Week 2 Thorax ✅ Flashcards
Where is the neurovascular bundle in relation to the rib?
Inferior of costal groove
How do you know where to insert the chest drain?
Palpate the rib, go above and aim for middle
How do the upper ribs move?
Laterally
How do the lower ribs move?
Bucket handle
What are the external intercostal muscles used for?
Inspiration
What are the internal intercostal muscles used for?
Expiration
What are the innermost intercostal muscles used for?
Expiration
Which nerves control automated and voluntary breathing?
C3,4,5
Why is referred pain from the diaphragm felt in the shoulder?
C3,4,5
Where might referred pain be felt in ectopic pregnancy?
Diaphragm
Why might the diaphragm be elevated on the right? What about if it was very elevated
Liver makes diaphragm higher on the right
Very high - ?paralysis of diaphragm
Which accessory muscles are used for inspiration?
Sternocleidomastoid
Anterior, middle and posterior scalenes
Pectoralis major/minor
Serratus anterior
How should you position patients in respiratory distress
Sat up/tripod
DO NOT LIE DOWN
How should a single rib fracture be managed?
Rest - rib above and below will act as a splint
Analgesic to keep moving
What happens if rib/chest pain is poorly treated?
Pneumonia
How do you differentiate between anterior and posterior ribs on CXR?
Anterior - sloped on CXR
Posterior - horizontal on CXR
What is kyphosis?
Forward rounding of the upper back
What is scoliosis?
Spine twists and curves to the side
What is kyphoscoliosis?
Kyphosis and scoliosis - spinal twisting on 2 planes
When might you see barrel chest?
Common with smoking. Larger lungs with emphysema
What is the difference between parietal and visceral pleura?
Visceral is against large organs, parietal is against wall of the cavity/structure
What can a flail chest cause?
Ineffective ventilation as negative pressure is not working
Pulmonary contusion
Hypoventilation with atelectasis
What is atelectasis?
Partial collapse or incomplete inflation of the lung
What is PPV?
Positive pressure ventilation
Machine pumps air in, positive pressure sucks air out
How do you treat flail chest?
PPV
ORIF (Open reduction and internal fixation)
Why treat flail chest with PPV?
Brings flail segment up with lungs as it should
What are complications of cardiac contusion?
ECG abnormalities, arrhythmias
Why does being hit in the chest cause cardiac arrest?
Arrhythmia
