Heart sounds
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Heart sounds can be studied using three methods: listening with a stethoscope, using a microphone, or recording with a phonocardiogram. When using a stethoscope, the chest piece is placed over four auscultation areas - the mitral, tricuspid, pulmonary, and aortic areas - to listen for the first and second heart sounds produced by the closing of the corresponding valves. The mitral area is located in the left fifth intercostal space and the tricuspid area is over the xiphoid process.
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The trachea is a cartilaginous tube that begins at the larynx and divides into the two main bronchi at the carina. It is located in the neck anterior to the esophagus and in the thorax anterior to the sternum. The trachea is supported by rings of cartilage and lined with ciliated epithelium. It supplies air to the lungs via the right and left main bronchi, which further divide to bring air into smaller bronchioles and alveoli within the lungs. The trachea receives blood supply from the inferior thyroid arteries and lymph drainage goes to pretracheal and paratracheal lymph nodes.
Diaphragm
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My Goals::::
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2-relationship of thorax to upper limb.
3-relationship of thorax to breasts : pleural cavity - pleural and Lung .
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This document discusses the anatomy and function of the diaphragm. It is a dome-shaped skeletal muscle that separates the thoracic and abdominal cavities. Contraction of the diaphragm during respiration decreases intrathoracic pressure, allowing air to enter the lungs and blood to return to the heart. The diaphragm receives motor innervation from the phrenic nerves and sensory innervation from the lower intercostal nerves. Structures such as the heart, lungs, liver, and kidneys are located superior and inferior to the diaphragm. Contraction of the diaphragm also helps with defecation, urination, childbirth, and weight lifting by increasing intra-abdom
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The trachea is a fibrocartilaginous tube that begins at the lower border of the cricoid cartilage and bifurcates into the two main bronchi. It contains 16-20 C-shaped rings of hyaline cartilage that help keep the lumen open. The trachea is located in the neck anterior to the esophagus and descends into the thorax where it ends at the level of T4. It has both cervical and thoracic portions and transports air to the lungs while its structure prevents collapse during movements. Congenital defects can cause tracheoesophageal fistulas.
Local chest examination
This document provides guidelines for performing a local chest examination, including inspection, palpation, percussion, and auscultation. The examination involves observing the patient's breathing patterns and chest shape, feeling the trachea, apex beat, and chest expansion, tapping to assess percussion notes, and listening for breath sounds, adventitious sounds like rhonchi or crackles, and vocal resonance. The examination is designed to evaluate the lungs, check for abnormalities, and compare both sides of the chest.
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5. Trachea
The trachea is a cartilaginous tube that begins at the larynx and divides into the two main bronchi at the carina. It is located in the neck anterior to the esophagus and in the thorax anterior to the sternum. The trachea is supported by rings of cartilage and lined with ciliated epithelium. It supplies air to the lungs via the right and left main bronchi, which further divide to bring air into smaller bronchioles and alveoli within the lungs. The trachea receives blood supply from the inferior thyroid arteries and lymph drainage goes to pretracheal and paratracheal lymph nodes.
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Trachea
The trachea is a fibrocartilaginous tube that begins at the lower border of the cricoid cartilage and bifurcates into the two main bronchi. It contains 16-20 C-shaped rings of hyaline cartilage that help keep the lumen open. The trachea is located in the neck anterior to the esophagus and descends into the thorax where it ends at the level of T4. It has both cervical and thoracic portions and transports air to the lungs while its structure prevents collapse during movements. Congenital defects can cause tracheoesophageal fistulas.
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The document describes the anatomy and function of the diaphragm. It is divided into three parts: the sternal, costal, and lumbar parts. The sternal part arises from the xiphoid process, the costal part from the lower six ribs, and the lumbar part from the lumbar vertebrae. The diaphragm is innervated by the phrenic nerves and contracts during inspiration to flatten its shape and increase the vertical diameter of the thorax. Relaxation of the diaphragm allows expiration to occur as the thorax decreases in size. The diaphragm plays an important role in respiration and separates the thoracic and abdominal cavities.
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The diaphragm develops from four sources in the embryo and matures to become a dome-shaped musculofibrous sheet that separates the thoracic and abdominal cavities. It has a central tendon to which muscular fibers attach and is the primary muscle of respiration. During inspiration, it contracts to flatten and lower, increasing the vertical space in the thorax. It has openings that allow structures like the esophagus, inferior vena cava and aorta to pass between the thorax and abdomen. The phrenic nerves provide motor innervation and allow the diaphragm to contract during breathing.
