Week 2 Thorax ✅

Question 1

Where is the neurovascular bundle in relation to the rib?

Answer 1

Inferior of costal groove

Question 2

How do you know where to insert the chest drain?

Answer 2

Palpate the rib, go above and aim for middle

Question 3

How do the upper ribs move?

Answer 3

Laterally

Question 4

How do the lower ribs move?

Answer 4

Bucket handle

Question 5

What are the external intercostal muscles used for?

Answer 5

Inspiration

Question 6

What are the internal intercostal muscles used for?

Answer 6

Expiration

Question 7

What are the innermost intercostal muscles used for?

Answer 7

Expiration

Question 8

Which nerves control automated and voluntary breathing?

Answer 8

C3,4,5

Question 9

Why is referred pain from the diaphragm felt in the shoulder?

Answer 9

C3,4,5

Question 10

Where might referred pain be felt in ectopic pregnancy?

Answer 10

Diaphragm

Question 11

Why might the diaphragm be elevated on the right? What about if it was very elevated

Answer 11

Liver makes diaphragm higher on the right
Very high - ?paralysis of diaphragm

Question 12

Which accessory muscles are used for inspiration?

Answer 12

Sternocleidomastoid
Anterior, middle and posterior scalenes
Pectoralis major/minor
Serratus anterior

Question 13

How should you position patients in respiratory distress

Answer 13

Sat up/tripod
DO NOT LIE DOWN

Question 14

How should a single rib fracture be managed?

Answer 14

Rest - rib above and below will act as a splint
Analgesic to keep moving

Question 15

What happens if rib/chest pain is poorly treated?

Answer 15

Pneumonia

Question 16

How do you differentiate between anterior and posterior ribs on CXR?

Answer 16

Anterior - sloped on CXR
Posterior - horizontal on CXR

Question 17

What is kyphosis?

Answer 17

Forward rounding of the upper back

Question 18

What is scoliosis?

Answer 18

Spine twists and curves to the side

Question 19

What is kyphoscoliosis?

Answer 19

Kyphosis and scoliosis - spinal twisting on 2 planes

Question 20

When might you see barrel chest?

Answer 20

Common with smoking. Larger lungs with emphysema

Question 21

What is the difference between parietal and visceral pleura?

Answer 21

Visceral is against large organs, parietal is against wall of the cavity/structure

Question 22

What can a flail chest cause?

Answer 22

Ineffective ventilation as negative pressure is not working
Pulmonary contusion
Hypoventilation with atelectasis

Question 23

What is atelectasis?

Answer 23

Partial collapse or incomplete inflation of the lung

Question 24

What is PPV?

Answer 24

Positive pressure ventilation

Machine pumps air in, positive pressure sucks air out

Question 25

How do you treat flail chest?

Answer 25

PPV ORIF (Open reduction and internal fixation)

Question 26

Why treat flail chest with PPV?

Answer 26

Brings flail segment up with lungs as it should

Question 27

What are complications of cardiac contusion?

Answer 27

ECG abnormalities, arrhythmias

Question 28

Why does being hit in the chest cause cardiac arrest?

Answer 28

Arrhythmia