Respiratory - Consequences of Chronic Cough - Week 3

Question 1

A pneumothorax is caused by…

Answer 1

Penetration injury of the parietal pleura or rupture of the visceral pleura

Question 2

In a large pneumothorax, the lungs are how many centimetres away from the parietal pleura?

Answer 2

> 2cm

Question 3

In a small pneumothorax, the lungs are how many centimetres away from the parietal pleura?

Answer 3

< 2cm

Question 4

O/E a pneumothorax would show…

Answer 4

Reduced ipsilateral chest expansion, reduced ipsilateral breath sounds, hyper-resonance

Question 5

A tension pneumothorax is likely to cause…

Answer 5

Mediastinal shift

Question 6

What is the effect of mediastinal shift on tracheal deviation?

Answer 6

Trachea deviates to the opposite side of the pneumothorax

Question 7

What is the most serious complication of mediastinal shift?

Answer 7

SVC compression resulting in hypotension

Question 8

What is the management of a large pneumothorax?

Answer 8

Siting of a chest drain in the mid-axillary line in the 4th or 5th intercostal space

Question 9

Explain the emergency management of a tension pneumothorax.

Answer 9

Insertion of a gauge cannula into the pleural cavity in the 2nd or 3rd intercostal space on the side of the tension pneumothorax

Question 10

What is meant by hernaie?

Answer 10

Any structure passing through another, so ending up in the wrong place

Question 11

Which two factors are usually required for the development of a hernia?

Answer 11

weakness of a structure and increased pressure on that side of the wall

Question 12

Where are the common diaphragmatic weaknesses?

Answer 12

Attachment to the xiphoid process, posterior attachments, aortic attachments, oesophageal hiatus

Question 13

What are the two types of hiatus hernia?

Answer 13

Paraoesophageal hiatus hernia, sliding hiatus hernia

Question 14

What is meant by a paraoesophageal hiatus hernia?

Answer 14

the herniated part of the stomach passes through the oesophageal hiatus to become parallel to the oesophagus & in the chest

Question 15

What is meant by a sliding hiatus hernia?

Answer 15

the herniated part of the stomach slides through the oesophageal hiatus into the chest with the gastro-oesophageal junction

Question 16

What is meant by a direct iguinal hernia?

Answer 16

a “finger” of peritoneum is forced through the posterior wall of the inguinal canal and directly out of the superficial ring into the scrotum

Question 17

What is meant by an indirect iguinal hernia?

Answer 17

a “finger” of peritoneum is first forced through the deep ring into the inguinal canal and then out of the superficial ring into the scrotum

Question 18

How would you differentiate clinically between a direct and indirect hernia?

Answer 18

Reduce the hernia, occlude the deep ring with pressure. If it reappears, it is direct, if not, it must be indirect

Question 19

Where do the iguinal ligaments attach?

Answer 19

Between the anterior superior iliac spine (ASIS) and pubic tubercle

Question 20

The iguinal ligaments are important because…

Answer 20

Their medial halves form the floor of the iguinal canal

Question 21

The openings to the iguinal canal are called…

Answer 21

The deep & superficial rings

Question 22

What drains blood from the testis?

Answer 22

R/L pampiniform venous plexus

Question 23

What brings blood to the testis?

Answer 23

R/L testicular artery

Question 24

the right spermatic cord contains the…

Answer 24

vas deferens, testicular artery & pampiniform plexus