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36 Cards in this Set

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