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Thoracic > Thoracic > Flashcards

Thoracic Flashcards

1
Q

This disease is progressive, irreversivble condition resulting in diminished lung compacity

A

COPD

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2
Q

Chest tubes must be connected to an open drainage system that is kept above chest level

A

False(below)

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3
Q

Lung scans are useful in identifying

A

Pulmonary edema
Embilosm
COPD

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4
Q

What are used as hemostatic agents in a thoracic case

A

Bone wax
Avitene
Gel foam

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5
Q

may be taken upon completion of thoracic procedure to asses lung re-expansion

A

PA and Lateral Xrays

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6
Q

right hemispheres of the lung consists of how many lobes

A

3

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7
Q

the rigid bronchoscopes is used to

A

remove foreign body

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8
Q

this incision is used for surgery involving the lower portion of the esophagus and upper abdomen

A

thoracoabdominal

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9
Q

what position is used to provide access to anterior lung surfaces and mediastinal structures

A

supine

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10
Q

prognosis of patient who had thoracic surgery because of cancer depends on

A

stage, location and type

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11
Q

for lung transplant the patient may be directly transported to PACU to be closely monitored

A

true

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12
Q

most thoracic procedures are performed under local anesthia

A

false

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13
Q

may thoracic procedures require the patient to be placed in what position

A

lateral

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14
Q

which is/are a post operative complication of thoracic surgery

A

PE
Hemorrhage
mediastinal shift

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15
Q

most thoracic procedures are performed under what anesthia

A

general

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16
Q

positioning for posterolateral thoracotomy approach

A

lateral

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17
Q

position used for median sternotomy approach

A

supine

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18
Q 
which of the following is NOT a change in pressure of fluid in the respiratory system?
atelectasis
pulmonary edema
emphysema
pneumothorax
A

emphsyema

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19
Q

where does the respiratory begin

A

nose

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20
Q

what is a pnuemothorax? how is it corrected?

A

lung deflation

chest tube

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21
Q

which way does the diaphragm move during inspiration and expiration

A

down

up

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22
Q

list the common diagnostic tools used for thoracic pathology

A

CT scan
Xray
bronchoscope

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23
Q

what is a bleb

A

fluid filled cyst or sac

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24
Q

how are chest tubes secured

A

silk suture

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25
Q

list the 3 types of bronchoscopy specimens

A

washing
brushing
biopsies

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26
Q

what is decortication

A

removal fibrinous deposits on visceral pleura of lung

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27
Q

what is thoracic outlet syndrome

A

compression of subclavian vessels and brachial plexus nerve complex

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28
Q

what is the membrane that surrounds the lungs? which layer is closest to the lungs

A

pleural

parietal and visceral pleura

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29
Q

how many lobes does each lung have

A

right 3

left 2

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30
Q

what is the primary function of the lungs

A

process of gas exchange called respiration

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31
Q

what is the name of the smallest structure of the lungs, where gasexchange occurs

A

bronchi

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32
Q

what is needed in the pleural cavity to keep the lungs inflated

A

negative pressure

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33
Q

what is the hilum

A

root of lung

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34
Q

what is being visualized in each of the following
bronchoscopy
mediastinoscopy
thoracoscopy

A

larynx
mediastium
thorax

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35
Q

what are the 2 functions of a chest tube

A

establish negative pressure

drain fluid

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36
Q

what 3 mechanisms are used to reestablish negative pressure in the pleural cavity when a chest tube is used

A

gravity below chest

PEP

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37
Q

what can be done to decrease postop pain for the thoracotomy patient, why is pain control important

