General Flashcards
How do you do chest drain?
Clean Local anaesthetic over a rib Find depth of entry 4-5mm incision insert needle into pleural space detach syringe and angle needle towards apex (for pneumothorax) or base (for fluid drainage) of pleural cavity insert guide wire into hub of needle remove needle, leave guide wire in insert dilator and remove guide wire insert catheter connect pleural drain via three way tap to drainage system secure drain using a suture
How do you know when you have entered the pleural cavity with a needle? What should you note at this point?
sudden aspiration of air
Depth of entry
How will you notice entry into the parietal pleura using a needle? How do you confirm this?
Slight loss of resistance
Aspiration of air and/or pleural fluid
How will you notice entry into the parietal pleura using a needle? How do you confirm this?
Slight loss of resistance
Aspiration of air and/or pleural fluid
What are the 3 key respiratory causes of clubbing?
Malignancy - lung cancer pleural mesothelioma
Interstitial lung disease - pulmonary fibrosis, pneumonitis (inflammation of alveoli walls)
Suppurative lung disease - (pus) bronchiectasis, lung abscess, empyema, CF
What is pectus carinatum and what condition is it associated with?
Pigeon chest - breast bone pushed out Marfan syndrome (connective tissue disease causes outgrowth of costal cartilage)
What is pectus excarvatum? What problems can this cause?
Sternum is sunken into the chest
Heart and lung problems
What vertebra level is sternal angle?
T4
What structures lie at the level of the sternal angle? RATPLANT
Rib 2 Aortic arch Trachea bifurcation Pulmonary trunk bifurcation Laryngeal nerve Azygous vein Nerves - cardiac plexus Thoracic duct
What is dextrocardia?
Apex beat in 5th right intercostal space
heart apex points right because of abnormal gastrulation
