Surgical Management Flashcards
Most common for lung resection?
Posterolateral & Lateral
Where is the incision for lung resection?
incision follows 4th IC space
What is subxiphoid common for?
peri and/or epicardium
Incision for diaphragmatic procedure:
Lateral or thoracoabdominal
Position for posteriolateral thoracotomy:
almost prone
arm overhead
What muscles are divided for poterolateral thoracotomy?
Lower trap, serr ant, lats divided – trying to preserve long thoracic
If cut & spread – intercostal nerve damage
Position for anterolateral thoracotomy?
Arm extended, behind the back
Muscles involved for anteriolateral thoracotomy?
Pec major incised;
serr ant separated,
breast tissue reflected for female
Bilat approach used for lung transplant
Position for lateral thoracotomy:
Shldr abduction, rotation – caution for integrity of brachial plexus
Muscles involved in lateral thoracotomy:
Lats is retracted;
serr ant or intercostals are incised
Spares the lats but gives gives good access
Care to preserve long thoracic nerve
Position for axillary thoracotomy:
Shldr abduction, rotation – caution for integrity of brachial plexus
Pec major & serr ant are incised
Most common approach for cardiothoracic operations:
median sternotomy
Advantage of VATS;
reduced hospital length of stay, less blood loss, less pain, improvement in pulmonary function, early patient mobilization, less inflammatory reaction
PT with Midsternotomy/Median Sternotomy:
UE ROM – full restoration post op
PT post thoracotomy:
Full ROM post op – shldr, trunk (thoracic extension)
Posture
Splinting with pain, splinted cough technique, incentive spirometry, functional mobility, chest expansion, airway clearance
Complications with thoracotomy:
Respiratory complications cardiac complications shoulder pain pain bleeding
Respiratory surgical complications:
Major cause of perioperative morbidity & mortality
Atelectasis, pneumonia, respiratory failure
