Co-existing diseases-Mediastinoscopy Flashcards Preview

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Flashcards in Co-existing diseases-Mediastinoscopy Deck (15)
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1
Q

Mediastinoscopy:
this procedure can either be done via a transverse incision just above the suprasternal notch or in the second or third rib interspace. the mediastinoscope is inserted between the _____ and the _____

A

rib cage and lung

2
Q

Mediastinoscopy:

what are some considerations to think about during these procedures (a lot to list just be familiar)

A

Myasthenic syndrome
tracheal deviation
thoracic inlet obstruction
type and cross for blood
may have air emboli if spont breathing (trend)
vagal response d/t stretching vagal nerve
Left RLN and phrenic n. are around the aortic arch

3
Q

Mediastinoscopy:

most useful for tumors located where

A

right lung

4
Q

Mediastinoscopy:

what is the most common complication

A

hemorrhage

5
Q

Mediastinoscopy:

what is the 2nd most common complication

A

pneumothorax (primarily right side)

6
Q

Mediastinoscopy:

where is the Arterial line placed

A

RIGHT radial artery

7
Q

Mediastinoscopy:

why is the A-line placed in the Right radial artery

A

to monitor compression of of innominate and right brachiocephalic arteries

8
Q

Mediastinoscopy:

monitor BP in what arm

A

left

9
Q

Mediastinoscopy:

should pulse ox be placed on right or left hand

A

right- to assess for vascular compression

10
Q

Mediastinoscopy:

why is positive pressure ventilation good

A

decrease likelihood of air emboli

11
Q

Mediastinoscopy:

do u tube?

A

yep

12
Q

Mediastinoscopy:

muscle relaxation?

A

yep

13
Q

Mediastinoscopy:

4 contraindications

A

previous Mediastinoscopy (scarring)
SVC obstruction
Tracheal deviation
Aneurysm of thoracic aorta

14
Q

Mediastinoscopy:

complications

A
hemorrhage
Pneumothorax
air emboli
nerve injury
esophageal injury
thoracic duct injury
tracheal compresion
15
Q

Mediastinoscopy:

what are the 3 vessels that can be most easily compressed during a Mediastinoscopy?

A

innominate
right brachiocephalic
right common carotid
(tip they all arise from the innominate) see pg 512

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