Lecture 22: Principles of Thoracic Sx (Exam 3)

Question 1

Define

thoracotomy

Answer 1

incision of chest wall

Question 2

Define

intercostal/lateral thoracotomy

Answer 2

incising between ribs

Question 3

Define

median sternotomy

Answer 3

splitting sternum

Question 4

Define

pulmonary lobectomy

Answer 4

removal of lung lobe or portion of a lung lobe

Question 5

Define

pneumonectomy

Answer 5

removal of all lung tissue on one side of the thoracic cavity

Question 6

What do 3/4 of the animals with blunt trauma also have?

Answer 6

thoracic injuries

Question 7

What do 1/2 of the animals with blunt trauma also have?

Answer 7

abdominal & thoracic injuries

Question 8

What is an easy tool can you use to assess thorax for thoracic trauma?

Answer 8

auscultation

Question 9

What can we use to determine if ventilatory impairment is present?

Answer 9

• capnography
• blood gass analysis
• pulse ox

Question 10

Where should you make your skin incision in an intercostal thoracotomy?

Answer 10

skin incision should extend from just below the vertebral bodies to near the sternum

Question 11

What thoracic approach is seen here?

Answer 11

intercostal/lateral thoracotomy

Question 12

Why shouldn’t you incise all the way down to the sternum in an intercostal thoracotomy?

Answer 12

you could incise the ventral internal thoracic artery

Question 13

What tool is seen here to retract the ribs?

Answer 13

Finochietto Retractor

Question 14

What do you usually place when closing an intercostal thoracotomy?

Answer 14

Thoracostomy Tube

Question 15

Where do you place the thoracostomy tube through the skin?

Answer 15

one to two spaces caudal to the thoracostomy incision prior to closing the thorax

Question 16

What surgical procedure do you use this closure technique?

Answer 16

intercostal thoracotomy

Question 17

What tool is shown here (used to pull ribs together)?

Answer 17

Rib Approximator

Question 18

When should you place the chest tube?

Answer 18

Before you close the thoracic wall

Question 19

What thoracic surgical approach is seen here?

Answer 19

Median Sternotomy

Question 20

When is a median sternotomy indicated?

Answer 20

• need exposure to both sides of thoracic cavity
• bilateral partial lobectomy
• need access to medial chest organs
• spontaneous pneumothorax
• mediastinal tumors
• exploratory thoracotomy

Question 21

What is shown in these photos?

Answer 21

mediastinal tumors

Question 22

Should you cut through the entire sternum in a median sternotomy?

Answer 22

not ideally, leave caudal or cranial 2 sternebrae intact

Question 23

What is this tool?

Answer 23

Sternal Saw

Question 24

What is this tool?

Answer 24

Oscillating Orthopedic Saw

Question 25

What saw can you use to incise the midline of the sternum?

Answer 25

* sternal saw (ideal) * oscillating orthopedic saw (need to be more careful)

Question 26

When should you place a thoracostomy tube in a median sternotomy?

Answer 26

before closing sternotomy

Question 27

Where should your thoracostomy tube exit in a median sternotomy?

Answer 27

between ribs or through diaphragm

Question 28

What should you never use to close the sternum?

Answer 28

double loop cerclage wire

Question 29

Why is a thoracostomy tube placed in thoracic surgery?

Answer 29

thoracic surgery introduces air creating pneumothorax, tube removes residual air

Question 30

What device is being used here to staple the lung lobe in a partial lobectomy?

Answer 30

Thoracoabdominal (TA) stapler

Question 31

What instruments are seen here (used in complete pulmonary lobectomy)?

Answer 31

* top: Right Angle Forceps * bottom: Satinsky Clamp

Question 32

What is a big concern of thoracic surgery?

Answer 32

hypothermia

Question 33

What is the incidence rate of pyothorax in dogs?

Answer 33

6.5%

Question 34

What is the mortality rate of dogs that develop a pyothorax?

Answer 34

67%