Thoracic Surg - Respiratory

Question 1

Correct Position of LEFT DLT - Ventilation thru bronchial lumen produces breath sounds in which lung?

Answer 1

Left Lung

Question 2

Correct Position of RIGHT DLT - Ventilation thru bronchial lumen produces breath sounds in which lung?

Answer 2

Right Lung

Question 3

DLT insertion is too shallow - Ventilation thru bronchial lumen produces breath sounds to?

Answer 3

Both Lungs

Question 4

DLT insertion is too DEEP in the RIGHT bronchus - Ventilation thru bronchial lumen produces breath sounds to?

Answer 4

Right middle and lower lobes

Question 5

DLT insertion is too DEEP in the LEFT bronchus - Ventilation thru bronchial lumen produces breath sounds to?

Answer 5

Left lung

Question 6

Correct Position of LEFT DLT - Ventilation thru tracheal lumen produces breath sounds in which lung?

Answer 6

Right Lung

Question 7

Correct Position of RIGHT DLT - Ventilation thru tracheal lumen produces breath sounds in which lung?

Answer 7

Left Lung

Question 8

DLT insertion is too shallow - Ventilation thru tracheal lumen produces breath sounds to?

Answer 8

Both Lungs OR Diminished or absent if bronchial cuff obstructs trachea

Question 9

DLT insertion is too DEEP in the RIGHT bronchus - Ventilation thru tracheal lumen produces breath sounds to?

Answer 9

Left lung or right upper lobe (depending on depth of tracheal cuff)

Question 10

DLT insertion is too DEEP in the LEFT bronchus - Ventilation thru tracheal lumen produces breath sounds to?

Answer 10

Left Lung

Question 11

DLT troubleshooting - What to do if BS are diminished at the apex of the lungs?

Answer 11

Withdraw the tube until upper lung sounds return.

Question 12

Mid portion of the expiratory curve is most effortless & most sensitive indicator of small airway disease.

Answer 12

Forced Expiratory Flow

Question 13

What is the value in L/sec of normal FEF25%-75%

Answer 13

4-5 L/sec

Question 14

Where is the innominate artery

Answer 14

Brachiocephalic artery on the right.

Question 15

Used to monitor right-sided heart function. May be placed for thoracotomies (esp pneumonectomy)

Answer 15

CVP Lines

Question 16

Why are CVP lines placed in the RIJ instead of the EIJ?

Answer 16

EJ are more likely to kink when the pt is turned into the lateral position.

Question 17

This is the most useful and accurate intraoperative monitor for ventricular function, valvular function, and wall motion changes that might reflect ischemia

Answer 17

TEE

Question 18

What is an ONE indication for PA catheter during Thoracic Surgery?

Answer 18

Pulmonary Hypertension

Question 19

In the anesthetized patient (Closed Chest), what is the V/Q relationship in the DL?

Answer 19

V is decreased, Q is increased

Question 20

In the anesthetized patient (Closed Chest), what is the V/Q relationship in the NDL?

Answer 20

V is increased and the Q is Decreased.

Question 21

In the anesthetized patient (Open Chest), what is the V/Q relationship in the NDL?

Answer 21

V is increased and the Q is Decreased.

Question 22

In the anesthetized patient (Open Chest), what is the V/Q relationship in the DL?

Answer 22

V is decreased, Q is increased

Question 23

In the lateral decubitus position has most tidal ventilation in the nondependent lung (where there is the least perfusion) and less tidal ventilation in the dependent lung (where there is the most perfusion).
Does this occur in the anesthetized patient with an open or closed chest?

Answer 23

Lateral Anesthetized SV Chest Closed

Question 24

Blood Flow Distribution: in two lung ventilation - The average of both lungs being NDL is equal to?

Answer 24

40%:60% - NDL:DL

Question 25

Blood Flow Distribution: in two lung ventilation - When
LEFT Lung is NDL
What is the distribution of BF between the NDL:DL?

Answer 25

35%:65% NDL:DL

Question 26

Blood Flow Distribution: in two lung ventilation - When
RIGHT Lung is NDL
What is the distribution of BF between the NDL:DL?

Answer 26

45%:55% - NDL:DL

Question 27

Onset and resolution of HPV occurs within ______ (time).

What causes the change?

Answer 27

Seconds; change in partial pressure

Question 28

How long does it take for the peak effect of HPV to occur?

Answer 28

15 mins.

Question 29

HPV is usually localized to atelectatic areas of the lung, however, it can occur in both lungs in the presence of?

Answer 29

High altitude pulmonary edema