Clinical cases-Thorax human anatomy applied anatomy

This pdf includes the clinical cases of the the chapter thorax. It is an unit of human anatomy

1. Clinical cases-Thorax

2. A patient came to OPD with left side chest pain radiating up to left shoulder. One ECG S.T.elevation seen.Physician diagnosed it as acute myocardial infarction 1) Write down arteries supplying to involved organ (2m) 2) What is cardiac dominance? (2m) 3) Why the pain gets radiated to left shoulder (1m)

3. The central lymphoid organ situated in the superior mediastinum ,more prominent in children and gradually increases in size till puberty 1) Name the mentioned organ or structure 1M 2) Name the neuromuscular disorder associated with the mentioned organ .2m 3)Enlist any other two contents of superior mediastinum .2m

4. A 30-year-old female visited the hospital and complained that she had been feeling severe pain on the right side of her chest for the past two weeks and has little difficulty in breathing. She also told that pain often radiated to the anterior abdominal wall. On auscultation, the doctor noticed the absence of breath sounds over the inferior lobe of her right lung. The X-ray of the chest PA view revealed blunting of the right costodiaphragmatic angle and the line of the fluid level.   1. What is the probable diagnosis ? 1m 2. Enumerate the recesses of the pleura.2m 3. What is the anatomical basis of radiation of pain to the anterior abdominal wall? 2m Extra 4. Mention the (a) cause of pleural effusion and (b) site where pleural fluid accumulates first. 5. What is pleural cavity ? 1m  

5. A male infant was brought to the hospital having markedly laboured respiration and cyanosis. The heart sounds were displaced and there was an apparent dextrocardia . The left side of the chest was dull (flat) to percussion and had diminished breath sounds. The abdomen was characteristically scaphoid (i.e. boat shaped). The X-ray chest revealed the presence of bowel, spleen, and portions of the liver within thorax. 1.What will be the probable diagnosis ? 1m 2. Mentioned hernia is common on which side-right or left?1m 3. What are the different types of congenital diaphragmatic hernia? 2m 4. Which is the commonest congenital hernia of the diaphragm? Give its incidence.1m

6. A heavy smoker, 60-year-old male, visited the hospital and complained that he lost 10 kg of his weight in past three months and has persistent cough with the blood-stained sputum. He also noticed the loss of sweating on the right side of his face. On physical examination, the doctors found partial ptosis and constriction of pupil in his right eye. X-ray chest (PA view) revealed a radiopaque shadow in the apical region of the right lung. Biopsy revealed malignancy . A diagnosis of malignancy of the apex of the lung was made.   . Enumerate any two posterior relations of the apex of the lung. 2m 2. extra Mention the anatomical basis of loss of sweating in the right half of the face, and partial ptosis and constriction (meiosis) of the right eye. 3. What is the bronchopulmonary segment?2m 4. Which is the most dependent bronchopulmonary segment in supine position?1m

7. A 60-year-old male visited the hospital and complained that he (a) has noticed alternation in his voice, (b) has lost 15 kg weight, and (c) has persistent cough with blood-stained sputum. On asking, he told that he is a chronic smoker and smokes 20-30 cigarettes per day. The X-ray chest revealed a large well circumscribed radiopaque shadow in the hilar region of his right lung and the widening of the mediastinum.   1. What is the probable diagnosis? 1m 2. What is the cause of hoarseness of the voice? 2m 3. Mention the anatomical basis of metastasis of broncho - genic carcinoma to brain and bones.2m

8. A 60-year-old man visited a cardiologist and complained that he was feeling pressure/tightness within his chest, accompanied by profuse sweating and pain in the left precordium that is radiating along the medial side of the arm and the forearm. On questioning, he told that earlier also he suffered from such symptoms which always occurred on exertion, for example when climbing stairs or digging in the garden. He also told that these symptoms disappear after resting. He was diagnosed as a case of angina pectoris . QUESTIONS   1. What is angina pectoris? 1m 2. Mention the anatomical basis of pain felt in the region of the left precordium and medial side of the arm and the forearm.2m 3. Name the arteries that supply the cardiac muscle and mention their origin.2m

9. A mother took her 12-year-old son to the hospital and complained that he feels weakness even after slight exertion (reduced exercise tolerance), leg cramps on walking, and shortness of the breath. On examination, the doctors noticed radiofemoral delay. Blood pressure was 126/20 mmHg in upper limbs and 80/60 mmHg in the lower limbs. The X-ray of the chest showed notching of the lower borders of the ribs. Clinically, he was diagnosed as a case of coarctation of the aorta, which was confirmed later by echocardiography. QUESTIONS   1. What is coarctation of the aorta? 1m 2. . What is the cause of high blood pressure in the upper limbs and low blood pressure in the lower limbs? 2m 3. Mention the reason for notching of the ribs 2m Extra Which is the largest branch of arch of aorta

10. A 65-year-old woman visited the hospital and complained of difficulty in swallowing (dysphagia) and marked loss of weight. The barium swallow revealed narrowing of the lower end of the oesophagus . The biopsy was taken from the end of the oesophagus and it confirmed as the case of oesophageal malignancy. QUESTIONS   1. What is the extent and length of oesophagus ? 2m 2. Name any two factors that can cause dysphagia.2m 3. What is the most common site of the malignant tumour in oesophagus ? 1m

11. The largest lymphatic vessel that drains lymph from most of the body parts ,laceration of involved vessel during surgery leads to leakage of chyle into the pleural cavity producing clinical condition called chylothorax 1. Name the lymphatic vessels involved 1m 2.Give its extent 2m 3.Enlist any two tributaries of it. 2m