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CPR Test 1 Flashcards

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1
Q

Which are the most commonly fractured ribs?

A

middle ribs, anterior to costal angle

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2
Q

supernumerary ribs

A

extra ribs in cervical or lumbar region

TOS/ issues w brachial plexus and subclavian A or asymptomatic

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3
Q

Dislocation of ribs

A

dislocation at the Sternocostal joint

sternum and costocartliage

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4
Q

separation of ribs

A

separation at the Costochondral joint

rib and costocartilage

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5
Q

Thoracentesis

Bw what ribs?

A

pleural cavity fluid sample taken w hypodermic needle in between intercoastal nv bundle and collateral branches

ribs 9 and 10, midaxillary

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6
Q

Where do you insert a chest tub?

A

bw 5 and 6th rib

removes large amt of air, fluid, blood or pus from pleural cavity with collapsed lung/ emergency

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7
Q

thoroscopy

A

visualization/biopsy with thoracoscope inside pleural cavity

intercostal spaces 1-3

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8
Q

gastroschisis

A

protrusion of viscera to right of umbilical cord
amniotic fluid (saltly) = bad for GI
bowel is uncovered and floating in ^^
failure of lateral folds to pull gut in

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9
Q

congenital epigastric hernia

A

midline bulge covered w skin and subcut. tissue

bw xiphoid process and umbilicus

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10
Q

congenital diaphragmatic hernia

A

posterolateral defect
viscera bulge into pleural cavity that delay lung growth
on left side
failure for myoblast to partially or fully infiltrate pericardiopertioneal canal

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11
Q

Lung cancer can involve what nerves due to proximity?

A

Phrenic N., Vagus N. and Recurrent Laryngeal N.

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12
Q

treatment for lung cancer?

A

removal of a Lung (Pneumonectomy), a lobe of a lung (Lobectomy) or a specific Bronchopulmonary Segment (Segmentectomy) through a procedure called Lung Resection

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13
Q

Pleuritis

A

inflammation of the Pleura producing a roughness on the lungs making breathing difficult.
friction! sometimes can adhere parietal and visceral
sharp pain (ie w walking upstairs), deeper and increased breathing

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14
Q

pulmonary collapse

A

enough air enters the Pleural Cavity to break the surface tension between the two layers of Pleura
lung elasticity causes them to collapse

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15
Q

Pneumothorax

A

thoracic wall wound or rupture of pulmonary lesion of PC

causes entry/build up of air/pressure into the Pleural Cavity, results in a collapse of the lung

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16
Q

Hydrothorax

A

excess fluid in the Pleural Cavity, usually the result of fluid escape into the Pleural Cavity, or Pleural Effusion.

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17
Q

Hemothorax

A

blood in pleural cavity

cut of intercostal vessel/internal thoracic vessel

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18
Q

bronchial asthma

A

widespread narrowing of the airways produced by contraction of smooth muscle, edema of the mucosa and mucus in the lumen of the Bronchi and Bronchioles

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19
Q

Bronchoscopy

A

insertion of a Bronchoscope into the trachea to visualize the Main Bronchi.

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20
Q

laryngeal atresia

A

failure of recanalization of larynx
CHAOS syndrome (obstruction of upper fetal airway)
airways dilated, lung enlarged, filled w fluid
diaphragm flattened/inverted, fetal ascites/hydrops

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21
Q

tracheoesophageal fistual

A

connection bw trachea and esophagus (most common LRT)
failed foregut endoderm to proliferate rapidly
cant swallow, drools, regurgitation, GI reflux
polyhydramnios

associated with esophageal atresia

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22
Q

pulmonary agenesis

A 
unilateral agenesis (lack lung, lobe, bronchi)
resp bud fail to split into bronchial buds
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23
Q

oligohydramnios

A

insufficient amniotic fluid production, severe retards lung devlp
assoc w renal agenesis/failure

