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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