able to pump blood

A

ventricular fibillation

61
Q

what can you do for ventricular fibrilliation

A

defibrillation - electric shock by electrodes to cease movement in hopes it starts back up again

62
Q

Cardiac Referred Pain

A

Ischemia stimulates visceral pain sensory fibers in the heart of the Autonomic Nervous system. These visceral sensory fibers often share a spinal ganglion with the somatic sensory fibers of areas such as the upper limb and superior lateral chest wall.

63
Q

Anginal pain is typically referred to the area innervated by

A

Left Medial Brachial Cutaneous nerve, the left substernal area, left pectoral area and medial aspect of the left upper limb are often involved in this variety of referred pain.

64
Q

What is used to treat heart failure? and what is the mechanism?

A

Cardiac glycosides

inhibit Na/K atpase K binding site, increase Na, decrease Ca out (increase of ca inside to SERCA), positive inotropic effect

65
Q

Cardiac Failure causes what to happen first in the heart? And then follows with?

A

negative inotropic effect
decreased inotropy and vas compliance, increase of Blood Volume and SVR/TPR
first decreases cardiac output, then increases volume to compensate

66
Q

Inflammation of the pericardium? Causes?

A

Pericarditis
causes friction on the heart and if not treated, can calcify

can also lead to pericardial effusion

67
Q

Pericardial Effusion leads to?

A 
cardiac tamponade (heart compression) makes it beat harder
accumulation of fluid or pus in the pericardial sac which can compress the heart
68
Q

Used to treat pericardial effusion/cardiac tamponade?

A

Pericardiocentesis

Drainage of blood, fluid or pus from the pericardial sac.

69
Q

where do surgeons clamp/insert tubes of a bypass machine?

A

transverse pericardial sinus

accesses area posterior to aorta and pulmonary trunk

70
Q

oligohydramnios (potters) sequence

A

still born childern
oligohydramnios -> fetal compression -> pulm hypoplasia, altered facies (nasal flaring, bridge wide, potter facies, limb hypoplasia, renal fail, club foot, breech presentation)

71
Q

in a rib fracture, what is most likely seen in an X-Ray?

A

hematoma at site of fracture, actually frac is hard to see
CT more sensitive

Can puncture kidney, liver (right side), and spleen (left side)

72
Q

air leaking in cavity with no outside intervention happens from?

A

spont pneumothorax
spon rupture of alveoli through vicseral pleura so air leaks into cavity
risks - smoke, copd, cystic fibrosis, inherited apical bleb
lung collapse, compress of mediastinal structure/vessel

73
Q

air entering thorax but can’t exit is?

A

tension pneumothorax
from trauma where injury fails to seal, + pressure ventilation during resuscitation
collapsed lung, impaired venous return -> cardiac arrest

74
Q

pulmonary meniscus sign

A

on surface of fluid seen with pleural effusion
due to surface tension between 2 diff fluids in pleural cavity (norm serous fluid and pleural effusion)
in costophrenic angles and substernal region

75
Q

coin sign

A

solitary round, circumscribed shadows on xray
can be calcified
symptomatic
causes: tuberculosis, neoplasms, cysts, vasc anomalies

76
Q

kerley lines

A

interlobular septa in pulmonary interstitium are prominent

lymph swelling makes them seen, pressing into CT making them dense

77
Q

kerley a vs b

A

a - diagonal lines from hila to periphery

b - short parallel lines at periphery perp to pleura

78
Q

causes of kerley lines

A

pulm edema, lymphoma, cancer, pna

79
Q

causes of cardiac tomponade

A

neoplasms, pericarditis, effusion due to renal fail, trauma
fiberous pericardium prevents overflow, and create issues when there is a build up of fluid because it can cause friction and decrease hr

80
Q

becks triad

A 
for cardiac tamponade
distant heart sounds muffled
jugular distention - restricted venous return
hypotension
signs of shock, decreased co
treat with pericardiocentsis
81
Q

cardiac tamponade can show up as what on xray

A

water bottle heart

globular heart silhouette in xray

82
Q

what do you use echocardiography for?

A

good in utero, child
adult - probe is on ant skin, red blood flow toward, blue away
color change = turbulence and can indicate mixing of blood
can indicate blood regurgitation

83
Q

What keeps the PDA open during development?

A

prostaglandins

regulated by o2 tension and blood flow -> regulates smooth m contraction

84
Q

consequences of pda?

A

lv hypertrophy, pulmonary congestion, congestive HF
treated with indomethacin or surgery
bad if mom has rubella

85
Q

aortic lumen narrowed due to abnormal thickening of the wall is? Types?

A

coarctation of aorta
aka turner’s syndrome

postductal (after da) - not noticed bc collateral circulation through intercostal arteries and internal thoracic a
preductal - collaterals not devlp, after birth little body goes to LE, pda, death often unless repaired

86
Q

aberrant origin of R subclavian

A

distal of right dorsal aorta and 7th intercostal a (intersegmental)
r AA IV, prox part of R dorsal aorta obliterated
dysphagia and dyspnea (dorsal aorta cross esophagus to reach r ue

87
Q

double aortic arch leads to?

A

esophageal dysfunction and strangulation of trachea

vascular ring around trachea and esophagus, looks like a heart shape

88
Q

right aortic arch

A

left AA IV and left dorsal aorta obliterated, replaced by vessels on r

89
Q

dysphagia and dyspnea happens in r aortic arch because?

A

l subclavian A pass behind esophagus and ligamentum arteriosum in front of trachea to reach R side

90
Q

interrupted aortic arch

A

left and right AA IV obliterated, as well as prox part of r dorsal aorta
pda, descending aorta and subclav A supplied by blood of low 02
aortic trunk supplies 2 common carotids

91
Q

what is seen in DiGeorge syndrome? dangerous?

A

interrupted aortic arch

life threatening

CPR I (12 decks)

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