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24
Q

pulmonary hypoplasia

A

restriction of fetal thorax (uterine pressure)
affects stretch recpt and lung growth
decreased hydraulic pressure on lungs

higher risk of oligohydramnios <26 weeks

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25
resp distress syndrome
``` rapid labored breaking surfactant deficiency (lung underinflated) tachy/nasal flaring, suprasternal/intercostal/subcostal retractions, grunts/cyanosis ```
26
congenital lung cysts
fluid or air filled bronchial develp. disturbance wheezing, cyanosis, diff breathing
27
bronchospasm
constriction of smooth m in bronchioles
28
emphysema
perm enlargement of air spaces distal to term bronchiole, narrowing of bronchioles, destruction of alveolar walls loss of gas exchange bc decrease SA dyspnea, cough, wt loss
29
PNA
inflamed lung tissue, filled w WBC (neutrophils), rbc, fibrin big capillaries w lots rbcs looks red/firm/heavy fever chills, cough, decreased breath sounds, crackles in lungs
30
What is abnormal bv/lymphatic capillary growth via vasculogenesis called?
Angiomas ex: capillary hemangioma (lots caps), cavernous hemangioma (lots venous sinuses) form from mesenchyme, regress on their own common in head and neck
31
What is called to have a right sided L ventricle?
ventricular inversion | ventricle folds to the right, outflow tract is on L
32
What is the name of a total heart reversal? Partial? Right heart, normal GI?
heterotaxia situs inversus - total, every body organ if filled to opposite side, no consequence situs ambiguous - partial, some organs, issue w/ venous return r heart, norm gi - visceroatrial heterotaxia (inflow, outflow problems)
33
What happens when the AV septum fails to fuse?
persistent AV canal (agnesis of av valves) | pulmonary hypertension, hard to exercise, SOB, cardiac congestion, endocarditis risk, linked down syndrome
34
What color does the skin changed to due to low o2 in the blood? symptoms?
blue - cyanosis clubbed fingers, blue fingernail beds/lips, tired, fatigue from mixing of blood
35
What is it when you have insufficient shifting of AV septum or cardiac looping? symptoms?
Double outlet right ventricle pulmonary a and aorta exit R ventricle, with VSD symptoms: cyanosis, breathlessness, murmur, and poor weight gain
36
Tetralogy of fallot
conotruncal ridges off center formation = aorta/pulm trunk are unequal pulmonary stenosis, aorta overrides where pulmonary a should be, VSD, RV hypertrophies (r to l shunt, cyanosis)
37
pulmonary valvular atresia
pulmonary a is closed off (semilunar valves closed) patent foramen ovale and ductus arteriosus Rv hypoplasia
38
aortic valvular stenosis
L ventricular hypertrophy = cardiac fail and pulm hypertension narrowing of aortic valve male dom, congenital, degenerative, infection (RF)
39
aortic valvular atresia
fused valves, hypoplastic LV, | big ductus arteriosus, hypertrophy RV
40
What can start as asymptotic and lead to L ventricular hypertrophy over time from less cusps?
bicuspid aortic valve (2 instead of 3) associated w aortic aneurysms regurgitation, stenosis
41
tricuspid atresia
r AV orfice destroyed patent foramen ovale, VSD, patent ductus arteriosis, atresia of valve cusps hypoplastic RV, hypertrophy LV
42
What is underdeveloped/not formed in hypoplastic L ventricle?
LV, mitral valve, aortic valve, ascending portion of aorta acts as univentricular, only using RV (univent) patent ductus arteriosus and patent foramen ovale (ASD)
43
What can you use for coronary a bypass graft?
great saphenous v bc easy dissection from LE, lengthy w no branching or valves, same size or radial a
44
What is coronary angioplasty do?
small ballon catheter flattens plaque against the wall of coronary a to increase the size of lumen for better blood flow
45
What can cause pulmonary embolism? track it runs?
blood clot, fat globule, air bubble embolus a vein on R side of heart to pulmonary A
46
what fills bronchiolar walls during asthma
eosinophils, lymphocytes, mast cells
