Pratical exam techniques Flashcards
What structures are endangered in a pericardial tap (name 10)?
Superior Epigastric vessels Peritoneum Liver (if done on the right) Stomach (if done on the left) Left pleural cavity Left lung Epicardium Coronary arteries Myocardium Heart chambers
Why is a pericardial tap performed at the left costal margin?
If performed on the right, the liver is endangered.
If performed in the middle, the recess will be missed, and the heart is endangered.
It is best performed on the left, however, the stomach can be endangered, amongst other structures.
The lung is endangered in all cases.
What structures do you puncture in a renal biopsy (name 8)?
Skin Subcutaneous tissue Lat dorsi -can also be quad lumborum or erector spinae depending on how medial Thoracolumbar fascia Extraperitoneal fat Renal fascia Perirenal fat Renal capsule
What is the danger of inserting a catheter through the urethra of women and men?
Trauma to the urethral mucosa may produce bleeding and undue force may even create a false passage in its wall. The long term complication of trauma or of introduction of infection may be a urethral structure (subsequent to contracture from healing with scar tissue).
Where may a catheter be difficult to navigate in the male urethra?
The junction of the bulbous with the membranous urethra at the level of the perineal membrane (the inferior fascia of the urogenital diaphragm) where the urethra changes direction (through almost a right angle) and narrows.
Navicular fossa may cause trouble in uncircumcised patients.
What is the significance of rich nerve supply to male urethra?
In view of the urethra’s rich sensory nerve supply (from the pudendal nerve) it is highly sensitive to painful stimuli. Reflex urethral sphincter spasm may hinder catheterisation.
What structures are endangered in a renal biopsy (name 5)?
Hilum of kidney Ureter Lung Liver Intestines
What is a peritoneal tap and peritoneal lavage? Why are they done (name 3)?
Tap - Aspiration of fluid from the peritoneal cavity.
Lavage - Catheter inserted, saline injected, and then withdrawn for analysis.
Done for peritoneal fluid analysis, excess fluid drainage and intraperitoneal bleeding detection.
What structures are endangered in a pudendal nerve block?
The internal pudendal vessels (they are located laterally to the pudendal nerve)
