sx approach to the thorax Flashcards

1
Q

explain the sx area for removing Esophageal foreign body at heart base using thoracotomy

A

right lateral thoracotomy at 4th intercostal space

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2
Q

surgical approach to Cardiopulmonary bypass

A

right lateral thoracotomy at 4th intercostal space

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3
Q

sx site for Cranial lung lobectomy

A

both left and right lateral thoracotomy

5th interspace

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4
Q

surgical approach to Intermediate lung lobectomy

A

6th interspace on the right

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5
Q

sx approach of Caudal lung lobectomy

A

both left and right lateral thoracotomy at 7th interspace

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6
Q

sx site for Thoracic duct (dog)

A

8thintercostal

on right side in dog

left side in cats

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7
Q

sx site for cranial thoracic duct

A

left thoracic intercostal at 3rd intercostal

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8
Q

surgical site for PDA, PS, PRAA, pericardium

A

left thoracotomy at 4th interspace

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9
Q

sx site for Cranial lung lobectomy

A

can be done on both left and right thoractomy at 5th intercostal space

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10
Q

sx site for Caudal lung lobectomy -

A

both right and left

thoracotomy at 7th intercostal space

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11
Q

sx site for Thoracic duct in cats

A

left lateral thoracotomy at 8th intercostal space

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12
Q

right lateral thoracotomy at 4th intercostal space is used to?

A
  1. esophageal fb
  2. cardiopulmonary bypass
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13
Q

sx thoracotomy approach to thoracic duct of cats

A

8th intercostal on the left

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14
Q

sx thoractomy approach for the caudal esophagus

A

left lateral at 9interspace

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15
Q

discribe the sx procedure for left lateral thoracotomy

A
  • sharply incise skin,subq tissue,and cutaneous trunchi mm.

deepen the incision thru the laticimus dorsi mm. with scissors

transect the scalenius,pectoral, serratusventralis,and intercostal mm

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16
Q

discuss closure of lateral thoracotomy

A

place thoracostomy tube
Preplace sutures around ribs and tie
Routine closure of musculature

DO NOT SUTURE INTERCOSTAL MM

CLOSE CUTANEOUS TRUNCI WITH SUBQ IN SMALL PATIENTS

DO NOT OVERLAP RIBS
Close cutaneous trunci with subcutaneous
tissue in small patients
Routine closure of skin

17
Q

things to avoid while closing the lateral thoracotomy

A

DO NOT SUTURE INTERCOSTAL MM

CLOSE CUTANEOUS TRUNCI WITH SUBQ IN SMALL PATIENTS

DO NOT OVERLAP RIBS

18
Q

discuss Thoracostomy Tube Placement

A

Stab incision in skin and subcutaneous
tissue 2-3 intercostal spaces dorsal and
caudal to thoracotomy incision

Tunnel cranially 1-2 intercostal spaces,
enter pleural space, position tube in thorax
Place purse-string or chinese finger-trap
suture in skin around tube

19
Q

discuss post operative care for thoracic tube placement

A

Maintain chest tube until pleural
space is “free” of air and fluid
Analgesia
Intercostal nerve blocks
Narcotic analgesics
Intrapleural Bupivacaine

20
Q

indications for median stenoctomy

A

Access to entire lung field for
exploratory surgery
Subtotal pericardectomy
Aortic valve replacement

21
Q

discuss closure of median sternotomy

A
  • Thoracostomy tube (s) placed
  • Sternebrae closed with orthopedic wire
  • Remaining tissues closed routinely
22
Q

thoracostomy tube placement in median thoracotomy

A
  • Stab incision over 7th-9th intercostal space
  • Tunnel cranially 1-2 spaces to enter pleural

cavity

23
Q

advantages of median thoracotomy

A

access to entire thoracic cavity

24
Q

disadvantages of median stenoctomy

A

More lengthy and more difficult procedure
Increased morbidity
More severe postoperative pain
More severe physical dysfunction -
patient may be unable to ambulate
without assistance