Thoracic Wall

Question 1

most important symptom of cardiac disease

Answer 1

chest pain

Question 2

most common rib fracture

Answer 2

middle rib fractures (weakest anterior to angles)

Question 3

what can cause diaphragmatic hernia?

Answer 3

lower rib fractures

Question 4

1st rib fractures can cause?

Answer 4

damage to brachial plexus & subclavian vessels

Question 5

multiple rib fractures allowing segment of thoracic wall to move freely; painful & impairs ventilation

Answer 5

flail chest; fixed with wires to prevent movement

Question 6

surgical creation of opening through thoracic wall entering the pleural cavity

Answer 6

thoracotomy

Question 7

H-shaped cuts through perichondrium of costal cartilage

Answer 7

anterior thoracotomy

Question 8

thoracotomy through intercostal spaces 5-7

Answer 8

posterior thoracotomy

Question 9

thoracotomy used in a pneumonectomy

Answer 9

lateral thoracotomy

Question 10

where does a rib regenerate from?

Answer 10

periosteum

Question 11

additional cervical or lumbar ribs or lacking 12th pair of ribs

Answer 11

supernumerary ribs

Question 12

hard lump in epigastric fossa

Answer 12

ossified xiphoid processes (usually in elderly)

Question 13

a crush injury can cause?

Answer 13

sternal fractures; 25-45% mortality due to visceral injury to heart/lungs

Question 14

sternum divided at median plane, ribs allow spreading of chest

Answer 14

median sternotomy

Question 15

used in transplants & blood dyscrasias; bone marrow needle biopsy

Answer 15

sternal biopsy

Question 16

heart protusion (ectopia cordis) due to lack of sternal bar fusion

Answer 16

complete sternal cleft

Question 17

small perforation in sternum

Answer 17

sternal foramen

Question 18

receding or projecting of sternum evident in childhood

Answer 18

pectus excavatum/cavinatum

Question 19

structures emerging from superior thoracic aperture are obstructed (lower neck & limb)

Answer 19

thoracic outlet syndrome

Question 20

displacement of costal cartillage from sternum

Answer 20

sternocostal joint displacement

Question 21

unilaterally in ribs 8, 9, 10 with damage to underlying structures (diaphragm/liver); lump-like deformity

Answer 21

interchondral joint displacement

Question 22

dislocation between rib and costal cartillage in ribs 3-10

Answer 22

costochondrial junction dislocation

Question 23

paradoxical movement; diaphragm ascends during inspiration and descends during expiration

Answer 23

paralysis of diaphragm (hemidiaphragm)

Question 24

difficult breathing & how to make it better?

Answer 24

dypsnea —-> use accessory breathing muscles to expand thorax by leaning on arms/knees to allow muscles to act on the ribs

Question 25

shingles skin lesion, disease of ganglia that causes burning pain in dermatome; rare motor neuropathy

Answer 25

herpes zoster