Surgery Of Lung And Pleura Flashcards
Superior sulcus tumor symptoms?
Shoulder pain, Horner syndrome, numbness.
Best way to locate lung tumor?
Chest CT
How we treat lung cancer in stages 1-2?
Surgery
What is Bronchiectasis?
Dilation of bronchi
Bronchiectasis surgical indications?
Coughing up blood (harmopysis), doesn’t respond to treatment, isolated.
How are extra-lobar cysts found and treated?
They are found incidentally, and treated via excision
How do intra-lobar cysts present as, and how are they treated?
They increase B.F, recurrent pneumonia, and are common in Lower Lobes. They are treated via Lobectomy
What is a Bullae?
Air-filled space within the lung parenchyma.
What causes a Bullae?
The intrinsic destruction of alveolar tissue
How to treat Bullae?
Bullectomy/Lobectomy
Explain Transudate pleural effusion
Caused by unbalance of oncotic and hydrostatic pressures
Explain Exudate pleural effusion
Caused by inflammation of pleura or decreased lymphatic drainage
Clinical picture of large pleural effusion
Dyspnea, cough, chest pain. Diminished breath sounds and dullness
Pleural effusion investigations?
CXR, chest CT and US
What is Thoracentesis?
The Asipiration of the pleural fluid via a needle
What is the apirate of pleural effusion subjected to?
Biochemistry analysis
Pleural effusion treatment for Transudates?
Treat underlying cause
How do we treat moderate to massive pleural effusions?
Drainage with thoracentesis. Or intercostal tube connected to underwater seal.
How to Treat pleural effusion if malignant after drainage?
Pleurodesis. A procedure that obliterates the pleural space to prevent recurrence.
Explain Pleurodesis
A chest tube is inserted, when fluid is drained, a sclerosing agent is added until the space is obliterated, then the tube is removed
We can manage patients at home, those with malignant pleural effusion, how?
Via an indwelling pleural catheter.
What is Empyema?
Pus in the pleural space.
In Empyema, what are the commonest isolated organisms?
Aerobic and Anaerobic
General Empyema treatment?
Antibiotics
Empyema drainage treatment?
Thoracentesis or closed intercostal tube drainage
What is Chylothorax
Abnormal accumulation of chyle in the pleural space
Chylothorax if traumatic, and above T5 results in?
Left Chylothorax
Chylothorax if traumatic, and below T5 results in?
Right Chylothorax
If Chylothorax is post-operative, how do we examine it?
Milky chest tube drainage
Chylothorax if non-operative, how do we examine?
Physical and radiological evidence of pleural effusion.
Chylothorax treatment?
Drainage
What is Mesothelioma?
Tumor arising from a mesothelial space
If mesothelioma is diffuse, what is the cause?
Asbestos exposure
Mesothelioma clinical picture?
Dyspnea, weight loss, weakness, anorexia, fever
Mesothelioma treatment?
Radiation or surgery
Hemothorax definition and cause?
Blood in the pleural space, most commonly via blunt or penetrating trauma
Hemothorax diagnosis?
Thoracentesis, CXR
General Hemothorax treatment?
Airways, IV, monitoring and such
In Hemothorax intercostal tube drainage, where is it placed?
5th or 6th space in mid-axillary line
When do we do a thoracotomy in Hemothorax?
If drainage is inadequate
What is a pneumothorax?
Air in the pleural space
Pneumothorax clinical picture?
Diminished breath sounds AND hyper resonance
Pneumothorax treatment?
Pleurodesis, chest tube drainage, surgery if very necessary