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The diaphragm is a fibromuscular sheet that separates the thoracic cavity from the abdominal cavity. It has three parts - the sternal, costal, and vertebral parts. The diaphragm contracts during inspiration to increase the volume of the thoracic cavity. It receives motor innervation from the phrenic nerves and sensory innervation from intercostal and phrenic nerves. During development, the diaphragm forms from the septum transversum, pleuroperitoneal membranes, mesentery of the esophagus, and body wall mesoderm. Diseases affecting the diaphragm include hernias, paralysis, trauma, and tumors.
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Thorax (1) 2
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Please read the references for more information.
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This document discusses heart sounds, including their production and characteristics. It describes the four main heart sounds (S1, S2, S3, S4) and provides details on what causes each sound and when they occur in the cardiac cycle. Abnormal heart sounds are also addressed. Methods for studying heart sounds include using a stethoscope, microphone, or phonocardiogram. The stethoscope is placed over specific auscultation areas of the chest to best hear each heart sound.
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This document provides information on examining the respiratory system through inspection, palpation, percussion, and auscultation. It details the specific procedures and findings for each examination technique, including normal breath sounds, positions of structures like the trachea and apex beat, tactile vocal fremitus, and abnormal sounds. Key areas of the chest are identified for percussion. The lower borders of the lungs and types of breath sounds are also described.
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The diaphragm is a fibromuscular sheet that separates the thoracic cavity from the abdominal cavity. It has three parts - the sternal, costal, and vertebral parts. The diaphragm contracts during inspiration to increase the volume of the thoracic cavity. It receives motor innervation from the phrenic nerves and sensory innervation from intercostal and phrenic nerves. During development, the diaphragm forms from the septum transversum, pleuroperitoneal membranes, mesentery of the esophagus, and body wall mesoderm. Diseases affecting the diaphragm include hernias, paralysis, trauma, and tumors.
Thorax second part anatomy
The thorax contains the heart and lungs and is protected by the thoracic cage. It is separated from the abdomen below by the diaphragm. The thoracic wall is formed by bones including the sternum in front and ribs and vertebrae on the sides and back. Within the chest cavity are the mediastinum, which contains the heart and major blood vessels, and the pleural cavities housing the lungs. Openings in the diaphragm allow passage of structures between the chest and abdomen.
Thorax (1) 2
The thorax contains the heart and lungs and is protected by the thoracic cage. It is separated from the abdomen below by the diaphragm. The thoracic wall is formed by bones including the sternum in front and ribs and vertebrae on the sides and back. Within the chest cavity are the mediastinum, which contains the heart and major blood vessels, and the pleural cavities housing the lungs. Openings in the diaphragm allow passage of structures between the chest and abdomen.
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This document provides information on examining the respiratory system. It outlines steps for general examination including assessing respiratory rate, rhythm, use of accessory muscles and signs of distress. Examination of the upper and lower respiratory tract is described, including inspection of the nose, mouth, chest shape and listening to breath sounds. Evaluation of the chest involves palpation of the trachea and chest wall as well as percussion and auscultation of the lungs. Common breath sounds and adventitious lung sounds are defined.
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- During inspiration, the thoracic cavity diameters are increased through contraction of the diaphragm and intercostal muscles, raising the ribs and lowering the diaphragm. Forced inspiration involves additional muscle contractions.
- Expiration is largely passive through lung elastic recoil and muscle relaxation, though forced expiration uses abdominal muscle contractions.
Axial Thorax
The axial skeleton includes the sternum, ribs, and thoracic vertebrae that form the bony thorax. The sternum is formed by fusion of the manubrium, body, and xiphoid process bones. The twelve pairs of ribs are divided into true ribs attached to the sternum and false ribs either attached to other ribs or floating. Together these bones protect the heart, lungs, and major blood vessels in the thoracic cage.
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1. The posterior triangle is the triangular space behind the sternocleidomastoid muscle in the neck. It contains nerves, arteries, veins and lymph nodes.
2. The spinal accessory nerve and occipital artery pass through the upper part, while the subclavian artery and brachial plexus pass through the lower part.
3. The posterior triangle is divided into an upper occipital triangle and lower subclavian triangle by the omohyoid muscle. Structures in each triangle and potential spaces are described.
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This document summarizes the structure and function of blood vessels. It discusses how blood vessels are composed of smooth muscle cells and extracellular matrix lined with endothelial cells. It describes the differences between arteries, veins, capillaries and how their structures relate to their functions. It also discusses vascular diseases like atherosclerosis, aneurysms, hypertension and vasculitis at a high level.
