Respiratory - Consequences of Chronic Cough - Week 3 Flashcards
A pneumothorax is caused by…
Penetration injury of the parietal pleura or rupture of the visceral pleura
In a large pneumothorax, the lungs are how many centimetres away from the parietal pleura?
> 2cm
In a small pneumothorax, the lungs are how many centimetres away from the parietal pleura?
< 2cm
O/E a pneumothorax would show…
Reduced ipsilateral chest expansion, reduced ipsilateral breath sounds, hyper-resonance
A tension pneumothorax is likely to cause…
Mediastinal shift
What is the effect of mediastinal shift on tracheal deviation?
Trachea deviates to the opposite side of the pneumothorax
What is the most serious complication of mediastinal shift?
SVC compression resulting in hypotension
What is the management of a large pneumothorax?
Siting of a chest drain in the mid-axillary line in the 4th or 5th intercostal space
Explain the emergency management of a tension pneumothorax.
Insertion of a gauge cannula into the pleural cavity in the 2nd or 3rd intercostal space on the side of the tension pneumothorax
What is meant by hernaie?
Any structure passing through another, so ending up in the wrong place
Which two factors are usually required for the development of a hernia?
weakness of a structure and increased pressure on that side of the wall
Where are the common diaphragmatic weaknesses?
Attachment to the xiphoid process, posterior attachments, aortic attachments, oesophageal hiatus
What are the two types of hiatus hernia?
Paraoesophageal hiatus hernia, sliding hiatus hernia
What is meant by a paraoesophageal hiatus hernia?
the herniated part of the stomach passes through the oesophageal hiatus to become parallel to the oesophagus & in the chest
What is meant by a sliding hiatus hernia?
the herniated part of the stomach slides through the oesophageal hiatus into the chest with the gastro-oesophageal junction
What is meant by a direct iguinal hernia?
a “finger” of peritoneum is forced through the posterior wall of the inguinal canal and directly out of the superficial ring into the scrotum
What is meant by an indirect iguinal hernia?
a “finger” of peritoneum is first forced through the deep ring into the inguinal canal and then out of the superficial ring into the scrotum
How would you differentiate clinically between a direct and indirect hernia?
Reduce the hernia, occlude the deep ring with pressure. If it reappears, it is direct, if not, it must be indirect
Where do the iguinal ligaments attach?
Between the anterior superior iliac spine (ASIS) and pubic tubercle
The iguinal ligaments are important because…
Their medial halves form the floor of the iguinal canal
The openings to the iguinal canal are called…
The deep & superficial rings
What drains blood from the testis?
R/L pampiniform venous plexus
What brings blood to the testis?
R/L testicular artery
the right spermatic cord contains the…
vas deferens, testicular artery & pampiniform plexus
