February 11, 2016 - Chest Wall Disorders

Question 1

Cobb Angle

Answer 1

Used in scoliosis to assess the severity of the condition.

Question 2

Kyphoscoliosis

Answer 2

An abnormal curvature of the spine in both a coronal and sagittal plane. It is a combination of kyphosis and scoliosis.

This often leads to other issues such as under-ventilation of the lungs and pulmonary hypertension. Causes a stiff rib cage and difficulty expanding the lungs.

Question 3

Diffusion Capacity in Kyphoscoliosis

Answer 3

Is reduced.

Even though the lungs are normal, the lungs cannot expand as much because of the chest wall disorder. Because of this, there is less surface area available for diffusion of oxygen.

Question 4

Cor Pulmonale

Answer 4

Abnormal enlargement of the right side of the heart as a result of disease of thel ungs or the pulmonary blood vessels.

Question 5

Pulmonary Circulation and Chest Wall Disorders

Answer 5

Low P_AO₂ leads to hypoxic vasoconstriction.

The decreased vascular calibre at low lung volumes can lead to increased pulmonary arterial pressure and oxygen therapy may be used to prevent cor pulmonale and right heart failure.

Question 6

Sleep and Chest Wall Disorders

Answer 6

People tend to hypoventilate in their sleep.

For patients with significant chest wall disorders, this can lead to severe hypoxemia. Their hypoxemia and hypercapnia can be catastrophic.

Nocturnal ventilatory support may be used such as CPAP or BIPAP.

Question 7

Ankylosing Spondylitis and Respiratory Failure

Answer 7

Much less likely to develop into respiratory failure since the lung volume is relatively maintained. The exception of this is after abdominal surgery because their ventilation is primary abdominal.

After abdominal surgery, the patient requires careful monitoring.

Question 8

Obesity and Lung Volume

Answer 8

The extra weight of obesity presses on the chest wall and constricts breathing.

Patients with obesity have a lower FRC and may have trouble breathing, particularly when sleeping.

Question 9

Amyotrophic Lateral Sclerosis (ALS)

Answer 9

A specific disorder that involves the death of neurons.

Progressive disease which results in weakness of muscles. Aspiration pneumonia then causes respiratory failure and death.