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CPR > Midterm 1 Clinicals > Flashcards

Midterm 1 Clinicals Flashcards

1
Q

Gastrochisis

A

1 in 3000 births
Protrusion of viscera, happens to right of umbilical cord
Differs from epigastric hernia: bowel is uncovered and floating in amniotic fluid

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2
Q

Congenital Epigastric Hernia

A

Midline Bulge of abdominal wall b/n xiphoid and umbilicus

Bowel not exposed, remains covered by skin

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3
Q

Congenital Diaphragmatic Hernia (CDH)

A 
Posterolateral Defect: 1 in 2200
Viscera bulges into pleural cavity
Lung maturation delayed
Polyhydramnios
Left side impacted
Corrected at birth
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4
Q

Most Common Rib Fractures

A
  • Middle Ribs

- Anterior to Costal Cangle

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5
Q

Supernumerary Ribs

A
  • Occur in Cervical and Lumbar Region
  • Cervical has no symptoms unless if presses agaist Subclavian A or Brachial Plexus
  • Lumbar Ribs unproblematic
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6
Q

Dislocation vs. Separation of Ribs

A

Dislocation occurs at Sternocostal Joint

Separation occurs at Costochondral Joint

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7
Q

Thoracocentesis

A
  • Insertion of hypodermic needle through intercostal musculature
  • Inserted inferior to intercostal neurovascular bundle, but superior to collateral branches
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8
Q

Insertion of Chest Tube

A
  • To remove large amounts of air, fluid, blood, pus from Pleural cavity
  • Inserted in 5th or 6th intercostal space
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9
Q

Thoroscopy

A

Insertion of Thoroscope into Pleural cavity for visualization and biopsying Pleural Cavity

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10
Q

Lung Cancer Derivations

A
  • Actual Lung Tissue
  • From Bronchi (Bronchogenic Carcinoma)
  • Phrenic, Vagus, Recurrent Larygneal N
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11
Q

Removal Of Lung Procedures

A

Pneumonectomy: Removal of Lung
Lobectomy: Removing a Lobe
Segmentectomy: Removing specific Bronchopulmonary segment

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12
Q

Pleuritis

A

inflammation of pleura - - - -

  • producing roughness on lungs
  • Makes breathing difficult
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13
Q

Pulmonary Collapse

A
  • Occurs when air enters Pleural cavity to break surface tension b/n the two layers of pleura
  • Elasticity of lungs causes them to collapse
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14
Q

Entry of substances in Pleural Cavity

A

Pneumothroax: Entry of air through penetrating wound
Hydrothorax: Excess fluid, also caused Pleural Effusion
Hemothorax: Accumulation of blood, result of chest wound or laceration of intercostal/internal thoracic vessel

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15
Q

Bronchial Asthma

A
  • Widespread narrowing of lairways

- Produced by contraction of smooth muscle, edema of mucosa/mucus in lumen of bronchi/bronchioles

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16
Q

Bronchoscopy

A

Insertion of Bronchoscope into trachea to visualize Main Bronchi

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17
Q

Laryngeal Atresia

A
  • Failure of recanalization of Larynx
  • Congenital High Airway Obstruction Syndrome (CHAOS)
  • Airways dilates, lungs enlarged, diaphragm flat/inverted
  • Treated by endoscopic dilation of laryngeal web
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18
Q

Tracheoesophageal Fistula

A
  • Abnormal connection b/n trachea and esophagus
  • Most common congenital abnormality of lower respiratory tract
  • Failure of foregut endoderm to proliferate in relation to rest of embryo
  • Associated with esophageal atresia
  • Child unable to swallow
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19
Q

Fetal Breathing Movements

A
  • Essential for lung development
  • Used during fetal monitoring and predictor of fetal outcome
  • Aeration of lungs needs to happen rapidly at birth
  • Occurs by vaginal delivery, pulmonary vessels, lymphatics
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20
Q

Pulmonary Agensis

A
  • Unilateral
  • Complete absence of lung or lobe
  • Respiratory bud fails to split into bronchial buds
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21
Q

Oligohydraminos

A
  • Insufficient amniotic fluid production
  • Associated with renal agenesis/failure
  • Slows lung development
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22
Q

