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Thoracostomy
A thoracostomy is a small incision of the chest wall, with maintenance of the opening for drainage. It is most commonly used for the treatment of a pneumothorax. This is performed by physicians, paramedics, and nurses usually via needle thoracostomy or an incision into the chest wall with the insertion of a thoracostomy tube (chest tube) or with a hemostat and the provider's finger (finger thorocostomy), A thoracostomy is often confused with thoracotomy, which is a larger incision commonly used to gain access to organs within the chest. Medical uses When air, blood, or other fluids accumulate in the pleural cavity it may be drained by thoracostomy. Whereas air in this space (pneumothorax) may be released by needle thoracostomy, other substances require drainage with a thoracostomy tube. Contra-indications There are no absolute contraindications to thoracostomy. There are relative contraindications (such as coagulopathies); however, in an emergency setting these are outweighed ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Pneumothorax
A pneumothorax is an abnormal 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 shortness of breath. In a minority of cases, a one-way valve is formed by an area of damaged 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 oxygen shortage and 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 the risk of primary spontaneous pneumothora ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Thoracentesis
Thoracentesis , also known as thoracocentesis (from Greek ''thōrax'' 'chest, thorax'—GEN ''thōrakos''—and ''kentēsis'' 'pricking, puncture'), pleural tap, needle thoracostomy, or needle decompression (often used term), is an invasive medical procedure to remove fluid or air from the pleural space for diagnostic or therapeutic purposes. A cannula, or hollow needle, is carefully introduced into the thorax, generally after administration of local anesthesia. The procedure was first performed by Morrill Wyman in 1850 and then described by Henry Ingersoll Bowditch in 1852. The recommended location varies depending upon the source. Some sources recommend the midaxillary line, in the eighth, ninth, or tenth intercostal space. Whenever possible, the procedure should be performed under ultrasound guidance, which has shown to reduce complications. Tension pneumothorax is a medical emergency that requires emergent needle decompression before a chest tube is placed. Indications 48 ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Thoracostomy Tube
A chest tube (also chest drain, thoracic catheter, tube thoracostomy or intercostal drain) is a surgical drain that is inserted through the chest wall and into the pleural space or the mediastinum in order to remove clinically undesired substances such as air (pneumothorax), excess fluid (pleural effusion or hydrothorax), blood (hemothorax), chyle (chylothorax) or pus (empyema) from the intrathoracic space. An intrapleural chest tube is also known as a Bülau drain or an intercostal catheter (ICC), and can either be a thin, flexible silicone tube (known as a "pigtail" drain), or a larger, semi-rigid, fenestrated plastic tube, which often involves a flutter valve or underwater seal. The concept of chest drainage was first advocated by Hippocrates when he described the treatment of empyema by means of incision, cautery and insertion of metal tubes. However, the technique was not widely used until the influenza epidemic of 1918 to evacuate post-pneumonic empyema, which was first do ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Needle Thoracostomy
Thoracentesis , also known as thoracocentesis (from Greek ''thōrax'' 'chest, thorax'—GEN ''thōrakos''—and ''kentēsis'' 'pricking, puncture'), pleural tap, needle thoracostomy, or needle decompression (often used term), is an invasive medical procedure to remove fluid or air from the pleural space for diagnostic or therapeutic purposes. A cannula, or hollow needle, is carefully introduced into the thorax, generally after administration of local anesthesia. The procedure was first performed by Morrill Wyman in 1850 and then described by Henry Ingersoll Bowditch in 1852. The recommended location varies depending upon the source. Some sources recommend the midaxillary line, in the eighth, ninth, or tenth intercostal space. Whenever possible, the procedure should be performed under ultrasound guidance, which has shown to reduce complications. Tension pneumothorax is a medical emergency that requires emergent needle decompression before a chest tube is placed. Indications 48 ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Thoracostomy Tube
A chest tube (also chest drain, thoracic catheter, tube thoracostomy or intercostal drain) is a surgical drain that is inserted through the chest wall and into the pleural space or the mediastinum in order to remove clinically undesired substances such as air (pneumothorax), excess fluid (pleural effusion or hydrothorax), blood (hemothorax), chyle (chylothorax) or pus (empyema) from the intrathoracic space. An intrapleural chest tube is also known as a Bülau drain or an intercostal catheter (ICC), and can either be a thin, flexible silicone tube (known as a "pigtail" drain), or a larger, semi-rigid, fenestrated plastic tube, which often involves a flutter valve or underwater seal. The concept of chest drainage was first advocated by Hippocrates when he described the treatment of empyema by means of incision, cautery and insertion of metal tubes. However, the technique was not widely used until the influenza epidemic of 1918 to evacuate post-pneumonic empyema, which was first do ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Pulmonology
Pulmonology (, , from Latin ''pulmō, -ōnis'' "lung" and the Greek suffix "study of"), pneumology (, built on Greek πνεύμων "lung") or pneumonology () is a medical specialty that deals with diseases involving the respiratory tract.ACP: Pulmonology: Internal Medicine Subspecialty . Acponline.org. Retrieved on 2011-09-30. It is also known as respirology, respiratory medicine, or chest medicine in some countries and areas. Pulmonology is considered a branch of internal medicine, and is related to intensive care medicine ...
