Case 6 Flashcards
(37 cards)
Describe the anatomy of the chest wall in Figure 1
(Left down, then right down)
- Manubrium
- Superior Vena Cava
- Right main bronchus (Bronchus bifurcation)
- Horizontal fissure (on lobe of lung)
- Right atrium
- Oblique fissure (on lobe of lung)
- Inferior Vena Cava
- Diaphragm Liver
- Aortic Arch
- Pulmonary trunk
- Left main bronchus
- Left Atrium
- Left Ventricle
- Oblique fissure (on lobe)
- Diaphragm
- Left costophrenic nerve
Middle:
-Gastric bubble
From right to left, name the vessels which branch off the aortic arch (Figure 2)
- Brachiocephalic artery (branches off into right common carotid artery and right subclavian artery)
- Left common carotid artery
- Left subclavian artery
What are the types of ribs in our body?
- True: 1st 7 ribs, these attach/articulate directly to the sternum
- False: ribs 8-10, articulate to sternum via costal cartilage (not directly)
- Floating: posterior to thoracic walls/cage, doesn’t attach to sternum at all.
What level is the sternal angle at?
T4
What level is the suprasternal notch at?
T2
What are sternocostal joints?
Bond between sternum/sternal body and cartilage of rib
What are costochondrial joints?
Bond between ribs and cartilage
What are interchondrial joints?
Bond between false rib and true rib
What is a cartilagenous joint?
All cartilage, allows more movement than fibrous joint, but not more than synovial joints
What is a synovial joint?
When bones join together
Name the bony parts of the chest wall (figure 3)
- Manubrium
- Sternal body
- Xiphoid process
What is the joint between the Manubrium and the sternal body called?
Manubrial joint
What is the Xiphersternal joint?
Joint between Xiphoid process and sternal body
What is synchodrosis?
Joint between bones bound by layer of cartilage - almost immovable
Give the definition of health promotion (WHO, 1946)
Health is a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmary
Give the Downie, Tanahill and Tanahill definition for health promotion
Health promotion compromises efforts to enhance positive and reduce risk of ill-health, through the overlapping spheres of health education, prevention and health protection.
What is Primary Prevention?
Concerned with preventing the onset of disease, aims to reduce the incidence. It involves the interventions that are applied before there is any evidence of disease or injury.
What is Secondary Prevention?
Concerned with detecting a disease in its earliest stages, before symptoms appear, and intervening to slow or stop its progression to catch it early.
Distinguish people who are healthy on the surface, but may have risk factors which will lead to illness later.
What is Tertiary Prevention?
Refers to intervention designed to arrest the progress of an established disease and to control its negative consequences to avoid need for hospital.
Use of clinical treatment and rehabilitation e.g. speech therapy, physiotherapy
What is Primary prevention for COPD?
this is population/community level
- Detect the risk factors
- Screen high risk populations
- Health education (smoking cessation, wood cooking, air pollution, exposure)
What is Secondary prevention for COPD?
this is community health centre level
- Avoid exacerbations among known patients
- Screening e.g. FEV1 test
- Pneumococcal bird flu virus
- Smoking cessation
- Physical activity
What are the steps in Tertiary prevention of COPD?
patient is hospitalised at this point
-Person suspected to have COPD
-Confirm and record diagnosis
-Managing exacerbation of COPD (tertiary prevention)
-Review response to treatment
-If stable, discharge the patient and make sure they’re managing their stable COPD (through tertiary prevention and rehabilitation)
OR
-If not stable, go back to managing exacerbation of COPD step until it is stable
What is exacerbating COPD?
‘Flare up’ of COPD, worsening
(also known as worsening of chronic bronchitis)
Sudden worsening of COPD symptoms (SOB, quantity and colour of phlegm)
Triggered by infection from bacteria/viruses/environment pollutants
Can last for several days
What are signs of COPD in a patient?
-Smoker/ex smoker
-Coughing
-Productive cough
-Out of breath
-Over 35
3 and over = could be COPD
