Exam 2 - Clinical Notes Flashcards Preview

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Flashcards in Exam 2 - Clinical Notes Deck (72)
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1
Q

These cartilages may ossify, can be mistaken for a fracture on a x-ray

A

Corniculate + Cuneiform Cartilage

2
Q

In Hoarseness due to excessive singing or excessive speaking, the lubricant from the saccule is temporarily depleted. Nodules can form. This is referred to as?

A

Laryngeal saccule depletion

3
Q

Inflammation of the vocal folds by viral infection is called?

A

Laryngitis

4
Q

Paralysis of what muscle does NOT cause suffocation…the neutral position of vocal cords is partially abducted which reduces the risk of suffocation

A

Posterior Cricoarytenoid Muscle

5
Q

Voice Dimorphism is determined by what 3 things?

A

1) Length of vocal cords (males have longer)
2) Size of Resonating chamber
3) Thickness of vocal cords

6
Q

Lymph is moved by _________ _______ contraction, ________ helps clear toxins from tissues (a benefit of massage)

A

skeletal muscle, exercise

7
Q

What node? Enlarged supraclavicular node usually on the left, often 1st indication of visceral tumor of thorax/abdomen, lung/breast cancer

A

Signal (Sentinel) Node

8
Q

Primary tumor of the lymph nodes.

Hodgkin’s, Non-Hodgkin’s…which is worse?

A

Lymphoma, Non-Hodgkins has much worse prognosis

9
Q

Using Lymphatics for Diagnosis:
An enlarged nodule which is…
1) Tender/Painful: indicates?
2) Hard + Painless: indicates?

A

1) Tender/Painful: infection

2) Hard + Painless: cyst development or Cancer

10
Q

Parasitic infection of lymphatic system (worms) is called?

A

Filariasis

11
Q

Most common cancer in women. Spreads to lymphatics before entering blood stream. (Usually spreads to axilla first)

A

Breast Cancer

12
Q

Clinical Signs of Breast Cancer? (3)

A

1) dimpling of the skin (due to invasion of suspensory ligament)
2) inverted nipples (invasion of lactiferous duct)
3) leathery thickening of the skin (like an orange)

13
Q

_________ provides collateral circulation, which provides safety net in case of a blockage

A

Anastomosis

14
Q

What condition? Pleural cavities fill with air…causes? (3)

A

Pneumothorax, causes…

1) trauma (“sucking chest wound”)
2) Disease (COPD, Emphysema, TB)
3) congenital weak spot (common in people with large growth spurts)
* *(in causes 2 + 3, air comes in from the lung itself through rupture)

15
Q

What condition? Can be life threatening. Instead of a hole, a flap is present on the visceral pleura. Air enters pleural cavity on inspiration, but not exit on expiration.
Pleural cavity inflates like an inner tube, pushing the mediastinum to the opposite side and compressing the other lung (tire pump like mechanism)

A

Tension Pneumothorax

16
Q

Pleural Cavity fills with blood is known as what condition?

A

Hemothorax

17
Q

Both Hemothorax and Pneumothorax conditions are present, simultaneously. What condition?

A

Hemopneumothorax

18
Q

Lung Collapse is referred to as? (All of the aforementioned lung conditions can result in this)

A

Atelectasis

19
Q

Inflammation of the pleura which leads to adhesions between parietal and visceral pleura is called?

A

Pleuritis

20
Q

Most commonly occur with children…usually enter the _____ main bronchus due to its wider, short ventricle arrangement.

A

Aspiration of Foreign Objects, right

21
Q

Obstructive airway disease characterized by coughing, wheezing, difficulty breathing

A

Asthma

22
Q

2 types of Asthma

1) Extrinsic: triggered by _______
2) Intrinsic: triggered by stimuli such as ______, _____, _______

A

1) Extrinsic: triggered by allergens

2) Intrinsic: triggered by stimuli such as stress, cold, exercise (non-allergenic)

23
Q

Lungs and Tracheobronchial tree are rich with ________ b/c they are an interface with the environment.

A

lymphatics

24
Q

_______ destroys the cilia, resulting in heavy coughing

A

Smoking (smoker’s cough)

25
Q

Primary tumor of the bronchus? Most common tumor in males and females….directly related to cigarette smoking a/o air pollution.