47
atrial septal defect
L to R shunting from increased blood to lungs and decreased pulm resistantce after lungs expand this increased blood to lung, pulm resistance, R vent hypertrophy, CHF, then r to l shunt, cyanosis 90% ostium II (secundum, high atrial septal defect)
48
left to right blood shunt causes?
increased work load for R ventricle = hypertrophies, which causes right to left shunts, then cyanosis
49
failure of contruncal ridge formation and fusion is called? caused what else to happen?
persistent truncus arteriosus VSD, mix of blood, pulm congestion, RV hypertrophy, R vent pressure increase, cyanotic cond
50
failed conotruncal ridges to spiral? consequences?
transposition of great vessels pulm a connected to LV, aorta to RV survives w vsd, asd, patent ductus arteriosus
51
how can pt live with pulmonary valvular atresia?
patent ductus arteriosis used to flow of blood from aorta into pulmonary a patent foramen ovale transplant if hypoplasia too bad, vsd rv to left and out aorta = univentricular heart (mix of blood)
52
Which lymph nodes are most associated with breast cancer?
Axillary Lymph Nodes (include the Pectoral, Interpectoral, Deltopectoral, Supraclavicular and Inferior Deep Cervical Lymph Nodes also parasternal
53
what is down syndrome (trisomy 21) associated with?
failure of atrioventricular septa to form
54
lack of blood to myocardium is caused by? And can lead to?
block of coronary A | myocardial infarction
55
building up of lipids on the internal walls of the coronary arteries does what? leading to increase likelihood?
decrease the size of the lumen of vessel, can cause embolus and plugging the vessel fully. coronary atherosclerosis
56
What produces a strangling pain in the chest?
angina pectoris narrow or obstructed coronary arteries that produces ischemia of myocardium
57
cardiac catheterization
insert catheter in femoral v into inferior vena cava to look at RA, RV, PT, Pulm a
58
what ccan you do if you AV or SA node isnt working?
artificial cardiac pacemaker reg electrical impulse to ventricles via electrodes in large vein to superior vena cava into RA past valve in endocardium of trabecula carnae of RV
59
irregular twitching of atrial cardiac m fibers
atrial fibillation
60
irregular twitching of ventricle cardiac m fibers - not able to pump blood
ventricular fibillation
61
what can you do for ventricular fibrilliation
defibrillation - electric shock by electrodes to cease movement in hopes it starts back up again
62
Cardiac Referred Pain
Ischemia stimulates visceral pain sensory fibers in the heart of the Autonomic Nervous system. These visceral sensory fibers often share a spinal ganglion with the somatic sensory fibers of areas such as the upper limb and superior lateral chest wall.
63
Anginal pain is typically referred to the area innervated by
Left Medial Brachial Cutaneous nerve, the left substernal area, left pectoral area and medial aspect of the left upper limb are often involved in this variety of referred pain.
64
What is used to treat heart failure? and what is the mechanism?
Cardiac glycosides inhibit Na/K atpase K binding site, increase Na, decrease Ca out (increase of ca inside to SERCA), positive inotropic effect
65
Cardiac Failure causes what to happen first in the heart? And then follows with?
negative inotropic effect decreased inotropy and vas compliance, increase of Blood Volume and SVR/TPR first decreases cardiac output, then increases volume to compensate
66
Inflammation of the pericardium? Causes?
Pericarditis causes friction on the heart and if not treated, can calcify can also lead to pericardial effusion
67
Pericardial Effusion leads to?
``` cardiac tamponade (heart compression) makes it beat harder accumulation of fluid or pus in the pericardial sac which can compress the heart ```
68
Used to treat pericardial effusion/cardiac tamponade?
Pericardiocentesis Drainage of blood, fluid or pus from the pericardial sac.
69
where do surgeons clamp/insert tubes of a bypass machine?
