Co-existing diseases-Mediastinoscopy Flashcards
Mediastinoscopy:
this procedure can either be done via a transverse incision just above the suprasternal notch or in the second or third rib interspace. the mediastinoscope is inserted between the _____ and the _____
rib cage and lung
Mediastinoscopy:
what are some considerations to think about during these procedures (a lot to list just be familiar)
Myasthenic syndrome
tracheal deviation
thoracic inlet obstruction
type and cross for blood
may have air emboli if spont breathing (trend)
vagal response d/t stretching vagal nerve
Left RLN and phrenic n. are around the aortic arch
Mediastinoscopy:
most useful for tumors located where
right lung
Mediastinoscopy:
what is the most common complication
hemorrhage
Mediastinoscopy:
what is the 2nd most common complication
pneumothorax (primarily right side)
Mediastinoscopy:
where is the Arterial line placed
RIGHT radial artery
Mediastinoscopy:
why is the A-line placed in the Right radial artery
to monitor compression of of innominate and right brachiocephalic arteries
Mediastinoscopy:
monitor BP in what arm
left
Mediastinoscopy:
should pulse ox be placed on right or left hand
right- to assess for vascular compression
Mediastinoscopy:
why is positive pressure ventilation good
decrease likelihood of air emboli
Mediastinoscopy:
do u tube?
yep
Mediastinoscopy:
muscle relaxation?
yep
Mediastinoscopy:
4 contraindications
previous Mediastinoscopy (scarring)
SVC obstruction
Tracheal deviation
Aneurysm of thoracic aorta
Mediastinoscopy:
complications
hemorrhage Pneumothorax air emboli nerve injury esophageal injury thoracic duct injury tracheal compresion
Mediastinoscopy:
what are the 3 vessels that can be most easily compressed during a Mediastinoscopy?
innominate
right brachiocephalic
right common carotid
(tip they all arise from the innominate) see pg 512
