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Thoracotomy
A thoracotomy is a surgical procedure that involves cutting open the chest wall to gain access into the pleural cavity, It is mostly performed by specialist cardiothoracic surgeons, although emergency physicians or paramedics occasionally also perform the procedure under life-threatening circumstances. The procedure is performed under general anesthesia with double-lumen intubation, and commonly with epidural analgesia set up pre-sedation for postoperative pain management. The procedure starts with controlled cutting through the skin, intercostal muscles and then parietal pleura, and typically involves transecting at least one rib with a costotome due to the limited range of bucket handle movement each rib has without fracturing. The incised wound is then spread and held apart with a retractor ( rib spreader) to allow passage of surgical instruments and the surgeon's hand. Traditional thoracotomy is thus a highly invasive procedure, with bacterial pneumonia, hemothorax/pl ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Resuscitative Thoracotomy
A resuscitative thoracotomy (sometimes referred to as an emergency department thoracotomy (EDT), trauma thoracotomy or, colloquially, as "cracking the chest") is a thoracotomy performed to aid in the resuscitation of a major trauma patient who has sustained severe thoracic or abdominal trauma. The procedure allows immediate direct access to the thoracic cavity, permitting rescuers to control hemorrhage, relieve cardiac tamponade, repair or control major injuries to the heart, lungs or thoracic vasculature, and perform direct cardiac massage or defibrillation. The procedure is rarely performed and is a procedure of last resort. Indications A resuscitative thoracotomy is indicated when severe injuries within the thoracic cavity (such as hemorrhage) prevent the physiologic functions needed to sustain life. The injury may also affect a specific organ such as the heart, which can develop an air embolism or a cardiac tamponade (which prevents the heart from beating properly). The pri ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Hemothorax
A hemothorax (derived from hemo- lood+ thorax hest plural ''hemothoraces'') is an accumulation of blood within the pleural cavity. The symptoms of a hemothorax may include chest pain and difficulty breathing, while the clinical signs may include reduced breath sounds on the affected side and a rapid heart rate. Hemothoraces are usually caused by an injury, but they may occur spontaneously due to cancer invading the pleural cavity, as a result of a blood clotting disorder, as an unusual manifestation of endometriosis, in response to pneumothorax, or rarely in association with other conditions. Hemothoraces are usually diagnosed using a chest X-ray, but they can be identified using other forms of imaging including ultrasound, a CT scan, or an MRI. They can be differentiated from other forms of fluid within the pleural cavity by analysing a sample of the fluid, and are defined as having a hematocrit of greater than 50% that of the person's blood. Hemothoraces may be treated b ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Rib Spreader
A rib spreader, also known as Finochietto retractor, is a type of retractor specifically designed to separate ribs in thoracic surgery (see picture in external lin. Rack-and-pinion-type stainless steel rib spreaders (with a thumb-screw to lock it in place) were an innovation introduced by French surgeon Theodore Truffier in 1914. This was modified in 1936 by Argentinian surgeon Enrique Finochietto to have fenestrated blades (blades with "windows") and a hand-cranked lever to both separate the arms in a staged fashion and lock them in place at each stop. The Burford–Finochietto rib spreader has replaceable blades. The Tuffier and especially the Burford–Finochietto (and its variants) are ubiquitous in open thoracic surgery. Recently, a new intelligent, automated rib spreader in development demonstrated results superior to the Finochietto-style retractors. See also *Instruments used in general surgery There are many different Surgery, surgical specialties, some of which req ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Intercostal Muscle
The intercostal muscles comprise many different groups of muscle Muscle is a soft tissue, one of the four basic types of animal tissue. There are three types of muscle tissue in vertebrates: skeletal muscle, cardiac muscle, and smooth muscle. Muscle tissue gives skeletal muscles the ability to muscle contra ...s that run between the ribs, and help form and move the chest wall. The intercostal muscles are mainly involved in the mechanical aspect of breathing by helping expand and shrink the size of the chest cavity. Structure There are three principal layers: # External intercostal muscles also known as intercostalis externus aid in quiet and forced inhalation. They originate on ribs 1–11 and have their insertion on ribs 2–12. The external intercostals are responsible for the elevation of the ribs and bending them more open, thus expanding the transverse dimensions of the thoracic cavity. The muscle fibers are directed downwards, forwards and medially in the anteri ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Neuralgia
Neuralgia (Greek ''neuron'', "nerve" + ''algos'', "pain") is pain in the distribution of a nerve or nerves, as in intercostal nerve, intercostal neuralgia, trigeminal neuralgia, and glossopharyngeal nerve, glossopharyngeal neuralgia. Classification Under the general heading of neuralgia are trigeminal neuralgia (TN), atypical trigeminal neuralgia (ATN), occipital neuralgia, glossopharyngeal neuralgia and postherpetic neuralgia (caused by shingles or herpes). The term ''neuralgia'' is also used to refer to pain associated with sciatica and Brachial plexus, brachial plexopathy. Atypical (trigeminal) Atypical trigeminal neuralgia (ATN) is a rare form of neuralgia and may also be the most misdiagnosed form. The symptoms can be mistaken for migraines, dental problems such as temporomandibular joint disorder, musculoskeletal issues, and hypochondriasis. ATN can have a wide range of symptoms and the pain can fluctuate in intensity from mild aching to a crushing or burning sensation, ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Intercostal Nerve
