The patient with chest pain
Andrew Stewart in Pocket On Call, 2015
Patients may experience acid in the back of their mouths and often relate symptoms to particular types of food. Aortic dissections classically give rise to central burning/tearing chest pain that is sudden in onset and radiates through to the patient’s back. Patients usually have either hypertension or a connective tissue disorder. This is a common disorder resulting from dysfunction of the lower oesophageal sphincter, giving rise to symptoms that can be similar in nature to acute coronary syndromes (ACS). As a symptom, chest pain may originate from any structure within the chest wall, thoracic cavity, or mediastinum. The chapter provides chest pain may reflect pathology arising from any organ or structure within the thoracic cavity, mediastinum or chest wall. Whilst the initial focus should be to investigate for the presence of ACS or Pulmonary embolus it is important to consider other potential causes when assessing patients with chest pain.
Abdomen
David Heylings, Stephen Carmichael, Samuel Leinster, Janak Saada, Bari M. Logan, Ralph T. Hutchings in McMinn’s Concise Human Anatomy, 2017
The abdomen or abdominal cavity is the part of the trunk below the diaphragm that separates it from the thoracic cavity. Abdominal pain is a common reason to visit the doctor. The abdomen is also the site where excess fat is deposited. The possibility of disease or injury affecting so many organs makes abdominal surgery one of the more common reasons for admission to hospital. Inflammation of the peritoneum is highly dangerous because it involves about as much surface area in a pathological process as all of the skin covering the body. In thin muscular individuals the tendinous intersections may be seen as transverse depressions on the surface. Damage to the ilioinguinal nerve in the canal does not affect the nerve supply to the muscle fibres guarding the canal, because the motor innervation arises from the nerve well before it reaches the canal; it is incisions in the lateral part of the abdominal wall that may damage it.
Thorax
Bobby Krishnachetty, Abdul Syed, Harriet Scott in Applied Anatomy for the FRCA, 2020
This chapter is intended to cover the anatomical knowledge of thorax that helps trainee anesthetists who are revising for the Primary and Final FRCA exams. The topics of importance to anesthetists are presented under 'structures', 'circulation' and 'nervous system'. The chapter also includes a wide range of questions of clinical relevance that are asked in the exam. The superior thoracic aperture '(otherwise called thoracic inlet or outlet)' lies in an oblique transverse plane and connects the thoracic cavity with the root of the neck. The inferior thoracic aperture is larger and more oblique than the thoracic inlet and connects the thorax with the abdomen. Lungs are conical structures, where the right is heavier and larger but shorter than the left. The right lung is divided into three lobes by the oblique and horizontal fissures whilst the left has two lobes formed by the oblique fissure. The heart is a cone-shaped muscular organ weighing around 250 g situated in the middle mediastinum.
Retrieval of surgical blade by open thoracotomy – A case report of an iatrogenic complication
Published in Egyptian Journal of Anaesthesia, 2014
Anil Thakur, Kiranpreet Kaur, Garima Jain, Suresh K. Singhal, Jagdish Dureja, Susheela Taxak
Presence of foreign body in thoracic cavity is very uncommon. Most common etiologies for the presence of such foreign bodies are accidental, traumatic or iatrogenic. We report the management of a case with a rare foreign body in the thorax i.e. surgical blade. While inserting ICD the surgical blade slipped from the scalpel and was sucked into the pleural cavity. FB migrated in the mediastinum and Contrast Tomographic scan showed elongated radio-opaque object of metallic density in the mediastinum, just abutting the superior vena cava. An immediate open thoracotomy was planned to retrieve the blade.
Epicardial adipose tissue as a cardiovascular risk marker
Published in Clinical Lipidology, 2009
Dalton S. McLean, Arthur E. Stillman
Regional fat distribution appears to play a significant role in cardiovascular risk. Epicardial adipose tissue (EAT) is a type of visceral fat that is located adjacent to the heart in the thoracic cavity. Cytokines generated in EAT are postulated to diffuse directly to the vascular intima from the perivascular fat, leading to the initiation of inflammation, atherosclerosis development and plaque instability. Current research links increased EAT to an elevated risk of coronary artery disease. EAT has been correlated with both coronary artery calcification and angiographic coronary disease in most, but not all, studies. Further work is needed before EAT is included among the current battery of tests that are available for coronary artery disease risk stratification.
A Laparoscopic Approach to Left Diaphragmatic Rupture after Blunt Trauma
Published in Acta Chirurgica Belgica, 2009
A. Ouazzani, E. Guerin, E. Capelluto, G. Landolfo, A. Roman, J. Bruyns, G.B. Cadiere
Diaphragmatic rupture after blunt trauma is rare, but indicates a powerful external impact. Associated lesions are often life-threatening and require a rapid diagnosis and management. We report a case of a 24-year-old man, admitted to the emergency department after a serious car accident. He complained of a left sided thoraco-abdominal pain with breathing difficulties. Chest X-ray showed a left diaphragmatic elevation. Computed tomography demonstrated a left haemo-pneumothorax, herniation of the stomach in the chest and a haemoperitonium. Laparoscopically, herniated organs were re-integrated in the abdominal cavity; the diaphragmatic tear was repaired by both direct suture and synthetic prosthesis. Closure of a small bowel perforation found during the laparoscopic exploration was also performed. We consider this therapeutic modality to be an excellent approach in the management of acute left side diaphragmatic rupture in haemodynamically stable patients. Firstly, it permits an inspection of the thoracic cavity through the diaphragmatic tear and secondly, an easy repair of damaged structures in the abdominal cavity.
Related Knowledge Centers
- Lymph Nodes
- Pleura
- Pleural Cavity
- Abdomen
- Sternum
- Neck
- Trachea Esophagus Thymus Heart