Respiratory system - Applied Anatomy

Question 1

Applied anatomy of the sternum

Answer 1

Used for bone marrow biopsy
Can be split to make surgical access to the heart, great vessels and thymus

Question 2

Applied anatomy of the sternal angle

Answer 2

Landmark for counting ribs, costal cartilages and intercostal spaces

Question 3

What is thoracic outlet syndrome?

Answer 3

Compression of nerves/vessels at the superior aperture of thorax

Question 4

Fractures of the rib

Answer 4

Painful because the periosteum of the rib is supplied by the intercostal nerves
The rib may penetrate the lung and produce a pneumothorax or may damage the upper abdominal organs

Question 5

Uses of intercostal spaces

Answer 5

Surgical procedures, e.g. resection of lungs
Percussion and auscultation of underlying structures e.g. heart & lung
Obtaining samples of pleural fluid or drain pus/blood from the pleural cavity. The needle/drain is passed through the intercostal space just above the upper border of the rib to avoid the neurovascular bundle

Question 6

What are the mediastinal syndromes?

Answer 6

Mediastinal syndromes are a group of symptoms due to compression of mediastinal structure by any tumor:
* Engorged veins in upper ½ of body = compression of SVC
* Dysphagia = compression of esophagus
* Dyspnoea & cough = compression of trachea
* Hoarseness of voice - compression of left recurrent laryngeal nerve
* Paralysis of diaphragm = compression of phrenic nerve
* Intercostal neuralgia = compression of intercostal nerve
* Erosion of vertebral bodies

Question 7

What is pleurisy?

Answer 7

Inflammation of the pleura

Question 8

What is pneumonia?

Answer 8

Inflammation of the lung tissue

Question 9

What is pleural rub?

Answer 9

Sound of friction between inflamed pleurae

Question 10

What is pleural effusion?

Answer 10

Presence of excess serous fluid inside the pleural cavity

Question 11

What is hemothorax?

Answer 11

Blood filled pleural cavity

Question 12

What is empyema?

Answer 12

Pus-filled pleural cavity

Question 13

What is pneumothorax?

Answer 13

Presence of air inside the pleural cavity

Question 14

What is hydropneumothorax?

Answer 14

Presence of air and serous fluid in the pleural cavity

Question 15

What is a pyo-pneumothorax?

Answer 15

Presence of air and pus in the pleural cavity

Question 16

What is hemo-pneumothorax?

Answer 16

Presence of air and blood in the pleural cavity

Question 17

How can a benign neoplasm be removed from the lungs?

Answer 17

Surgical resection of one or more bronchopulmonary segments without causing damage

Question 17

How may tumor development on the lungs affect the body?

Answer 17

Tumor development in the lung may cause obstruction of blood vessels and lymphatics of the airway
Apical tumors may affect lower trunks of the brachial plexus producing arm symptoms
Recurrent laryngeal nerve may also become involved producing a change in the voice
Phrenic nerve invasion may produce paralysis of the diaphragm
Superior vena cava may be obstructed leading to dilation of the veins of the upper part of the chest and neck, producing headache, visual distortion etc.
Esophagus is a direct relation of the trachea and the hilum of the lung
Tumor growth in the mediastinum may cause obstruction or the development of a fistula

Question 18

How does fracturing the femur affect the lungs?

Answer 18

Fat emboli from fracture of the femur may block alveolar capillaries

Question 19

Normal lung radiograph

Answer 19