Term
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Definition
*Sucking pneumothorax:
Air enters and leaves the pleural cavity.
mediastinal flutter (mediastinum shifted
toward the normal side in inspiration and
shifted to the injured side in expiration)
*Tension Pneumothorax:
Air enters the pleural cavity but not leaving it.
Mediastinal shift: the mediastimum is shifted
toward the normal side, increased intrathoracic
Pressures.
Patient has dyspnea and/or cyanosis.
Hyper-resonant percussion tone,
radiolucent area in lung, in radiography.
*Pneumothorax is a surgical emergency.
Chest tube at -10cm H2O to reduce pneumothorax
inserted anteriorly in 2nd intercostal space.
Or if fluid is also present, in 5th-6th space
(near posterior axillary line).
*Inadvertent damage to pleura:
Catheterization of the subclavian vein,
brachial plexus block, injuries in the neck
over the clavicle or during kidney surgery. |
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Term
| Excess fluid in the pleural cavity |
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Definition
pleural effusion
*A- Hydrothorax (eg: congestive heart failure)
*B- Pyothorax (infection)
*C- Chylothorax (injury to thoracic duct)
*D- Hemothorax (blood in pleural cavity),
eg: injury to right subclavian vein during catheterization)
*Pleuritis (pleurisy): inflammation of the pleura
Pain only if parietal pleura is involved, not the
visceral layer. |
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Term
| Thoracocentesis (pleural tap) |
|
Definition
A procedure to drain pleural fluid in pathological conditions.
Is performed posterior to the midaxillary line while patient is seated. First determine the fluid
level by percussion and go 1-2 intercostal spaces below the fluid level but, not below
the 9th intercostal space (danger to injure the liver on the right side). |
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Term
|
Definition
| in herpes Zoster (shingles) or rib fractures |
|
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Term
|
Definition
parietal pleura: phrenic and intercostal nerves
Visceral pleura: Autonomic nervous system |
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Term
| Upper airways and Pharynx |
|
Definition
| It has 3 parts: Nasopharynx, Oropharynx and hypopharynx (laryngopharynx). |
|
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Term
|
Definition
*Inf border: at 6, 8, 10 ribs (midclavicular,
midaxillary and scapular lines). |
|
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Term
|
Definition
*1- Main bronchi (primary bronchus) at T4
(sternal angle), Carina.
*2- Main bronchi divide into: Lobar bronchi
(secondary bronchus).
*3- Lobar bronchi divide into segmental
bronchi (tertiary bronchus)
*R. Main bronchus: shorter (2.5 cm),
wider and more vertical
*L. Main bronchus: longer (5 cm), less
steep |
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Term
| Nerve supply: to lung and visceral pleura |
|
Definition
*Parasympathetic: Vagus (CN X)
*Sympathetic: (usually T1- T5)
*Vagal Efferent: motor to bronchial smooth M. (bronchoconstriction)
Inhibitor to pulmonary vessels: Vasodilator
Secretor to the bronchial glands: Secretomotor
*Vagal Afferent: Sensory in respiratory epithelium (pain and stretch)
*Sympathetic Efferent: Bronchodilator (inhibitor of bronchial M)
Vasoconstrictor to pulmonary vessels (motor)
Inhibitory to glands in bronchial tree |
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