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Thoracic Wall
The thoracic wall or chest wall is the boundary of the thoracic cavity. Structure The bony skeletal part of the thoracic wall is the rib cage, and the rest is made up of muscle, skin, and fasciae. The chest wall has 10 layers, namely (from superficial to deep) skin (epidermis and dermis), superficial fascia, deep fascia and the invested extrinsic muscles (from the upper limbs), intrinsic muscles associated with the ribs (three layers of intercostal muscles), endothoracic fascia and parietal pleura. However, the extrinsic muscular layers vary according to the region of the chest wall. For example, the front and back sides may include attachments of large upper limb muscles like pectoralis major or latissimus dorsi, while the sides only have serratus anterior. Function Diving reflex When not breathing for long and dangerous periods of time in cold water, a person's body undergoes great temporary changes to try to prevent death. It achieves this through the activation of ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Drainage (medical)
Incision and drainage (I&D), also known as clinical lancing, are minor surgical procedures to release pus or pressure built up under the skin, such as from an abscess, boil, or infected paranasal sinus. It is performed by treating the area with an antiseptic, such as iodine-based solution, and then making a small incision to puncture the skin using a sterile instrument such as a sharp needle or a pointed scalpel. This allows the pus fluid to escape by draining out through the incision. Good medical practice for large abdominal abscesses requires insertion of a drainage tube, preceded by insertion of a PICC line to enable readiness of treatment for possible septic shock. Adjunct antibiotics Uncomplicated cutaneous abscesses do not need antibiotics after successful drainage. In incisional abscesses For incisional abscesses, it is recommended that incision and drainage is followed by covering the area with a thin layer of gauze followed by sterile dressing. The dressing should be ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Thoracotomy
A thoracotomy is a surgical procedure to gain access into the pleural space of the chest. It is performed by surgeons (emergency physicians or paramedics under certain circumstances) to gain access to the thoracic organs, most commonly the heart, the lungs, or the esophagus, or for access to the thoracic aorta or the anterior spine (the latter may be necessary to access tumors in the spine). A thoracotomy is the first step in thoracic surgeries including lobectomy or pneumonectomy for lung cancer or to gain thoracic access in major trauma. Approaches There are many different surgical approaches to performing a thoracotomy. Some common forms of thoracotomies include: * Median sternotomy provides wide access to the mediastinum and is the incision of choice for most open-heart surgery and access to the anterior mediastinum * Posterolateral thoracotomy is an incision through an intercostal space on the back, and is often widened with rib spreaders. It is a very common approach ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Pleural Cavity
The pleural cavity, pleural space, or interpleural space is the potential space between the pleurae of the pleural sac that surrounds each lung. A small amount of serous pleural fluid is maintained in the pleural cavity to enable lubrication between the membranes, and also to create a pressure gradient. The serous membrane that covers the surface of the lung is the visceral pleura and is separated from the outer membrane the parietal pleura by just the film of pleural fluid in the pleural cavity. The visceral pleura follows the fissures of the lung and the root of the lung structures. The parietal pleura is attached to the mediastinum, the upper surface of the diaphragm, and to the inside of the ribcage. Structure In humans, the left and right lungs are completely separated by the mediastinum, and there is no communication between their pleural cavities. Therefore, in cases of a unilateral pneumothorax, the contralateral lung will remain functioning normally unless there is ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Contraindications
In medicine, a contraindication is a condition that serves as a reason not to take a certain medical treatment due to the harm that it would cause the patient. Contraindication is the opposite of indication, which is a reason to use a certain treatment. ''Absolute contraindications'' are contraindications for which there are no reasonable circumstances for undertaking a course of action. For example, children and teenagers with viral infections should not be given aspirin because of the risk of Reye syndrome, and a person with an anaphylactic food allergy should never eat the food to which they are allergic. Similarly, a person with hemochromatosis should not be administered iron preparations. ''Relative contraindications'' are contraindications for circumstances in which the patient is at higher risk of complications from treatment, but these risks may be outweighed by other considerations or mitigated by other measures. For example, a pregnant woman should normally avoid gett ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Coagulopathy
Coagulopathy (also called a bleeding disorder) is a condition in which the blood's ability to coagulate (form clots) is impaired. This condition can cause a tendency toward prolonged or excessive bleeding (bleeding diathesis), which may occur spontaneously or following an injury or medical and dental procedures. Coagulopathies are sometimes erroneously referred to as "clotting disorders", but a clotting disorder is the opposite, defined as a predisposition to excessive clot formation (thrombus), also known as a hypercoagulable state or thrombophilia. Signs and symptoms Coagulopathy may cause uncontrolled internal or external bleeding. Left untreated, uncontrolled bleeding may cause damage to joints, muscles, or internal organs and may be life-threatening. People should seek immediate medical care for serious symptoms, including heavy external bleeding, blood in the urine or stool, double vision, severe head or neck pain, repeated vomiting, difficulty walking, convulsions, or se ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
