Pulmonary Surgeries

Question 1

Bronchoplastic reconstruction

Answer 1

Resection of lung tissue and bronchus with end to end re-anastomosis of broncus

Question 2

Indications of bronchoplastic reconstruction

Answer 2

Bronchi stenosis

small lesions

may be combined with lobectomy

Question 3

Most common thoracic surgery approach

Answer 3

Posterolateral thoracotomy

Divides lower trap, lat, and serratus ant.

Question 4

Preferred approach for unilateral lung transplant

Answer 4

Anterolateral thoracotomy

Question 5

Incision of anterolateral thoracotomy

Answer 5

Pec. major and serratus ant.

Question 6

Advantages of anterolateral thoracotomy

Answer 6

Shorter incision

Muscle sparing

Less effect on pulmonary function

Faster recovery

Question 7

Incision of axillary thoracotomy

Answer 7

Serratus ant. and ext. intercostals

Question 8

Curved axillary incision

Answer 8

Lat. Dorsi is retracted; serratus ant. muscle division along its intercostal fibers

Question 9

Purpose of chest tube during thoracic and CV surgery

Answer 9

Evacuate fluid or air that can impede breathing and cause lung to collapse

Question 10

Where does shoulder pain come from after open thoracotomy and VATS?

Answer 10

Thought to be referred pain from diaphragmatic irritation transmitted by phrenic nerve afferent

Question 11

Why does positioning matter for post thoracic surgery pts?

Answer 11

Increases functional residual capacity

Prevents lung atelectasis

Gravity assisted positions to improve ventilation and gas exchange

Question 12

Common early therapeutic interventions after a thoracotomy

Answer 12

Splinting for pain and coughing

Incentive spirometer use

Functional mobility to encourage chest expansion and airway clearance

Question 13

Which of the following muscles is not usually affected with a thoracotomy?
Trapezius
Teres major
Rhomboid
Latissimus dorsi
Serratus anterior
Pectoralis major
Pectoralis minor

Answer 13

Pec minor

Question 14

Which group of muscles are usually affected by a posterolateral thoracotomy?

Answer 14

Trap

Serratus ant.

Latissimus dorsi

Question 15

Which group of muscles are usually affected by an anterolateral thoracotomy?

Answer 15

Serratus ant.

Pec major

Question 16

Which group of muscles are usually affected by an axillary thoracotomy?

Answer 16

Serratus ant.

Intercostal muscles

Question 17

What is/are the primary respiratory complication(s) after a thoracotomy?

Answer 17

Atelectasis

Pneumothorax

Pneumonia

Respiratory failure

Question 18

What are the secondary common complications after a thoracotomy?

Answer 18

Cardiac arrythmia

Question 19

What region of the thorax is affected by the posterolateral thoracotomy?

Answer 19

T4

5 or 6 intercostal space

Question 20

Which of the following structures is not affected by the posterolateral thoracotomies?
Latissimus dorsi muscle
Long thoracic nerve
Serratus anterior muscle
Lower trap

Answer 20

Long thoracic nerve

Question 21

What region of the thorax is affected by anterolateral thoracotomy?

Answer 21

Breast tissue

Pec major

Intercostals

Question 22

Which of the following structures is not affected by anterolateral thoracotomy?
Pec major muscle
Pec minor muscle
Serratus anterior
Breast tissue

Answer 22

Pec minor

Question 23

When to start bed to chair transfer after thoracic surgery in stable pt?

Answer 23

Day 1

Question 24

How to transfer a pt with posterolateral thoracic surgery from bed to chair?

Answer 24

Log roll, avoid pushing down with arms

2-3 people

Protect incision