Pulmonary Surgery Flashcards

1
Q

What is a typical procedure for pneumonectomy, lobectomy, lung volume reduction surgery, and single lung transplant?

A

Thoracotomy (possible phrenic nerve laceration)

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2
Q

What are the common PT implications after a thoracotomy?

A

Chest tubes

ROM on surgical side

Breathing training needed

Bad bed mobility (want them to lay on impacted side ASAP)

Bad transfers and mobility

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3
Q

Why is a lung bulla procedure performed?

A

Remove parts of lung that are just taking up space and not working

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4
Q

What occurs in a pneumonectomy?

A

Leaves you with 50% of lung volume

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5
Q

What are the most common reasons to perform a pneumonectomy?

A

Lung cancer, congenital abnormalities, traumatic lung injury, and chronic lung infection

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6
Q

What should you look at when dealing with chest tubes?

A

Color and amount of fluid coming out during activity

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7
Q

What do chest tubes do?

A

Remove fluid out of pleural space post surgery

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8
Q

What is the advantage of a VATS (arthroplasty) approach compared to a ORIF?

A

Less surgical and anesthesia time

Less painful

Less chance of wound infection

Faster recovery

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9
Q

What is a thoracentesis used for?

A

Big pleural effusions

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10
Q

Why is thoracentesis typically used with ultrasonography?

A

Pinpoint location to draw out fluid

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11
Q

What do large pleural effusions result in?

A

Heart failure

Liver cirrhosis

Nephrotic syndrome

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12
Q

What is a Jackson Pratt drain?

A

Closed suction drain (typically used for persistent fluid leaks after surgery)

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13
Q

What is lung volume reduction surgery?

A

Treatment for emphysema where 30% of damaged lung tissue is removed to improve mechanics of breathing

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14
Q

What are the alveolar changes in COPD?

A

Deterioration of small airways (alveolar wall destruction and dilation of alveolar spaces)

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15
Q

Why does lung volume reduction surgery work?

A

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

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16
Q

Who was lung volume reduction surgery best at treating?

A

Those who had emphysema in their upper lobe

17
Q

Who had negative effects from lung volume reduction surgery?

A

Those who had whole lobe involvement

Those with greater exercise capacity prior to surgery

18
Q

What is done in lung volume coil surgery?

A

Close off ineffective areas of lungs so air goes to more effective areas

19
Q

What type of incision is typically done in a lung transplant?

A

Clamshell incision

20
Q

What are PT implications for a lung transplant?

A

Remind patient to cough regularly

Shoulder ROM

Bed mobility and posture

Deep breathing exercises (spirometry)

21
Q

What will happen if a lung transplant is done and the patient was not mobile?

A

Poor outcomes

22
Q

Why do you need to encourage patients with a lung transplant to cough?

A

Lungs are denervated so they do not feel desire to cough

23
Q

What are symptoms after having a lung transplant?

A

SpO2 lower

Increased Dyspnea

Lower exercise tolerance

Lower FEV1/FVC ratio

24
Q

How long should precautions be taken post clamshell incision?

A

6 weeks

25
Q

Why are lung transplant patients at an increased risk of getting sick?

A

Long term immunosuppressive therapy

26
Q

What is an esophagogastrectomy?

A

Removal of part of esophagus, stomach, and lymph nodes due to esophageal cancer

27
Q

What is a nissen fundoplication used for?

A

Prevent acid reflux (GERD)

28
Q

How is a nissen fundoplication done?

A

Wraps upper part of stomach around (laparoscopically)

29
Q

When is a LINX procedure done?

A

Treatment for GERD when medication fails

30
Q

What age must you be for a LINX procedure?

A

> 21

31
Q

What does LINX procedure help the sphincter do?

A

Stay closed (removable)