Lungs & Pleura

Question 1

presence of air in pleural cavity

Answer 1

pneumothorax due to injuries to superior thoracic aperature (cervical pleura & apex)

Question 2

collapse of a previously inflated lung

Answer 2

secondary atelectasis

Question 3

failure of a lung to inflate at birth

Answer 3

primary atelectasis

Question 4

how do you prevent secondary atelectasis during open chest surgery?

Answer 4

intubation and positive pressure pump (keeps lungs inflated during surgery)

Question 5

effusion of fluid into pleural cavity

Answer 5

hydrothorax

Question 6

blood enters pleural cavity due to chest wound hitting intercostal or internal thoracic arteries

Answer 6

hemothorax

Question 7

insertion of needle into pleural cavity to attain sample; superior to rib

Answer 7

thoracentesis (9th intercostal space to avoid inferior border of lung & angle needle superiorly to avoid recess)

Question 8

where would you insert a chest tube?

Answer 8

5th or 6th intercostal space in midaxillary line; angle superiorly to drain air or inferiorly to drain fluid

Question 9

surgical excision of part of pleura

Answer 9

pleurectomy

Question 10

induced adherence of parietal and visceral pleura to prevent secondary atelectasis from pneumothorax

Answer 10

pleurodesis

Question 11

examination of pleural cavity

Answer 11

thoracoscopy

Question 12

inflammation of pleura

Answer 12

pleuritis (detectable with stethoscope)

Question 13

accessory lobe in right lung superior to hilum & separated with arch of azygos vein

Answer 13

azygos lobe

Question 14

sites for auscultation of lungs and percussion of thorax

Answer 14

root of neck (apices of lungs) & inferioposterior part of inferior lobe (posterior thoracic wall at T10 level)

Question 15

typical site for aspirated foreign bodies

Answer 15

right main bronchus

Question 16

distortion of carina visualized in a bronchoscopy is indicative of?

Answer 16

enlarged tracheobronchial lymph nodes from bronchogenic carcinoma

Question 17

surgical removal of lung

Answer 17

pneumonectomy

Question 18

surgical removal of lobe

Answer 18

lobectomy

Question 19

surgical removal of segment

Answer 19

segmentectomy

Question 20

air absorbed into blood due to a blocked brochial segment, resulting in segmental collapse; adjacent segments will expand to accommodate reduced volume

Answer 20

segmental atelectesis

Question 21

obstruction of pulmonary artery by embolus resulting in no lung perfusion

Answer 21

pulmonary embolism

Question 22

major decrease in blood oxygen saturation —-> contralateral lung will dilate

Answer 22

acute respiratory distress

Question 23

ischemia of visceral pleura causes?

Answer 23

pleuritis & attachment to parietal pleura —> referred pain in cutaneous intercostals

Question 24

carbon particle presence in axillary node is indicative of?

Answer 24

lymphatic vessels in lung and visceral pleura anastomosing with parietal lymph vessels

Question 25

bronchitis, lung cancer, pneumonia, pulmonary embolism, & tuberculosis can cause?

Answer 25

hemoptysis —> spitting of blood from lungs from bronchial/pulmonary hemorrhage from bronchial arteries

Question 26

cancer that arises from a bronchus; usually from cigarette smoke; causes hemoptysis; common hematogenous metastastis are brain, bones, lung, adrenal glands

Answer 26

bronchogenic carcinoma

Question 27

lymph nodes that first receive lymph from a cancerous

Answer 27

sentinel nodes

Question 28

hemidiaphragm & vocal cord paralysis (recurrent laryngeal) is indicative of?

Answer 28

apical lung cancer involving mediastinal nerves such as phrenic and vagus nerves

Question 29

where is mediastinal/central diaphragmatic pain referred to?

Answer 29

C3-5 dermatome (root of neck & shoulder)

Question 30

where is costal/peripheral pain referred to?

Answer 30

dermatomes in abdominal/thoracic walls

Question 31

if a chest x-ray shows that the inferior margin of the lung does not descend into the recess, what is wrong with patient?

Answer 31

pleural effusion

Question 32

birth defect resulting in failed recanalization of larynx, causing congenital high airway obstruction syndrome —> distal dilation of airway, lungs fill with fluid, diaphragm flattens, & accumulation of serous fluid (intracellular edema)

Answer 32

laryngeal atresia

Question 33

what is incomplete laryngeal atresia called & how do you treat it?

Answer 33

laryngeal web; endoscopic dilation of web

Question 34

symptoms: infant can’t swallow, drools excessively, instantly regurgitates, pneumonitis, & polyhydramnios in utero

Answer 34

tracheoespophageal fistula —-> incomplete division of cranial part of foregut into esophagus & trachea

Question 35

failure of larynx & upper trachea to separate from esophagus; symptoms similar to fistula

Answer 35

laryngotracheoesophageal cleft

Question 36

recurrent infection and respiratory distress are typical of?

Answer 36

tracheal diverticulum —> bronchus like projection from trachea that can terminate in lung tissue which forms a tracheal lobe of lung

Question 37

insufficient amount of amniotic fluid which causes lung development to slow & pulmonary hypoplasia due to restriction of thorax

Answer 37

oligohydramnios

Question 38

how are the lungs of a stillborn different from a normal neonate?

Answer 38

a stillborn’s lungs have fluid and will sink in water while a normal neonate’s lungs have air and will float in water

Question 39

labored breathing shortly after birth; common in premies due to a deficiency of surfactant

Answer 39

respiratory distress syndrome or hyaline membrane disease; treat with corticosteroids to induce surfactant production

Question 40

linear marking on radiograph that suggests the azygos vein lies on the bottom of the horizontal fissure in the superior lobe of the right lung & is indicative of?

Answer 40

azygos lobe of lung due to apical bronchus growing superior & medial (instead of lateral) to azygos vein

Question 41

honeycomb appearance on radiograph usually in periphery of lungs; formed by dilation of terminal bronchi

Answer 41

congenital lung cysts

Question 42

failure of respiratory bud to develop; mostly unilaterally; shifting of heart & mediastinal structures; hyperexpansion of lungs

Answer 42

agenesis of lung (think table six’s uni-lung?)

Question 43

reduced lung volume & hypertrophy of smooth muscle in pulmonary arteries —> pulmonary hypertension leads to ischemia of lungs

Answer 43

lung hypoplasia in utero; typically results in death

Question 44

pulmonary sequestration usually at base of left lung; nonfunctional and no communication with tracheobronchial tree but has systemic blood supply

Answer 44

accessory lung