Pulmonary Hypoplasia

A
  • Restriction of fetal thorax from uterine pressure
  • Decreased hydraulic pressure on lungs
  • Impacts stretch receptors and lung growth
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23
Q

Respiratory Distress Syndrome

A
  • Rapid labored breathing shortly after birth
  • Surfactant Deficiency
  • Underinflated lungs, alveoli resemble glass membranes
  • Symptoms: Nasal flaring, grunting, cyanosis
  • Suprasternal, intercostal, subcostal retractions
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24
Q

Congenital Lung Cysts

A

Filled with fluid or air

  • Formed by dilation of terminal bronchi
  • Disturbance of bronchial development during late fetal life
  • Weezing cyanosis etc
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25
Q

Cause of Asthma

A
  • Infiltration of bronchiolar wall by eosinophils, lymphocytes, mast cells
  • Symptoms: Dyspnea, wheezing, productive cough
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26
Q

Emphysema

A
  • Permanent enlargement of air spaces distal to terminal bronchiole
  • Chronic obstruction of airflow due to narrowing, accompanied by destruction of alveolar walls
  • Loss of gas exchange with decrease in surface area
  • Caused by smoking, particulate material in lungs, genetics
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27
Q

Pneumonia

A
  • Inflammation of lung tissue
  • Air spaces filled with exudate (WBCs/neutrophils, RBSs, fibrin)
  • Hepatization stage where lungs look like liver
  • Enlarged capillaries
  • Symptoms: fever/chills, productive cough, crackles in lungs
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28
Q

Bronchiolitis Obliterans (Popcorn Lungs)

A
  • Plug of granulation tissue in terminal and respiratory bronchioles
  • Caused by vaping, lung transplants, infectious pneumonias, alveolar damage
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29
Q

Myocardial Infarction

A
  • Lack of blood flow to specific area of myocardium, result of blockage in Coronary A, coronory arthereosclerosis, or buildup of lipids
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30
Q

Angina Pectoris

A

Pain that originates in heart and produces strangling pain in chest
- Results from narrow/obstructed coronary arteriesproducing ischemia of myocardium

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31
Q

Atrial Septal Defects

A

Incomplete closure of Foramen Ovale

  • 15-20% of adults have small potency of Foramen Ovale
  • Larger openings in interatrial septum can be clinically significant as it allows blood mixture
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32
Q

Cardiac Catheterization

A

Insertion of catheter into femoral vein, passed to inferior vena cava to allow radiographic visualization of right atrium, right ventricle, and pulmonary trunk

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33
Q

Ventricular Septal Defects

A

All defects are clinically relevant as these septal defects allow mixture of oxygen rich and oxygen depleted blood

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34
Q

Artificial Cardiac Pacemaker

A
  • Produces regular electrical impulse that is carried to ventricles via electrodes
  • Electrodes inserted through large vein to Superior Vena Cava –> Right atrium –> tricuspid valve –> endocardium of trabeculae carnae
35
Q

Atrial Fibrillation

A
  • Irregular Twitching of Atrial Cardiac Muscle

- Ventricles respond at irregular intervals, circulation comprimised

36
Q

Ventricular Fibrillation

A
  • Rapid irregular twitching of ventricles
  • Heart unable to pump blood
  • Electric shock ceases all cardiac movement in hopes of restarting
37
Q

Cardiac Referred Pain

A
  • Ischemia stimulates visceral pain sensory fibers in ANS
  • Fibers share a spinal ganglion with somatic sensory fibers of areas in upper limb/lateral chest etc.
  • Travels via Left Medial Brachial Cutaneous N.
38
Q

Transverse Pericardial Sinus

A
  • Space allows cardiac surgeons to access area posterior to aorta and pulmonary trunk
  • Clamp/insert tubes of bypass into vessels
39
Q

Pericarditis

A
  • Inflammation of pericardium which makes it rough and frictious
  • This pericardial friction rub is observed with stethoscope and can calcify
40
Q

Pericardial Effusion

A

Inflammation of pericardium resulting in buildup of fluid/pus in percardial sac
- Can compress heart (Cardiac Tamponade)

41
Q

Percardiocentesis

A
  • Drainage of blood/fluid/pus from pericardial sac

- Relieves cardiac tamponade

42
Q

Coronary Artery Bypass Graft

A
  • Obstruction of coronary arteries can result in replacement of segment
  • Great saphenous vein often used b/c of its diameter + ease of access
  • Radial artery also used
43
Q

