Professional Documents
Culture Documents
Name
Thoracic Outlet Syndrome [TOS]
Problem
Compression of neurovascular structures in outlet
Cause
Pressure on lower trunk of Brachial Plexus [C8/T1] Cervical Rib cause compression of subclavian artery
Symptoms
Pain, numbness, tingling, weakness and fatigue of upper limb Ischemic muscle pain in upper limb
Treatment
Rib Fracture
Pain due to movement of rib during respiration, coughing, laughing and sneezing Impaired ventilation Paradoxical respiration Affect oxygenation of blood cause respiratory failure
Flail Chest
Large segment of anterior or lateral part of chest moves freely Wall moves inward during inspiration Wall moves outward during expiration
Paralysis of Half of Diaphragm Diaphragmatic Ruptures Breast Infection [mastitis] Tearing mostly likely in posterolateral side Infection of the tissue of breast
Injury of Phrenic nerve on same side Blunt or penetrating trauma Mostly motor vehicle crash Usually occurs during breast feeding Bacteria from baby goes in through nipple Attachment to suspensory (Cooper) ligament causing shortening Obstruction of subcutaneous lymphatic and lymph accumulation on skin Shortening of lactiferous ducts
Paradoxical movement Lung Compression Pain, swelling, redness, and increase of temperature
Carcinoma of Breasts
1. 2.
1. 2. 3.
Shortening of ligaments cause dimpling Prominent or puffy skin between dimpling pores give is DOrange Sign Inversion of nipple
3.
Heart
Name
Cardiac Tamponade
Problem
Inflammation of Pericardium Restricts venous filling and reduce cardiac output Failure to close foramen ovale after birth Failure of septum primum and septum segundum to fuse Mixing of oxygenated and deoxygenated blood Failure to close foramen ovale after birth Failure of septum primum and septum segundum to fuse Mixing of oxygenated and deoxygenated blood
Cause
Accumulation of pericardial fluid due to penetrating injury (stab wound or gun shot)
Symptoms
Treatment
Hypotension Pericardiocentisis Faintly Audible Heart Sounds Insert needle in medial 5th/6th intercostal space 45 degree angle upward and backward to avoid damage to lung Blood shunt from left to right Non-Cyanotic Effect (no sign) May need surgical repair if large
Foramen in ventricles
Blood Shunt from left to right Right Ventricular Hypertrophy Non-Cyanotic Effect Cause blueness of skin after physical activity Right to Left Shunt of blood Cyanotic
Tetralogy of Fallot
1. 2. 3. 4.
Pulmonary Stenosis Overriding Aorta Interventricular Septal Defect [VSD] Right Lung Hypertrophy [secondary]
Cardiac Hypertrophy
Angina Pectoralis
Pain over sternum May spread to arms, root of neck, and lower jaw Lead to myocardial infarction
Lungs
Name
Esophageal Artesia or Tracheoesophageal fistulae Pulmonary Hypoplasia Bronchogenical Carcinoma
Problem
Wrong connection of trachea and esophagus Underdevelopment of Lung Cancer is mucosa of bronchi
Cause
Symptoms
Treatment
Persistent cough and hemoptysis Pancoast tumor [apex] may lead to TOS
Pain in medial side of forearm Atrophy of intrinsic hand muscles Constriction of pupil [miosis] Drooping eyelid [ptosis] Loss of sweating [hemianhydrosis] Dilation of head and neck veins Facial swelling Cyanosis
Horners Syndrome
Bronchogenic Carcinoma
Bronchogenic Carcinoma
Pneumonia
Inflammation of Lung
Open Pneumothorax
Stab wound of thoracic wall Pierce the parietal pleura Cavity is exposed to air
Pleuritis Inflammation of Pleura Coartation of Aorta Congenital Narrowing of Aorta Inflammation of Coastal Pleura produce local chest pain via intercostal nerve Irritation mediastinal pleura produce pain via phrenic nerve to shoulder C3-C5 dermatomes
Cough, chest pain, fever and difficulty breathing Enlargement of bronchomediastinal lymph nodes Air moves freely through wound Inspiration: Air enters chest wall and mediastinum will shift to other side Expiration: Mediastinum will move back Hear friction of rough surfaces of lungs Level of fluid is good visible on X-Ray Sharp Pain upon respiration
Thoracocentsis Fluid and Air = 7th -9th Intercostal space Air only = 2nd intercostal space Inserted in upper border of rib to avoid neurovascular damage Thoracocentsis Fluid and Air = 7th -9th Intercostal space Air only = 2nd intercostal space Inserted in upper border of rib to avoid neurovascular damage
Patent Ductus Arterious Failure for ductus arterious (connection between aorta and pulmonary trunk) to constrict after birth Causes mixing of oxygenated and deoxygenated blood Foreign body lodging High Prostaglandin Low Oxygen Common in premature babies
Higher Blood pressure in upper limb compared to lower limb Cause collateral circulation between internal thoracic and thoracic aorta X-Ray show notches on inferior border of ribs Cause left to right shunt of blood Non-Cyanotic Pulmonary hypertension Increase oxygen Prostaglandin inhibitors Surgical ligation Surgery may damage left recurrent laryngeal nerve (wraps aortic arch) causing hoarseness
C6: Pharynx joins upper end T4/T5: Crossing of aortic arch and left bronchus