Week 4 Surgical Techniques, CXR, and Auscultations

Question 1

What kind of surgery is done when the patient has the following:
Indications:
- Ca, ulceration (Barretts Oesophagus

Surgical procedure:
- Thoracotomy and Laparotomy
- long surgical line
remove oesophagus, pyloroplasty - joins stomach to proxima part,

Answer 1

Oesophagectomy (Upper GIT)

Question 2

What kind of surgery is done when the patient has the following:
Indications:
- reflux, hiatus hernia

Surgical procedure:
- often laparoscopic
- fundus wrapped around sphincter to reduce reflux

Answer 2

Fundoplication
- not really much of a big wound
- may not require physiotherapy

Question 3

What kind of surgery is done when the patient has the following:
Indications:
- Ca prostate or enlargement

Surgical procedure:
- midline laparotomy
- usually done transurethral - TURP
Post op: - renal or surgical ward
Physio: nil specifics

Answer 3

Prostatectomy

Question 3

What kind of surgery is done when the patient has the following:
Small intestine
Indications:
- Ca (rare)
- usually obstruction - fibrosis/ulceration (Crohns)

Surgical procedure:
- Laparotomy - incision in the abdomen

Answer 3

Duodenectomy

Question 4

What kind of surgery is done when the patient has the following:
Indications:
- Ca, ulceration, diverticulitis

Surgical procedure:
- laparotomy
- resection of the part of colon and re anastomosis of remains

Answer 4

Large intestine - colectomy (hemicolectomy, proctocolectomy)

Question 5

What kind of surgery is done when the patient has the following:
Indications:
- liver Ca
- Cysts, and other liver pathology

Surgical procedure:
- High laparotomy -Roof top Mercedes Benz

Answer 5

Hepatectomy

Physio key points- take note of high respiratory complications, usually the Right lower lobe is affected.

Question 6

In chest x rays, you read the x rays as the patient is looking towards?

Answer 6

You, so in the x-ray your right is the patient’s left and vice versa.

Question 6

What kind of surgery is done when the patient has the following: (something to do with the removal of the gall bladder)
Indications:
- cholecystitis, cholelithiasis

Surgical procedure:
- lateral subcostal incision
- often laparoscopic
- combined with cholangiogram

Answer 6

Cholecystectomy

Question 7

What are the signs of hyperinflation?

Answer 7

• barrel chest
• flattened ribs
• elongated mediastinum
• blackened lung fields
• increased number of ribs visible above the diaphragm
• flattened diaphragm

Question 7

These are short, parallel lines at the periphery of the CXR. It represents the interlobular septal thickening and is indicative of fluid overload

Answer 7

Kerley b-lines

Question 7

A kind of surgery done to remove obstruction in the carotid artery. Usually no requirement for physiotherapy and patient is high dependent due to risks of surgery.

Answer 7

Carotid Endarterectomy

Question 8

What is an AAA repair?

Answer 8

Abdominal Aortic Aneurysm repair
- aorta clamped off, long midline incision.
- Indications: Aortic Aneurysm
- a graft and stent is placed

Question 8

In a lung collapse, the trachea/mediastinal shifts towards which area?

Answer 8

Towards the Collapsed region

Question 9

Surgery done to remove the bladder

Answer 9

Cystectomy
Surgical Procedure: Midline laparotomy, ileum formed into conduit (looks like a belly button) for urine to skin the surface

Question 10

• Bypass of stenosis in Artery
• Peripheral Vascular disease with ischaemia
• fempop, ileofemoral

Answer 10

Vascular Bypass surgery

Question 11

What is the most common organ transplant?
Surgical procedure is done via: Nepherctomy and lateral sub costal
- Transplant is then attached to the iliac artery

Answer 11

Renal Transplant

Question 12

The horizontal fissure is approximately where?

Answer 12

In the 4th IC space

Question 12

If the x-ray exposure is too white? is it underexposed or overexposed?

Answer 12

Overexposed