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Surginal Procedures > Cardiac and thoracic surgery > Flashcards

Cardiac and thoracic surgery Flashcards

1
Q

Epicardium
Myocardium
Endocardium

A

Above or upon; heart; noun ending – “layer”
Muscle; heart; noun ending – “layer”
Within; heart; noun ending – “layer”

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2
Q

Heart is surrounded by fluid-filled sac called the:

A

Pericardium = around; heart; noun ending – “layer”

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3
Q

4 chambers (atria, ventricles); Valves

A 
Right atrium
     Tricuspid - and it has 3 leaflets
Right ventricle
left atrium
     Bicuspid/Mitral - and it has 2 leaflets
left ventricle
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4
Q

What are the chordae tendinae and what is their function?

A

Fibrous cords attached to valve cusps; prevent cusps from folding back into atrium

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5
Q

The semi-lunar valves are:

A

Aortic and pulmonic (pulmonary)

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6
Q

Flow of blood through heart

A 
Superior and inferior venae cava (empty into the)
Right atrium (and pass through the)
Tricuspid valve (into the)
Right ventricle (Blood goes to the lungs through the)
Pulmonary valve (to the)
Pulmonary artery (where it is oxygenated in the lungs and returns to the heart via the)
(where it is oxygenated in the lungs and returns to the heart via the)
Pulmonary veins (Those structures empty into the)
Left atrium (and pass through the)
Bicuspid valve (into the)
Left ventricle (Blood is then pumped through the)
Aortic valve (into the)
Aorta (and out to the body)
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7
Q

Cardiac intrinsic conduction system

A 
Impulse originates at the:
S-A node (sino-atrial)
     and travels through the internodal pathways to the:
A-V node
     the impulse spreads to the: 
A-V bundle (Bundle of His)
     which divides into the: 
Right and left bundle branches
     which terminate in the
Purkinje fibers (AKA: myoconduction fibers)
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8
Q

Why is the pump-oxygenator (CPB) used in cardiac surgery?

A

Assumes roles of heart and lungs so heart can be stopped during procedure.

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9
Q

Why is hypothermia used in CPB?

A

To protect the heart muscle (myocardial protection)

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10
Q

Which three means are used to achieve this purpose?

A

Systemic hypothermia; topical myocardial hypothermia; cold potassium cardioplegia solution; and ice slush or iced saline.

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11
Q

List 4 diagnostic tests used in thoracic surgery

A

Chest x-ray
CT
MRI
Pulmonary angiography

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12
Q

List 4 items of special equipment used for thoracic surger

A 
Cell saver
Headlight and light source
Defibrillator with sterile internal paddles
Video tower for MIS
Advanced patient monitoring
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13
Q

Which structures form the skeletal framework of the thorax?

A

Formed by sternum, ribs, and thoracic vertebrae

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14
Q

List 3 parts of the sternum

A

Manubrium; Body (gladiolus); Xiphoid

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15
Q

What is the diaphragm and what is its function?

A

Muscle that separates thorax from abdomen
primary muscle of breathing
The Diaphragm contracts during inhalation to pull air into the lungs and during exhalation, the diaphragm relaxes and the air is pushed out of lungs.

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16
Q

Where are the intercostal nerve, artery, and vein located?

A

On the inferior edge of the corresponding rib

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17
Q

What is the mediastinum?

A

Anatomic region; cavity between R and L thoracic cavities; no specific function

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18
Q

What is contained in the mediastinum?

A

Esophagus, trachea, pericardium, great vessels, thymus, lymph nodes

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19
Q

What is the parietal pleura?

What is the visceral pleura?

A 
Lining of the inner surface of each hemi-thorax
The reflection (or folding) of the parietal pleura over the lung tissue
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20
Q

What is the pleural space?

What is pneumothorax?

A

Potential space between parietal and visceral pleurae

Air in the chest cavity

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21
Q

What is the function of the lungs?

A

Essential organs of respiration; facilitate O2/CO2 exchange

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22
Q

Right lung contains:

Left lung contains:

A

3 lobes

2 lobes

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23
Q

Hilum what is it and which structures exit here?