4. CARDIOMYOPATHIES.pptx
Cardiomyopathies are diseases of the heart muscle that can be primary or secondary. The main types are dilated cardiomyopathy, hypertrophic cardiomyopathy, and restrictive cardiomyopathy. Dilated cardiomyopathy is characterized by cardiac dilation and contractile dysfunction. Causes include genetic factors, myocarditis, toxins like alcohol, and peripartum cardiomyopathy. Hypertrophic cardiomyopathy causes thickening of the heart walls and impaired diastolic filling. It is usually genetic and causes sarcomere protein mutations. Restrictive cardiomyopathy decreases ventricular compliance and impairs filling. Causes include amyloidosis, endomyocardial fibrosis, and Loeffler endomyocarditis. Myocarditis involves infectious or inflammatory processes targeting
3. ARRHYTHMIAS.pptx
This document discusses various types of arrhythmias and heart conditions including their causes, characteristics, and clinical presentations. It covers topics such as:
- Arrhythmias which can be initiated anywhere in the heart's conduction system and may present as tachycardia, bradycardia, or other irregular rhythms.
- Hypertension can lead to hypertensive heart disease over time due to increased pressure on the heart.
- Valvular heart diseases like rheumatic heart disease and degenerative valve diseases can cause stenosis or insufficiency of the heart valves.
- Infective endocarditis is a bacterial infection of the heart valves that forms vegetations and can cause embol
2. ISCHEMIC HEART DISEASE.pptx
Ischemic heart disease (IHD) is caused by reduced blood flow to the heart muscle and usually results from plaque buildup in the coronary arteries. This leads to not enough oxygen reaching the heart muscle. The main manifestations of IHD include angina pectoris (chest pain), myocardial infarction (heart attack), and sudden cardiac death. A heart attack occurs when a plaque ruptures and causes a blood clot that completely blocks blood flow, causing heart cell death. Reperfusion through procedures like angioplasty can limit damage but also cause additional injury. Complications from a heart attack include heart failure, arrhythmias, and cardiac rupture.
1. Heart.pptx
This document discusses heart failure, including its causes, symptoms, and effects on the left and right sides of the heart. Heart failure can result from systolic or diastolic dysfunction and weakens the heart's ability to pump blood efficiently. Common symptoms of left heart failure include dyspnea, orthopnea, and paroxysmal nocturnal dyspnea. Right heart failure usually results from left heart failure and causes systemic venous congestion. The document also reviews several types of congenital heart defects such as atrial septal defects, ventricular septal defects, and tetralogy of Fallot.
thyroid and parathyroid.pptx
The document discusses the endocrine functions of the thyroid gland, parathyroid glands, and their roles in calcium and bone homeostasis. Specifically, it describes how thyroid hormones are synthesized and regulated, their effects on growth, metabolism and other body systems. It also explains how parathyroid hormone regulates blood calcium levels by acting on bone, kidneys and intestines. The importance of maintaining normal calcium levels and balancing bone formation and resorption is emphasized.
Infections Pharmacology.pptx
This document discusses various drugs used to treat bacterial, viral, fungal and parasitic infections. It describes the mechanisms of antibacterial drugs including inhibiting cell wall synthesis, protein synthesis and DNA/RNA function. Specific drug classes are outlined for each mechanism such as penicillins, cephalosporins and aminoglycosides. The document also discusses antiviral drugs used to treat HIV including different classes that act on reverse transcriptase and protease. Finally, it briefly outlines antifungal, antiparasitic and anthelmintic drugs used to treat various infections.
Respiratory Drugs.pptx
This document discusses several classes of respiratory drugs including antitussives, decongestants, antihistamines, mucolytics and expectorants, bronchodilators, and anti-inflammatory drugs. It describes the mechanisms of action, indications for use, routes of administration, and potential adverse effects of drugs from each class. The classes covered include cough suppressants, nasal decongestants, antihistamines, mucus-thinning and cough-loosening drugs, beta-agonists, xanthines, anticholinergics, glucocorticoids, and cromones.
DM.pptx
This document discusses pancreatic hormones and their role in diabetes mellitus. It describes how the pancreas functions as both an exocrine and endocrine gland, secreting digestive enzymes and hormones like insulin and glucagon. Problems with insulin production cause diabetes mellitus, characterized by high blood glucose. The document outlines the roles of insulin and glucagon in regulating blood glucose levels, compares type 1 and type 2 diabetes, and discusses treatment approaches like insulin therapy, oral medications, diet/exercise, and new therapies.
Introduction to Endocrine.pptx
The document summarizes the major endocrine glands and their hormones. It describes the hypothalamus and pituitary gland which secretes six important peptide hormones. It also discusses the thyroid gland which produces thyroxine and triiodothyronine, regulating cellular metabolism. The parathyroid glands contain four glands which secrete parathyroid hormone regulating calcium levels. The pancreas has endocrine functions secreting insulin and glucagon to regulate blood sugar. The adrenal glands are composed of an outer cortex secreting glucocorticoids and mineralocorticoids, and an inner medulla secreting epinephrine and norepinephrine. The gonads are the testes and ovaries which produce sex
CAT Systematic reviews of RCT.pptx
The document discusses key aspects of systematic reviews that should be addressed to minimize bias, including clearly specifying inclusion/exclusion criteria, conducting comprehensive searches to identify most relevant studies, and accounting for quality of reviewed studies. It emphasizes the importance of transparently reporting how trials were selected and quality assessed to strengthen the evidence provided by the systematic review.
