Thoracic Surgery (Noncardiac) Lecture Powerpoint

Question 1

4 types of pneumothorax

Answer 1

• spontaneous (blebs which are weak areas cause it to occur often in thin tall males or immunocompromised)
• traumatic (closed from something like a rib fx or open from penetrating)
• iatrogenic (PEEP or thoracocentesis)
• tension (complete collapse and displacement of mediastinum to opposite side)

Question 2

Pneumothorax can potentially cause what type of nonshockable cardiac arrest?

Answer 2

Pulseless electrical activity

Question 3

Transudate vs exudate

Answer 3

Transudate is pushed thru the capillary at high pressures, vs exudate

Question 4

Chest tube insertion procedure

Answer 4

• obtain consent
• position patient in lateral decubitus or reclined
• incision into the 4-5th intercostal space at mid anterior line
• insert chest tube
• attach bottle to tube so atmospheric air is not drawn into the lung

Question 5

Video assisted thoracoscopy applications (4)

Answer 5

• spontaneous pneumo
• pleural effusions
• lobectomy
• tissue biopsy

Question 6

Pleurodesis definition

Answer 6

Inflammation of plura that will lead to scarring, can be brought on by mechanical scraping (least inflammatory), chemical tox or dextrose (more irritating to pleura), or talc powder (most inflammatory to pleura)

Question 7

Thoracomtomy is very painful, and can see pain in this location

Answer 7

the back

Question 8

Postop management of chest tube

Answer 8

-can be removed when CXR stable on water seal and drainage <150-200cc/24 hours

Question 9

What phase of the respiratory cycle should a chest tube be removed?

Answer 9

Maximum inhalation

Question 10

Heimlich valve

Answer 10

Device that attaches to end of chest tube that allows for air to only flow out (1 way valve) so any time they take a breath if there is any air in the pleural space it will come out, can allow for patient to discharge from hospital as long as attach well and make sure it doesn’t come detached