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36 Cards in this Set
- Front
- Back
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Patients w/ early LC have better chance of survival if ___.
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all of their cancer can be surgically resected
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Empyemas usually require which surgery?
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thoractomy, usually not able to be drained
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Resections are performed along ____ divisions.
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segmental
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Right lung has ___ segments while left lung has ____ segments.
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10,8
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In right lung, the ___ and the ___ segments are more medial-basal.
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7th and 10th
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The ___of the left lung is analogous to the right middle lobe.
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lingula
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Phrenic nerve is always ____ to hilum
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anterior
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Vagus nerve is always ____ to hilum.
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posterior
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W/in hilum, the pulmonary veins are always _____.
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anterior
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The pulmonary arteries are ___ to ___.
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middle to superior, depending on the lung
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W/in the hilum, the bronchi are more ____.
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posterior
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Indications for tube thoracostomy.
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pneumothorax - most common
hemothorax chylothorax pleural effusions post-op drainage |
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Where do you stick the tube when performing a tube thoracostomy.
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mid-axillary line, above 6th rib in 5th intercostal space
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Remember to put tube ____ the rib to avoid intercostal vein, artery, and nerve.
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above
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For fluid in a patient lying supine, you want to tunnel tube ____.
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posteriorly
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Done by pulmonologists. Can be done w/ patient awake w/ minimal sedation. Good for looking in airways and evacuating secretions.
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Flexible bronchoscopy
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For tumors or large bleeds. Patient under anesthesia. Give anesthesia through special ports in scope. Can use huge instruments to remove foreign bodies. Can dilate airways, put stents in, perform laser surgery.
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Rigid bronchoscopy
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Similar to bronchoscopy, except outside the airway. Used for lung cancer staging or to remove lymph nodes/masses around airway or drain abscesses.
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Mediastinoscopy
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Open incision in thorax.
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Thoracotomy
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In thoracotomy, commonly entrer chest through ___ intercostal space.
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5th
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Thoracotomy most commonly used for ___.
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lung resection
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Patient position for thoracotomy
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lateral decubitus
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In thoracotomy, this muscle is always divided.
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latissimus
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Single lung ventilation uses a ____.
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double lumen endotracheal tube
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___ sided tubes are easier to put in b/c ___ has a special slot that lets ___ ventilate.
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left, RUL, RUL
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NSCLC Stages ____ are resectable.
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1-3a
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Nodes 1-6 are ___ nodes.
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N2, biopsied b/f surgery
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Nodes 10-14 are ____ nodes
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N1, interparenchymal nodes
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In patients w/ LC, lymph node spread usually goes from ___ lung to ____.
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distal, proximal
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If patient is really old or on steroids, what can be done to avoid leaks in resection?
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intercostal muscle flap can be placed over bronchial stump to encourage healing around staple lines
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Average hospital stay for lung resection patient.
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3-4 days
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What order do you tie off vessels/airways in a lung resection?
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First pulmonary veins, then pulmonary arteries, then the bronchus
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Allows us to do minimally invasive lobectomies. Less painful.
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Video Associated Thoracic Surgery
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Common indications for VATS
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pleural disease
spontaneous pneumothorax mediastial masses lung resection |
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Young people tend to get pneumothorax b/c ?
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blebs rupture at the apex of lung
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Most common indicatino for VATS?
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malignant pleural effusion from breast cancer, surgeons use pleurodesis
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