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Respiratory system
Published in Aida Lai, Essential Concepts in Anatomy and Pathology for Undergraduate Revision, 2018
Phrenic nerves (C3–5)– Pass ant. to lung roots– R. phrenic n. runs along R. BCV, SVC, RA; pierces diaphragm at T8– L. phrenic n. pierces diaphragm as a solitary structure– The only motor SS to diaphragm– Sensory SS to fibrous pericardium, parietal serous pericardium, parietal pleura, central tendon of diaphragm → irritation of diaphragm can be referred to C4 dermatome, resulting in sensation of pain at shoulder tip
Clinical presentation and treatment of catameinal pneumothorax and endometriosis-related pneumothorax
Published in Expert Review of Respiratory Medicine, 2018
Ludovic Fournel, Antonio Bobbio, Edouard Robin, Emelyne Canny-Hamelin, Marco Alifano, Jean-François Regnard
Obviously, absence of the abovedescribed typical presentation must not exclude diagnosis of CP- or non-CP-TER but, on the contrary, requires careful intraoperative exploration and histopathological assessment in operated women of child-bearing age. As evidence of this disease mostly relies on surgical exploration, minimally invasive approaches in particular (VATS), thus diagnostic and therapeutic procedures, are often combined. Complete intrathoracic exploration should be performed including visualization of the parietal and visceral pleura, the lung, and above all the diaphragm. Indeed, diaphragmatic lesions are frequently observed in series of patients treated mini-invasively with thoracoscopy allowing magnification of lesions presenting as small brown, red, purple, or violet nodules and/or subsequent perforations, usually surrounding the central tendon of diaphragm [6,7,30–34]. An appropriate parenchymal inspection is also recommended for diagnosis and treatment effectiveness, to rule out potential endometrial implants or to assess the presence of other lung defect which could have caused non-TER pneumothorax.