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MEDIASTINUL

MEDIASTINUL. anatomia. mijlocul toracelui apertura toracica cavitatile pleurale stern torace posterior diafragm. , divertic. Abces TBC (Pott). corpi vertebrali ao descendenta duct toracic vv azygos&hemi lanturi nn simpatice. traheea vase mari. inima vase mari traheea

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MEDIASTINUL

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  1. MEDIASTINUL

  2. anatomia mijlocul toracelui apertura toracica cavitatile pleurale stern torace posterior diafragm

  3. , divertic. Abces TBC (Pott) corpi vertebrali ao descendenta duct toracic vv azygos&hemi lanturi nn simpatice traheea vase mari inima vase mari traheea bronhii pr. esofag n.frenic n.vag

  4. Sdr. mediastinal • Semne si simptome  iritatia/compresia elementelor din mediastin • Frecvent: • durere toracica (n. ic, n.frenic) • tuse (n.vag) • raguseala (laringeu recurent stg.) • dispnee • mai putin frecvent: • stridor - pareza diafragm • disfagie • Horner (mioza, enoftalmie, ptoza palpebrala, congestie hemifata)

  5. Sdr. specifice • Timom: miastenia gravis (50%) • Sdr. VCS: • edem in pelerina • jugulare turgescente • cianoza cefalica • edem papilar • circulatie colaterala

  6. Majoritatea maselor mediastinale: • asimptomatice, sau • simptomatologie generala (febra, scadere ponderala) matitate sternala, interscapulo-vertebrala

  7. tumori • Neganglionare • embrionare (benigne sau maligne) • tesut conjunctiv • neurogene (mediast.post) - benigne • sarcoame, fibrosarcoame • timus, tiroida • Ganglionare • limfom - TBC • cancer pulmonar - sarcoidoza • histoplasmoza

  8. diagnostic • Rx. fata + profil • CT • mediastinoscopie, toracotomie

  9. MEDIASTINITA ACUTA • perforatie esofag (tub Blakemore, endoscopie, ingestie obiecte ascutite) • poststernotomie mediana 5%

  10. MEDIASTINITA ACUTA • durere toracica • dispnee • febra • soc toxic contrast gravitate simptomatologie toracica  absenta localizarii pulmonare sau pleurale

  11. MEDIASTINITA ACUTA • Emfizem mediastinal + subcutanat ± fata • Rx: umbra mediastinala largita, aer retrosternal • Dg  IM ruptura anevrism aortic

  12. MEDIASTINITA CRONICA • Inflamatie mediastinala propagata de la procese patologice din vecinatate: noduli limfatici medastinita fibrozanta  sdr. VCS TBC, histoplasmoza, sarcoidoza • dg: CT

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