BBC Exam 4
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| What is the most important symptom of cardiac disease? | Chest pain (crushing)
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| MOI of diaphragmatic hernia? | Fracture of lower ribs that tears the diaphragm
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| What is flail chest? | Multiple rib fractures that may allow a sizable segment of anterior and/or lateral thoracic wall to move freely
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| Which intercostal spaces are important for a posterior thoracotomy incision? | Posterolateral aspect of 5th-7th
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| What is supernumerary ribs? | Extra ribs
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| What ribs are most commonly dislocated? | 8-10
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| What is considered a rib dislocation? | Displacement of a costal cartilage from the sternum
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| What is considered a rib separation? | Dislocation of the costochondral junction between the rib and its costal cartilage
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| Are the 2 domes of the diaphragm dependent or independent of each other? | Independent
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| What is dyspnea? | Difficulty breathing
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| What is herpes zoster infection? | Shingles - primarily a viral disease of spinal ganglia, usually a reactivation of the varicella-zoster virus
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| What is a pneumothorax? | Entry of air into the pleural cavity which results in collapse of the lung
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| What is hydrothorax? | Fluid in the pleural cavity
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| What is a hemothorax? | Blood entering the pleural cavity
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| What is a hemopneumothorax? | Air and flood in the lungs
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| What is a pleural rub? | The sound that the friction from the lungs rubbing together makes when there is inflammation of the pleura
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| What does a pleural rub sound like? | Clump of hair being rolled between fingers
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| What is the normal color of lungs? | Pink
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| Purpose of auscultation? | Assess airflow through the tracheobronchial tree into the lobes of the lungs
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| Purpose of percussion? | Helps establish whether the underlying tissues are air filled, fluid filled, or solid
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| What would air filled lungs sound like? | Resonant sound
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| What would fluid filled lungs sound like? | Dull sound
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| What would solid lungs sound like? | Flat sound
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| 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
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| Does visceral pleura receive nerves or feel pain? | No
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| Does parietal pleura receive nerves or feel pain? | Yes
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| What is cardiac tamponade? | Heart compression
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| What is a cause of cardiac tamponade? | Blood in the pericardial cavity
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| What is dextrocardia? | Congenital anomaly that causes the apex pointing to the R instead of the L
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| What does dextrocardia do to the vessels of the heart? | Mirror image positioning of the great vessels
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| 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
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| 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
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| 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
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| What is a CVA? | Cerebrovascular accident - occlusion of an artery supplying the brain
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| What do disorders involving the valves of the heart disturb? | Pumping efficiency of the heart
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| What is stenosis? | Failure of a valve to open fully, slowing blood flow from a chamber
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| What is insufficiency or regurgitation? | Failure of the valve to close completely
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| 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
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| What is pulmonary valve stenosis? | Valve cusps are fused, forming a dome with a narrow central opening
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| What is incompetent pulmonary valve? | Backrush of blood under high pressure into the R ventricle during diastole
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| What is aortic valve stenosis? | Most frequent valve abnormality resulting in left ventricular hypertrophy
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| What are the 3 most common sites of coronary artery occlusion? | Anterior IV (LAD) branch of LCA
RCA
Circumflex branch of LCA
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| What type of problem is usually associated with tightness? | Angina
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| 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
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| Purpose of a pacemaker? | Produce electrical impulses that initiate ventricular contractions at a predetermined rate
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| What is fibrillation? | Multiple, rapid, circuitous contractions or twitchings of muscular fibers, including cardiac muscle
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| Which is the most disorganized of all dysrhythmias? | Ventricular fibrillation
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| Does circulation remain satisfactory in atrial fibrillation? | Yes
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| Does circulation remain satisfactory in ventricular fibrillation? | No - normal ventricular contractions are replaced by rapid, irregular twitching movements that do not pump
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| Is the heart sensitive to touch, cutting, cold, or heat? | No
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| 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
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| 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
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| What would an aortic aneurysm look like on an angiogram? | Enlarged area of ascending aorta silhouette
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| 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
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| What does the recurrent laryngeal nerve supply? | All muscles of the larynx except one
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| How does blood get back to the heart when the IVC is blocked? | Through the azygos, hemiazygos, and accessory hemiazygos veins
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| Importance of thymus? | Plays a role in the development and maintenance of the immune system
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| 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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