A

epedural catheter

decrease respiratory effort

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38
Q

what is pnuemonectomy

A

removal lung/partial

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39
Q

what is lobectomy

A

removal lobe of an organ

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40
Q

what is wedge resection

A

removal cancerous lung diagnosis

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41
Q

what is empyema? what can be done to treat it

A

collection pus in cavity

insert needle into pleural space

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42
Q

what carries deoxygenated blood to the lungs

A

pulmonary artery

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43
Q

what is the functional unit of the respiratory system exchanges o2 andCO2

A

alveoli

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44
Q

what is the landmark for ETT tube placement - bifuracation of bronchi

A

carina

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45
Q

what is a C-shaped ring

A

Trachea

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46
Q

what is the muscle of respiration phrenic nerve

A

diaphragm

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47
Q

what lines the cavity with fluid to prevent friction

A

parietal pleura

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48
Q

how many true ribs are there

A

7

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49
Q

what covers the organs

A

visceral pleura

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50
Q

damage to this can cause diaphragmatic paralysis

A

phrenic

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51
Q

what carries oxygenated blood to atrium

A

pulmonary vein

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52
Q

what is concave medial side of each lung

A

hilum

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53
Q

what 5 ribs are attached and floating

A

false ribs

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54
Q

what is used to determine pulmonary embolism

A

angiogram

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55
Q

is bronchoscopy strictly a diagnostic procedure, explain

A

no, can provide visual diagnosis remove foreign body

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56
Q

what does VAT stand for

A

video assisted thoracico surgery

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57
Q

what is a pectus excavatum, what implant is used

A

congenital deformity of chest funnel shaped

pectus bar inserted

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58
Q

what are the signs and symptoms of pulmonary embolism

A

chronic hypertension
heart failure
chronic cough

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59
Q

what can be used to find the plaque if needed

A

fiberoptic endoscope

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60
Q

define empyema, what procedure can be done to restore to normal lung function

A

blood or pus from chest injury

decortation of lung to restore to normal

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61
Q

when the lung is incised how is the anastomosis checked for leaks

A

irrigation to look for bubbles

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62
Q

name 4 specific thoracic instruments used during a thoracic procedure

A

rib shears
rasp
doyen
bailey rib retractor

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63
Q

during a donor lung transplant what is used to preserve the donor lung, what must the patient do to preserve the lung tissue postop

A

collins solution
deep breathing excersie
physical therapy
blood test

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64
Q

which of the following tunica is NOT park of the structure of an artery
adventitia, media, intima, vaginalis

A

vaginalis

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65
Q

what is the largest artery in the body

A

aorta

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66
Q

which vessels are responsible for the exchange of oxygen and metablic waste

A

capillaries

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67
Q

which part of the artery is responsible for vasoconstriction and vasodilation

A

tunica media

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68
Q

what is only found in veins

A

valves

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69
Q

which diagnostic study is considered the gold standard for evaluation of vascular disease

A

angiography

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70
Q

what are the serrations of debakey and cooley vascular instruments considered to be

A

atramatic

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71
Q

how far beyond the atherosclerotic lesion should a balloon angioplasty reach

A

1-2cm

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72
Q

where is the balloon dilator inserted percutaneoulsy in coronary artery angioplasty

A

femoral artery

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73
Q

what are urokinase and streptokinase used for in vascular pathology

A

lysis of embolus

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74
Q

what is the name of the frequently used balloon embolectomy catheter

A

fogarty

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75
Q

TIAs are treated surgically by

A

carotid endarterectomy

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76
Q

javid and argyle are examples of which type of device used in select vascular procedures

A

shunts

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77
Q

11 blade, potts-smith, small bore suction and insertion of fogarty cath. is the sequence for

A

arteritomy for embolectomy

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78
Q

what would be used to suture a graft to an artery

A

running 5-, 6-0 non absorbable suture

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79
Q

PT with end stage renal failure may have what procedures to create access for dialysis

A

arteriovenous fistula and shunt

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80
Q

serious condition that occurs when a blood clot forms in a vein located deep inside your body

A

deep vein thrombosis

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81
Q

a blood clot that travels to the lng

A

pulmonary embolus

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82
Q

hemorrhage, ulceration, and cellulitis are possible complications of

A

varicose veins

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83
Q

what are the prep borders for a unilateral vein stripping procedure

A

toes to groin circumferentially

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84
Q

what is the longest vein in the body

A

saphenous

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85
Q

balloon angioplasty performed in the cardiac catheterization lab is used to treat

A

atherosclerotic thickening

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86
Q

peripheral vessel angioplasty stents may be made of all of the following except

A

ceramic

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87
Q

wnat are vessel loops and umbilical tapes commonly used for in vascular cases

A

retraction

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88
Q

condition that manifests by deep aching pain in the lower extremity during rest periods

A

claudication

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89
Q

what is the best choice for distal bypass graft in the lower extremity

A

saphenous vein

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90
Q

double llumened vascular device for administration of chemo, antibiotic tx and IV fluids

A

groshong

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91
Q

11 blade and forward angle or reverse angle potts smith scissors are used for

A

arteriotomy

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92
Q

the atheromatous core removed from the carotid artery during endarterectomy is known as

A

plaque

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93
Q

what are the operative mortality rates of patients with ruptured AAA and shock

A

> 80%

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94
Q

what are the operative mortality rates of patients with unruptured AAA and elective repair

A

2-3%

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95
Q

diagnostic study provides the most detailed information for surgical planning in AAA repair

A

aortogram

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96
Q

what is the specimen in an AAA procedure

A

thrombus and plaque

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97
Q

what is done with the aneurysm sac in AAA repair

A

anterior wall suture over the proximal graft

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98
Q

which chamber of the heart is responsible for pumping blood into the pulmonary artery

A

right ventricle

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99
Q

the coronary arteries originate from the

A

ascending aorta

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100
Q

what is not one of the cardiac valves

A

septal

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101
Q

what suture is frequently used for anastomosis of the saphenous vein in a CABG

A

6-0, 7-0 ploypropolene

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102
Q

with what is a median sternotomy closed

A

heavy gauge stainless steel wire

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103
Q

what is frequently used to repair septal defect in pediatric patients

A

dacron patch

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104
Q

which congenital defect involves failure of closure of connection between the PA and Aorta

A

patient ductus arteriosis

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105
Q

term meaning incurable diseases of the heart for which the only treatment is transplant

A

cardiomyopathies

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106
Q

atraumatic instrument designed to gently occlude blood flow without causing permanent damage

A

vascular clamp

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107
Q

tiny vessels that nourish the cells of arterial walls

A

vasa vasorum

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108
Q

portion of the aorta that descends but is above the diaphragm

A

thoracic

109
Q

portion of the aorta that runs between level of diaphragm and bifurcation of iliac arteries

A

abdominal

110
Q

arteries that become the femoral arteries as they exit the pelvis

A

external iliac

111
Q

artery that serves the head and neck and arises directly from the aortic arch

A

left common carotid

112
Q

the largest vein in the body, runs alongside the aorta

A

vena cava

113
Q

how many ribs are TRUE ribs with direct connection to sternum with costal carilage

A

7

114
Q

what structures are found within the mediastinum except

A

diaphragm

115
Q

for which procedure would the rigid bronchoscope be preferred

A

removal of foreign body in children

116
Q

what part of the respiratory system does exchange of oxygen and carbon dioxide take place

A

alveoli

117
Q

lung reduction surgery is performed for patients with emphysema

A

true

118
Q

lung tissue is friable

A

true

119
Q

the apex of the lung is located superiorly and just above the clavicle

A

false

120
Q

the coronary arteries originate from the

A

ascending aorta

121
Q

collection device attached to chest tubes relies on water seal to reestablished negative pressure

A

true

122
Q

the manubrium, body and xiphoid process are portions of the

A

sternum

123
Q

condition when pus is not cleared from pleural cavity and makes a fibrous constrictive layer

A

empyema

124
Q

harvested saphenous vein for coronary artery graft is reversed for anastomosis due to the valves

A

true

125
Q

the ventricles of the heart have thinnger myocardium than the atria

A

false

126
Q

thymomas, neurogenic tumors and pleuropericardial cysts can be biopsied during which procedure

A

mediastinoscopy

127
Q

video assisted thoracic surgery procedures use carbon dioxide for distention

A

false

128
Q

what is frequently used to repair atrial and ventrical septal defects in pediatric patients

