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BBC Exam 4

Quiz yourself by thinking what should be in each of the black spaces below before clicking on it to display the answer.

What is the most important symptom of cardiac disease?   Chest pain (crushing)  
MOI of diaphragmatic hernia?   Fracture of lower ribs that tears the diaphragm  
What is flail chest?   Multiple rib fractures that may allow a sizable segment of anterior and/or lateral thoracic wall to move freely  
Which intercostal spaces are important for a posterior thoracotomy incision?   Posterolateral aspect of 5th-7th  
What is supernumerary ribs?   Extra ribs  
What ribs are most commonly dislocated?   8-10  
What is considered a rib dislocation?   Displacement of a costal cartilage from the sternum  
What is considered a rib separation?   Dislocation of the costochondral junction between the rib and its costal cartilage  
Are the 2 domes of the diaphragm dependent or independent of each other?   Independent  
What is dyspnea?   Difficulty breathing  
What is herpes zoster infection?   Shingles - primarily a viral disease of spinal ganglia, usually a reactivation of the varicella-zoster virus  
What is a pneumothorax?   Entry of air into the pleural cavity which results in collapse of the lung  
What is hydrothorax?   Fluid in the pleural cavity  
What is a hemothorax?   Blood entering the pleural cavity  
What is a hemopneumothorax?   Air and flood in the lungs  
What is a pleural rub?   The sound that the friction from the lungs rubbing together makes when there is inflammation of the pleura  
What does a pleural rub sound like?   Clump of hair being rolled between fingers  
What is the normal color of lungs?   Pink  
Purpose of auscultation?   Assess airflow through the tracheobronchial tree into the lobes of the lungs  
Purpose of percussion?   Helps establish whether the underlying tissues are air filled, fluid filled, or solid  
What would air filled lungs sound like?   Resonant sound  
What would fluid filled lungs sound like?   Dull sound  
What would solid lungs sound like?   Flat sound  
What nerve besides the phrenic nerve can be involved in lung cancer and what does this cause?   Recurrent laryngeal nerve which results in hoarseness owing to paralysis of vocal cords  
Does visceral pleura receive nerves or feel pain?   No  
Does parietal pleura receive nerves or feel pain?   Yes  
What is cardiac tamponade?   Heart compression  
What is a cause of cardiac tamponade?   Blood in the pericardial cavity  
What is dextrocardia?   Congenital anomaly that causes the apex pointing to the R instead of the L  
What does dextrocardia do to the vessels of the heart?   Mirror image positioning of the great vessels  
What can result from large atrial septal defect and why?   Enlargement of the R atrium and ventricle because it allows oxygenated blood from the lungs to be shunted from the L atrium through the ASD to the R atrium  
Where are percussions performed on the heart?   3rd, 4th, and 5th intercostal spaces from the left anterior axillary line to the right anterior axillary line  
How does the percussions of the heart change?   Not changes from resonance to dullness (because of the presence of the heart approximately 6 cm lateral to the left border of the sternum  
What is a CVA?   Cerebrovascular accident - occlusion of an artery supplying the brain  
What do disorders involving the valves of the heart disturb?   Pumping efficiency of the heart  
What is stenosis?   Failure of a valve to open fully, slowing blood flow from a chamber  
What is insufficiency or regurgitation?   Failure of the valve to close completely  
What is mitral valve prolapse?   Insufficient or incompetent valve with one or both leaflets enlarged, redundant, or "floppy" and extending back into the L atrium during systole  
What is pulmonary valve stenosis?   Valve cusps are fused, forming a dome with a narrow central opening  
What is incompetent pulmonary valve?   Backrush of blood under high pressure into the R ventricle during diastole  
What is aortic valve stenosis?   Most frequent valve abnormality resulting in left ventricular hypertrophy  
What are the 3 most common sites of coronary artery occlusion?   Anterior IV (LAD) branch of LCA RCA Circumflex branch of LCA  
What type of problem is usually associated with tightness?   Angina  
Which vessel is commonly harvested for coronary bypass surgery and why?   Great saphenous vein because it has a diameter equal to or greater than that of the coronary arteries, it can be easily dissected from the lower limb. and it offers relatively lengthy portions with a minimum occurrence of valves or branching  
Purpose of a pacemaker?   Produce electrical impulses that initiate ventricular contractions at a predetermined rate  
What is fibrillation?   Multiple, rapid, circuitous contractions or twitchings of muscular fibers, including cardiac muscle  
Which is the most disorganized of all dysrhythmias?   Ventricular fibrillation  
Does circulation remain satisfactory in atrial fibrillation?   Yes  
Does circulation remain satisfactory in ventricular fibrillation?   No - normal ventricular contractions are replaced by rapid, irregular twitching movements that do not pump  
Is the heart sensitive to touch, cutting, cold, or heat?   No  
What is cardiac referred pain?   Noxious stimuli originating in the heart are perceived by a person as pain arising from a superficial part of the body  
Where all can cardiac pain be referred to?   Although L is most common it can also be referred to the R side, both sides, or the back  
What would an aortic aneurysm look like on an angiogram?   Enlarged area of ascending aorta silhouette  
S/S of aneurysm   Chest pain that radiates to the back, difficulty swallowing or breathing due to pressure on trachea, esophagus and recurrent laryngeal nerve  
What does the recurrent laryngeal nerve supply?   All muscles of the larynx except one  
How does blood get back to the heart when the IVC is blocked?   Through the azygos, hemiazygos, and accessory hemiazygos veins  
Importance of thymus?   Plays a role in the development and maintenance of the immune system  
How does the thymus change with age after puberty?   Decreases in size and by adulthood, it is usually replaced by adipose tissue, but still continues to produce T-lymphocytes  


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