Thoracic Surgical Conditions Flashcards
what are the clinical signs associated with lower thoracic conditions?
- Tachypnoea
- Abnormal breathing
- Orthopnoea
- Hyperpnoea
- Dyspnoea
- Abdominal breathing
- +/- Cough
- Pale mucous membranes > cyanosis
- Exercise intolerance > collapse
- +/- injuries
- +/- systemically ill
what preliminary management would you do if a patient has a lower thoracic condition?
- Minimise deterioration
- Oxygen
- Wounds
- Monitor the patient closely
- Temperament
- Progression
- Diagnostics
how can you provide oxygen?
- Flow by
- Nasal cannula
- Face mask
- Oxygen collar
- Oxygen cage
- Intubation
what diagnostic imaging can be done?
radiography and ultrasound?
what can radiologiy and ultrasound diagnose?
- Pleural effusion
- Pneumothorax
- Foreign bodies
- Soft tissue masses e.g., abscess / neoplasia
- Traumatic injuries e.g., broken ribs; diaphragmatic rupture
what would radiography or ultrasound determine if pleural effusion is diagnosed?
- Unilateral / bilateral
- Small volume / large volume
- Thoracocentesis required
- Lab analysis
whatwould ultrasoundor radiography determine if pneumothroax was diagnosed?
- Open / closed chest important
- Unilateral / bilateral
- Small volume / large volume
- thoracocentesis required
how would you spot a foreign body on ultrasound or radiography?
the foreign body will be radiopaque or radiolucent
what surgical thoracic conditions are?
- Pneumothorax
- Chest and lung trauma
- Pulmonary blebs or bullae
- Diaphragmatic rupture
- Pleural effusion
- Pyothorax
- Pericardial effusion
- Pulmonary neoplasia
what is a pyothorax?
pus in the chest
what is a pericardialeffusion?
fluid around the heart
what is pulmonary neoplasia?
lung cancers
what type of pneumothorax is it if there is an internal air leak?
internal air leak
what type of pneumothorax is it if there is an external air leak?
closed
what accidental trauma might cause chest and lung trauma?
RTA, train, fall/jump off a cliff, impaling or run on injury
what are the clinical signs of chest and lung trauma?
- Shock likely to be a big component
- Dyspnoea
- Soft tissue damage - Open, can be very extensive - Bruising / crushing, these wounds progress
- Ortho damage
- Rib fractures including flail chest
- Other parts of the skeleton can complicate management
what are complications that can arise from chest and lung trauma surgery?
- Infection /Inflammation
- Issues with healing
- Ongoing effusion/Pneumothorax
where are blebs found?
on the edges of lung lobes
where are bullae found?
within the lung lobes
what are the non-specific clinical signs of pulmonary blebs/bullae?
lethargy, anorexia, exercise intolerance
what are the respiraotyr signs of pulmonary blebs and bullae?
sudden onset dyspnoea, progressive tachypnoea/orthopnoea/coughing
spontanous closed tension pneumothorax
what are the clinical signs of diaphragmatic rupture?
- None / Vague ill-health
- Dyspnoea / Shock
- Severity
- Speed of onset
- Herniation
- Concurrent injuries
how would you stabilise a patient with diaphragmatic hernia?
oxygen, anlagesia, IVFT
what are the clinical signs of pleural effusion?
- Dyspnoea
- Lethargy
- Cough
- Exercise intolerance
how would you diagnose a pleural effusion?
- Imaging
- Thoracocentesis
- Lab work
what is the causes of a cat with pyothorax?
idiopathic e.g bites, extension from pulmonary abscesses
pasteurella
what are the causes of pyothorax in dogs?
foreign bodies, oesophgeal tears, pulmonary infection
what arethe clinincal sign sof pyothorax?
lethargy, inappetance, pyrexia of unknown origin
how can you treat a pyothorax?
conservative management (antibiotics)
surgery (sternotomy)
what are the clinical signs of pericardial effusion?
cardiac tamponade, collapse
how would you treat pericardial effusion?
pericardiocentesis, pericardectomy
what are the clinical signs of pulmonary neoplasia?
vague, lameness, non-productive cough, haemoptysis, dyspnoea, non-specific weight loss, exercise intolerance, anorexia
what treatment can be provided to pulmonary neoplasia patients?
palliative, thoractomy for lung lobectomy
how would you nurse a thoractomy patinet?
- nalgesia
- Management of hypothermia
- Preparation for IPPV once thorax is open
- Monitoring
- TPR
- Pain scoring
- Drugs
- Appropriate drug regime
- Surgical site & Wound management if trauma case
- May include ointments/ gels to reduce air leaks
- body bandage for comfort, reduced infection risk and patient interference
how would you nurse a hospitalised thoracotomy patient?
- Assistance with basic functions like eating, drinking, urinating, defaecating
- IVFT to take into account fluid losses
- Urinary catheters if struggling to do it themselves e.g. cat can’t get into litter tray; dog struggling to
walk outside - DON’T NEED MORE ANALGESIA IF WHAT THEY NEED IS TO URINATE!
- Feeding tubes to take into account calorifics needs and increased losses while healing
