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Flashcards in Anterior Chest Wall Deck (8)
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Insertion of central venous catheter

Access to SVC & right side of the heart to monitor BP, long-term parenteral feeding, administer drugs

Internal jugular vein & subclavian vein usually

Complications: puncture of subclavian artery, pneumothorax, hemothorax, trauma to the trunks of brachial plexus, arrhythmia, venous thrombosis, erosion of catheter through SVC, tricuspid valve damage, infection

1

Distal to left subclavian artery & Ligamentum arteriosum

⬆️ BP to upper extremities & ⬇️ femoral artery pulses

Collateral circulation:
- internal thoracic artery --> intercostal artery --> superior epigastric artery --> inferior epigastric artery --> external iliac artery
- these arteries become dilated --> rib notching in dilatation of intercostals artery

Postductual coarctation of aorta

2

Less common, proximal to ductus arteriosus, blood reached the lower part of the body aneurysm of the aorta

- felt by palpitation the trachea at sternal notch (T2)

Preductal coarctation

3

From deceleration

Aorta tears just distal to the left subclavian artery through tunica intima & media

Aortic disruption

4

Knife wound above the clavicle may damage the ff structures

Subclavian artery

Brachial plexus, lower trunk --> loss of hand movement (ulnar nerve), sensory loss over medial aspect arm, forearm & last 2 digits (C8 & T1 dermatomes)

Cervical pleura & apex of the lung --> open pneumothorax, collapse of the lung

5

Projection of diaphragm on the chest wall

Central tendon
- posterior to xiphoidsternal joint

Right dome
- arches superiorly to upper border of rib 5, MCL

Left dome
- arches superiorly to lower border of rib 5, MCL

6

Cause: anomalous cervical rib --> compresses lower trunk of brachial plexus, subclavian artery or both

Thoracic outlet syndrome

7

Located behind the clavicle

Surrounded by pleura, lymph ducts & phrenic nerve

Complications: pneumothorax, lymph leakage & diaphragm paralysis

Scalene lymph node biopsy