Anatomy clinical correlates: Pleura and lungs

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Anatomy clinical correlates: Pleura and lungs

Subspeciality surgery

Cardiothoracic surgery

Coronary artery disease: Clinical (To be retired)

Valvular heart disease: Clinical (To be retired)

Pericardial disease: Clinical (To be retired)

Aortic aneurysms and dissections: Clinical (To be retired)

Chest trauma: Clinical (To be retired)

Pleural effusion: Clinical (To be retired)

Pneumothorax: Clinical (To be retired)

Lung cancer: Clinical (To be retired)

Anatomy clinical correlates: Thoracic wall

Anatomy clinical correlates: Heart

Anatomy clinical correlates: Pleura and lungs

Anatomy clinical correlates: Mediastinum

Adrenergic antagonists: Beta blockers

ACE inhibitors, ARBs and direct renin inhibitors

cGMP mediated smooth muscle vasodilators

Lipid-lowering medications: Statins

Lipid-lowering medications: Fibrates

Miscellaneous lipid-lowering medications

Antiplatelet medications

Plastic surgery

Benign hyperpigmented skin lesions: Clinical (To be retired)

Skin cancer: Clinical (To be retired)

Blistering skin disorders: Clinical (To be retired)

Bites and stings: Clinical (To be retired)

Burns: Clinical (To be retired)

ENT (Otolaryngology)

Anatomy clinical correlates: Olfactory (CN I) and optic (CN II) nerves

Anatomy clinical correlates: Trigeminal nerve (CN V)

Anatomy clinical correlates: Facial (CN VII) and vestibulocochlear (CN VIII) nerves

Anatomy clinical correlates: Glossopharyngeal (CN IX), vagus (X), spinal accessory (CN XI) and hypoglossal (CN XII) nerves

Anatomy clinical correlates: Skull, face and scalp

Anatomy clinical correlates: Ear

Anatomy clinical correlates: Temporal regions, oral cavity and nose

Anatomy clinical correlates: Bones, fascia and muscles of the neck

Anatomy clinical correlates: Vessels, nerves and lymphatics of the neck

Anatomy clinical correlates: Viscera of the neck

Antihistamines for allergies

Neurosurgery

Stroke: Clinical (To be retired)

Seizures: Clinical (To be retired)

Headaches: Clinical (To be retired)

Traumatic brain injury: Clinical (To be retired)

Neck trauma: Clinical (To be retired)

Brain tumors: Clinical (To be retired)

Lower back pain: Clinical (To be retired)

Anatomy clinical correlates: Olfactory (CN I) and optic (CN II) nerves

Anatomy clinical correlates: Oculomotor (CN III), trochlear (CN IV) and abducens (CN VI) nerves

Anatomy clinical correlates: Trigeminal nerve (CN V)

Anatomy clinical correlates: Facial (CN VII) and vestibulocochlear (CN VIII) nerves

Anatomy clinical correlates: Glossopharyngeal (CN IX), vagus (X), spinal accessory (CN XI) and hypoglossal (CN XII) nerves

Anatomy clinical correlates: Vertebral canal

Anatomy clinical correlates: Spinal cord pathways

Anatomy clinical correlates: Cerebral hemispheres

Anatomy clinical correlates: Anterior blood supply to the brain

Anatomy clinical correlates: Cerebellum and brainstem

Anatomy clinical correlates: Posterior blood supply to the brain

Anticonvulsants and anxiolytics: Barbiturates

Anticonvulsants and anxiolytics: Benzodiazepines

Nonbenzodiazepine anticonvulsants

Migraine medications

Osmotic diuretics

Antiplatelet medications

Thrombolytics

Ophthalmology

Eye conditions: Refractive errors, lens disorders and glaucoma: Pathology review

Eye conditions: Retinal disorders: Pathology review

Eye conditions: Inflammation, infections and trauma: Pathology review

Anatomy clinical correlates: Olfactory (CN I) and optic (CN II) nerves

Anatomy clinical correlates: Oculomotor (CN III), trochlear (CN IV) and abducens (CN VI) nerves

Anatomy clinical correlates: Eye

Orthopedic surgery

Joint pain: Clinical (To be retired)

Lower back pain: Clinical (To be retired)

Anatomy clinical correlates: Clavicle and shoulder

Anatomy clinical correlates: Axilla

Anatomy clinical correlates: Arm, elbow and forearm

Anatomy clinical correlates: Wrist and hand

Anatomy clinical correlates: Median, ulnar and radial nerves

Anatomy clinical correlates: Bones, joints and muscles of the back

Anatomy clinical correlates: Hip, gluteal region and thigh

Anatomy clinical correlates: Knee

Anatomy clinical correlates: Leg and ankle

Anatomy clinical correlates: Foot

Trauma surgery

Traumatic brain injury: Clinical (To be retired)

