15: Airway and pleural

Question 1

How do you prepare for a thoracocentesis?

Answer 1

Give O2, clip, scrub, EMLA cream

Question 2

Where is your landmark to remove air by throracocentesis?

Answer 2

7th IC space

Question 3

How do you avoid piercing the lung?

Answer 3

In and down

Question 4

What is an advantage or median sternotomy?

Answer 4

Can explore whole thorax

Question 5

What are disadvantages of median sternotomy?

Answer 5

Prolonged recovery, increased morbidity

Question 6

What is a bleb?

Answer 6

Air-filled space

between lung and pleura

Question 7

How do you close a median sternotomy?

Answer 7

Cruciate sutures, chest drain, opioids, NSAIDs

Question 8

What should you always do for penetrating trauma?

Answer 8

Surgically explore

Question 9

What is advantage of lateral thoracotomy?

Answer 9

Reduced morbidity

Question 10

What is disadvantage of lateral thoracotomy?

Answer 10

Disolcating ribs so painful

Question 11

How can you check for air leaks?

Answer 11

Fill chest with water

Question 12

Why do you leave in drains after a lobectomy?

Answer 12

To avoid tension as lung-reinflated

Question 13

What are some indications for lobectomy?

Answer 13

Neoplasia, abscess, FB, torsion, trauma

Question 14

How can you make the thoracic duct become visible?

Answer 14

Give cream before surgery with methylene blue dye

Question 15

What do you do if fibrosis of pericardium?

Answer 15

Pericardectomy

Question 16

What is pleurodesis?

Answer 16

Fuse lungs to chest wall

Question 17

What is a bulla?

Answer 17

Air-filled space within parenchyma

Question 18

WHich nerve block could you do for a lateral thoracotomy?

Answer 18

Intercostal

Question 19

Where should you try to ligate the thoracic duct?

Answer 19

As close to the diaphragm as possible before it splits.

Question 20

Why do a pericardectomy in chylothorax?

Answer 20

Fibrosis of pericardium a feature, could restrict venous return