Transcript CVPV/Thoracic Review 3

CVPV/Thoracic Review 3
 Thoracic and _____________ surgery includes procedures of
the _________ system and thoracic cavity, excluding those that
involve the heart and cardiac vessels.
 pulmonary, endocrine
 cardiac, respiratory
 pulmonary, respiratory
 none of the above
pulmonary, respiratory
______________________ is bloody sputum or bleeding
arising from the respiratory tract.
 Empyema
 Hemoptysis
 Hypoxia
 Pleuritis
Hemoptysis
With the patient in the ___________ position, it is necessary to
position a magnetic instrument pad over the top drape to serve as
a neutral zone and to retain any instruments that are placed on the
drape.
 prone
 lateral
 supine
 dorsal recumbent
lateral
____________of one or both lungs is performed to remove a
diseased lung and replace it with a donor lung.
 Donors
 Transplantation
 Transferred
 A and B
Transplantation
The surgical removal of a portion of the parietal pleura is called
________________.
 lung volume reduction
 pneumonectomy
 decortication of the lung
 lobectomy
decortication of the lung
The procedure that removes an entire lung to debulk (reduce the
size of) a malignant tumor is called a
_______________________.
 lobectomy
 pneumonectomy
 decortication of the lung
 lung volume reduction
pneumonectomy
The ________ nerves are carefully preserved during
pneumonectomy.
 vagus, left recurrent laryngeal, and phrenic
 vagus, pneumatic, and phrenic
 phrenic, pneumatic, and epigastric
vagus, left recurrent laryngeal,
and phrenic
The ________ begins at the larynx and branches into two main
airways.
 bronchi
 Hilum
 trachea
 pharynx
trachea
During a pulmonary function test, the total volume of air is
exhaled after maximum inspiration. This is called
____________________.
 tidal volume
 vital capacity
 total lung capacity
 minute volume
vital capacity
Bronchoscopy is the insertion of a flexible fiberoptic or rigid
telescope into the _________.
 trachea
 mediastinum
 pleura
 thoracic cavity
trachea
When a thoracotomy is performed, the edges of the wound are
covered with laparotomy sponges to protect the wound edges
from ____________.
 hemorrhaging
 sticking
 drying
 bruising
bruising
Decortication of the lung is the surgical removal of a portion of
the ______________.
 pericardium
 parietal pleura
 diaphragm
 visceral pleura
parietal pleura
_____________ is defined as difficulty in breathing.
 Hypoxia
 Empyema
 Dyspnea
 Pleuritis
Dyspnea
__________________ is the loss of elasticity and distension of
the alveoli.
 Emphysema
 Fibrosis
 Pleural effusion
 Sarcoidosis
Emphysema
__________________ requires 10-mm lenses in sizes 0 and 30
degrees.
 Rigid bronchoscopy
 Mediastinoscopy
 Thoracoscopy
 Flexible bronchoscopy
Thoracoscopy
_____________ is the distribution of oxygen to the tissue.
 Diffusion
 Ventilation
 Respiration
 Perfusion
Perfusion
________________ is generally used only for the removal of
large tissue or a foreign body.
 Rigid bronchoscopy
 Flexible bronchoscopy
 Mediastinoscopy
 Thoracoscopy
Rigid bronchoscopy
With a thoracotomy, the shoulder muscles are retracted using a
__________.
 wide Deaver
 scapular retractor
 ribbon retractor
 Finochietto retractor
scapular retractor
Pulmonary angiography is performed when computed
tomography (CT) scans are inconclusive for diagnosis of:
 pulmonary infusion
 obstructive pulmonary disease
 pulmonary embolism
 spontaneous pneumothorax
pulmonary embolism
Patients who undergo a VATS technique for resection of blebs may
be placed on mechanical _______ in the immediate
postoperative period.
 ventilation
 hypoventilation
 hyperventilation
 diffusion
ventilation
pneumothorax is air in the chest cavity that prevents the lungs
from expanding and may ____________________.
 displace the mediastinal structures
 collapse the contralateral lung
displace the mediastinal structures
The reason an inhaled foreign material is more likely to enter the
right lung is because the right bronchus is _____ than the left.
 larger
 straighter
straighter
When the diaphragm __________, the potential space between
the two pleural membranes is decreased and air is pulled into
airways and lungs.
 expands
 contracts
contracts
During a single lung transplant, to be effective in the scrub role,
the surgical technologist (ST) must be _______about specific
surgical procedures and the steps involved in each procedure.
 knowledgeable
 experienced
knowledgeable
 Thoracic outlet syndrome (TOS) is a rare condition in which
the subclavian vessels and the brachial plexus are compressed at
the ___________.
 apex of the thorax
 suprasternal notch
apex of the thorax
 The lung is divided into anatomical regions. The right lung has
____ lobes and the left lung has _____ lobes.
 two, three
 three, two
three, two
The diaphragm is a sealed barrier between the ________
cavities.
 thoracic and abdominal
 abdominal and mediastinal
thoracic and abdominal
Diffusion is the transfer of oxygen from the
__________________.
 bronchi in the lungs to the alveoli
 alveoli in the lungs to the bloodstream
alveoli in the lungs to the bloodstream
An arterial blood gasses test assesses the arterial blood for
___________.
 red and white blood cells and platelets
 oxygen and carbon dioxide levels, as well as pH
oxygen and carbon dioxide levels, as well
as pH
 The patient is placed in semi-Fowler’s position to perform a
_____ bronchoscopy.
 rigid
 flexible
flexible
WHAT IS IT AND WHAT’S IT
USED FOR?
Doppler Scanning
 Probe directs an ultrasound beam that is reflected back to the
probe by moving RBC’s, the velocity of which is then
converted into an audible signal through a speaker
 What is a potential problem in CVPV Surgery?
Temperature!
 What can be done?
 Hypo/hyperthermia blankets
 Warm or cold fluids
 Blood should be warmed prior to transfusion to prevent
hypothermia
 Fluids may be cooled to help lower body temperature
 Slush may be used to help lower body temperature
What are some Instrument
Considerations ?
 Vascular clamps are non-crushing to prevent undue trauma to
vessels
 Patient must be heparinized prior to clamp placement
 Distal clamp is placed first, then the proximal clamp
 Proximal clamp is removed first, then the distal
 Partial Occlusion Clamp
What are some Suture Considerations?
 Double-armed NA vascular (prolene, Gore-Tex, Polyester)
sutures are used, and frequently have a larger swaged sutureto-needle ratio to avoid leakage
 Moisten doctors hands for tying prolene
What are some Common CV/PV Drugs?
 Heparin
 Anticoagulant
 Given systemically and used as an irrigant
 Protamine sulfate
 Heparin antagonist
 Reverses the anticoagulant effect of heparin
 Papaverine hydrochloride
 A vasodialator used to relax the smooth muscle of the vessel