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Benign Thoracic Patholgy - Coggle Diagram

- - - - Thymus
      - Lymph nodes
      - Fat
    - - Heart
      - Great vessels
    - - Oesop
      - Azygos
      - Vagusa
      - Thoracic duct
- - - - Pleuritic pain
      - Tracheal deviation
      - Hyperresonance
      - Onset sudden
      - Reduced breath sounds (and dyspnea)
      - Absent fremitus
      - X-ray show collapse
  - - - Suspect spinal injury
      - High flow O2
      - Surveillance vs aspiration vs chest tube
      - Establish airway / amintain
    - - BTS Guidelines
    - - VATS vs Open
        
        Pleurectomy
        
        Blebectomy/ Bullectomy
        
        Talc Pleurodesis
        
        VATS = Videa assisted thoracic surgery
      - Complications
      - Indications
        
        Persistent airleak > 7 days
        
        Recurrent ipsilateral pneumothorax
        
        First contralateral pneumothorax
        
        Synchronous bilateral pneumothoraces
        
        Tension pneumothorax
        
        High risk profession eg)Pilot, Diver
    - - Large bore needle
      - Second intercostal space
      - Midclavicular line
    - - Mid / Anterior Axillary line behind pect majoy
        Above 5th rib to avoid diaphragm
      - Connect tube to underwater seal and suture in palce
      - Examine chest effect
      - CXR check placement and position
      - Bethadine / cloraprep on area
  - - - One way valve
        Air travped in pleural space
        Pressure rises
        Mediastinal shift
        Vena cava becomes obstructed
        CO falls
        Shock
- - - - Common
        
        Malignancy
        
        Paranpneumonic effusion
      - Rare
        
        PE
        
        RA and other autoimmune pleur
        
        Pancreatitis
        
        Post MI
      - Class
        
        Effusion protein : Serum protein >0.5
        Effutino LDH : Serum LDH > 0.6
        Effusion LDH
    - - VEry common
        
        LVF
        
        Liver cirrhosis
      - Less commonqHypoalbuminaemoa
      - Perionteal
- - - - Image guided chest drainage and tbx
    - - Wide bore ches drain +/- VATS drain
    - - Open decortication
      - ALways exclude malignancy
- - - - Standard of Care
      - Modified Ravitch repair (open)
        Most common
        
        Removing deformed costal cartilages (which connect the ribs to the sternum).
        
        Reshaping or repositioning the sternum.
        
        Placing a stabilizing bar or mesh to support the chest wall during healing.
      - Nuss procedure (minimmaly invasive
        
        Removed at roughly 2 years
        
        Not common