Term
| What are the most surgeries for lung resection? |
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Definition
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Term
| What is a common surgery for cardiac procedures? |
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Definition
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Term
| This type of surgery is common for pericardium and epicardium |
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Definition
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Term
| These 2 surgeries are common for diaphragmatic procedures |
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Definition
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Term
| What muscles are cut in a posterolateral thoracotomy? |
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Definition
Latissimus Dorsi
Trapezius
Rhomboids
Serratus Anterior |
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Term
| Which is more common: anterolateral or posterolateral thoracotomy? |
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Definition
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Term
| This type of thoracotomy may be done for lung and esophageal procedures. The Serratus and pecs may be cut. |
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Definition
| Anterolateral Thoracotomy |
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Term
| This type of thoracotomy is often used for lung procedures. May result in neuro symptoms after surgery due to the position of the arm being overhead during surgery. Serratus is the main muscle involved; lats are spared. |
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Definition
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Term
| This type of thoracotomy is used for apical bleb resection or dorsal sympathectomy. Pt is in the side-lying position with arm flexed at elbow, abducted 90 degrees at shoulder, and rotated. |
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Definition
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Term
| An air-filled sac typically in the upper portion of the lungs. Can leak air and cause the lungs to collapse |
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Definition
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Term
| This is very common for heart surgery. Pt will not be able to lift over 8-10 lbs after sx for 6-8 weeks. Pt cannot do bilateral shoulder abduction for a while; more unilateral movements at first. Stop movement if "clicking" is heard. All transfers should be done to prevent stress on the sternum. Roll to side and hug body while someone else helps sit up. |
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Definition
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Term
| These often cause problems with coughing, deep breathing, and thoracic extension. Have pt splint with pillow to help them cough more effectively. |
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Definition
| Thoracoabdominal incisions |
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Term
| With thoracic surgeries, what are the major causes of perioperative morbidity and mortality related to respiratory complications |
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Definition
pneumonia
Respiratory failure
atelectasis |
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Term
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Definition
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Term
| A common respiratory condition due to prolonged positioning such as laying down |
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Definition
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Term
| __ complications are the 2nd most common cause of perioperative morbidity/mortality and this includes __ and __ |
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Definition
Cardiac
Arrhythmias and Ischemia |
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Term
| After thoracic surgery, 80% of pts describe ipsilateral __ pain. Primarily referred pain of diaphragmatic irritation transmitted by phrenic nerve afferent. Other causes should be considered. |
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Definition
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Term
| Why might a person have a PICC line? |
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Definition
| Usually done for pt who needs long-term antibiotics even after they go home. Be very careful to avoid extreme shoulder movements |
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Term
| With invasive hemodynamic monitoring during thoracic procedures, arterial lines are usually present due to incidence of what? |
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Definition
| Transient severe hypotension |
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Term
| ___ monitoring and access is routine procedure for thoracic surgery. |
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Definition
| CVP (central venous pressure) |
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Term
| A standard procedure for minimally invasive surgery |
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Definition
| VATS (video-assisted thoracoscopic surgery) |
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Term
| Name some advantages of VATS |
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Definition
| reduced hospital stay, less blood loss, less pain, improvement of lung function, early pt mobilization, less inflammation |
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Term
| What precautions should you take if pt has in a femoral artery line? |
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Definition
| Cannot flex hip above 90. Cannot abduct leg a lot |
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Term
| Name 3 percutaneous revascularization procedures |
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Definition
Angioplasty
Arthrectomy
Stenting
-Common among procedures is intro to balloon-equipped catheter, via peripheral arterial access site |
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Term
| This is where they take out the saphenous vein and put it above and below the blocked vein to bypass it. Must have good veins for this to work. |
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Definition
| CABG (coronary artery bypass graft) |
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Term
| Coronary arterial atheroclerotic lesions progresses resulting in what? |
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Definition
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Term
| The optimal choice for management of coronary artery disease when all 3 vessels are severly obstructed. |
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Definition
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Term
| Name 2 vascular grafts for CABG |
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Definition
Saphenous veins
Internal mammary artery |
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Term
| What are some recent improvements to CABG? |
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Definition
| Use of smaller incisions with microinstrumentation |
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Term
| Use of ultrasound guided cannulations; Off-pump coronary artery bypass |
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Definition
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Term
| Name some clinical complications of CABG |
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Definition
Pulmonary infections
Atelectasis
Chest wall soreness
Shoulder soreness
LE discomfort
Infection |
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Term
| Minimizes the invasiveness of CABG |
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Definition
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Term
| There is an increased risk of stroke during this procedure but a decreased risk of stroke once procedure is over. |
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Definition
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Term
| Name 3 characteristics for a good candidate for a Carotid Endarterectomy |
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Definition
1. Symptomatic pt with carotid artery stenosis 70% or more
2. Symptomatic pt with stenosis of 50-69% of the carotid artery
3. Asymptomatic pt with stenosis of 60% or greater (may choose just to monitor this) |