A

dacron patch

129
Q

the average lifespan of biolgic and mechanical heart valve replacements is 10-15 years

A

true

130
Q

cardiomyopathy is incurable disease of heart and only treatment is heart transplant

A

true

131
Q

what is the medical term for coughing up blood

A

hemoptysis

132
Q

the name of an air filled sac has the appearnece of a blister on the surface of lung tissue

A

bleb

133
Q

an acute condition in which heart muscle dies from ischemia and may lead to sudden caridac death

A

lukens tube

134
Q

lung decortication is perfromed to release constriction of the lungs by fibrun layers

A

true

135
Q

atelectasis is

A

collapsed lung

136
Q

a heart murmur is usully hear with ausculation over the mitral valve

A

true

137
Q

device for newley diagnosed patient in need of meodialysis is

A

arterivenous fistula and shunt

138
Q

aortic valve stenosis often result from

A

aging process and rheumatic fever

139
Q

atherosclerotic thickening is treated with balloon angioplasty

A

true

140
Q

procedure after lung ransplant to aspirate secretions and check for leaks is

A

bronchoscopy

141
Q

glass syringes cause less accumulation of bubbles

A

true

142
Q

angioplasty balloon should reach 1-2 cm beyond the atherosclerotic lesion

A

true

143
Q

ejection fraction is percentage blood pumped out of the heart

A

true

144
Q

heartblock would require a pacemaker

A

true

145
Q

specialized receptors in arterial tissue that control BP, O2 and carbon dioxide concentrations

A

aortic bodies

146
Q

tiny vessels that nourish arterial walls

A

vasa vasorum

147
Q

superior mesenteric artery supplies inferior upper abdominal organs

A

true

148
Q

angioplasty stents are made from

A

titanium, polypropylene and stainless steal mesh

149
Q

water seal in drainage collection device for chest tubes reestablishes negative pressure

A

true

150
Q

section of the CNS that controls force rate of contractions heart

A

medualla oblangata

151
Q

TIAs are not treated are with carotid endarterectomy

A

false

152
Q

what is done with aneurysm sac in AAA repair

A

suture over proximal graft

153
Q

device attached to suction to collect mucous or bronchial washing

A

lukens tube

154
Q

where is dilator inserted for angioplasty

A

femoral artery

155
Q

epidural is given to control pain with VATS

A

yes

156
Q

50% of occlusive coronary lesion occur in the

A

left anterior descending

157
Q

used for patiens awaiting heart transplant

A

ventricular assist device

158
Q

diagnostic method that provides the most extensive detail of valve is heart catheterization

A

true

159
Q

gold standard for evaluation vascular disease

A

angioplasty

160
Q

is hypothermia a method used to preserve the heart by reducting its metablic needs

A

yes

161
Q

best choice for distal bypass graft for the lower extremity is

A

saphenous vein

162
Q

congenital defect in which closure of pulmonary artery and aorta does not occur after birth

A

patent ductus arteriosus

163
Q

vessels responsible for exchange of oxygen and metalic waste

A

capillaries

164
Q

suture technique for attaching bifurcated graft to an artery is

A

running 5-0, 6-0 non absorbable

165
Q

apex of heart is inferiorly on left side mediastinum

A

true

166
Q

speciemn with AAA

A

thrombus

167
Q

phrenic nerve needs to be protected during lung decortication to prevent paralysis diaphragm

A

true

168
Q

aortogram provides detailed information with AAA

A

true

169
Q

the thorax is separated from the abdomen by the

A

diaphragm

170
Q

the respiratory begins with the nares and the

A

trachea

171
Q

each primary bronchi divide into what

A

secondary bronchi

172
Q

what do the lungs will

A

the thorax and pleural cavity

173
Q

what is the function of the lungs

A

exchange carbon dioxide for oxygen

174
Q

gas exchange order

A

bronchi-bronchioles-alveolar ducts-alveoli

175
Q

what are the aveoli coated with

A

surfactant

176
Q

what are the lungs lined with

A

pleural membrane and separated by the mediastinum

177
Q

the pleural cavity has what kind of pressure

A

negative

178
Q

when a whole is made in the chest the lung deflates this is called what

A

pneumothorax

179
Q

the top of the lung is the

A

apex

180
Q

blood supply to lungs is from

A

bronchial arteries which branch off the aorta

181
Q

each bronchus has its own what

A

pulmonary artery and vein

182
Q

what happens when you breathe in oxygen and release CO2

A

external respiration

183
Q

what happens when the blood carries the oxygen to the capillaries

A

internal respiration

184
Q

diagnostic tools for thoracic pathology

A

chest xray
CT scans
NOT ULTRASOUND

185
Q

what is an infection of the pleural fluid causing pus

that may lead to fibrothorax

A

empyema

186
Q

majority of most procedures are

A

lateral

187
Q

what type of lumen is used with the affected lung will need to be collapsed during the procedure

A

double lumen ET tube

188
Q

what things will be used for patient monitoring

A

foley catheter
arterial line
CVP (measure core blood pressure)
SWAN GANZ CATHETER

189
Q

what incision is made into the chest wall to provide an opening for the purpose of drainage

A

thoracostomy

190
Q

why would an underwater chest drainage system be used

A

to reestablish negative pressure in chest cavity

191
Q

if a chamberlin procedure is done you would use

A

robinson 22fr catheter to create negative pressure and remove it

192
Q

name 3 chest tube mechanisms

A

positive expiratory pressure
gravity
suction

193
Q

why would bronchoscopy be performed

A

inspect the inside of the trachea and bronchi

194
Q

what stapler can be used for a wedge resection

A

GIA

195
Q

what is the removal of fibrinous deposits or restrictive membrane on the visceral pleura

A

decortication

196
Q

what is compression of the subclavian vessels and the brachial plexus nerve complex at the superior aperture of the thorax

A

thoracic outlet syndrome

197
Q

can thoracic outlet syndrome be genetic

A

yes

198
Q

how do you relieve thoracic outlet syndrome

A

resection of the first rib

199
Q

why would a single lung transplant be done

A

emphysema

200
Q

why would a double lung transplant be done

A

cystic fibrosis or chronic infection in end stage pulmonary disease

201
Q

for a lung transplant what can the donor be

A

cadaver
living relatives
brain death

202
Q

what is the condition in which the breastbone is sunken into the chest

A

pectus excavatum

203
Q

uncommon deformity chest wall that presents during childhood and worsens during adolescence

A

pectus carinatum

204
Q

collapse of alveoli

A

Atelectasis

205
Q

inhalation of foreign material or acidic vomitus

A

aspiration

206
Q

blood clot inside the blood vessels to the lungs

A

pulmonary embolus

207
Q

inherited disorder of exocrine glands that causes them to produce abnormally thick secretions of mucuous

A

cystic fibrosis

208
Q

inflammation of mucous membrane of tracheobronchial tree

A

bronchitis

209
Q

accumulation of pus in pleural space from bacterial infection such a pleurisy of TB

A

empyema

210
Q

what is the name of the smallest structure of the lungs, where gas exchange occurs

A

bronchi

211
Q

what is used to quiet the heart during cardiac surgery, how does it work

A

bypass machine

cannula inserted in aorta

212
Q

what is cardioplegia

A

delivery of solution into coronary arteries

213
Q

what are the 3 most common types of autografts for bypasses of the coronary artery

