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SA Sx > Thoracic Sx > Flashcards

Thoracic Sx Flashcards

1
Q

What is the most common thoracic sx approach?

A

Lateral thoracotomy

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2
Q

What sutures are used for lateral thoracotomy closure?

A

Circumcostal sutures

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3
Q

What surgical approach would you perform for bilateral thoracic exploration, cranial mediastinal masses, cranial thoracic trachea?

A

Median sternotomy

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4
Q

What needs to be left intact when performing a median sternotomy?

A

Manubrium or xiphoid

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5
Q

What sx is indicated with diffuse disease through multiple lung lobes?

A

Pneumonectomy- removal of all lobes of one lung

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6
Q

How is a total lung lobectomy performed?

A

Lateral thoracotomy/thoracoscopy

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7
Q

What suture pattern is used in a partial lobectomy?

A

Continuous suture pattern

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8
Q

What suture is used for a complete lobectomy?

A

Triple ligation of vessels- horizontal mattress sutures in bronchus

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9
Q

What can be done to the affected tissue to decrease risk of contamination?

A

Isolate affected tissue w/ moistened laparotomy sponges

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10
Q

T/F: Traumatic pneumothorax is typically an emergency surgery situation

A

FALSE- sx is not typically necessary

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11
Q

What are some examples of surgical disease of the pulmonary parenchyma?

A

Sponteaneous pneumothorax, traumatic pneumothorax, bronchoesophageal fistulas, lung lobe consolidation, bronchiectasis, lung lobe lacerations, lung lobe torsions and neoplasia

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12
Q

What is the recommended tx for spontaneous pneumothorax?

A

Median sternotomy

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13
Q

T/F: Lung lacerations are typically small and resolve spontaneously on their own

A

TRUE

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14
Q

If you have an uncontrolled pneumothorax with ongoing hemorrhage of >2mL/kg/hr- what is recommended?

A

Sx treatment

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15
Q

What are the surgical techniques used for lung lacerations

A

Continuous inverting suture pattern
Deep hemostatic mattress suture
Partial/Complete lobectomy

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16
Q

What is another name for a continuous inverting suture pattern?

A

Lembert pattern

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17
Q

Which breeds are predisposed to lung lobe torsion?

A

Afghan’s and pugs
Large dogs- right middle or left cranial lobe
Pugs- left cranial lobe

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18
Q

What are the cs of lung lobe torsion?

A

Acute onset

Dyspnea, tachycardia, cough, exercise intolerance, hemoptysis

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19
Q

What are the dx tests for lung lobe torsion?

A

Thoracocentesis
Rads
CT

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20
Q

What is the treatment of choice for lung lobe torsion?

A

Lung lobectomy- DON’T UNTWIST LUNG LOBE

21
Q

Dx of idiopathic chylothorax is based on what?

A

Pleural effusion and rule outs

22
Q

what does chylous effusion result from?

A

Impaired drainage of disrupted lymphatic drainage

23
Q

What is an important history factor in idiopathic chylothorax patients?

A

History of cough due to pleural effusion

24
Q

What can be given to patient to visualize the lymphatic drainage route?

A

Oil or cream fed PO or methylene blue into ileocecal node

25
Q

What sx procedure MUST be performed and what are the optional procedures for idiopathic chylothorax?

A

Thoracic duct ligation or en bloc ligation=must be performed

Pericardectomy, cisterna chyli ablation and pleuroperitoneal shunt recommended

26
Q

What is occurring when there is loss of continuity of diaphragm resulting in movement of abdominal organs into thoracic cavity

A

Diaphragmatic hernia

27
Q

What is the most common cause of diaphragmatic hernia?

A

Traumatic

Radial and circumferential tears are most common

28
Q

What does an acute diaphragmatic hernia patient present like?

A

Acute: respiratory distress, shock and other injuries

29
Q

What does a chronic diaphragmatic hernia patient present like?

A

Respiratory and GI signs

30
Q

What is the name for when intestinal sounds are found in the thoracic cavity

A

Borborygmi

31
Q

What is the dx test for diaphragmatic hernia?

A

Thoracic and abdominal imaging

32
Q

What is a diagnostic sign of diaphragmatic hernia?

A

Abdominal contents in thoracic cavity

33
Q

What is the most accurate choice of dx test for diaphragmatic hernia?

A

U/S

34
Q

When would a diaphragmatic hernia be considered emergency sx?

A

Stomach is herniated

35
Q

What is the surgical procedure performed to fix a diaphragmatic hernia?

A

Diaphragmatic herniorraphy- ventral midline abdominal approach

36
Q

What suture pattern is used to close up the diaphragmatic herniorraphy?

A

Continuous suture pattern

37
Q

When is re-expansion pulmonary edema seen and what is it associated with?

A

Rapid expansion of previously atelectic lung associated with chronic hernia association

38
Q

What should your internal pressure be kept below?

A

PPV should be below 15 cmH20

39
Q

T/F: No tx for re-expansion pulmonary edema

A

TRUE

40
Q

What type of hernias are these considered- peritoneopericardial, pleuroperitoneal, hiatal, paraesophageal hernias

A

Congenital

41
Q

What is a sx commonly performed to correct congenital hernias?

A

Gastropexy- hold GE junction in abdominal cavity

42
Q

What breeds are high risk for congenital hernias?

A

Weimaraners, cocker spaniels. DLH and himalayans

43
Q

What are CS associated with congenital hernias?

A

Muffled heart sounds, ascites, murmur and concurrent ventral abdominal wall defect

44
Q

What is a common cause of thoracic wall trauma?

A

HBC

45
Q

T/F: most thoracic wall traumas don’t require sx intervention

A

TRUE

46
Q

T/F: never remove objects penetrating the chest wall

A

TRUE

47
Q

What is the sx procedure for a flail chest?

A

Stabilization with external splint

48
Q

What is the term for inward concavity of sternum?

A

Pectus excavatum

SA Sx (22 decks)

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