transverse pericardial sinus accesses area posterior to aorta and pulmonary trunk
70
oligohydramnios (potters) sequence
still born childern oligohydramnios -> fetal compression -> pulm hypoplasia, altered facies (nasal flaring, bridge wide, potter facies, limb hypoplasia, renal fail, club foot, breech presentation)
71
in a rib fracture, what is most likely seen in an X-Ray?
hematoma at site of fracture, actually frac is hard to see CT more sensitive Can puncture kidney, liver (right side), and spleen (left side)
72
air leaking in cavity with no outside intervention happens from?
spont pneumothorax spon rupture of alveoli through vicseral pleura so air leaks into cavity risks - smoke, copd, cystic fibrosis, inherited apical bleb lung collapse, compress of mediastinal structure/vessel
73
air entering thorax but can't exit is?
tension pneumothorax from trauma where injury fails to seal, + pressure ventilation during resuscitation collapsed lung, impaired venous return -> cardiac arrest
74
pulmonary meniscus sign
on surface of fluid seen with pleural effusion due to surface tension between 2 diff fluids in pleural cavity (norm serous fluid and pleural effusion) in costophrenic angles and substernal region
75
coin sign
solitary round, circumscribed shadows on xray can be calcified symptomatic causes: tuberculosis, neoplasms, cysts, vasc anomalies
76
kerley lines
interlobular septa in pulmonary interstitium are prominent | lymph swelling makes them seen, pressing into CT making them dense
77
kerley a vs b
a - diagonal lines from hila to periphery | b - short parallel lines at periphery perp to pleura
78
causes of kerley lines
pulm edema, lymphoma, cancer, pna
79
causes of cardiac tomponade
neoplasms, pericarditis, effusion due to renal fail, trauma fiberous pericardium prevents overflow, and create issues when there is a build up of fluid because it can cause friction and decrease hr
80
becks triad
``` for cardiac tamponade distant heart sounds muffled jugular distention - restricted venous return hypotension signs of shock, decreased co treat with pericardiocentsis ```
81
cardiac tamponade can show up as what on xray
water bottle heart | globular heart silhouette in xray
82
what do you use echocardiography for?
good in utero, child adult - probe is on ant skin, red blood flow toward, blue away color change = turbulence and can indicate mixing of blood can indicate blood regurgitation
83
What keeps the PDA open during development?
prostaglandins | regulated by o2 tension and blood flow -> regulates smooth m contraction
84
consequences of pda?
lv hypertrophy, pulmonary congestion, congestive HF treated with indomethacin or surgery bad if mom has rubella
85
aortic lumen narrowed due to abnormal thickening of the wall is? Types?
coarctation of aorta aka turner's syndrome postductal (after da) - not noticed bc collateral circulation through intercostal arteries and internal thoracic a preductal - collaterals not devlp, after birth little body goes to LE, pda, death often unless repaired
86
aberrant origin of R subclavian
distal of right dorsal aorta and 7th intercostal a (intersegmental) r AA IV, prox part of R dorsal aorta obliterated dysphagia and dyspnea (dorsal aorta cross esophagus to reach r ue
87
double aortic arch leads to?
esophageal dysfunction and strangulation of trachea vascular ring around trachea and esophagus, looks like a heart shape
88
right aortic arch
left AA IV and left dorsal aorta obliterated, replaced by vessels on r
89
dysphagia and dyspnea happens in r aortic arch because?
l subclavian A pass behind esophagus and ligamentum arteriosum in front of trachea to reach R side
90
interrupted aortic arch
left and right AA IV obliterated, as well as prox part of r dorsal aorta pda, descending aorta and subclav A supplied by blood of low 02 aortic trunk supplies 2 common carotids
91
what is seen in DiGeorge syndrome? dangerous?
interrupted aortic arch | life threatening

CPR I (12 decks)

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