Week 12 - Thoracic Surgery

Question 1

List some possible Lung surgeries

Answer 1

Pneumonectomy
Lobectomy
Segmental resection

Question 2

What is a Pneumonectomy

Answer 2

Removal of the entire lung

Question 3

What is a lobectomy

Answer 3

Removal of one lobe of the lung from the lobar bronchus

Question 4

What is a segmental resection

Answer 4

This is the removal of a section of the lung distal to the segmental bronchus

Question 5

What is a posterolateral Thoracotomy incisions and what is it used for

Answer 5

Used in most pulmonary resections, oesophageal and some cardiac surgery
Performed with patient in side lying position. Starts at ant axillary line down to several finger breadths below the inferior angle of scapula to the spinour process

Question 6

Muscles affected by a posterolateral thoracotomy are:

Answer 6

Traps, LD and serratus anterior

Ribs are retracted and used to open the space

Question 7

Describe the Anterolateral incisions

Answer 7

Used in trauma where patients are too CV unstable.

Submammary from the midline anterior to mid axillary line

Question 8

Muscles affected by an Anterolateral incision

Answer 8

Pec Maj, Pec minor, SA and intercostals

Question 9

What is pleural surgery for

Answer 9

Pleurodeses where the pleural surfaces are irritated and sick together to we put power in the space to glue them together and stop effusions
Pleurectomy and decortication - stripping away the pleura if fibrosed or in the presence of malignancy

Question 10

Benefits of VAT over thoracotomy

Answer 10

Decrease in imparimetn of VC and ^ minute walk test

Decreased Postoperative pain and less reduction in lung function

Question 11

What dd Reeve et al (2007) find in relationship to Physiotherpay following thoracic surgery?

Answer 11

Most common treatments used were DB, ACBT and COUGH with FET
But little post op rehab, outpatient follow up and no pain mainage
Factors influencing Personal experience, literaure and established practice

Question 12

Revee et al 2010 completed a study comparing DB and C versus standard medical and nursing care including mobililisation. What did they find

Answer 12

There was no difference between the two groups. The addition of DB and C to Mobilisation had little affect so they actually stoped the study early

Question 13

Reeve et al 2010 completed another study about the inclusion of shoulder exercises into treatment post thoracic surgery what did they find

Answer 13

At D/C treatment group experiences less total pain - decrease of 2.2 units
and at D?C they experienced less shoulder pain by 1.3 units
THis was also seen at 1 and 3 months post