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Surginal Procedures > Cardiac and thoracic surgery > Flashcards

Cardiac and thoracic surgery Flashcards

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1
Q

Epicardium
Myocardium
Endocardium

A

Above or upon; heart; noun ending – “layer”
Muscle; heart; noun ending – “layer”
Within; heart; noun ending – “layer”

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2
Q

Heart is surrounded by fluid-filled sac called the:

A

Pericardium = around; heart; noun ending – “layer”

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3
Q

4 chambers (atria, ventricles); Valves

A 
Right atrium
     Tricuspid - and it has 3 leaflets
Right ventricle
left atrium
     Bicuspid/Mitral - and it has 2 leaflets
left ventricle
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4
Q

What are the chordae tendinae and what is their function?

A

Fibrous cords attached to valve cusps; prevent cusps from folding back into atrium

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5
Q

The semi-lunar valves are:

A

Aortic and pulmonic (pulmonary)

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6
Q

Flow of blood through heart

A 
Superior and inferior venae cava (empty into the)
Right atrium (and pass through the)
Tricuspid valve (into the)
Right ventricle (Blood goes to the lungs through the)
Pulmonary valve (to the)
Pulmonary artery (where it is oxygenated in the lungs and returns to the heart via the)
(where it is oxygenated in the lungs and returns to the heart via the)
Pulmonary veins (Those structures empty into the)
Left atrium (and pass through the)
Bicuspid valve (into the)
Left ventricle (Blood is then pumped through the)
Aortic valve (into the)
Aorta (and out to the body)
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7
Q

Cardiac intrinsic conduction system

A 
Impulse originates at the:
S-A node (sino-atrial)
     and travels through the internodal pathways to the:
A-V node
     the impulse spreads to the: 
A-V bundle (Bundle of His)
     which divides into the: 
Right and left bundle branches
     which terminate in the
Purkinje fibers (AKA: myoconduction fibers)
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8
Q

Why is the pump-oxygenator (CPB) used in cardiac surgery?

A

Assumes roles of heart and lungs so heart can be stopped during procedure.

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9
Q

Why is hypothermia used in CPB?

A

To protect the heart muscle (myocardial protection)

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10
Q

Which three means are used to achieve this purpose?

A

Systemic hypothermia; topical myocardial hypothermia; cold potassium cardioplegia solution; and ice slush or iced saline.

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11
Q

List 4 diagnostic tests used in thoracic surgery

A

Chest x-ray
CT
MRI
Pulmonary angiography

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12
Q

List 4 items of special equipment used for thoracic surger

A 
Cell saver
Headlight and light source
Defibrillator with sterile internal paddles
Video tower for MIS
Advanced patient monitoring
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13
Q

Which structures form the skeletal framework of the thorax?

A

Formed by sternum, ribs, and thoracic vertebrae

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14
Q

List 3 parts of the sternum

A

Manubrium; Body (gladiolus); Xiphoid

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15
Q

What is the diaphragm and what is its function?

A

Muscle that separates thorax from abdomen
primary muscle of breathing
The Diaphragm contracts during inhalation to pull air into the lungs and during exhalation, the diaphragm relaxes and the air is pushed out of lungs.

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16
Q

Where are the intercostal nerve, artery, and vein located?

A

On the inferior edge of the corresponding rib

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17
Q

What is the mediastinum?

A

Anatomic region; cavity between R and L thoracic cavities; no specific function

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18
Q

What is contained in the mediastinum?

A

Esophagus, trachea, pericardium, great vessels, thymus, lymph nodes

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19
Q

What is the parietal pleura?

What is the visceral pleura?

A 
Lining of the inner surface of each hemi-thorax
The reflection (or folding) of the parietal pleura over the lung tissue
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20
Q

What is the pleural space?

What is pneumothorax?

A

Potential space between parietal and visceral pleurae

Air in the chest cavity

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21
Q

What is the function of the lungs?

A

Essential organs of respiration; facilitate O2/CO2 exchange

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22
Q

Right lung contains:

Left lung contains:

A

3 lobes

2 lobes

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23
Q

Hilum what is it and which structures exit here?

