Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Clin MED > Week 4 Cardiothoracic & Vascular Surgeries > Flashcards

Week 4 Cardiothoracic & Vascular Surgeries Flashcards

1
Q

What is the most common approach for cardiac surgeries?

A

Median sternotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the suture for median sternotomy?

A

from suprasternal notch to xiphoid process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How are median sternotomy closed?

A

wired or sutured

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Posterolateral Thoracotomy muscles

A

serratus anterior, lats, lower trap are split/resected; risk of intercostal nerve injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Anterolateral Thoracotomy Muscles

A

cut into pec major and serratus anterior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Lateral thoracotomy muscles

A

lats are spared

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Axillary Thoracotomy muscles

A

Serratus and pec major are splits but lats are spared

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Median sternotomy

A

mainly for open heart surgery
sternum is cracked open and chest is opened

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Median sternotomy indications

A

valve surgery, congenital cardiac defect correction, CBG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Pacemaker scar

A

Usually on left side of chest but can be on right

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Pacemaker Scar indications

A

pacemaker/ICD/loop recorder insertion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Anterolateral thoracotomy

A

Under breast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is left anterolateral thoracotomy

A

Used for open chest massage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the most common thoracotomy?

A

Posterolateral Thoracotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What position is the posterolateral position performed in?

A

Decubitus position

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Where is the posterolateral thoracotomy?

A

Cut through intercostal space beginning inferomedially to tip of scapula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Posterolateral Thoracotomy indications

A

pulmonary resections and oesophageal surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Why do a axillary thoracotomy?

A

muscle sparing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Axillary thoracotomy indications

A

pneumothorax, pleurectomy, pulmonary restrictions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Mini-thoracotomy/mini-sternotomy

A

Aortic valve accessed via right anterior mini-thoracotomy (2nd intercostal space) or mini-sternotomy
Mitral valve assessed via right lateral mini-thoracotomy (below nipple or in breast crease)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Mini-Thoracotomy/Mini-sternotomy indications

A

minimally invasive valve replacement/repair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Surgery Complications

A

Pain
Respiratory compliance
Impaired cognition/delirium
Acute blood loss/anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the types of revascularization procedures?

A

Percutaneous coronary intervention (PCI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

ACS widow time

A

<90 min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Coronary artery bypass graft (CABG)
Grafts taken from saphenous vein vein, internal mammary arteries, or radial arteries and used as a bypass around lesions in coronary artery (on pump or off pump)
25
Most common PCI
drug-eluting stents
26
Which CBAG has a longer duration patency?
internal mammary arteries is longer compared to saphenous arteries
27
CABG indications
multivessel disease, too significant of a lesion for PCI
28
CABG contraindications
lack of target for bypass
29
What does the literature show about CABG?
CABG is superior to PCI with regards to mortality, MI occurence
30
Indications for valve repair/replacement
valve insufficiency, stenosis, prolapse, regurgitation
31
What side is a valve repair/replacement performed on?
more common on left side of heart due to elevated pressures
32
Valve repair/replacement risk factors
RA, IVDA, smoking, obesity, congenital heart defects, family hx, autoimmune disorders, age
33
Types of valve repair/replacement
Tricuspid (TVR) Bicuspid/mitral (MVR) Aortic Valve (AVR) Valvuloplasty
34
How is a valve repair/replacement performed?
ministernotomy
35
What is an LVAD?
a battery-powered device for patients with end-stage HF that helps left ventricle work more efficiently
36
Components of LVAD
Pump tubing drive line controller external power
37
How is an LVAD implanted?
Surgically (via sternotomy or thoracotomy) into L ventricle after extensive pre-operative workup
38
LVAD battery information
LVAD is connected to external power source, but switched to batteries for mobility/community living (typical power supply is 10-17 hours)
39
Who is your LVAD tea?
Patient + family/caregiver Cardiothoracic surgeon Heart failure physician PT, OT, ST Respiratory therapist Cases management Nurse navigator Licensed clinical social worker
40
LVAD POC pre-implication
Medical optimization 6MWT MOCA Meeting with HF team, social worker Power bill Family meeting
41
LVAD post-implantation
Medical optimization Training in VAD management Nutrition Pain management Pulm function Rehab services Addressing social/psych needs
42
PPM
single chamber, dual chamber, or biventricular
43
How does a PPM function?
by creating an action potential
44
Indications for PPM
bradycardia, complete heart block, Type II AV block, tachyarrhythmias; arrhythmia with symptoms such as lightheadedness or syncope
45
After getting PPM, how long does it take to get discharged
Many patients d/c within 24 hours
46
When does PPM get replaced
every 10 years
47
PPM considerations
proximity to mobile phones, magnets, MRI
48
What does the PPM do
function at fixed rate, demand/inhibited mode, or in conjunction with patient's typical rhythm
49
How is PPM implanted
Implanted via incision – typically in L lateral chest pocket (below skin but above pectorals) with leads inserted transvenously (typically through cephalic vein) to the R atrium, R ventricle, or L ventricle
50
PPM components
generator, leads
51
PPM complications
bleed, failure to capture, blood clot, bruising, infection, device/lead migration
52
A =
atrium
53
V =
ventricle
54
D =
dual
55
I =
inhibited
56
O =
none
57
EKG difference with PPM
Arterial Pacing Spike Ventricular Pacing spike
58
Micra leadless pacemaker
inserted through femoral vein with catheter and sheath directly into right ventricle
59
Indications for temporary Pacemaker
complete heart block, post cardiac surgery, post-MI, bridge to PPM
60
Where is temporary Pacemaker placed
subclavian or femoral vein with sheath
61
Rate
at which pacer is firing
62
Output
MA going to each lead
63
Mode
which leads are paced and where
64
Sensitivity
level of current in mA that allows for detection of action potential
65
Can a pt have a ICD and PPM
yes
66
AICD
is also a defibrillator
67
MAZE procedure
uses cryo or radiofrequency ablation to create a “maze” of scar tissue for passage of electrical signals through the atria in patients with a fib
68
LLA Ligation
L atrial appendage is an area where blood often pools/collects or clots in patients with a fib; can decrease risk of CVA by 30%
69
Ablation
cryoablation or electrocautery to create scar tissue that does not conduct electrical impulses; for a fib, VT/VF
70
Aneurysm
ballooning, swelling, or weak spot in vascular wall/blood vessel to >50% more than its normal width
71
Abdominal Aorta
supplies major abdominal organ and LE
72
AAA Rupture + repair most commonly occurs
btw near renal arteries intro retroperitoneal space
73
AAA Rupture risk factors
HTN smoking DM HLD
74
AAA Rupture symptoms
acute abdominal pain pulsating mass in abdomen lumbar pain nausea decrease appetite
75
Classic triad of AAA rupture
flank/back pain, pulsatile abdominal mass hypotension
76
Indications for AAA surgery
>5.0-5.5cm rupture +symptoms large growth risk of dissection
77
EVAR sx for AAA rupture
access through femoral artery
78
Open sx for AAA
large incision from xiphoid to umbilical region
79
What are the peripheral vascular sx
surgical bypass angioplasty and stenting atherectomy
80
Surgical Bypasses
aorto(bi)femoral, femoral-popliteal, femoral-tibial
81
Angioplasty & stenting
percutaneous transluminal angioplasty
82
Atherectomy
removal of plaque(s) from blood vessels

Clin MED (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions