Surgery Thoracic Flashcards
most common presenting s/sx referred to thoracic surgeons
pulmonary neck masses or nodules, effusions
what is ct guided aspiration biopsy
- local anes or mild iv anes
- on peripheral lesions about > 2 cm
- real time ct
what is ct/mr angiography
- to assess vascular lesions
- lung av malformations, hemangiomas, sequestrations, fistulas between blood vessel and another hollow organ structure
what is transthoracic needle aspiration biopsy
- not guided by real time ct bu ct images
- can also be uts guided
complications in ttna and ctgab
pneumothorax, hemothorax, hemoptysis and hemorrhage, hematoma
what is mediastinoscopy
- insert scope at suprasternal notch to access ln level 2, 4, 7
- must avoid innominate vein and great vessels
mediastinoscopy is gold standard for
- central lesions
- hilar involvement
- obvious mediastinal involvement on radiographic examinations
- cases with positive gallium 67 scans of mediastinal nodes
what is fiber optic bronchoscopy
- to visualize oropharynx, larynx, vocal cords, and tracheobronchial tree
- to obtain tissue samples for diagnosis
- to ligate and stop bleeding
- to do bronchial lavage in a patient with atelectasis
- under general anes / iv sedation with muscle relaxants
indications for fob
- infection (increased secretions)
- atelectasis
- abnormal finding on imaging studies
- hemoptysis
- airway narrowing (stridor or noisy breathing)
- complement rigid bronchoscopy
what is rigid bronchoscopy
- to visualize the oropharynx, larynx, vocal cords, and tracheobronchial tree
- for diagnosis and treatment
- under general anes / iv sedation with muscle relaxants
indications for rigid bronchoscopy
- bleeding or hemorrhage
- foreign body extraction
- dilation of tracheal and bronchial strictures
- relief of airway obstruction
- insertion of stents
- pedia bronchoscopy
- tracheobronchial laser therapy
what is endobranchial uts
- can determine depth of tracheobronchial tumor invasion
- guides access and evaluation of peritracheal and peribronchial ln biopsy
- can access ln 2 4 7 10 11 12
what is electromagnetic navigation bronchoscopy
- uses electromagnetic to localize and guide endoscopic tools/catheters through tracheobronchial tree
- used to access and biopsy peripheral lesions and lymph nodes
steps to enb
- ct scan to construct virtual 3d map using dicom data
- planning
- navigate, biopsy, localize
t/f there is no difference between ebus-tbna and mediastinoscopy in staging nsclc
true
