Final Exam Flashcards
Is endovascular repair of vessel disease generally associated with less blood loss and shorter recovery times?
Yes. EV surgery is a minimally invasive surgery that was designed to access many regions of the body via major blood vessels. As catheter is introduced a radio opaque dye can be seen on X-ray or fluoroscopy allowing visualization of atherosclerosis, vascular trauma, or aneurysms. Advantages: shorter recovery period, less discomfort, local or regional anesthesia vs general, smaller incisions, less stress on heart, and fewer risks.
Name some indications for one-lung ventilation:
Empyema, lung resection, multiple lung biopsies with sclerosing, large cyst or bulla, esophageal surgery, single lung transplant. NOT medianstinoscopy, which is a procedure the enables visualization of the contents of the mediastinum… Usually to obtain a biopsy… This is often used for staging lymph nodes of lung cancer… An incision is made approx 1cm above the suprasternal notch of the sternum (breast bone)…. Dissection down to pretracheal space and down to carina…scope is advanced into created tunnel which provides view of the mediastinum.
After placing a left double lumen tube you inflate and hear breath sounds only on the left. What is the problem?
More than likely the tube is too far in the left bronchus.
If you have a patient upright and convert from spontaneous ventilation to positive pressure ventilation, gas flow is increased to the (APEXES OR BASES)
Apexes
The lung that has a bronchus branch closest to the carina is the ______ lung.
Right
In the lungs, blood flows preferentially to (DEPENDENT OR NONDEPENDENT) areas?
dependant
A patient receiving positive pressure ventilation in the left lateral position will have greatest gas flow and greatest blood flow to which areas?
greatest gas flow to the right lung; greatest blood flow to the left lung
The zone that is best for optimal respiration is _____________.
Zone 3
The most detrimental scenario that affects V\Q mismatching is:
Mechanically ventilated patient, VAA general anesthesia, and muscle paralysis; (Any spontaneous breathing is better than mechanically ventilated)
Internal intercostal muscles aid in which part of breathing?
expiration
Is pneumothorax control an indication for lung isolation?
NO; unilateral, broncho-pleural fistula, lung resection are examples of indications for lung isolation
What are treatment techniques for hypoxia during one lung ventilation with double lumen tube?
insufflation of O2 into the non-ventilated lung, CPAP to the non-ventilated lung, re-inflate non-ventilated lung; NEVER INCREASE TV HIGHER THAN WHAT WAS ADEQUATE FOR BOTH LUNG VENTILATION
What responses to non-depolarizing muscle relaxants might be seen in a patient during a thymectomy for treatment of myasthenia gravis?
prolonged blockade, heightened sensitivity, exaggerated response; NOT A RESISTANCE TO PARALYSIS
What are some characteristics of upright spontaneous ventilation?
end expiration alveolar volume greatest in apex alveoli, blood flow best to the bases, alveolar ventilation closely matched to blood flow; NOT GREATEST ALVEOLAR VENTILATION IN APEXES!!
What is considered a functional respiratory unit of the lung?
alveoli
How do you verify proper placement of a left double lumen tube?
fiber optic visualization of blue bronchial cuff in left bronchus
What are some concerns associated with tracheal resection surgery for tracheal stenosis?
difficult intubation, surgical drainage into lung fields, tracheal edema; NOT TRIGEMINAL NERVE INJURY
What are some risks associated with medianstinoscopy?
hemorrhage, tracheal collapse, right innominate artery occlusion; NOT DIAPHRAGM RUPTURE
What is the standard size of double lumen tube for a 70kg 70” male patient?
37-39 French
If you clamp the tracheal lumen on a properly placed left double lumen tube, what side will the breath sounds end on?
left side
