Thorax Flashcards
Clinical importance of rib 1?
its close relationship to lower nerves of the brachial plexus and main vessels of arm
What is thoracic outlet syndrome?
group of disorders causing pain and paraesthesia’s in the neck, shoulder, arms or hands caused by compression of brachial plexus and/or subclavian vessels .
What ribs are commonly fractured?
uncommon in children, rib 4,5 or 6 most commonly fractured. In adults rib fractures will occur at the angle of the rib
Significance of cervical rib?
elongation of C7, can lead to thoracic outlet syndrome = abnormal compression of brachial plexus
What is costochondritis?
inflammation of rib cage. In elderly the cartilages lose their elasticity become brittle and may calcify making them radiopaque
Signs of Ossified xiphoid process ?
people in early 40s may detect their xiphoid process are partly ossified, they consult with GP about hard lumps ‘pits in stomach’ and fear its stomach cancer
What is pleural effusion?
collection of pleural fluid in response to surgery. This causes a lot of surface tension leading to a collapsed lung. When a lung collapses the pleural cavity becomes real space
Pneumothorax
collection of air in the pleural cavity. This causes surface tension leading to a collapsed lung. When a lung collapses the pleural cavity becomes a real space
Connection between deep and superficial lymph nodes
There is communication between deep and superficial lymph nodes allowing redirection of flow from one system to the other. This is useful because in the Prescence of lung disease that obstructs the lymphatics there is an alternate route for drainage
Cardiac silhouette
outline of the heart seen on lateral and frontal chest radiographs. Divided into right and left borders:
- Right border = formed by right atrium, SVC enters superiorly and IVC seen at lower margin
- Left border = formed by left atrium and ventricle, PA and aortic notch extend superiorly
Importance of transverse pericardial sinus?
A digit can be passed through this sinus which is posterior to the aorta and pulmonary trunk. By passing a surgical clamp/placing ligature around these vessels, inserting the tubes of a coronary bypass machine, and then tightening the ligature, surgeons can stop or divert blood circulation of these arteries whilst performing cardiac surgery
What is Pericarditis?
inflammation of pericardium, usually causes chest pain and certain inflammatory diseases may produce pericardial effusion (escape of fluid from pericardial capillaries into the pericardial cavity. Large amount of pericardial effusion accumulate it will prevent heart from expanding fully limiting blood flow to ventricles
What is Cardiac tamponade?
heart compression. Can be lethal because the fibrous pericardium is tough inelastic and cannot expand. Reduces cardiac output and circulation of the blood. Treated by inserting a needle at Larrys point.
Auscultation points
Aortic valve- Medial end if the right second intercostal space
Pulmonary valve- medial end of the 2nd left intercostal space
Tricuspid valve- 4th intercostal space at the lower left sternal border
Mitral valve- Left fifth intercostal space at the midclavicular line
What causes apical Lung cancers?
recurrent laryngeal nerve to the apex and the hilum of the lung this nerve is involved in lung cancers. This results in hoarseness associated with vocal cords because this nerve supplied most of the laryngeal muscles.
