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
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