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Term
| With this procedure, the use of angioplasty in carotid artery dz is not indicated. Use of stents may be indicated. |
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Definition
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Term
| Name some common risk factors for thoracic aortic aneurysms |
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Definition
Hypotension
Hypercholesterolemia
Prior tobacco use
Collagen vascular dz
Family hx of aortic dz |
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Term
| Thoracic aortic aneurysms are classified by location, size, shape, and etiology. Where might he pain present at? |
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Definition
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Term
| Name to indications for surgery if pt has a thoracic aortic aneurysm |
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Definition
-Aneurysms greater or equal to 5cm o with rapid aneurysm enlargement
-Sudden change in pain |
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Term
| If a pt has an abdominal aortic aneurysmectomy, what are they at high risk for? |
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Definition
| Pulmonary complications due to incisional pain limiting cough and deep breathing |
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Term
| What is a less invasive alternative to abdominal aortic aneurysmectomy? |
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Definition
| Endovascular repair of descending thoracic aortic aneurysm |
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Term
| The type of intervention (surgical vs. percutaneous transluminal angioplasty) is determined by what 5 things for peripheral vascular problems. |
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Definition
1. Characteristics of a lesion (location, stenosis vs. occlusion, length)
2. Pattern of arterial occlusion disease (multilevel vs single level, runoff status)
3. Patient demographics (gender, diabetes, age)
4. Clinical situation (recurrent dz and indications)
5. Intraprocedural factors (initial hemodynamic response) |
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Term
| WB on the affected extremity is a concern, exercise and mobility is important, elevate affected extremity when sitting. The strongest predictor of successful outcome involves clinical symptom of claudication. |
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Definition
| Peripheral Vascular Interventions |
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Term
| Why is + claudication pain a sign of better long-term outcomes and fewer amputations? |
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Definition
| Because this means that they have some circulation instead of none at all |
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Term
| A surgical bypass and arterial reconstruction that can be done on any vessel. |
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Definition
| Peripheral Vascular Surgery |
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Term
| Name 4 common sites for peripheral vascular surgery |
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Definition
1. Femoral-popliteal region
2. Aortofemoral region
3. Infrapopliteal
4. Axiobifemoral |
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Term
| Treatment of chronic myocardial ischemia in those to failed conventional bypass and angiplasty. Creation of small channels in myocardium using transmyocardial laser revascularization. Holes stimulate development of collateral vessels. |
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Definition
| Percutaneous Myocardial Revascularization |
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Term
| An agent for stimulating growth of new blood vessels |
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Definition
| Recombinant human vascular endothelial growth factor (VEGF) |
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Term
| The adult heart has a reduced ability to produce __ and stimulate __ |
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Definition
Growth factors
Angiogenesis |
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Term
| What are the disadvantages of gene therapy for stimulation of angiogenesis? |
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Definition
| Stimulation of cell proliferation may cause detrimental effects if cell proliferation occurs at wrong site |
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Term
| VEGF plus a collagen-binding domain; transplantation of mesenchyma stem cells |
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Definition
| Gene therapy for the stimulation of angiogenesis |
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Term
| __ has been investigated for the tx of stent restenosis |
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Definition
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Term
| Effective in treating proliferation disorders; After treatment, incidence of restenosis of artery was reduced. |
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Definition
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Term
| An electronic pulse generator used to create an artificial action potential. Some may do atria while other do ventricles |
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Definition
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Term
| This controls some types of cardiac arrhythmias. May be temporary measure or may be surgically implanted for permanent function. General indications include SA nose disorders, atrioventricular nodal disorders, tachyarrhythmias. |
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Definition
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Term
| Initiate myocardial depolarization by creating electrical voltage. Electrical conduction configurations are classified as unipolar or bipolar |
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Definition
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Term
| Name 2 types of cardiac pacing leads |
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Definition
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Term
| __ leads are placed inside the right atrium, right ventricle, or both via transvenous route |
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Definition
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Term
| __ leads are attached directly to surface of right atrium or right/left ventricle |
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Definition
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Term
| What is the typical SA node rate? |
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Definition
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Term
| What is the typical rate of AV node? |
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Definition
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Term
| The type of lead effects what? |
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Definition
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Term
| Similar to pacemaker, but designed to correct life-threatening arrhythmias. Detects and corrects. Implanted into the pt with or without a pacemaker. Pts with left ventricular ejection fraction of 30% have a 3 to 5 time increase in the incidence of sudden death. |
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Definition
| Implantable Cardioverter Defibrillator |
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Term
| Postoperative thoracic procedure, tubes are commonly placed where? |
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Definition
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Term
| __ and __ system permit the amount of drainage and intrathoracic blood loss to be monitored |
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Definition
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Term
| Provides a means to verify air leaks; drain pleural or mediastinal fluid and air. |
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Definition
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Term
| Chest Drainage Tubes and PT (3) |
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Definition
1. Presence of chest tubes should not preclude pt's participation in PT activities
2. Mobility is encouraged
3. Intraabdominal tubes - elimate air or fluid from the abdominal cavity |
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