CSA 2 Clinicals

Question 1

flail chest

Answer 1

multiple adjacent rib fractures

paradoxical movement of chest

impairs ventilation + extremely painful

Question 2

Supernumerary Ribs

Answer 2

extra rib at C7 vertebrae

compress C8/T1 spinal nerve + subclavian artery

ischemic muscle pain + tingling + numbness of upper limb

Question 3

thoracotomy

Answer 3

surgical opening of the thoracic wall to enter pleura cavity

Question 4

median sternotomy

Answer 4

gain access to the thoracic cavity by splitting the sternum into two

Question 5

pneumonectomy

lobectomy

segmentectomy

Answer 5

removal of a lung

removal of a lobe

removal of a bronchopulmonary segment

side note leave periosteum, the rib will regenerate

Question 6

thoracic outlet syndrome

Answer 6

pallor + coldness of skin of upper limb + diminished radial pulse

due to compression of subclavian artery

Question 7

paralysis of diaphragm

Answer 7

diaphragm to phrenic nerve that causes paradoxical movements

paralyzed side is pushed superiorly by abd viscera

Question 8

herpes zoster infection

Answer 8

viral disease that spreads along the dermatome invading the spinal ganglion

extremely painful w. red vesicular eruptions on skin

Question 9

intercostal nerve block

Answer 9

local anesthesia injected into the intercostal nerve area of 2+ adjacent intercostal spaces

Question 10

atelectasis (lung collapse)

Answer 10

air enters pleural cavity increasing surface tension

pleural cavity becomes a real space

Question 11

pneumothorax

hydrothorax

hemothorax

chlyothorax

Answer 11

entry of air into the pleural cavity

entry of fluid

entry of blood

entry of lymph

Question 12

pleuritis

Answer 12

inflammation of the pleurae

audible lung sounds due to pleural rub

extremely painful (stabbing)

Question 13

thoracentesis

Answer 13

removal of blood or pleural fluid form pleural cavity

Question 14

percussion of lungs

Answer 14

air-filled = resonant sound

fluid-filled = dull sound

solid = flat sound

Question 15

aspiration of foreign body

Answer 15

right bronchus is wider and shorter

more likely to lodge in right bronchus

Question 16

pulmonary embolism (PE)

Answer 16

obstruction of pulmonary artery by embolus

Question 17

inhalation of carbon particles

Answer 17

color the surface of the lung + associated lymph nodes

Question 18

pericarditis + pericardial effusion

Answer 18

inflammation of the pericardium

causes chest pain

accumulation of fluid in the pericardium

Question 19

cardiac tamponade

pericardiocentesis

Answer 19

compression of the heart due to pericardial effusion

fibrous pericardium is inflexible, tough, + inelastic

drainage of fluid from the pericardium using a wide-bore needle

completed at the 5th / 6th intercostal space near sternum

Question 20

ASD + VSD

Answer 20

septal defects that allow for shunting of blood btw two sides of the heart

large ASD + VSDs allows oxygenated blood from the lungs to be shunted to the right atrium and mix w. deoxygenated blood

Question 21

valvular stenosis or insufficiency/regurgitation

Answer 21

valvular stenosis is failure of a valve to open fully

valvular regurgitation failure of the valve to close fully

both cause turbulence w. vessel + increase workload on heart

Question 22

prolapsed mitral valve

Answer 22

insufficient or incompetent where one or both leaflets are enlarged or floppy

blood regurgitates into the left atrium when ventricle contracts

characteristic murmur

Question 23

aortic valve stenosis

Answer 23

results in LVH

caused by degenerative calcification

Question 24

pulmonary valve stenosis

Answer 24

valve cusps are narrowed + fused forming a central dome opening

results in underdeveloped conus arteriosus causing restriction of the right ventricular outflow tract

Question 25

CAD

Coronary Artery Disease

Answer 25

leading cause of death in the US

reduced blood supply to the heart

Question 26

Myocardial Infarction (MI)

Answer 26

coronary blood vessels become infarcted + undergo necrosis

to three offenders LAD, RCA, circumflex branch of LCA

Question 27

atherosclerosis

Answer 27

lipid (plaque) deposition w.i. coronary arteries

causes stenosis of the lumen

Question 28

coarctation of aorta

Answer 28

stenosis or narrowing of the arch or descending portion of the aorta

pre vs post-ductal coarctation

post-ductal has good collateral circulation

pre-ductal usually PDA present