Non- lung cancer thoracic surgery Flashcards
name 2 tracheal tumours
salivary gland tumours
squamous carcinoma
benign lung tumours
Hamartoma Fibroma Lipoma Neural tumours Papillomas Chondroma
bronchogenic cysts
present from birth
cause symptoms by pressing on the trachea or oesophagus
belong to group of cysts known as foregut duplication cysts
most found next to trachea at corina
other than surgery for cancer what other things can surgery be used for in the chest
tumour
infection
trauma
describe swinging pyrexia
temperature of patient cyclically going up and down - can be characteristic of lung abscess
main reasons for a lung abscess to arise? (5)
aspiration - foreign object inhaled into lung
previous/current pneumonia
PTE- pulmonary thromboembolism
lung cancer
septic emboli - infected embolism (pus formed)
what is a lung abscess?
localised infection in the lung
can heal but doesn’t always - accumulation of macrophages, neutrophils and pus
what might bacteria within pus produce within thoracic cavity
they might produce gas - you would see air-fluid level in CXR
psoas abscess
abscess in psoas muscle in abdomen
empyema thoracic may come about in what circumstances? (5)
post pneumonic - most commonly
post operative
oesophageal
upper abdominal related
post traumatic
describe oesophageal cause of empyema thoracis
if oesophagus is obstructed and patient vomits then the oesophagus may rupture and the contents spill into either side of the pleural cavity (usually R). This can lead to empyema - pus in the pleural space
treatment of empyema
try to operate weeks after the infection occurs to give it time to clear
however if ‘trapped lung’ arises then may have to undergo surgery. Trapped lung is when the infection prevents the lung from expanding
what is removed in decortication surgery
the cortex (surface) of the lung in order that the lung will be able to expand
What is thymoma?
a tumour of the thymus that tends to always be malignant (staged as mild - lethal
if fit for surgery then they will surgically remove it
carcinoid tumours
atypical and typical
atypical - malignant, similar prognosis to lung cancer
typical - benign seen in adolescents, can often present as asthma, easy to remove
hamartoma
usually benign
cells of the tumour are native to that area of the body e.g fat cells
removed due to uncertainty of malignant change or that they could be carcinoid
neurofibroma tumours
benign,grow on nerves around the body
want to remove these as despite being benign, they can grow to great size and cause problems - they also become harder to remove as they get bigger
NF1 - Neurofibromatosis type 1
autosomal dominant pattern of inheritance. Likely to develop neurofibroma
primary pneumothorax
usually affects young people around adolescent age
tend to operate
secondary pneumothorax
usually affects older people who may have diseased lungs
usually not operated on
open pneumothorax?
hole in chest wall – air is sucked directly from atmosphere into chest – most commonly seen during surgery due to open wounds
difference between recurrent and persistent pneumothorax
recurrent - 2nd/3rd/4th times of coming back after treated
persistent- constant, can’t really be fixed
tension pneumothorax
the progressive build-up of air within the pleural space as air leaves during expiration but can’t get back in during inspiration
usually due to a lung laceration
Leads to total collapse of lung and mediastinum moves over
When both lungs totally collapse – death can occur in 5/10 minutes
Positive pressure ventilation may exacerbate this ‘one-way-valve’ effect.
spontaneous haemopneumothorax
Sometimes if they’ve had previous pneumothorax new adhesions will have been made-
Adhesions have blood vessels so when lung collapses again it tears these adhesions and this can lead to bleeding
what is boyle’s law
P1V1 = P2V2
the volume of a mass of gas is inversely proportional to its pressure
When the volume of the lungs changes, the pressure of the air in the lungs changes
when you breathe in the lungs expand and pressure in the lungs decrease
what is bullous lung disease
bullae (can develop or be from birth) are blisters or pockets of dead air in the lung parenchyma
a bullous is more than 2cm in size
giant bulla
can take up to half of the lung volume
sever pain when the lungs expand
why might a person need a double lung transplant?
for example if they’ve had cystic fibrosis, infection might still spread to the other lung if only one side is removed.
what is a chest drain commonly used for
It is used to remove the following from the intrathoracic space:-
air - pneumothorax
fluid - pleural effusion, blood
or pus - empyema