Coronary Angioplasty

A
  • Insertion of small balloon catheter into lumen of coronary artery
  • Balloon inflated to flatten plaque and increase size of lumen
44
Q

Pulmonary Embolism

A
  • Obstruction of a Pulmonary A. by an embolus

- Embolus passes from vein through right side of heart into pulmonary arteries

45
Q

Angiomas

A
  • Abnormal blood vessels and lymphatic capillary growth via vasculogenesis
  • Capillary Hemangioma: Excessive capillary formation
  • Cavernous Hemangioma: Excessive formation of venous sinuses
46
Q

Proepicardial Organ

A
  • Remnant of dorsal mesocardium attached to primitive heart

- Migrates and forms majority of epicardium

47
Q

Heterotaxia

A

Symmetrical anomaly of internal body plan

  • Ventricular Inversion: Reverse cardiac looping results in right sided left ventricle
  • Situs Inversus: Total reversal of organs
  • Situs ambiguous: Partial reversal of organs
  • Visceratrial Heterotaxia: Right heart, normal GI
48
Q

Persistant AV Canal

A
  • Failure of AV septum fusion
  • Abnormal/agenesis of AV valves
  • Results in pulmonary hypertension, exercise intolerance, shortness of breath
  • Very strong link with Down Syndrome
49
Q

Atrial Septal Defects

A
  • Small gap in foramen ovale allows blood to bypass pulmonary system
  • Types of defect:
    1) Excessive resorption of septum primum: very big foramen ovale
    2) Absence or inadequate development of septum secundum
    3) Ostium Primum defect
50
Q

Cyanosis

A
  • Bluish skin tone due to low O2 saturation
  • Mixing of deoxy blood with oxy
  • Club fingers, blue features
51
Q

Double Outlet Right Ventricle

A
  • AV septum does not shift over
  • Aorta and pulmonary artery exit into right ventricle
  • Everything mixed, cyanosis, breathlessness, murmurs
52
Q

Ventricular Septal Defects

A
  • Left to right ventricle shunt
  • Left does more work as right hypotrophies
  • Deoxy mixes with oxy
53
Q

Persistant Truncus Arteriosus

A

Outflow tract between aorta and pulmonary artery does not get separated

  • Common trunk
  • Can be fixed by closing off defect
54
Q

Tetralogy of Fallot

A

Conal truncus does not separate from atrial well

  • Very narrow pulmonary arteries
  • Right sided ventricular hypertrophy as it must pump extra hard to get blood through
  • Accompanied by a VSD and overriding aorta
  • Most common
55
Q

Transposition of Great Vessels

A

No spiralling which designates correct side to aorta/pulmonary artery
- Aorta receives deoxy, pulm receives oxy

56
Q

Pulmonary Valvular Atresia

A

Persistance of foramen ovale

  • Pulmonary artery closed off and right ventricle severely underdeveloped
  • Mixing of oxy and deoxy blood
57
Q

Aortic Valve Stenosis

A
  • Narrowing of aortic valve
  • Left ventricular hypertrophy
  • 4:1 male:female ratio
    Can be congenital, pathological, degenerative
58
Q

Aortic Valvular Atresia

A
  • No outleft for left ventricle, aortic valve closed
  • Right ventricle must push out blood; hypertrophy
  • Accompanied with ASD
59
Q

Bicuspid Aortic valve

A
  • Asymptomatic but can cause LV hypertrophy

- Associated with aortic aneurysms

60
Q

Tricuspid Atresia

A
  • Whole tricuspid valve closed off

- Left sided ventricular hypertrophy

61
Q

Hypoplastic Left Ventricle

A
  • Left ventricle underdeveloped
  • Mitral/Aortic valve not formed/ver small
  • Ascending aorta underdeveloped
  • ASD
  • RV does all work
62
Q

Heart Murmur

A
  • Heard when blood is moving in a direction it shouldn’t be
  • Blood is having a hard time moving in direvtion it should be
  • Can be hear in diastole and systole
63
Q

