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Dysmorphology
Chest
Question | Answer |
---|---|
Chest "cage" | Enclosure for the thoracic organs |
12 pairs of ribs | -All articulate with spinal column posteriorly |
"True" Ribs | -7 - articulate to sternum |
"False" Ribs | -5 -Articulate to the costal cartilage above them (Pairs 11 and 12 don't articulate anteriorly |
Mesoderm | -Skeletal muscles -In the trunk-source of all connective tissues including cartilage, bones, tendons, ligaments, dermis, and stoma of the internal organs |
Sternum is made up of... | 1. Ribs 2. Sternal Bars 3. Clavicles |
When the baby is born, the sternum is... | Bone |
All parts of the sternum should be fused by what week gestation? | 10th |
Landmarks of chest | 1. Sternal Notch 2. Clavicles 3. Midclavicular line 4. Anterior axillary line 5. Nipples 6. Xiphoid process 7. Costal angle |
Examination techniques (of the chest) | 1. Inspection 2. Palpation 3. Measurements |
Inspection of the chest for... | 1. Symmetry 2. Unusual masses 3. Abnormal configuration 4. Shape of thorax 5. Placement of nipples 6. Contour of ribs and sternum 7. Symmetry of chest motions |
Palpation of the chest for... | 1. Masses 2. Amount of breast tissue |
Measurements | 1. Internipple distance 2. Total chest circumference |
Syndromes associated with chest anomalies | 1. Poland 2. Cerebro-costo mandibular syndrome 3. Noon syndrome |
Minor Variants of chest | 1. Pectus excavatum 2. Pectus carinatum 3. Shield chest |
Minor anomalies of chest | 1. Fused/bifid ribs |
Deformations of the chest | 1. Scoliosis |
Disruptions of the chest | 1. Rare 2. Extreme injury to organs/structures |
Dysplasias of the chest | 1. Rib involvement (usually lysosomal) 2. Absence/hypoplasia of clavicles (Cleidocranial dysostosis) |
Malformations of the chest | 1. Absence of the pectoralis major muscle 2. Beaded ribs 3. Short sternum 4. Cleft sternum 5. Ectopia cordis |
Pectus carinatum | -Minor variant -"Pigeon chest" - Chest if narrow |
Pectus excavatum | -Minor variant -"Funnel chest" |
Syndromes associated with Pectus excavatum | -Marfan -Coffin-Lowry |
Treatment for pectus excavatum | - Nuss (uses a stabilizing bar to pop chest out) - Ravitsch (take out cartilage & put bar in) |
Treatment for pectus carinatum | - Do a chest wall brace (usually gone within a year), might also have to a Ravitsch procedure |
Disorder associated with Pectus carinatum | 1. Homocystinuria |
Shield Chest | - Minor Variant -Widely spaced nipple -Costal angle is a good judgment |
Syndrome associated with shield chest | -Turner syndrome |
Fused/bifid ribs | -Minor anomaly -1/ 5000 LB -Usually asymptomatic -More frequently unilateral |
Scoliosis | -Deformation - Can produce asymmetry of the thorax - Widens intercostal space on one side and narrows the space on the other -Affects breathing and heart -Crouching on one side, expanding on the other |
Rib Involvement | -Dysplasia -Many bone dysplasias and mucopolysaccharides - Usually widening or cupping of distal ends - X-ray needed -Lysosomal |
Absence/hypoplasia of clavicles | -Dysplasia - Cleidocranial dysostosis |
Absence of pectoralis major muscle | -Malformation -Most common chest abnormality -Poland sequence |
Beaded ribs | -Malformation - Ribs meet sternum= Costochondral junction enlarged |
Short sternum | -Malformation -Failure of development of one or more ossification centers |
Cleft sternum | -Malformation |
Ectopia cordis | -Malformation -Failure of midline fusion - Large cleft sternum, skin coverage may be incomplete, structures exposed -Put a plate to cover the defect |