Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

THRALL - Thom > 32. Diaphragm > Flashcards

32. Diaphragm Flashcards

1
Q

What structures embryologically form the diaphragm?

A
  • Septum transversum (ventrally)
  • Mesentery of foregut (dorsally)
  • 2 pleuroperitoneal folds (dorsally)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

During queit respiration, what % of change in thoracic volume is achieved by diaphragmatic movement vs intercostal mm?

A
  • 75% diaphragm
  • 25% intercostal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What reason is given for potenital spread of abdominal disease to mediastinum / pleural space?

A
  • unidirectional drainage of lymph nodes -> final destination thoracic trunks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Detail the anatomical portions of the diaphragm?

A
  • Central tendinous part
  • Peripheral muscular part (3 areas)

Pars sternalis => attaches to xiphoid cartilage

Pars costalis => attaches to 8-13th ribs

Pars lumbalis => 2 crura. R attaches to craionventral border L4, L attaches to body of L3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which 2 recesses are formed by the diaphragm?

A
  • Phrenicocostalis (costodiaphragmatic) recess

=> formed between layesrs of pleura lining diaphragm and ribs

  • Phrenicolumbalis (lumbodiaphragmatic) recess

=> formed similarly, but region dorsal to crura and ventral to vertebra (bilateral)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

List the 3 openings within the diaphragm, and what they contain

A

Aortic hiatus

  • Aorta, hemiazygous, azygous, lumbar cistern of thoracic duct

Oesophageal hiatus

  • Oesophagus, vagus trunks

Caval hiatus

  • CaVC
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which portions of the diaphragm are not visible radiographically?

A
  • Visibility dependent on adjcanet opacity.
  • Accordingly majority of thoracic portion visible

EXCEPT recesses, as lung not contacting

  • Ventral portion of abdominal diaphragm may be visible if falciform fat present
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Where is the cupula?

A

= the body

Most cranial convex portion on both DV and laterals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What effect can poor radiographic technique (cranial centring, rotation) have on the appearance of the diaphragm in the lateral projections?

A
  • INcreased seperation of the crura (up to 2.5 vertebral lengths)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

In what views does the diaphragm have a dome / mickey mouse shape?

A

Dome: DV thorax, VD mid abdomen

Mickey: VD thorax, DV mid abdomen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Where does the diaphragm extend caudally to (intersection with spine)? How does it change with extreme resp?

A
  • Normal: T11-13
  • May vary between T9-L1
  • Extreme: More verteical, flattened / straight, tenting in the cat
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Table - Rx signs of diaphragmatic disease

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Where are the most common changes to diaphragmatic shape seen? why?

A
  • Cupula -> heart contact, patient postiioning, large breed dogs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the possible causes of asymmetry of the diaphragm? Name one way to confirm your suspicions for more unusual dx….

A
  • Unilateral tension pneumo
  • Hemiparalysis -> FLURO
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

List 5 broad types of diaphragmatic hernia

A
  • Traumatic
  • Peritoneopericardial
  • Hiatal
  • Peritoneopleural
  • Other congenital diaphragmatic defects
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe the pathophys of traumatic hernia

A
  • Increased abdominal pressure with OPEN glottis

=> leads to large peritoneo-pleural pressure gradient

  • Subsequent rent formation
17
Q

What radiographic techniques are described to better characterise diaphragmatic herniation?

A
  • Positional radiographs
  • Removal of pleural fluid + repeat
  • Barium study (0.5ml / kg, 30%w/v)
  • +ve contrast peritneography (2ml/kg, iodinated), other selective +ve contrast techniques
  • Horizontal beam

=>LAST RESORT, position animal so accumulates cranially

  • other modalities
18
Q

Table: Radiographic features of traumatic diaphragmatic hernia

A
19
Q

Incidence of laterality of traumatic hernia?

A
  • In one report equal….

BUT in dogs has been reported R>L

20
Q

Which organs are most commonly herniated in traumatic diaphragmatic hernias? And when chronic?

A

Acute (IN ORDER)

Liver > small intestine > stomach > spleen > omentum

Chronic (IN ORDER)

Liver > small intestine > omentum > spleen > stomach > colon > pancreas

21
Q

What are the most consistent radiographic features of traumatic diaphragmatic hernia?

A
  • Abdo organs in thorax
  • Displacement of abdo/thoracic organs
  • loss of thoracic diaphgramatic surface
  • assym / altered slope on lateral
  • Pleural fluid
22
Q

What specific life-threatening complication occurs secondary to tension gastrothorax?

A
  • Potential / actual cardiovascular tamponade
23
Q

What feature is a consistent finding with chronic diaphragamatic hernias?

A
  • Pleural fluid

=> also consistent if strangulated organ is present

24
Q

Approximately what % of diaphragmatic hernias are congenitally predisposed?

A

15%

25
Q

Which cats (and with what means of inheritance / rate of incidence) are predisposed to congenital DH?

A
  • Himalayans and DLH
  • Simple autosomal recessive in cats, reported 1:500 to 1:1500 incidence
26
Q

What comorbidity has been associated with herniation of liver in PPDH?

A
  • Hepatic cysts
27
Q

Box; Radiographic features of PPDH

A
28
Q

What is a consistent feature of PPDH in cats?

A

Dorsal peritoneopericardial mesothelial remnant

29
Q

List three proposed causes of hiatal hernia

A

1) Congenital
2) Traumatic
3) Contraction of longitudinal oesophageal muscle

30
Q

Hiatal hernia classification

A

1) sliding
2) Paraoesophageal
3) Combo of 1 and 2
4) EITHER herniation of other organ OR GO intussusception

31
Q

Which breed have congenital hiatal hernia?

A

Shar pei

32
Q

Rx signs of sliding HH

A
33
Q

What presdisposing features for GO intussusception are reported?

A
  • Male
  • GSD
  • Pre-existing oesophageal dilation
34
Q

Box: Radiographic features of GO intussusception

A
35
Q

Congenital diaphragmatic defects have beend described in the dog in certain locations. List them

A

1) Muscular portion, dorsolateral location
2) Membranous (central) in association with umbilical hernia

36
Q

What causes for diaphragmatic motor disturbances are reported?

A

Traumatic

Myopathy

Neuropathy

Pneumonia

Idiopathic

37
Q

Features of diaphragmatic paralysis

A
  • Unilateral: Cranial displacement of one crus, unequal movement
  • Bilateral: Cranial displacement of both crura, minimal or no movement

NB: Diaphragmatic flutter reported -> Contracture synchronous with heart beat

THINK FLURO FOR THESE

38
Q

Features of muscular dystrophy

A
  • Dystrophin deficiency, dogs and cats
  • Rx: Diaphragmatic assymetry, undulation, and GO hiatal hernia, scalloping of diaphragm with muscular HYPERTROPHY (chec with US). Hiatal thickening / obstruction can cause megaO

THRALL - Thom (40 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions