Thoracic and cardiac surgery Flashcards
What additional equipment/monitoring is required for thoracic surgery
IPPV
Invasive BP
Capacity to perform thoracic drainage
Additional surgical equipment: surgical stapler
Post operative care, monitoring and management
What are the pulmonary indications for thoracic surgery
primary lung tumour
idiopathic pneumothorax
pulmonary foreign body
lung lobe torsion
What are cardiac indications for thoracic surgery
vascular ring anomaly
patent ductus arteriosus
pericardiectomy for idiopathic pericardial effusion
opne heart surgery (mitral valve repair)
What are the miscellaneous indications or cardiac surgery?
-Thymectomy for thymoma
-Thoracic duct ligation
-Oesophagotomy for FB
-Tracheal avulsion
-Exploratory thoracotomy
Where is incision in lateral 4th thoracetomy
between 4th and 5th rib
what surgery is commonly performed via thoracoscopy
pericardiectomy
What is the treatment for repeat idiopathic pericardial effusion
Subtotal pericardiectomy
What is used for ligation of the bronchi in a lobectomy?
Suture or staples
How does lobectomy vary according to whether blebs or bulla are the cause of idiopathic pneumothorax?
-Partial lobectomy for blebs (gas containing space <1cm)
-Whole lobectomy for bulla (gas containing space >1cm)
Which lung lobe most commonly twists causing lung lobe torsion?
right middle lung lobe
How does vascular ring anomaly present on contrast radiography?
Dilation of oesophagus up to the level of obstruction (heart base)
What is the name of the device implanted in PDA surgery?
Amplatz device- blocks flow between pulmonary artery and aorta
What is meant by pulse paradoxus?
Different cardiac outputs (and pulses) between heartbeats
What equipment is needed to perform pericardiocentesis?
-16 to 14 gauge cannula
-Three way stopcock
-20ml or 60ml syringe
-Extension tube/giving set
Where is the cannula inserted when performing pericardiocentesis?
4th 5th or 6th ICS just below the costochondral junction on the right side
Why does surgery not need to be performed for a bony foreign body in the stomach?
will be dissolved by gastric acid
What are the indications for pacemaker implantation?
-Symptomatic bradycardia in dogs and cats
-Advanced second-degree AV block
-Advanced third-degree AV block
-Sick sinus syndrome
-Persistent atrial standstill
-Vasovagal syncope
What is second degree AV block?
AV node only allows some SAN initiated beats to travel through the node into the ventricles
How does second degree AV block appear on ECG?
-Consistent regular p waves
-More p waves that QRS complexes
-When present QRS complex is often wide
What is third degree AV block?
All SAN initiated beats are blocked at the AV node and ventricles generate their own inherent contraction
How does third degree AV block appear on ECG
Lack of relationship between P waves and QRS complex
How does atrial standstill appear on ECG
Lack of p waves due to atria being unable to depolarise
What is sick sinus syndrome?
A heart rhythm whereby the sinus node (which normally initiates the beating heart) intermittently does not discharge an impulse to trigger the heart to contract
What is vasovagal syncope
Sudden decrease in blood pressure causing syncope due to an increase in parasympathetic tone and decrease in sympathetic tone
How are pacemakers implanted?
Normally transvenously using endocardial leads
-Rarely at open surgery using epicardial leads
Where does the battery pack of the pacemaker commonly reside insitu?
In the neck
Where does the implanted endocardial lead of a pacemaker sit?
Against epicardium or endocardium of the ventricle
What is the treatment of choice for a primary lung tumour
lung lobe removal
why do we commonly use staples for lobectomys
as they can provide an air tight seal very quickly
what is a alveolar bleb
integrity of the parietal surface of the plura is not right and small bubbles form - blebs
gas filled structure <1cm
what is an alveolar bulla
single structures that develop due to a problem in the anatomoical makeup of the airway or a physiological issue
gas filled structure >1cm
treatment for blebs or bulla
partial lobectomy
what can make lung lobes more prone to torsion
pleural effusion
