Surgery Flashcards
What are the postoperative complications of surgery and GA
Chest atelectasis and infection Wound complications Pulmonary oedema Cardiovascular problems and MI Shock DVT/PE Acute renal failure Nausea and vomiting Nerve damage
What is the common surgeries seen in cardio respiratory physio
General Thoracic Cardiac Vascular Head and neck Breast
What are the most common vascular surgeries?
Abdominal Aortic Aneurysm (AAA), Aortic Bifemoral (Aortobifemoral) and Thoracic Aortic Aneurysm (TAA)
What are Aneurysms?
They are a result in the degeneration of the media and elastic laminate of an artery wall which results in bulges and weaknesses at risk of rupturing
What is an Atherosclerosis?
It leads to blocking of the artery which can lead to tissue death
What happens during an Abdominal Aortic aneurysm?
Most occur below the renal arteries, however those that occur above risk the blood supply to the kidneys
There is an open or a transfemoral/Endovascular surgery.
Immediate treatment if it ruptured but carries an 80% mortality rate.
What is a Thoracic Aortic Aneurysm?
Some patients with an AAA will have a thoracic extension.
4 types- 1.Affects descending thoracic and proximal abdominal aorta
2.affects all descending and abdominal aorta
3. Affects distal thoracic and all of the abdominal aorta
4. Affected upper aorta from where all visceral arteries arise
An aortic valve replacement may be required as well
What does TEVAR stand for?
Trans Endovascular Aortic Repair?
What’s an Aortic Bifemoral Bypass?
It is performed in patients with atherosclerotic disease of the infra renal aorta and iliac arteries
Patients have symptoms of claudication, impotence and poorly healing ulcers
Weak femoral pulses are noted upon palpation
What other surgeries can be performed?
Gastric band, bypass or sleeve for bariatric patients
Transplantation- heart, lung, liver and kidney
HEMICOLECTOMY
a hemicolectomy is a surgical procedure that involves removing a segment of the colon. A surgeon performs a hemicolectomy to treat colon cancer and bowel diseases, such as chrohns disease or severe diverticulitis
The incision is made down the abdomen, affected part of the bowel is then removed.
Physiotherapy management involves Deep breathing exercises and mobilising ASAP
What is anterior resection surgery?
It is done to remove an area of the patients bowel that is diseased. It is done to remove a cancerous area of the bowel or rectum
The surgery is done through an incision in the abdomen. The resulting abdominal wound is then closed with staples/ stitches.
Physiotherapy management plan- respiratory physio, clearing sputum, helping with the chest infection, helping re expand the lungs and inflate them Mobility and exercise Education Breathing re ed Sputum clearance
What is a gastrectomy?
Where all or some of the stomach is removed probably because of stomach cancer.
Can be done openly or closed, can have partial or total stomach removals.
Physiotherapy management- get them sitting up and walking ASAP, deep breathing exercises, coughing and huffing, abdominal exercises
What is a liver resection
The removal of all or part of your liver
They are commonly performed to treat hepatic neoplasms, (cancer)
Up to one half of the liver can be removed if the rest of it is healthy. The doctors make an incision. The liver has the ability to grow back.
Physio management plan - early mobilisation helps to promote blood flow
Breathing exercises to optimise ventilation
Building exercise tolerance and core strength
Should be patient specific
Why perform a whipple
To remove tumours form the head or neck of the pancreas
The surgeon removed the head of the pancreas, the lower end of the stomach, duodenum, gallbladder, part of the bile duct and surrounding lymph nodes.
Management- eat small meals, avoid fatty food, rest
Physio management- pain management, massage, heat, meds
Strengthen weak muscles, reduce fatigue, mobilise and remove secretions