A

The “root” of lung where vital structures enter and leave the lung
Bronchus, nerves, lymphatics and pulmonary artery and veins

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24
Q

Define CABG

A

Coronary artery bypass graft

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25
Q

Anatomy/physiology CABG

A

Heart, pericardium, epicardium, myocardium, endocardium;
Coronary arteries: Left anterior descending (LAD), circumflex, right coronary artery;
Ascending aorta
Saphenous vein
IMA
Physiology: circulation to the heart muscle

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26
Q

IMA

A

internal mammary artery

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27
Q

Define MID-CABG

A

Minimally invasive direct coronary artery bypass graft

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28
Q

Anatomy/physiology MID-CABG

A

Heart, pericardium, epicardium, myocardium, endocardium;
Coronary arteries: Left anterior descending (LAD), circumflex, right coronary artery;
Ascending aorta
Saphenous vein
IMA
Physiology: circulation to the heart muscle

29
Q

Pathology/indication CABG

A

Coronary artery disease (CAD) due to atherosclerosis in one or more coronary arteries

30
Q

Pathology/indication MID-CABG

A

CAD; due to atherosclerosis; usually for one vessel; the left anterior descending coronary artery (LAD)

31
Q

Define Mediastinoscopy with lymph node biopsy

A

Visual exam, mediastinum; with excision of lymph nodes for pathologic exam

32
Q

Anatomy/physiology Mediastinoscopy with lymph node biopsy

A

Surgical Anatomy/physiology
Mediastinum
FYI: Mediastinum contains Heart; Great vessels: aortic arch
Tracheobronchial junction (carina)
Trachea
Bronchi (FYI: right and left main stem bronchi)
Lymph nodes
Physiology: None specific to mediastinum; it is simply a location containing many structures

33
Q

Pathology/indication Mediastinoscopy with lymph node biopsy

A

Lung cancer; determine metastatic spread to lymph nodes

FYI: may also be used to stage esophageal cancer

34
Q

Define Thoracoscopy AKA: VATS

A

Video-assisted thoracic surgery

Visual exam; chest cavity

35
Q

Anatomy/physiology Thoracoscopy AKA: VATS

A 
Lung; lobes (3 right; 2 left)
Bronchi
Pulmonary arteries/veins
Ribs; intercostal muscles
Pleurae (parietal and visceral)
Diaphragm
Mediastinum
Pericardium
Physiology: respiration
36
Q

Pathology/indication Thoracoscopy AKA: VATS

A

Diagnostic procedure
Treatment for:
Peripheral lung lesion (do a wedge resection)
Lung tumor (lobectomy)
Excessive pericardial fluid (do a pericardial window)
Pulmonary blebs (like blisters; resect affected areas)
Pleural effusion (drain/possible pleurodesis)
Emphysema (lung volume reduction)

37
Q

Define Decortication of the lung

A

Removal of a restrictive membrane from the lungs

38
Q

Anatomy/physiology Decortication of the lung

A 
Lung; lobes (3 right; 2 left)
Bronchi
Pulmonary arteries/veins
Ribs; intercostal muscles
Pleurae (parietal and visceral)
Diaphragm
Mediastinum
Pericardium
Physiology: respiration
39
Q

Pathology/indication Decortication of the lung

A

Empyema (pus in the thoracic cavity)

40
Q

Define Lobectomy

A

Excision of a lobe of the lung

41
Q

Anatomy/physiology Lobectomy

A 
Lung; lobes (3 right; 2 left)
Bronchi
Pulmonary arteries/veins
Ribs; intercostal muscles
Pleurae (parietal and visceral)
Diaphragm
Mediastinum
Pericardium
Physiology: respiration
42
Q

Pathology/indication Lobectomy

A

Peripheral pulmonary tumor without hilar node involvement

43
Q

Define Pulmonary embolectomy

A

Excision of a blood clot in the pulmonary artery

44
Q

Anatomy/physiology Pulmonary embolectomy

A

pulmonary artery/ies

45
Q

Pathology/indication Pulmonary embolectomy

A

pulmonary artery blood clot

46
Q

Define Thoracotomy/pneumonectomy

A

Incision into thoracic cavity with excision of entire lung

47
Q

Anatomy/physiology Thoracotomy/pneumonectomy

A 
Lung; lobes (3 right, 2 left)
Bronchi
Pulmonary arteries/veins
Ribs; intercostal muscles
Pleurae (parietal and visceral)
Diaphragm; mediastinum; pericardium
Physiology: respiration
48
Q

Pathology/indication Thoracotomy/pneumonectomy

A

Bronchogenic carcinoma

pertaining to; origin; bronchus

49
Q

Define Lung Transplantation

A

Replacing a diseased lung with a donor lung

50
Q

Anatomy/physiology Lung Transplantation

A 
Lung; lobes (3 right, 2 left)
Bronchi
Pulmonary arteries/veins
Ribs; intercostal muscles
Pleurae (parietal and visceral)
Diaphragm; mediastinum; pericardium
Physiology: respiration
51
Q

