Pulmonary Surgery Flashcards
What is a typical procedure for pneumonectomy, lobectomy, lung volume reduction surgery, and single lung transplant?
Thoracotomy (possible phrenic nerve laceration)
What are the common PT implications after a thoracotomy?
Chest tubes
ROM on surgical side
Breathing training needed
Bad bed mobility (want them to lay on impacted side ASAP)
Bad transfers and mobility
Why is a lung bulla procedure performed?
Remove parts of lung that are just taking up space and not working
What occurs in a pneumonectomy?
Leaves you with 50% of lung volume
What are the most common reasons to perform a pneumonectomy?
Lung cancer, congenital abnormalities, traumatic lung injury, and chronic lung infection
What should you look at when dealing with chest tubes?
Color and amount of fluid coming out during activity
What do chest tubes do?
Remove fluid out of pleural space post surgery
What is the advantage of a VATS (arthroplasty) approach compared to a ORIF?
Less surgical and anesthesia time
Less painful
Less chance of wound infection
Faster recovery
What is a thoracentesis used for?
Big pleural effusions
Why is thoracentesis typically used with ultrasonography?
Pinpoint location to draw out fluid
What do large pleural effusions result in?
Heart failure
Liver cirrhosis
Nephrotic syndrome
What is a Jackson Pratt drain?
Closed suction drain (typically used for persistent fluid leaks after surgery)
What is lung volume reduction surgery?
Treatment for emphysema where 30% of damaged lung tissue is removed to improve mechanics of breathing
What are the alveolar changes in COPD?
Deterioration of small airways (alveolar wall destruction and dilation of alveolar spaces)
Why does lung volume reduction surgery work?
Improves elastic recoil and airway patency
Results in less expanded thoracic cage and improved muscles of respiration
Lung expansion of compressed normal lung tissue can occur due to removal of damaged lung
Who was lung volume reduction surgery best at treating?
Those who had emphysema in their upper lobe
Who had negative effects from lung volume reduction surgery?
Those who had whole lobe involvement
Those with greater exercise capacity prior to surgery
What is done in lung volume coil surgery?
Close off ineffective areas of lungs so air goes to more effective areas
What type of incision is typically done in a lung transplant?
Clamshell incision
What are PT implications for a lung transplant?
Remind patient to cough regularly
Shoulder ROM
Bed mobility and posture
Deep breathing exercises (spirometry)
What will happen if a lung transplant is done and the patient was not mobile?
Poor outcomes
Why do you need to encourage patients with a lung transplant to cough?
Lungs are denervated so they do not feel desire to cough
What are symptoms after having a lung transplant?
SpO2 lower
Increased Dyspnea
Lower exercise tolerance
Lower FEV1/FVC ratio
How long should precautions be taken post clamshell incision?
6 weeks
