cardiothoracic scars Flashcards
1
Q
A
midline sternotomy
- valve surgery
- CABG
- cardiac transplant
- congenital cardiac defects
1
Q
signs of CABG
A
vein harvesting on legs
2
Q
mini-sternotomy
A
- for aortic valve replacement
- from the substernal notch to the 3rd or 4th intercostal space
- a J-shape towards the right.
3
Q
A
posterolateral thoractomy
- mid-spinal line to the anterior axillary line.
4
Q
A
anterolateral thoracotomy
- mid-axillary line to the lateral sternal border.
5
Q
indications for thoractomy
A
- lobectomy - malignancy / recurrent infection / trauama / infarction
- pneumonectomy
- open lung biopsy
- lung vol reduction
- bullectomy
- pleurectomy - recurrent pneumothoraces or effusions
- single lung transplant
- minimally invasive cardiac surgery
- oesophagectomy (look for laparotomy scars)
6
Q
signs of lobectomy and pneumonectomy
A
dull percussion
reduced/absent breath sounds
7
Q
A
clamshell incision
- widespread traumatic chest injury
- bilateral transplant - look for signs of immunocompromise
- malignancy
8
Q
signs of immunocompromise
A
- bruising or a cushingoid appearance from steroid use
- tremor or gum hypertrophy from cyclosporin use
- signs of infection
- signs of rejection or transplant failure.
9
Q
indications for lung transplant
A
CF
bronchiectasis
COPD
pul fibrosis
10
Q
A
subclavicular incision
- pacemaker insertion - usually palpable
11
Q
indications for pacemaker
A
AF
sick sinus syndrome
AV block
heart failure
defibrillator function
12
Q
types of pacemaker
A
- single chamber - wire to RA or RV
- dual chamber - 2 wires to RA and RV
- triple chamber RA RV and LV
13
Q
what are triple chamber pacemakers used for
A
cardiac resynchronisation therapy - in certain HF pts
14
Q
borders of the safe triangle
A
- anterior border of latissimus dorsi,
- the lateral border of pectoralis major,
- the base of the axilla
- the 5th intercostal space.