A

saphenous vein, mammory artery and radial artery

214
Q

where do the majority of abdominal aortic aneurysms begin

A

below renal artery

215
Q

what needs to be done in order to use an insitu graft

A

de valve, free up

216
Q

what shapes do graft material come in

A

straight, bifurcated and patch

217
Q

what is de-airing

A

sew in with clamp on

release clamp let blood flow threw clamp again sew and repeat

218
Q

what is coarctation of aorta

A

narrowing of aorta descending

219
Q

what is intermittent claudication

A

not enough oxygen to extremity

220
Q

when an arterial embolectomy catheter is used what is attached to it

A

TB syringe filled with saline or heparin

221
Q

how is carotid stenosis diagnosed

A

arteriogram

222
Q

the muscle layer of the heart it

A

myocardium

223
Q

which part of the heart is the largest and strongest

A

left ventricle

224
Q

name the 4 valves of the heart

A

mitral, tricuspid, aortic and pulmonary

225
Q

list the route of electrical activity of the heart

A

SA NODE
AV NODE
BUNDLE OF HIS
PARKINJE FIBERS

226
Q

the heart has 2 layers what are they

A

parietal- outer layer

visceral- inner layer

227
Q

what seperates the 2 layers

A

pericardial fluid

228
Q

layers of the cardiac wall

A

epicardium-outter
myocardium-muscular
endocardium-inner

229
Q

which are larger atrium or ventricles

A

ventricles

230
Q

what supplies blood to the heart

A

right and left coronary arteries

231
Q

the left atrium receives what type of blood from the lungs

A

oxygenated

232
Q

the right atria receives what blood from the vena cava

A

deoxygenated

233
Q

veins enter the what

A

heart

234
Q

arteries leave the

A

heart

235
Q

what is the main artery of the body

A

aorta

236
Q

the aorta carries what blood out to the peripheral arteries

A

oxygenated

237
Q

what type of arteries connect to the aortic arch

A

innominate

238
Q

what is the largest vein of the body

A

vena cava

239
Q

what are the layers of blood vessels

A

tunica adventitia- outer layer
tunica media- middle
tunica intima- outer

240
Q

do veins have valves

A

yes

241
Q

also known as plaque “coronary artery disease”

A

atherosclerosis

242
Q

catheterization steps

A 
vessel entered with finder needle
guide wire inserted
dilator is used to enlarge
catheter is threaded
wire removed 
catheter secured
243
Q

what is the 2nd most common pathology of the heart

A

valve insufficiency or stenosis

244
Q

the wall separating the chambers of the heart is called

A

septum

245
Q

a weakened wall of an artery often thinned out and pouching

A

aneurysms

246
Q

disorder of blood clotting system

A

hemophilia

247
Q

what is attached to each end of a webster vessel cannula

A

syringe and vessel

248
Q

when sewing in a graft what end is attached first

A

proximal

249
Q

3 most common meds on the sterile field for vascular cases are

A

saline
thrombin
antibiotic irrgation

250
Q

what medication is used to keep arterial grafts from spasaming

A

papaverine

251
Q

what are some hemostatic agents

A

surgical
oxycel
bioglue

252
Q

what are some drugs that affect the heart

A

isupre
levophed
dopamine

253
Q

what are some diuretics

A

Lasix

bumex

254
Q

what are some of the characteristics for grafts

A

non reactive to body

readily accessible

255
Q

common suture

A

prolene 3-0 to 8-0 most common

ethibond braided non absorbable

256
Q

coronary artery bypass grafts
saohenous vein
mammory artery
radial vein

A

must be inverted
only one anastomosis needed
must inverted

257
Q

aortic or mitral valve replacements heartrate removed with

A

valve removed with pituitary rongeur

258
Q

what is the pacemakers of the heart

A

SA node

259
Q

what happens when the SA node or the AV node don’t work

A

need artificial pacemaker

260
Q

what is the partial excision of adhered and thickened scarred pericardium

A

pericardiectomy

261
Q

what is the most common filter for vena cava

A

greenfield

262
Q

how long is pressure applied to the site for vena cava filter

A

3 minutes

263
Q

where does abdominal aortic aneurysm begin

A

below the renal arteries

264
Q

what kind of grafts are used in peripheral vascular surgeries

A

gortex

saphenous vein

265
Q

during an embolectomy what is the most common post op complication

A

blood clot

266
Q

how is arteriotomy closed

A

6-0 or 7-0 prolene suture

267
Q

during an AV fistula if the patients own vessel cant be used for a graft what kind would they use

A

gortex

268
Q

what are the common devices for venous access device implantation

A

groshong catheter

hickman catheter

269
Q

why is a venous closure done

A

to treat venous reflux or venous insuffienceny

Thoracic (1 decks)

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