Thoracic Surg - Respiratory Flashcards
Correct Position of LEFT DLT - Ventilation thru bronchial lumen produces breath sounds in which lung?
Left Lung
Correct Position of RIGHT DLT - Ventilation thru bronchial lumen produces breath sounds in which lung?
Right Lung
DLT insertion is too shallow - Ventilation thru bronchial lumen produces breath sounds to?
Both Lungs
DLT insertion is too DEEP in the RIGHT bronchus - Ventilation thru bronchial lumen produces breath sounds to?
Right middle and lower lobes
DLT insertion is too DEEP in the LEFT bronchus - Ventilation thru bronchial lumen produces breath sounds to?
Left lung
Correct Position of LEFT DLT - Ventilation thru tracheal lumen produces breath sounds in which lung?
Right Lung
Correct Position of RIGHT DLT - Ventilation thru tracheal lumen produces breath sounds in which lung?
Left Lung
DLT insertion is too shallow - Ventilation thru tracheal lumen produces breath sounds to?
Both Lungs OR Diminished or absent if bronchial cuff obstructs trachea
DLT insertion is too DEEP in the RIGHT bronchus - Ventilation thru tracheal lumen produces breath sounds to?
Left lung or right upper lobe (depending on depth of tracheal cuff)
DLT insertion is too DEEP in the LEFT bronchus - Ventilation thru tracheal lumen produces breath sounds to?
Left Lung
DLT troubleshooting - What to do if BS are diminished at the apex of the lungs?
Withdraw the tube until upper lung sounds return.
Mid portion of the expiratory curve is most effortless & most sensitive indicator of small airway disease.
Forced Expiratory Flow
What is the value in L/sec of normal FEF25%-75%
4-5 L/sec
Where is the innominate artery
Brachiocephalic artery on the right.
Used to monitor right-sided heart function. May be placed for thoracotomies (esp pneumonectomy)
CVP Lines
Why are CVP lines placed in the RIJ instead of the EIJ?
EJ are more likely to kink when the pt is turned into the lateral position.
This is the most useful and accurate intraoperative monitor for ventricular function, valvular function, and wall motion changes that might reflect ischemia
TEE
What is an ONE indication for PA catheter during Thoracic Surgery?
Pulmonary Hypertension
In the anesthetized patient (Closed Chest), what is the V/Q relationship in the DL?
V is decreased, Q is increased
In the anesthetized patient (Closed Chest), what is the V/Q relationship in the NDL?
V is increased and the Q is Decreased.
In the anesthetized patient (Open Chest), what is the V/Q relationship in the NDL?
V is increased and the Q is Decreased.
In the anesthetized patient (Open Chest), what is the V/Q relationship in the DL?
V is decreased, Q is increased
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?
Lateral Anesthetized SV Chest Closed
Blood Flow Distribution: in two lung ventilation - The average of both lungs being NDL is equal to?
40%:60% - NDL:DL