A

Bronchogenic Carcinoma

26
Q

Chiropractic Note: intrathoracic diseases such as bronchogenic carcinoma or lung infections may refer pain to where? (both have sympathetic + vagal branches to lungs that contain sensory fibers)

A

Upper or middle thoracic spinal cord segments

27
Q

What may occur due to weakness in the diaphragmatic wall around the esophageal hiatus? Upper part of stomach slides up into the thoracic cavity through opening

A

Hiatal Hernia

28
Q

Result of spasmodic contraction of the diaphragm. Most commonly caused by irritation of the phrenic nerve, usually benign

A

Hiccups

29
Q

What condition? Fibrous pericardium is very unyielding. If fluid leaks into the pericardial cavity (pericardial effusion), the heart may be compressed and venous return impeded. (Superior Vena Cava particularly vulnerable)

A

Cardiac Tamponade

30
Q

Inflammation of the pericardium is known as? (Always life threatening)

A

Pericarditis

31
Q

Important to differentiate from Pleural friction rub. Distinguish by auscultating while patient holds their breath (heart doesn’t stop beating, but lungs will stop moving)

A

Pericardial Friction Rub

32
Q

What causes obstruction of the pulmonary artery via blood clot? The clot forms in systemic venous system (ex. Leg), passes through the heart to the lungs. Blood flow is blocked to the lung, results in acute respiratory distress. Leads to dilation of RV + RA, resulting in heart failure.

A

Pulmonary Embolism

33
Q

Pulmonary Embolism which blocks BOTH pulmonary arteries, death can occur within minutes

A

Saddle Embolism

34
Q

Auscultation of Tricuspid Valve…

Reasons why you can NOT listen directly to the Tricuspid valve? (3)

A

1) bc the presence of the sternum
2) orientation of the heart
3) blood carries sound in its direction of flow

35
Q

When the Foramen Ovale persists as a small opening in the superior part of the Fossa Ovalis is known as what? (25% of adults have this abnormality) There are 2 types.

A

Atrial Septal Defect

36
Q

Enlargement of the heart can occur in what two ways?

A

1) Muscular Hypertrophy

2) Chamber Dilation

37
Q

Deposition of lipid plaques on the inner walls of arteries results in a narrowing of the lumen is known as?

A

Atherosclerosis

38
Q

What condition?
Causes subcostal chest pain upon exertion**
Is a symptom of PARTIAL occlusion/blockage of coronary artery branches occurs due to insufficient blood flow to heart tissue (ischemia)

A

Angina Pectoris

39
Q

Occurs when a coronary artery branch becomes COMPLETELY occluded/blocked. Portion of the heart supplied by the artery dies (necrosis) and is converted to fibrous scar tissue.

A

Myocardial Infarction

40
Q

Chiropractic note for heart…
Subluxations and related soft tissue changes restrictive to T1-T4 are frequently associated with what?
Hypothesis: Impingement on sympathetics could allow parasympathetic activation to dominate, lead to constriction of what?

A

Myocardial infarctions and other heart problems

Coronary arteries

41
Q

Vocal Cord + Vocal ligament have _________ receptors

A

androgen receptors

42
Q

Breast Caner spreads to ________ first before entering blood stream (Usually spreads to axilla first)

A

lymphatics

43
Q

(Referring to Breast Cancer) Posterior Intercostal V drains to azygos + hemiazygos…connection to the vertebral venous plexus allows spread to ________ and ______

A

vertebral column + brain

44
Q

Chiropractic note: ______ is one cause of mid-thoracic back pain in females

A

Breast cancer

45
Q

______ will be out of midline in Tension Pneumothorax?

A

Trachea

46
Q

Pleuritis can be painful due to sensory innervation of ________ pleura. (not _______ pleura, which lacks innervation)

A

parietal, visceral

47
Q

In Pleuritis, pain is often referred to the _______ via _______ nerve (C3,4,5). Pain radiates along distribution of _____________ nerves (c3,4).