Neck trauma: Clinical (To be retired)

Chest trauma: Clinical (To be retired)

Abdominal trauma: Clinical (To be retired)

Urology

Penile conditions: Pathology review

Prostate disorders and cancer: Pathology review

Testicular tumors: Pathology review

Kidney stones: Clinical (To be retired)

Renal cysts and cancer: Clinical (To be retired)

Urinary incontinence: Pathology review

Testicular and scrotal conditions: Pathology review

Anatomy clinical correlates: Male pelvis and perineum

Anatomy clinical correlates: Female pelvis and perineum

Anatomy clinical correlates: Other abdominal organs

Anatomy clinical correlates: Inguinal region

Androgens and antiandrogens

PDE5 inhibitors

Adrenergic antagonists: Alpha blockers

Vascular surgery

Peripheral vascular disease: Clinical (To be retired)

Leg ulcers: Clinical (To be retired)

Aortic aneurysms and dissections: Clinical (To be retired)

Anatomy clinical correlates: Anterior and posterior abdominal wall

Adrenergic antagonists: Beta blockers

Lipid-lowering medications: Statins

Lipid-lowering medications: Fibrates

Miscellaneous lipid-lowering medications

Antiplatelet medications

Thrombolytics

Assessments

Anatomy clinical correlates: Pleura and lungs

USMLE® Step 1 questions

0 / 4 complete

USMLE® Step 2 questions

0 / 9 complete

Questions

USMLE® Step 1 style questions USMLE

of complete

USMLE® Step 2 style questions USMLE

of complete

A 62-year-old man presents to the emergency department for evaluation of facial swelling. Over the past several weeks, he has noticed his face has become “puffier,” particularly in the morning. In addition, he has a new cough and shortness of breath on exertion. His own past medical history is unremarkable, though his father passed away from a pulmonary embolism. The patient takes no medications. He has smoked one pack of cigarettes per day for thirty years. He does not use alcohol or illicit drugs. Temperature is 37.6°C (99.7°F), pulse is 111 /min, and blood pressure is 131/66 mmHg. Respirations are 18/min, and oxygen saturation is 96% on room air. Physical examination demonstrates distended neck veins and bilateral facial fullness without tenderness to palpation or erythema. Which of the following is the most likely etiology of this patient's clinical presentation?  

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Transcript

Contributors

Anca-Elena Stefan, MD

Sam Gillespie, BSc

Jennifer Montague, PhD

Ursula Florjanczyk, MScBMC

Before you start watching this video, relax, and take a deep breath.

Think about the air filling up your lungs, which are located on either side of your thoracic cavity.

Now, we often take breathing for granted because it is under autonomic control, and it’s not until we have trouble breathing when we realize just how important our lungs are.

There are many conditions that can affect the lungs, which can have a huge impact on our day to day lives.

Now let’s look at some causes for lung ailments, starting with injuries of the cervical pleura and lung apex.

Both these structures project through the superior thoracic aperture into the neck.

So when there’s an injury involving the base of the neck, the lungs and pleural sacs can be injured as well, which can cause a pneumothorax.

The pleura is also exposed to potential injury in its inferior portion, because it descends below the costal margin in three regions, where a penetrating injury may enter into the pleural sac.

The first is the right part of the infrasternal angle, the other two parts are the right and left posterior costovertebral angles which are inferomedial to the 12th ribs and posterior to the superior poles of the kidneys.

So kidney surgery can pose a risk for pleural injury.

When discussing injuries to the pleura and lungs, it’s important to understand what pleuritic chest pain means.

Pleuritic chest pain is caused by irritation to the pleura, which results in a classical ‘sharp’, stabbing pain that gets worse when you breathe in, and is exacerbated even further by deep inhalation and exhalation.

Pleuritic chest pain can have multiple causes, including a pneumothorax, which is when there’s air trapped within the pleural cavity, or a pleural effusion, when fluid builds up in the pleural cavity.

Sources

  1. "Ferri's Clinical Advisor 2017 E-Book" Elsevier Health Sciences (2016)
  2. "Disease & Drug Consult: Respiratory Disorders" Lippincott Williams & Wilkins (2012)
  3. "Textbook of Pleural Diseases Second Edition" CRC Press (2008)
  4. "Pneumothorax Following Thoracentesis" Archives of Internal Medicine (2010)
  5. "Therapeutic thoracentesis: the role of ultrasound and pleural manometry" Current Opinion in Pulmonary Medicine (2007)
  6. "Improving the safety of thoracentesis" Current Opinion in Pulmonary Medicine (2011)
  7. "Spontaneous pneumothorax" BMJ (2014)
  8. "Pleurisy" Am Fam Physician. (2007)
  9. "Needle thoracentesis decompression: observations from postmortem computed tomography and autopsy" Spec Oper Med (2013)
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