The intercostal nerves are part of the somatic nervous system, and arise from the anterior rami of the thoracic spinal nerves from T1 to T11. The intercostal nerves are distributed chiefly to the thoracic pleura and abdominal peritoneum, and differ from the anterior rami of the other spinal nerves in that each pursues an independent course without plexus formation. The first two nerves supply fibers to the upper limb and thorax; the next four distribute to the walls of the thorax; the lower five supply the walls of the thorax and abdomen. The 7th intercostal nerve ends at the xyphoid process of the sternum. The 10th intercostal nerve terminates at the navel. The 12th ( subcostal) thoracic is distributed to the walls of the abdomen and groin. Each of these fibers contains around 1300 axons. Unlike the nerves from the autonomic nervous system that innervate the visceral pleura of the thoracic cavity, the intercostal nerves arise from the somatic nervous system. This enables th ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Pneumothorax
A pneumothorax is collection of air in the pleural space between the lung and the chest wall. Symptoms typically include sudden onset of sharp, one-sided chest pain and dyspnea, shortness of breath. In a minority of cases, a one-way valve is formed by an area of damaged Tissue (biology), tissue, and the amount of air in the space between chest wall and lungs increases; this is called a tension pneumothorax. This can cause a steadily worsening Hypoxia (medical), oxygen shortage and hypotension, low blood pressure. This leads to a type of shock called obstructive shock, which can be fatal unless reversed. Very rarely, both lungs may be affected by a pneumothorax. It is often called a "collapsed lung", although that term may also refer to atelectasis. A primary spontaneous pneumothorax is one that occurs without an apparent cause and in the absence of significant lung disease. A secondary spontaneous pneumothorax occurs in the presence of existing lung disease. Smoking increases ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Pleural Effusion
A pleural effusion is accumulation of excessive fluid in the pleural space, the potential space that surrounds each lung. Under normal conditions, pleural fluid is secreted by the parietal pleural capillaries at a rate of 0.6 millilitre per kilogram weight per hour, and is cleared by lymphatic absorption leaving behind only 5–15 millilitres of fluid, which helps to maintain a functional vacuum between the parietal and visceral pleurae. Excess fluid within the pleural space can impair inhalation, inspiration by upsetting the functional vacuum and hydrostatically increasing the resistance against lung expansion, resulting in a fully or partially collapsed lung. Various kinds of fluid can accumulate in the pleural space, such as serous fluid (hydrothorax), blood (hemothorax), pus (pyothorax, more commonly known as pleural empyema), chyle (chylothorax), or very rarely urine (urinothorax) or feces (coprothorax). When unspecified, the term "pleural effusion" normally refers to hydro ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Bacterial Pneumonia
Bacterial pneumonia is a type of pneumonia caused by bacterial infection. Types Gram-positive '' Streptococcus pneumoniae'' () is the most common bacterial cause of pneumonia in all age groups except newborn infants. ''Streptococcus pneumoniae'' is a Gram-positive bacterium that often lives in the throat of people who do not have pneumonia. Other important Gram-positive causes of pneumonia are ''Staphylococcus aureus'' () and '' Bacillus anthracis''. Gram-negative Gram-negative bacteria are seen less frequently: ''Haemophilus influenzae'' (), '' Klebsiella pneumoniae'' (), ''Escherichia coli'' (), ''Pseudomonas aeruginosa'' (), '' Bordetella pertussis'', and '' Moraxella catarrhalis'' are the most common. These bacteria often live in the gut and enter the lungs when contents of the gut (such as vomit or faeces) are inhaled. Pneumonia caused by '' Yersinia pestis'' is usually called pneumonic plague. Atypical Atypical bacteria causing pneumonia are '' Coxiella burnetii'', ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Surgical Instrument
A surgical instrument is a medical device for performing specific actions or carrying out desired effects during a surgery or operation, such as modifying biological tissue, or to provide access for viewing it. Over time, many different kinds of surgical instruments and tools have been invented. Some surgical instruments are designed for general use in all sorts of surgeries, while others are designed for only certain specialties or specific procedures. Classification of surgical instruments helps surgeons to understand the functions and purposes of the instruments. With the goal of optimizing surgical results and performing more difficult operations, more instruments continue to be invented in the modern era. History Many different kinds of surgical instruments and tools have been invented and some have been repurposed as medical knowledge and surgical practices have developed. As surgery practice diversified, some tools are advanced for higher accuracy and stability while so ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Retractor (medicine)
A retractor is a surgical instrument used to separate the edges of a surgical incision/wound or to hold away certain organs and tissues (i.e. to provide tissue ''retraction'') so that body parts underneath may be accessed during surgical operations. The broad term ''retractor'' typically describes a simple steel tool possessing a curved, hooked, or angled blade, which is manually manipulated to help maintain a desired position of tissue during surgery. More sophisticated retractors may be clamped in place (usually to a tableside frame) or suspended at the end of a robotic arm. Retractors can also be "self-retaining" and no longer need to be held once inserted, having two or more opposing blades or hooks which are separated via spring, ratchet, worm gear or other method. The term ''retractor'' is also used to describe distinct, hand-cranked devices such as rib spreaders (also known as thoracic retractors, or distractors) with which surgeons may use to forcefully drive tissues apa ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Bone Fracture
A bone fracture (abbreviated FRX or Fx, Fx, or #) is a medical condition in which there is a partial or complete break in the continuity of any bone in the body. In more severe cases, the bone may be broken into several fragments, known as a ''comminuted fracture''. An open fracture (or compound fracture) is a bone fracture where the broken bone breaks through the skin. A bone fracture may be the result of high force Impact force, impact or Stress fracture, stress, or a minimal trauma injury as a result of certain medical conditions that weaken the bones, such as osteoporosis, osteopenia, bone cancer, or osteogenesis imperfecta, where the fracture is then properly termed a pathologic fracture. Most bone fractures require urgent medical attention to prevent further injury. Signs and symptoms Although bone tissue contains no nociceptors, pain receptors, a bone fracture is painful for several reasons: * Breaking in the continuity of the periosteum, with or without similar disconti ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