A

The “root” of lung where vital structures enter and leave the lung
Bronchus, nerves, lymphatics and pulmonary artery and veins

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24
Q

Define CABG

A

Coronary artery bypass graft

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25
Anatomy/physiology CABG
Heart, pericardium, epicardium, myocardium, endocardium; Coronary arteries: Left anterior descending (LAD), circumflex, right coronary artery; Ascending aorta Saphenous vein IMA Physiology: circulation to the heart muscle
26
IMA
internal mammary artery
27
Define MID-CABG
Minimally invasive direct coronary artery bypass graft
28
Anatomy/physiology MID-CABG
Heart, pericardium, epicardium, myocardium, endocardium; Coronary arteries: Left anterior descending (LAD), circumflex, right coronary artery; Ascending aorta Saphenous vein IMA Physiology: circulation to the heart muscle
29
Pathology/indication CABG
Coronary artery disease (CAD) due to atherosclerosis in one or more coronary arteries
30
Pathology/indication MID-CABG
CAD; due to atherosclerosis; usually for one vessel; the left anterior descending coronary artery (LAD)
31
Define Mediastinoscopy with lymph node biopsy
Visual exam, mediastinum; with excision of lymph nodes for pathologic exam
32
Anatomy/physiology Mediastinoscopy with lymph node biopsy
Surgical Anatomy/physiology Mediastinum FYI: Mediastinum contains Heart; Great vessels: aortic arch Tracheobronchial junction (carina) Trachea Bronchi (FYI: right and left main stem bronchi) Lymph nodes Physiology: None specific to mediastinum; it is simply a location containing many structures
33
Pathology/indication Mediastinoscopy with lymph node biopsy
Lung cancer; determine metastatic spread to lymph nodes | FYI: may also be used to stage esophageal cancer
34
Define Thoracoscopy AKA: VATS
Video-assisted thoracic surgery | Visual exam; chest cavity
35
Anatomy/physiology Thoracoscopy AKA: VATS
``` Lung; lobes (3 right; 2 left) Bronchi Pulmonary arteries/veins Ribs; intercostal muscles Pleurae (parietal and visceral) Diaphragm Mediastinum Pericardium Physiology: respiration ```
36
Pathology/indication Thoracoscopy AKA: VATS
Diagnostic procedure Treatment for: Peripheral lung lesion (do a wedge resection) Lung tumor (lobectomy) Excessive pericardial fluid (do a pericardial window) Pulmonary blebs (like blisters; resect affected areas) Pleural effusion (drain/possible pleurodesis) Emphysema (lung volume reduction)
37
Define Decortication of the lung
Removal of a restrictive membrane from the lungs
38
Anatomy/physiology Decortication of the lung
``` Lung; lobes (3 right; 2 left) Bronchi Pulmonary arteries/veins Ribs; intercostal muscles Pleurae (parietal and visceral) Diaphragm Mediastinum Pericardium Physiology: respiration ```
39
Pathology/indication Decortication of the lung
Empyema (pus in the thoracic cavity)
40
Define Lobectomy
Excision of a lobe of the lung
41
Anatomy/physiology Lobectomy
``` Lung; lobes (3 right; 2 left) Bronchi Pulmonary arteries/veins Ribs; intercostal muscles Pleurae (parietal and visceral) Diaphragm Mediastinum Pericardium Physiology: respiration ```
42
Pathology/indication Lobectomy
Peripheral pulmonary tumor without hilar node involvement
43
Define Pulmonary embolectomy
Excision of a blood clot in the pulmonary artery
44
Anatomy/physiology Pulmonary embolectomy
pulmonary artery/ies
45
Pathology/indication Pulmonary embolectomy
pulmonary artery blood clot
46
Define Thoracotomy/pneumonectomy
Incision into thoracic cavity with excision of entire lung
47
Anatomy/physiology Thoracotomy/pneumonectomy
``` Lung; lobes (3 right, 2 left) Bronchi Pulmonary arteries/veins Ribs; intercostal muscles Pleurae (parietal and visceral) Diaphragm; mediastinum; pericardium Physiology: respiration ```
48
Pathology/indication Thoracotomy/pneumonectomy
Bronchogenic carcinoma | pertaining to; origin; bronchus
49
Define Lung Transplantation
Replacing a diseased lung with a donor lung
