Fichas
anatomy cases
Fichas del conjunto (25)
- 1recess: empty cavity. pleural recesses: 1/costodiaphragmatic recess: the largest of the pleural recesses, lying between the diaphragm and the thoracic wall into which the basal border of the lung encroaches during inspiration.2/2/costomediastinal recess:
a pleural recess between the mediastinum and costal wall into which the ventral border of the lung encroaches during inspiration. - 2—**The costodiaphragmatic recess is the lowest extent of the pleural sac, and so it is where any pleural effusion will collect in an upright patient.
- 3—at the midclavicular line, the recess is between rib spaces 6 and 8,
at the midaxillary line between 8 and 10 and at the paravertebral line between 10 and 12. - 4these different sites of recess because of its shape; anteriorly it's oblique and has a sharp end,[ this sharp end is important if I make the thoracocentesis from midaxillary line]. while posteriorly it's widened and has a flat end.Parasthesia:
tingling وخزا خفيفا,
caused chiefly by pressure on or damage to peripheral nerves.
**normally caused by some sort of nervous insult, i.e. impingement, cutting, or rough handling of a cutaneous nerve during a medical procedure, for instance. - 5*impingement: Compression of a nerve or blood vessel through a constricted space.-8th intercostal nerve;
innervate 8th rib (medially and inferiorly), towards the region just above the umbilicus. - 6*dermatome : the area of skin supplied with afferent nerve fibers by a single posterior spinal root.*The most superior structure is the vein, and the nerve is the most inferior structure.
This neurovascular bundle is found between the internal and innermost intercostal muscles. - 7so any injury to those veins or nerves would affect internal and innermost intercostal muscles.*techniques for removing fluid or air that is accumulating in the pleural space:
1/Thoracocentesis.
2/Chest tube (Thoracostomy). - 8-ostomy: artificial opening in an organ of the body.-needle should always be inserted near the upper border of a rib in order to avoid damage to the neurovascular bundles found below the ribs.
** However, in an intercostal nerve block, the needle would be inserted along the inferior margin in order to deliver the anesthetic agent to the nerve lying there - 9**Thoracocentesis may be used to drain a: pleural effusion, empyema, or hemothorax, as well as to remove air from the pleural space in the case of pneumothorax.**Empyema is most frequently a complication of pneumonia.
*Empyema is a condition in which pus and fluid from infected tissue collects in a body cavity. - 10-crepitus: a طقطقةcrackling sound in the lungs, by air moving in a tissue space. e,g: crackles of a consolidated area of the lung in pneumonia.-parasthesia:
an abnormal spontaneous sensation such as burning, pricking, and numbness - 11-pleural effusion: excess fluid in the pleural space. This can be either a transudate or an exudate-tension pneumothorax:
a condition in which the ruptured tissue forms a valve that permits air to enter the chest cavity upon inspiration, but does not allow air to escape during expiration.
* therefore greatly increases the pressure inside the cavity such that the vessels and [trachea are displaced to the opposite side] - 12tension pneumothorax cause: injuries to the chest wall may create an opening that acts like a one-way valve. *Air is sucked into the pleural cavity during inspiration, but during expiration the chest wall closes on itself, preventing air from escaping.Insertion of the chest tube at the fifth intercostal space allows the release and escape of air from the pleural space into the chest drainage device.
we do it to prevent further damage to a potentially injured diaphragm, and because it's a life-threatening injury. - 13-structures did the chest tube pass through to enter the pleural cavity in pneumothorax: Skin, fat, external intercostal muscle, internal intercostal muscle, innermost intercostal muscle, endothoracic fascia, and parietal pleura.**cupula:
serous membrane lining the pleural cavity which extends above the level of the 1st rib into the root of the neck.
-cupular pleura is continuous inferiorly with the costal and mediastinal parietal pleurae; also known as cervical parietal pleura. - 14-endothoracic fascia; the connective tissue between inner aspect of chest wall & costal parietal pleura.-fascia:
a thin sheath of fibrous tissue enclosing a muscle.
what separate pleura-lining the lung from rib cage in chest wall is a CT called:
endothoracic fascia. - 15- tension pneumothorax: is the presence of air in the pleural space under pressure. The lung collapses, and a mediastinal shift interferes with the expansion of the contralateral lung and compromises venous return to the heart via the IVC. This condition is extremely dangerous and requires urgent action.symptoms of tension pneumothorax:
Tachypnea, contralateral tracheal deviation, hyperresonance, distended neck veins, dyspnea, and hypotension. - 16**contralateral: denoting the side of the body opposite to that on which a particular structure or condition occurs.tension pneumothorax treatment:
Needle thoracocentesis in the second intercostal space in the midclavicular line, followed by chest tube placement. - 17—- chylothorax:
A pleural effusion composed of lymphatic fluid due to disruption of the thoracic duct.
- 18-The fluid is lymph, which contains lipids and hence presents as milky white drainage. Given the location of the surgical procedure - dissection of the left neck - there is a danger of injuring the thoracic duct or its major tributaries, particularly the jugular trunk found within the neck.-structures drain into the thoracic duct:
The thoracic duct receives branches from the intercostal spaces, and the jugular, subclavian, and bronchomediastinal trunks of the lymphatic system. - 19-the sternal angle is where the costal cartilage of the second rib attaches to the sternum. This is a significant landmark!-The sternal angle is a very important anatomical landmark which is used when placing the stethoscope and listening for heart sounds.
So, once you locate the sternal angle on a patient, you know the location of the second rib, and you can use that landmark to find the right spots to auscultate each valve of the heart.
*Also remember that a horizontal plane through the sternal angle passes through the T4/T5 intervertebral disc and marks the inferior boundary of the superior mediastinum. - 20-The costodiaphragmatic recess: is the area inferior to the lung where the costal and diaphragmatic pleura are continuous. This is the lowest extent of the pleural cavity.-The costomediastinal recess is a small anterior recess where the costal and mediastinal pleura are continuous.
- The cupola is the pleural space that extends above the first rib. - 21-The pulmonary ligament; is a fold of pleura located beneath the root of the lung.
- 22—**The lowest extent of the pleural cavity, into which lung tissue does not extend=
costodiaphragmatic recess.
- 23- By clearing the endothoracic fascia, it is easy to separate the costal pleura from the thoracic wall. -Deep fascia is a fascial layer it is not present around the lungs. -The parietal pleura is made up of the cupula or cervical pleura, costal pleura, diaphragmatic pleura, and mediastinal pleuraEndothoracic fascia is the layer provides a natural cleavage plane for surgical separation of the costal pleura from the thoracic wall.
- 24-During a lung transplant procedure, an observing 4th year attempted to pass his index finger posteriorly inferior to the root of the left lung, but he found passage of the finger blocked. Which structure would most likely be responsible for this?pulmonary ligament.
The pulmonary ligament is a double layer of pleura extending from the inferior end of the hilar reflection downward to the diaphragm.
So, it is a structure that would block you from moving your finger posteriorly at the root of a lung. - 25-The inferior vena cava is found in the mediastinum and would not be near the root of the lung. -The left pulmonary veins are part of the root of the lung and would not block someone from reaching behind the lung.
Información
- Descripción
- Fichas sobre anatomy cases, creado por alice zoldiac el 07/05/2018.
- Creado por
- alice zoldiac
- Visitas
- 0
- Valoración