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Dysmorphology

Chest

QuestionAnswer
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
Created by: KChatham
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