50
Anatomy/physiology Lung Transplantation
``` Lung; lobes (3 right, 2 left) Bronchi Pulmonary arteries/veins Ribs; intercostal muscles Pleurae (parietal and visceral) Diaphragm; mediastinum; pericardium Physiology: respiration ```
51
Pathology/indication Lung Transplantation
Emphysema (COPD = emphysema + chronic bronchitis) Idiopathic pulmonary fibrosis Pulmonary hypertension Bilateral: cystic fibrosis
52
Atherosclerosis Cardiomyopathy Coarctation of aorta
Abnormal condition; fatty plaque; hardening resulting loss of elasticity Disease; heart; muscle Narrowing of the aortic arch
53
Surgical intervention: Atherosclerosis Cardiomyopathy Coarctation of aorta
Carotid endarterectomy-Excision of atherosclerotic plaque in the carotid artery Left ventricular assist device (VAD); implantable cardiac defibrillator (ICD); heart transplant Resection and end-to-end anastomosis; patch aortoplasty; left subclavian flap aortoplasty; or tubular bypass grafts
54
Patent ductus arteriosus Tetralogy of Fallot Myocardial infarction
Failure of closure of an embryologic blood vessel; the connection between pulmonary artery and aorta A group of 4 congenital heart defects; “Heart attack”; interruption of blood flow to heart muscle
55
Surgical intervention: Patent ductus arteriosus Tetralogy of Fallot Myocardial infarction
Transcatheter occlusion Repair of Tetralogy of Fallot Rurgical is not first line of treatment
56
Rheumatic heart disease Mitral stenosis Mitral regurgitation
Scarring or damage to heart, especially heart valves due to inflammation from rheumatic fever Abnormal condition; narrowing; pertaining to bicuspid valve Backflow through the biscuspid valve; “incompetent” valve
57
Surgical intervention: Rheumatic heart disease Mitral stenosis Mitral regurgitation
Heart valve repair or replacement Mitral valvotomy or replacement Mitral valve repair or replacement
58
Aneurysm Coronary artery disease (CAD) Gangrene, foot
A ballooning or abnormal dilation of a blood vessel; (of the aorta) Atherosclerosis of the coronary arteries Tissue death due to lack of blood supply to the foot
59
Surgical intervention: Aneurysm Coronary artery disease (CAD) Gangrene, foot
Aneurysmectomy (Excision of aneurysm with placement of aortic graft); open or endoscopic Coronary artery bypass graft (CABG) Amputation
60
Thrombophlebitis Varicose veins Pleural effusion
Inflammation; blood clot; vein Incompetent venous valves Fluid in the thoracic cavity between the parietal and visceral pleurae
61
Surgical intervention: Thrombophlebitis Varicose veins Pleural effusion
``` Venous thrombectomy (Excision of blood clot in a vein) Excision of varicose veins Thoracocentesis with placement of chest tube/s; talc pleurodesis; or decortication ```
62
Pulmonary embolus Cystic fibrosis Empyema
Blood clot in the pulmonary artery or branches Genetic disease primarily affecting lungs; thick secretions Collection of pus in body cavity, particularly the pleural space
63
Surgical intervention: Pulmonary embolus Cystic fibrosis Empyema
Pulmonary embolectomy Double-lung transplant (at end-stage) Decortication of lung (Excision of restrictive fibrous tissue covering the lung)
64
Pneumothorax | Hemothorax
Air in the pleural cavity (FYI: from outside trauma or inside rupture of blebs) Blood in the pleural cavity
65
Surgical intervention: Lung cancer Pneumothorax Hemothorax
Thoracotomy (incision into thoracic cavity) with lobectomy (excision of a lobe of the lung) or pneumonectomy (excision of an entire lung (right or left) Insertion of chest tube/s Thoracotomy and insertion of chest tubes
66
Define Pectus excavatum repair
Repair of a posterior displacement of the sternum
67
Anatomy/physiology Pectus excavatum repair
Sternum and ribs
68
Pathology/indication Pectus excavatum repair
Posterior displacement of the sternum with impaired cardiorespiratory function

Surginal Procedures (14 decks)

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