Human Anatomy Vol 1

Pneumothorar; Presence of air in the pleural cavity.

Haemothorax; Presence of blood in the pleural

cavity.

Hyd,ropneumothorax: Presence of both fluid and air

in the pleural cavity.

Empyema: Presence of pus in the pleural cavity.

Coronary artery: Thrombosis of a coronary artery

is a common cause of sudden death in persons past

middle age. This is due to myocardial infarction and

ventricular fibrillation.

Incomplete obstruction, usually due to spasm of

the coronary artery causes angina pectoris, which is

associated with agonising pain in the precordial

region and down the medial side of the left arm and

forearm.

Coronary angiography determines the site(s) of

narrowing or occlusion of the coronary arteries or

their branches.

Angioplasty helps in removal of small blockage.

It is done using small stent or small inflated balloon

(see Fig.78.27).

If there are large segments or multiple sites of

blockage, coronarybypass is done using either great

saphenous vein or internal thoracic artery as graft(s)

(see Fig.18.28).

Cardiac pain is an ischaemic pain caused by

incomplete obstruction of a coronary artery.

Viscera usually haae low amount of sensory output,

wheress skin is an area of high amount of sensory output.

S o pain arising fr om low sensory output ar ea is pr oj ected

as coming from high sensory output area.

Axons of pain fibres conveyed by the sensory

sympathetic cardiac neryes reach thoracic one to

thoracic five segments of spinal cord mostly through

the dorsal root ganglia of the left side. Since these

dorsal root ganglia also receive sensory impulses

from the medial side of arm, forearm and upper part

of front of chest, the pain gets referred to these areas

as depicted in Fig. 1.8.26.

Though the pain is usually referred to the left side,

it may even be referred to right arm, jaw, epigastrium

or back.

Oesophageal oarices: In portal hypertension, the

communications between the portal and systemic

veins draining the lower end of the oesophagus

dilate. These dilatations are called oesophagenlaarices

(see Fig.20.6). Rupture of these varices can cause

serious haematemesis or vomiting of blood. The

oesophageal varices can be visualised radiogra-

phically by barium swallow; they produce worm-

like shadows.

Barium szoallow: Left atrial enlargement as in

mitral stenosis can also be visualised by barium

swallow. The enlarged atrium causes a shallow

depression on the front of the oesophagus. Barium

swallow also helps in the diagnosis of oesophageal

strictures, carcinoma and achalasia cardia.

Coarctation of the aorta: Coarctation of the aorta is

a localised narrowing of the aorta opposite to or just

beyond the attachment of the ductus arteriosus. An

extensive collateral circulation develops between the

branches of the subclavian arteries and those of the

descending aorta. These include the anastomoses

between the anterior and posterior intercostal

arteries. These arteries enlarge greatly and produce

a characteristic notching on the rlbs (see Fig.79.6).

Aortic flfleurysm: Aortic aneurysm is a localised

dilatation of the aorta which may press upon the

surrounding structures and cause the mediastinal

syndrome (see Fig. 1.9.8).

MUTTIPLE CHOICE QUESTIONS

APPENDIX 2

iii. 1st-7th

iv, 1st, 2nd, 10th, 12th

i. TB

ii. T10

iii. T11

iv. T12

A.

1.

b.

c.

d.

2.

Motch the following on the left side with their

oppropriole onswels on lhe ilght side.

Arteries and their branches:

a. Internal thoracic i.

b. Descending aorta ii.

c. Right coronary iii.

d. Left coronary iv.

Ribs

a. True ribs i. 8th, 9th and 10th

b. Atypical ribs ii. 1st, 11th, 12th

Posterior

interventricular 3'

Posterior intercostal

Anterior

interventricular

Anterior intercostal

c. Least fractured ribs

d. Vertebrochondral

ribs

Vertebral levels

Aortic opening

in diaphragm

Oesophageal opening

in diaphragm

Inferior vena caval

in diaphragm

Gastro-oesophageal

junction