A

shoulder, phrenic, supraclavicular

48
Q

Pleuritis produces a sound known as _______ ______ ___ (which can be heard on auscultation)

A

Pleura Friction Rub

49
Q

The ______ is covered with sensitive mucous membrane. It represents the lowest part in the tracheobronchial tree where ______ reflex is mechanically initiated. Once Carina is passed, coughing stops but chemical bronchitis and atelectasis may ensue

A

Carina, cough

50
Q

With aspiration of a foreign object…once Carina is passed, ________ stops but chemical bronchitis and atelectasis may ensue

A

coughing

51
Q

Asthma is caused by spasm of the ______ ______, which lines the segmental bronchi and bronchioles. Accompanied by excessive secretion of _____

A

smooth muscle, mucus

52
Q

Chiropractic Note: What condition is often associated with upper thoracic subluxations. Adjustments often bring relief

A

Asthma

53
Q

_________ originate from T2-T5. Impingement here may allow ___________ activation to dominate. Lower thoracics (T9-T11) supply adrenal medulla which secretes _________, a potent bronchodilator

A

Sympathetics, parasympathetic, epinephrine

54
Q

________ epithelium has ciliated hair like projections

A

Respiratory

55
Q

What refers to the movement of mucus + dirt up and out of the Larynx?

A

Mucociliary Clearance

56
Q

________ _________ is highly metastatic. Spreads quickly to lymph nodes, enters bloodstream by eroding a venule, traveling via the pulmonary veins to the heart and systemic circulation. Often causes enlargement of a sentinel node.

A

Bronchogenic Carcinoma

57
Q

2 nerves that Lung Cancer/Bronchogenic Carcinoma may affect?

1) ? resulting in paralysis of the diaphragm.
2) ? at apex of lung, resulting in paralysis of half of the larynx

A

Phrenic N

Recurrent Laryngeal N

58
Q

Major cause of Gastroesophageal reflux? (usually occurs after age 50)
Symptoms: belching + epigastric pain

A

Hiatal Hernia

59
Q

(Referring to a Hiatal Hernia) What chiropractic technique can be an effective treatment?

A

SOT (Sacro-Occipital Technique)

60
Q

Morbid underlying causes of hiccups? (3)

A

Brain Lesions, Pleuritis, Peritonitis

61
Q

Cardiac Tamponade will produce…

1) Prominent _______ _______ Vein
2) Eventually all veins of the _____ and _____ become engorged

A

1) External Jugular V

2) face and neck

62
Q

When fluid leaks into the pericardial cavity is known as what?

A

Pericardial effusion

63
Q

What aspect of the heart is particularly vulnerable in reference to Cardiac Tamponade?

A

Superior Vena Cava

64
Q

In reference to Pericardial Friction Rub…the _____ keeps working, but the _____ will stop.

A

heart, lungs

65
Q

In the case of a Pulmonary Embolism…the clot forms in systemic venous system (ex. Leg) and passes through the ____ → ____ → _____ →_____ → _____. Causes blockage of blood flow to lungs.

A

Inferior/Superior Vena Cava → right atrium → right ventricle → Pulmonary Trunk → Pulmonary Arteries

66
Q

A Pulmonary Embolism causes blood flow blockage to the lung which results in ____ _______ ______. Leads to dilation of _______ and _______, resulting in heart failure.

A

acute respiratory distress, right ventricle and right atrium

67
Q

2 types of Atrial Septal Defects?

A

Probe Patent Foramen Ovale

Clinical Atrial Septal Defect

68
Q

Type of Atrial Septal Defect when the defect is small. In most cases, not clinically significant.

A

Probe Patent Foramen Ovale

69
Q

Type of Atrial Septal Defect when the defect is larger, blood is shunted from the left atrium, to the right, causing dilation of the 1) RA 2) RV 3) Pulmonary Trunk

A

Clinical Atrial Septal Defect

70
Q

In reference to enlargement of the heart…
________ _______ refers to lost elasticity of right ventricle with age, particularly with atherosclerosis a/o hypertension. (More force is required to push blood through arteries, walls of heart grow due to enlargement of cardiac muscle fibers)

A

Muscular Hypertrophy

71
Q

In reference to enlargement of the heart…
_______ _______ may be due to: Septal Defects, Valve incompetency, with incompetent mitral valve, there is a regurgitation of blood from left ventricle to left atrium. Left atrium may dilate to accommodate the extra blood

A

Dilation of Chamber

72
Q

Most common sites for Myocardial Infarction? (3)

A

1) Anterior Interventricular Artery (40-50%) (“Widow-Maker”)
2) Right Coronary Artery (30-40%)
3) Circumflex artery (15-20%)