Procedure - Thoracotomy

Question 1

Where should you cut in a thoracotomy?

Answer 1

Fourth intercostal space (at the level of the inframammary fold)

Question 2

Cut on the _______ side of the rib.

Answer 2

top

Remember the neurovascular bundle is on the top of the rib.

Question 3

Review the steps of a thoracotomy.

Answer 3

• Cut to the level of the muscles with a scalpel.
• Use scissors to cut through the intercostal muscles
• Use a towel to pull apart the ribs
• Use a clamshell to pull open the ribs

Question 4

What is the proper technique for relieving tamponade during a thoracotomy?

Answer 4

Use toothed forceps to pull the pericardium off the heart at the apex and then use scissors to incise the pericardium to the aortic root. Cut parallel to the phrenic nerve.

Question 5

In which direction should the handle of the rib spreader point?

Answer 5

Down toward the left axilla