Spontaneous Pneumothorax

A
  • Spontaneous rupture of alveoli through visceral pleura
  • Air leaks into cavity
  • Risks: Smoking, COPD, cystic fibrosis
64
Q

Tension Pneumothorax

A
  • Air enters thorax but cannot exit

- Trauma where injury fails to seal (penetrating wound)

65
Q

Pulmonary Meniscus Sign

A
  • Meniscus found on surface of fluid with pleural effusion

- Due to surface tension b/n two different fluids

66
Q

Coin Sign

A
  • Solitary, round circumscribed shadows on X-Ray
  • May be calcified
  • Causwed by tuberculosis, neoplasms, cysts
67
Q

Pulmonary Radiological Signs of Disease

A
  • Kerley A Lines: running from hila to periphery, caused by distension of anastomosic channels
  • Kerley B Lines: Short parallel lines at periphery perpindicular to pleura
68
Q

Patent Ductus Arteriosus

A
  • Prostoglandins keep the ductus arteriousus b/n aorta and pulmonary arteries open
  • After birth, should become ligament, but can remain there
  • Results in severe LV hypertrophy, and congestive heart failure
  • Risk increased with rubella
  • Treated with indomethacin or surgery
69
Q

Coartctation

A

Postductal: Narrowing of descending aorta after ductus arteriosus
Preductal: Narrowing before dusctus arteriosus
- Body compensates by pushing blood around through the subclavians, makes them longer

70
Q

Aberrant Origin of Right Subclavian

A
  • When right subclavian forms much further downstream of dorsal aorta than the left
  • Occurs via abnormal obliteration of 4th aortic arch
71
Q

Double Aortic Arch

A

Whole Dorsal Aortic section on right does not obliterate

- Results in constriction of vagus nerve and trachea/esophagus

72
Q

Interrupted Aortic Arch

A
  • Both left and right aortic arches disappear
  • Lose entire systemic circulation
  • Newborn cant survive
73
Q

Coronary Heart Disease

A
  • 1/6 adults in US affected
  • STEMIs account for 30% of all MIs
  • Presents with history of chest discomfort, heavy pressure, nausea, vomiting, diaphoresis, dyspnea
74
Q

Sinus Tachycardia

A
  • HR > 100
  • Normal physiological response for pregnancy, emotion, anxiety, fear, exertion
  • Abnormal with drugs, hyperthyroid, fever, preggos, anemia
75
Q

Sinus Bradycardia

A
  • HR < 60
76
Q

Premature Atrial Contraction

A
  • Seen in absence of significant heart disease

- Associated with stress, alcohol, tobacco, COPD CAD

77
Q

Premature Ventricular Contraction (PVC)

A
  • Many causes
  • More ominous than Premature atrial contraction
  • Indictative of heart failure, AMI, ischemic heart disease, hypokalemia
  • Appears as wide QRS
78
Q

Ventricular Tachycardia

A
  • Non-sustaines/sustained/pulseless
  • Wide complex
  • Multiple causes
  • Shown as multiple PVCs on EKG
79
Q

Supravetricular Tachycardia

A
  • Narrow complex, fast HR
  • Thyroid disease, caffeine, stimulants, stress
  • Atrial rate greater than 160-180
  • Shown as tight QRS with p-wave buried behind
80
Q

Atrial Fibrillation

A
  • Very high rate 360-600
  • Multiple causes: heart disease, CHF, CAD, obesity
  • Atria not contracting
  • no P-waves, irregularly irregular rate
81
Q

1st Degree AV Block

A
  • Very long PR interval, more than 1 block
82
Q

Tangier’s Disease

A
  • Lose ABC A1 receptor on macrophages and endothelial cells
  • MAcrophages and endothelial cells can’t give cholestrol to HDL
  • Foam cell development is end result
83
Q

Type 1 Hyperlipoproteinemia

A
  • 2 Types:
  • Primary Capillary Lipoprotein Lipase Def
  • Apo-C2 Def
  • Cant hydrolyze hydroglycerides in chylos and VLDL
  • ## Result is very high plasma triglycerols
84
Q

Type 2 Hyperlipoproteinemia

“Familial hypercholestrolemia”

A
  • Caused by defective LDL receptor cant bind APO-B100
  • High cholestrol in blood
  • can have the atherosclerosis where LDLs get oxidized and they start making plaques

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