Lungs & Pleura Flashcards
presence of air in pleural cavity
pneumothorax due to injuries to superior thoracic aperature (cervical pleura & apex)
collapse of a previously inflated lung
secondary atelectasis
failure of a lung to inflate at birth
primary atelectasis
how do you prevent secondary atelectasis during open chest surgery?
intubation and positive pressure pump (keeps lungs inflated during surgery)
effusion of fluid into pleural cavity
hydrothorax
blood enters pleural cavity due to chest wound hitting intercostal or internal thoracic arteries
hemothorax
insertion of needle into pleural cavity to attain sample; superior to rib
thoracentesis (9th intercostal space to avoid inferior border of lung & angle needle superiorly to avoid recess)
where would you insert a chest tube?
5th or 6th intercostal space in midaxillary line; angle superiorly to drain air or inferiorly to drain fluid
surgical excision of part of pleura
pleurectomy
induced adherence of parietal and visceral pleura to prevent secondary atelectasis from pneumothorax
pleurodesis
examination of pleural cavity
thoracoscopy
inflammation of pleura
pleuritis (detectable with stethoscope)
accessory lobe in right lung superior to hilum & separated with arch of azygos vein
azygos lobe
sites for auscultation of lungs and percussion of thorax
root of neck (apices of lungs) & inferioposterior part of inferior lobe (posterior thoracic wall at T10 level)
typical site for aspirated foreign bodies
right main bronchus
distortion of carina visualized in a bronchoscopy is indicative of?
enlarged tracheobronchial lymph nodes from bronchogenic carcinoma
surgical removal of lung
pneumonectomy
surgical removal of lobe
lobectomy
surgical removal of segment
segmentectomy
air absorbed into blood due to a blocked brochial segment, resulting in segmental collapse; adjacent segments will expand to accommodate reduced volume
segmental atelectesis
obstruction of pulmonary artery by embolus resulting in no lung perfusion
pulmonary embolism
major decrease in blood oxygen saturation —-> contralateral lung will dilate
acute respiratory distress
ischemia of visceral pleura causes?
pleuritis & attachment to parietal pleura —> referred pain in cutaneous intercostals
carbon particle presence in axillary node is indicative of?
lymphatic vessels in lung and visceral pleura anastomosing with parietal lymph vessels
bronchitis, lung cancer, pneumonia, pulmonary embolism, & tuberculosis can cause?
hemoptysis —> spitting of blood from lungs from bronchial/pulmonary hemorrhage from bronchial arteries
cancer that arises from a bronchus; usually from cigarette smoke; causes hemoptysis; common hematogenous metastastis are brain, bones, lung, adrenal glands
bronchogenic carcinoma
lymph nodes that first receive lymph from a cancerous
sentinel nodes
hemidiaphragm & vocal cord paralysis (recurrent laryngeal) is indicative of?
apical lung cancer involving mediastinal nerves such as phrenic and vagus nerves
where is mediastinal/central diaphragmatic pain referred to?
C3-5 dermatome (root of neck & shoulder)
where is costal/peripheral pain referred to?
dermatomes in abdominal/thoracic walls
if a chest x-ray shows that the inferior margin of the lung does not descend into the recess, what is wrong with patient?
pleural effusion
birth defect resulting in failed recanalization of larynx, causing congenital high airway obstruction syndrome —> distal dilation of airway, lungs fill with fluid, diaphragm flattens, & accumulation of serous fluid (intracellular edema)
laryngeal atresia
what is incomplete laryngeal atresia called & how do you treat it?
laryngeal web; endoscopic dilation of web
symptoms: infant can’t swallow, drools excessively, instantly regurgitates, pneumonitis, & polyhydramnios in utero
tracheoespophageal fistula —-> incomplete division of cranial part of foregut into esophagus & trachea
failure of larynx & upper trachea to separate from esophagus; symptoms similar to fistula
laryngotracheoesophageal cleft
recurrent infection and respiratory distress are typical of?
tracheal diverticulum —> bronchus like projection from trachea that can terminate in lung tissue which forms a tracheal lobe of lung
insufficient amount of amniotic fluid which causes lung development to slow & pulmonary hypoplasia due to restriction of thorax
oligohydramnios
how are the lungs of a stillborn different from a normal neonate?
a stillborn’s lungs have fluid and will sink in water while a normal neonate’s lungs have air and will float in water
labored breathing shortly after birth; common in premies due to a deficiency of surfactant
respiratory distress syndrome or hyaline membrane disease; treat with corticosteroids to induce surfactant production
linear marking on radiograph that suggests the azygos vein lies on the bottom of the horizontal fissure in the superior lobe of the right lung & is indicative of?
azygos lobe of lung due to apical bronchus growing superior & medial (instead of lateral) to azygos vein
honeycomb appearance on radiograph usually in periphery of lungs; formed by dilation of terminal bronchi
congenital lung cysts
failure of respiratory bud to develop; mostly unilaterally; shifting of heart & mediastinal structures; hyperexpansion of lungs
agenesis of lung (think table six’s uni-lung?)
reduced lung volume & hypertrophy of smooth muscle in pulmonary arteries —> pulmonary hypertension leads to ischemia of lungs
lung hypoplasia in utero; typically results in death
pulmonary sequestration usually at base of left lung; nonfunctional and no communication with tracheobronchial tree but has systemic blood supply
accessory lung
