Typical heart attack pain
<strong>"Crushing" substernal pain</strong> that does not disappear w/ rest

Flail chest
<answer>
Multiple rib fractures resulting in <span style="text-decoration:underline;"><strong>paradoxical movement of the affected ribs

</strong></span>Very painful breathing; ventilation / oxygenation is affected
</answer>

Thoracic outlet syndrome
Compression of superior thoracic aperture
Affects arteries and T1 nerve (going to UE / neck)

Paralysis of the diaphragm
Injury to the phrenic nerve causes <strong><span style="text-decoration:underline;">ipsilateral paradoxical movement</span></strong>

Thoracocentesis
<strong>9<sup>th</sup> intercostal space MAL 
</strong>Sample fluid in pleural cavity at the costodiaphragmatic recess

What structures are crossed in a thoracocentesis?
External intercostal m.
Internal intercostal m.
Innermost intercostal m. 
Endothoracic fascia
Parietal pleura

<question>
What structures are crossed during an intercostal nerve block in MAL?
What nerves are blocked?
</question>
<answer>
External intercostal m.
Internal intercostal m.

collateral and intercostal nn.
</answer>

Pneumothorax
<answer>
<strong>Entry of air into pleural cavity

</strong>fluid = hydrothorax
blood = hemothorax
</answer>

Pulmonary Embolism
<answer>
<strong>Obstruction of a pulmonary artery</strong> by a thrombus / fat glubule / air from leg vein causes <strong>decrease in oxygenation of blood</strong>

large embolus = emergency (patient can die w/in minutes)
</answer>

<question>
What nerves could be injured during a radical mastectomy?
What functions are lost?
</question>
<answer>
Long thoracic nerve ()
Thoracodorsal nerve () 

SLIDE 16
</answer>