CAT effect of intervetion.pptx
This document discusses key criteria for evaluating the quality of evidence from randomized trials:
1) Groups must be comparable, which randomization aims to ensure by distributing participants evenly across groups through chance alone. Randomization can be computer-generated or through processes like coin tossing.
2) Allocation must be concealed so researchers are unaware which group a participant will be in to prevent bias. This is usually done through sealed envelopes or an off-site registry.
3) Follow-up must be complete or near-complete to prevent bias from non-random dropout patterns between groups. Less than 15% total dropout is ideal, with concerns rising above 20% where groups differ substantially.
Adrenocorticosteroids.pptx
This document discusses adrenocorticosteroids and their roles and effects in the body. It focuses on glucocorticoids like cortisol which regulate glucose, stress response, and inflammation. Glucocorticoids work by entering cells and activating receptors that travel to DNA to inhibit inflammatory genes. The document also discusses mineralocorticoids like aldosterone which regulate sodium and fluid balance. Therapeutic uses of glucocorticoids include replacement therapy for adrenal insufficiency and treatment of inflammatory/autoimmune conditions. Side effects include adrenal suppression and Cushing's syndrome.
Male and Female Hormones.pptx
This document discusses the roles and functions of androgens and estrogens in the male and female body. It describes how androgens and estrogens contribute to sexual development and function, their clinical uses, and potential side effects of hormone therapy. The summary also outlines the menstrual cycle and the roles of various hormones like FSH, LH, estrogen, and progesterone in regulating the female reproductive cycle.
Respiratory Drugs.pptx
This document discusses several classes of respiratory drugs including antitussives, decongestants, antihistamines, mucolytics and expectorants, bronchodilators, and anti-inflammatory drugs. It describes the mechanisms of action, indications for use, routes of administration, and potential adverse effects of drugs from each class. The classes covered include cough suppressants, nasal decongestants, antihistamines, mucus-thinning and cough-loosening drugs, beta-agonists, xanthines, anticholinergics, glucocorticoids, and cromones.
Introduction to Endocrine.pptx
The document summarizes the major endocrine glands and their hormones. It describes the hypothalamus and pituitary gland which secretes six important peptide hormones. It also discusses the thyroid gland which produces thyroxine and triiodothyronine, regulating cellular metabolism. The parathyroid glands contain four glands which secrete parathyroid hormone to regulate calcium levels. The pancreas has endocrine functions secreting insulin and glucagon to regulate blood sugar. The adrenal glands are composed of an outer cortex secreting glucocorticoids and mineralocorticoids, and an inner medulla secreting epinephrine and norepinephrine. The gonads are the testes and ovaries which se
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This document discusses key criteria for evaluating the quality of evidence from randomized trials:
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3) Follow-up must be complete or near-complete, with less than 15-20% loss to follow-up to avoid bias from non-random dropout patterns between groups. Loss to follow-up threatens validity the more participants are lost.
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Heart sounds
- 3. METHODS OF STUDY OF HEART SOUNDS • Heart sounds are studied by three methods: 1. By using stethoscope 2. By using microphone 3. By using phonocardiogram
- 4. BY STETHOSCOPE • First and second heart sounds are heard on the auscultation areas, by using the stethoscope. • The chest piece of the stethoscope is placed over four areas on the chest, which are called auscultation areas.
- 5. i. Mitral area (Bicuspid area) • Mitral area is in the left 5th intercostal space, about 10 cm away from the midline (midclavicular line). • Sound produced by the closure of mitral valve (first heart sound) is transmitted well into this area. It is also called apex beat area because apex beat is felt in this area. Apex beat • Apex beat is the thrust of the apex of ventricles, against the chest wall during systole.
- 6. ii. Tricuspid area • Tricuspid area is on the xiphoid process. Sound produced by the closure of tricuspid valve (first heart sound) is transmitted well into this area.
- 7. iii. Pulmonary area • Pulmonary area is on the left 2nd intercostal space, close to sternum. Sound produced by the closure of pulmonary valve (second heart sound) is heard well on this area.
- 8. iv. Aortic area • Aortic area is over the right 2nd intercostal space, close to the sternum. On this area, the sound produced by the closure of aortic valve (second heart sound) is heard well.