Medical Quiz on Thyroid and Pulmonary Conditions

Clinical Anatomy of the Thorax

• Focuses on applying anatomical knowledge to clinical situations.
• Covers the thoracic respiratory system, including lungs, bronchi, trachea, and pleura.
• Details penetrating neck trauma, differentiating by zones (I, II, and III) and their associated structures.
• Discusses the structures of each zone in detail. Zone I covers the area from the clavicles-manubrium to the cricoid cartilage, including cervical pleura, apices of lungs, thyroid gland, parathyroid glands, trachea, esophagus, common carotid arteries, jugular veins, and cervical vertebral column. Zone II expands from the cricoid cartilage to the angle of the mandible, including the superior part of the thyroid gland, thyroid cartilage, cricoid cartilages, larynx, laryngopharynx, carotid arteries, jugular veins, esophagus, and cervical vertebral column. Zone III encompasses the superior area above the angle of the mandible, including salivary glands, oral and nasal cavities, oropharynx, and nasopharynx.
• Highlights injury patterns, complications, and repair strategies for each zone. Zone I and III injuries are associated with airway obstruction, high mortality and morbidity, and challenging surgical complications for repair of the injured structures and vascular damage. Zone II injuries are more common with less severe mortality and morbidity; direct pressure can manage hemorrhages and injuries are readily identifiable for repair.
• Explains radical dissections of the neck to remove deep cervical nodes and surrounding structures.
• Details preserved and not preserved structures during these procedures. Preserved structures include vagus and phrenic nerves, brachial plexus, and major arteries. No preserved structures include cutaneous branches of cervical plexus and deep cervical nodes.
• Defines and describes pleural pain, distinguishing between visceral pleura, insensitive to pain due to lack of sensory nerves, and parietal pleura, highly sensitive due to its innervation (e.g., intercostal nerves, phrenic nerves). This section highlights referred pain areas from different parts of the diaphragmatic and mediastinal pleura.
• Discusses injuries of the pleura, including pneumothorax (a condition where air enters the pleural cavity).
• Identifies areas for pleural injury (e.g., right infrasternal angle, costovertebral angles).
• Defines pulmonary collapse/atelectasis and describes its types (primary and secondary).
• Explains that pleural cavities have a negative pressure which helps in lung inflation.
• Provides radiological signs of pulmonary collapse.
  • Elevation of the diaphragm, intercostal space narrowing, and displacement of the mediastinum.
  • Describes a whitened lung area surrounded by a black halo (to diagnose lung collapse).
• Describes segmental atelectasis due to blockage of a segmental bronchus .
• Explains pneumothorax and hydrothorax. This section distinguishes causes (e.g., penetrating wound, fractured ribs) and liquid types (blood -hemothorax).
• Explains the inhalation of carbon particles, indicating that normal lung color is pink, and that smokers and those in industrial areas tend to have darker mottled lungs due to buildup.
• Describes pulmonary embolism, including its causes (blood clot, fat globule, air bubble) and how it obstructs pulmonary arteries.
• Discusses consequences of pulmonary embolism, including right heart overload, risk of pulmonary infarct, and possible inflammation of pleura around the affected area.
• Describes symptoms of hemoptysis (coughing up blood).
• Covers lung carcinoma, including metastasis and main cause.
• Covers the anatomy of nasal fractures and possible consequences.
• Discusses deviation of the nasal septum including causes, consequences, and treatment.
• Characterizes rhinitis (inflammation of the nasal mucosa).
• Discusses epistaxis (nosebleeds), including causes, location of the bleeding source (Kiesselbach area), and typical treatments (anterior/posterior nasal packs, surgical embolization).
• Explores sinusitis, how infections spread to the paranasal sinuses, and how swelling blocks sinus openings (meatus).
• Explains transillumination of sinuses and describes its use in dark environments.
• Expands description of fractures of laryngeal skeleton caused by traumas in sports and seatbelt compressions in car accidents.
• Details consequences of laryngeal fractures (e.g., hemorrhage, edema, breathing issues, hoarseness).
• Explains the Valsalva maneuver, including its function (maintaining glotis closure during forced expiration), and its use in diagnostics.
• Outlines the stages of the Valsalva maneuver. This highlights the significance of deep inspiration and forced expiration.
• Details about the mechanism of the Valsalva maneuver, particularly the role of anterolateral abdominal muscles, pressure changes, and impact on venous return.
• Describes the history of the Valsalva maneuver.
• Describes the Heimlich maneuver including its use in cases of choking.
• Describes the method of the Heimlich maneuver, steps for performing in adults and children.
• Covers cancer of the larynx, its symptoms, diagnostics, and possible treatments like laryngectomy and vocal rehabilitation methods (e.g., electrolarynx, tracheo-esophageal prosthesis).
• Outlines the age changes in the larynx, such as consistent growth during childhood, significant changes in puberty for males, and the presence, though less significant, of changes for females.
• States that artificial testosterone does not always result in a lower voice.
• Covers the different components of the throat, such as the thyroid, cricoid, and arytenoid cartilages that can become ossified with age, that make them visible in radiographic images.
• Details about Peak Expiratory Flow Rate test (PEFR) method use for diagnosing respiratory conditions.
• Presents ways for performing a PEFR test, such as setting up the machine, positioning the patient, instructions for breathing, and repeating procedure.
• Discusses the thyroid and parathyroid glands, including their anatomy and the causes and implications of goiter and their removal (thyroidectomy).
• Looks at the different parts where the sinus tract from the piriform fossa to the thyroid gland is found and their treatment.
• Details a collection of congenital abnormalities involving the thyroid gland (e.g., aberrant thyroid tissue, pyramidal lobe).
• Provides information on the causes, impact, and location of possible abnormalities.
• Discusses injury of a phrenic nerve, particularly paralysis of diaphragm half.
• States that the anesthetic is used to block phrenic nerves during lung surgery.
• Provides radiographic images for diagnostics and anatomy study purposes of injury of the phrenic nerve.
• Lists the sources for the references.

Thoracic Respiratory System

• Includes the lungs, bronchi, trachea, and pleura.
• Presents their clinical anatomy; application of anatomical knowledge to clinical reality.

Penetrating Traumatisms in the Neck

• Explains the methodology for diagnosing severity of neck trauma.
• Explains in detail the structure in each zone.

Radical Dissections of the Neck

• Describes the purpose of the procedure.
• Presents preserved and non-preserved structures.

Pleural Pain

• Differentiates visceral and parietal pleura.
• Defines referred pain areas for both.

Injuries of Pleura

• Describes pneumothorax and its causes.
• Identifies areas for injury.

Pulmonary Collapse/Atelectasis

• Details primary and secondary atelectasis.
• Explains negative pleural pressure and lung elasticity.

Neurological Injuries

• Discusses phrenic nerve injury and paralysis of the diaphragm.

Injuries to the Thoracic Cavity and Respiratory Tract

• Presents a thorough description of the different components involved in these types of injuries.

Other Topics

• Covering various other topics like pulmonary embolism, lung carcinoma, hemoptysis, nasal fractures, nasal septum deviations, rhinitis, epistaxis, sinusitis, laryngeal fractures, Valsalva maneuver, Heimlich maneuver, and the use of PEFR.
• Providing a deeper understanding of the anatomical structures and their implications in various clinical situations.