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Clinical notes
MEDIASTINUM, PLEURAE, LOWER RESPIRATORY TRACT
| Question | Answer |
|---|---|
| In the cadaver, the mediastinum is _______________ | an inflexible, fixed structure |
| why is the mediastinum an inflexible, fixed structure in the cadaver | because of the hardening effect of the preserving fluids |
| In the living, the mediastinum is | very mobile; the lungs, heart, and large arteries are in rhythmic pulsation, the esophagus distends as each bolus of food passes through it |
| a condition in which air enters the pleural cavity | pneumothorax |
| a condition where the lung on that side Immediately collapses and the mediastinum is displaced to the opposite side | pneumothorax |
| condition reveals Itself by the patient being breathless and in a state of shock | pneumothorax |
| on examination, the trachea. and the heart are displaced to the opposite side. | pneumothorax |
| In esophageal perforations, air escapes into the connective tissue spaces and ascends beneath the fascia to the root of the neck, producing | subcutaneous emphysema |
| how can functions can vital structures within the mediastinum be interfered with by an enlarging tumor or organ | Because they structures are crowded together |
| Enlargement of the tumor of the left lung can rapidly spread to involve the mediastinal lymph nodes which may compress the __________________ | left recurrent laryngeal nerve |
| compression of the left recurrent laryngeal nerve produes | paralysis of the left vocal fold |
| results to partial occlusion the superior vena cava | An expanding cyst or tumor |
| An expanding cyst or tumor and partial occlusion the superior vena cava causes __________________ | severe congestion of the veins of the upper part of the body |
| Other pressure effects can be seen ______________ | (1) in the sympathetic: trunks, phrenic nerves, and (2) sometimes the trachea, main bronchi, and esophagus |
| a diagnostic procedure whereby specimens of tracheobronchial lymph nodes are obtained without opening the pleural cavities | Mediastinoscopy |
| How is the mediastinoscopy performed? | A small lnclslon Is made in the midline In the neck Just above the suprasternal notch, and the superior mediastinum Is explored down to the region of the bifurcation of the trachea. |
| used to determine the diagnosis and degree of spread of carcinoma of the bronchus | mediastinoscopy |
| pleural cavity normally contains _______________ of clear fluid | 5 to 10 mL |
| lubricates the apposing surfaces of the visceral and parietal pleurae during respiratory movements | pleural cavity |
| stimulate formation of the fluid | Hydrostatic and osmotic pressures |
| Because the hydrostatic pressures are greater in the capillaries of the parietal pleura than in the capillaries of the visceral pleura (pulmonary circulation), the capillaries of the visceral pleura normally absorb the pleural fluid. | Any condition that increases the production of the fluid (e.g., inflammation, malignancy, congestive heart disease) or impairs the drainage of the fluid (e.g., collapsed lung) results in abnormal accumulation of fluid |
| abnormal accumulation of fluid | pleural effusion |
| presence of ______________ of fluid in the costodiaphragmatic recess in an adult is sufficient to enable its clinical detection | 300 ml |
| (1) decreased lung expansion on the side of the effusion (2) decreased breath sounds and dullness on percussion over the effusion These are the clinical signs of: | pleural effusion |
| inflammation of the pleura | pleuritis or pleurisy |
| secondary to inflammation of the lung | pneumonia) |
| caused by (pleuritis or pleurisy) or pneumonia | inflammatory exudate coating the pleural surfaces, |
| inflammatory exudate coating the pleural surfaces results to | roughening of the surfaces |
| roughening of the surfaces produces | produces friction, which can be heard with the stethoscope as a pleural rub on inspiration and expiration. |
| Fibroblasts often invade the exudate, resulting in deposition of collagen and formation of __________________ that bind the visceral pleura to the parietal pleura. | pleural adhesions |
| pneumothorax (Air can enter the pleural cavity from the lungs or through the chest wall ) results from | disease or injury (e.g., interstitial lung disease, gunshot wounds). |
| the old treatment of tuberculosis, air was purposely injected into the pleural cavity to collapse and rest the lung | artificial pneumothorax |
| a condition in which air enters the pleural cavity suddenly without its cause being immediately apparent | spontaneous pneumothorax |
| Investigation usually reveals that air has entered from a diseased lung and ________________ has ruptured | a bulla (bleb) |
| Wounds that penetrate the thoracic wall (e.g., stab wounds) may pierce the parietal pleura so that the pleural cavity is open to the outside air. | open pneumothorax |
| a collapsed lung is on the injured side, and the opposite lung is compressed by the deflected mediastinum | tension pneumothorax |
| Air in the pleural cavity associated with serous fluid | hydropneumothorax |
| Air in the pleural cavity associated with pus | pyopneumothorax |
| Air in the pleural cavity associated with blood | hemopneumothorax |
| (1) trauma to the chest may result in bleeding from blood vessels in the chest wall, (2) from vessels in the chest cavity, or (3) from a lacerated lung | hemopneumothorax |
| collection of pus (without air) in the pleural cavity | empyema |
| presence of excess serous fluid in the pleural cavity is referred to as a | pleural effusion |
| Fluid (serous, blood, or pus) can be drained from the pleural cavity through a _______________ | wide-bore needle (Needle Thoracostomy |
| In the neck, a unilateral or bilateral enlargement of the thyroid gland can cause | gross displacement or compression of the trachea |
| A dilatation of the ___________ can compress the trachea | aneurysm |
| With each cardiac systole, the pulsating aneurysm may tug at the trachea and left bronchus, a clinical sign that can be felt by ___________________________ | palpating the trachea in the suprasternal notch |
| Innervates the mucosa lining much of the trachea | recurrent laryngeal nerves |
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abigael1deduro
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