Pathology/indication Lung Transplantation

A

Emphysema (COPD = emphysema + chronic bronchitis)
Idiopathic pulmonary fibrosis
Pulmonary hypertension
Bilateral: cystic fibrosis

52
Q

Atherosclerosis
Cardiomyopathy
Coarctation of aorta

A

Abnormal condition; fatty plaque; hardening resulting loss of elasticity
Disease; heart; muscle
Narrowing of the aortic arch

53
Q

Surgical intervention:
Atherosclerosis
Cardiomyopathy
Coarctation of aorta

A

Carotid endarterectomy-Excision of atherosclerotic plaque in the carotid artery
Left ventricular assist device (VAD); implantable cardiac defibrillator (ICD); heart transplant
Resection and end-to-end anastomosis; patch aortoplasty; left subclavian flap aortoplasty; or tubular bypass grafts

54
Q

Patent ductus arteriosus
Tetralogy of Fallot
Myocardial infarction

A

Failure of closure of an embryologic blood vessel; the connection between pulmonary artery and aorta
A group of 4 congenital heart defects;
“Heart attack”; interruption of blood flow to heart muscle

55
Q

Surgical intervention:
Patent ductus arteriosus
Tetralogy of Fallot
Myocardial infarction

A

Transcatheter occlusion
Repair of Tetralogy of Fallot
Rurgical is not first line of treatment

56
Q

Rheumatic heart disease
Mitral stenosis
Mitral regurgitation

A

Scarring or damage to heart, especially heart valves due to inflammation from rheumatic fever
Abnormal condition; narrowing; pertaining to bicuspid valve
Backflow through the biscuspid valve; “incompetent” valve

57
Q

Surgical intervention:
Rheumatic heart disease
Mitral stenosis
Mitral regurgitation

A

Heart valve repair or replacement
Mitral valvotomy or replacement
Mitral valve repair or replacement

58
Q

Aneurysm
Coronary artery disease (CAD)
Gangrene, foot

A

A ballooning or abnormal dilation of a blood vessel; (of the aorta)
Atherosclerosis of the coronary arteries
Tissue death due to lack of blood supply to the foot

59
Q

Surgical intervention:
Aneurysm
Coronary artery disease (CAD)
Gangrene, foot

A

Aneurysmectomy (Excision of aneurysm with placement of aortic graft); open or endoscopic
Coronary artery bypass graft (CABG)
Amputation

60
Q

Thrombophlebitis
Varicose veins
Pleural effusion

A

Inflammation; blood clot; vein
Incompetent venous valves
Fluid in the thoracic cavity between the parietal and visceral pleurae

61
Q

Surgical intervention:
Thrombophlebitis
Varicose veins
Pleural effusion

A 
Venous thrombectomy (Excision of blood clot in a vein)
Excision of varicose veins
Thoracocentesis with placement of chest tube/s; talc pleurodesis; or decortication
62
Q

Pulmonary embolus
Cystic fibrosis
Empyema

A

Blood clot in the pulmonary artery or branches
Genetic disease primarily affecting lungs; thick secretions
Collection of pus in body cavity, particularly the pleural space

63
Q

Surgical intervention:
Pulmonary embolus
Cystic fibrosis
Empyema

A

Pulmonary embolectomy
Double-lung transplant (at end-stage)
Decortication of lung (Excision of restrictive fibrous tissue covering the lung)

64
Q

Pneumothorax

Hemothorax

A

Air in the pleural cavity (FYI: from outside trauma or inside rupture of blebs)
Blood in the pleural cavity

65
Q

Surgical intervention:
Lung cancer
Pneumothorax
Hemothorax

A

Thoracotomy (incision into thoracic cavity) with lobectomy (excision of a lobe of the lung) or pneumonectomy (excision of an entire lung (right or left)
Insertion of chest tube/s
Thoracotomy and insertion of chest tubes

66
Q

Define Pectus excavatum repair

A

Repair of a posterior displacement of the sternum

67
Q

Anatomy/physiology Pectus excavatum repair

A

Sternum and ribs

68
Q

Pathology/indication Pectus excavatum repair

A

Posterior displacement of the sternum with impaired cardiorespiratory function

Surginal Procedures (14 decks)

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