Disorders of the chest wall Flashcards Preview

Clinical Medicine- Pulmonary > Disorders of the chest wall > Flashcards

Flashcards in Disorders of the chest wall Deck (21):

Increased fat in this area is more likely to influence mechanical effects of breating?

Increased abdominal fat and in the thoracic region


Obese individuals also have these pulmonary problems?

Increased proinflammatory cytokines (increased asthma and bronchoconstriction), orthopnea, chronic hypoxia, and hypercapnia


Common effects on respiratory function from obesity?

Basic reduction in lung volume. Decreased expiratory reserve volume, reduced functional residual capicity (amount of air remained in lungs after normal tidal volume expiration),


In kyphoscoliosis, this lung disease is common and can be quite severe?

Restrictive lung disease. Obstructive lung diseases are less common


This test is used to measure severity of kyphoscholiosis? What results indicate respiratory impairment?

Cobb Angle, > 50-60 lung function is generally impaired, >90 respiratory failure, deformity above T10 associated with greater impairment


More severe kyphoscoliosis causes what?

Decreased lung volume and total lung capacity


Problems from pectus excavatum?

Left heart displacement, rotation, compression of heart, mild restrictive lung impairment with reduced TLC and FVC


What is flail chest?

Fracture of 3 or more ribs in 2 places that causes the flail segment to move paradoxically (opposite) to the rest of the chest wall


Due to independent segment movement, there is not enough________ to maintain adequate perfussion?

intrathoracic pressure


Treatment of flail chest?

Pain control is important, severe respiratory compromise need ventilation, surgical rib fixation necessary in some cases


What is in the anterior mediastinum and what associated lesions can be found?

Thymus & lymph nodes. Thymoma, Teratoma, Terrible lymphoma, thyroid tissue


What is found in the middle mediastinum and what lesions can be found?

Heart, bronchi, hila, lymph nodes, trachae. Lymphadenopathy from lymphoma, sarcoidosis, metastasis


What is in the posterior mediastinum and what lesions can be found?

Esophagus, lymph nodes, descending aorta. Neurogenic tumors


Symptoms of mediastinum masses?

Cough, dyspnea, dysphagia, hoarseness, cardiac tamponade. Patients with lymphoma may have weight loss, fever, night sweats.


What is mediastinitis?

Infection of the mediastinum that usually occurs post CABG or cardiovascular procedure.


Clinical presentation of mediastinitis?

Fever, tachycardia, chest pain, sternal wound drainage from infection


What is Hammans sign?

Crunching or air bubbles heard when auscultating. synchronous with heart beat.


Treatment of mediastinitis?

Surgical debridment or sternal wound, closure or left open with vaccum assisted closure (VAC) device, IV vanco + either 3rd gen cephalo, cipro, or aminoglycoside


What is pneumomediastinum? Causes?

Air in the medistinum from chest trauma, esophageal rupture, ventilator, severe cough from asthma, severe vomitting or defication strain, barotrauma, hyperpnea


What is eventration of the diaphragm

Diaphragmatic weakness, usually unilateral, caused by disorder that affects phrenic nerve, spinal cord, muscle or neuromuscular junction


What must you be sure to exclude on patients with diaphragmatic paralysis?

Mestastatic tumor