Thoracic Anesthesia Part 1 Flashcards
- Leading cause of cancer deaths?
- ___% of all cancer
- ___% of all cancer deaths
- Categorized as (2)
- ___ new cases in US a year, 1.2 million worldwide
- Lung cancer
- 15%
- 28%
- Small cell carcinoma and non-small cell carcinoma
- 200,000
Poor prognosis, metastatic, 3 month survival after diagnosis?
*Tumor of ____ origin (2)
(Can secrete ectopic hormones mostly ___ and ___)
Small cell carcinoma
*neuroendocrine origin
Lambert Easton Myasthenic syndrome, SIADH
(ACTH and ADH)
Linked to cigarette smoking, prognosis variable, 75-80% of all primary lung cancers?
- ___ CONSIDERED in all patients
- Less than 50% survive ____
Non-small cell carcinoma
- surgery
- 5 years
Preop = Tumor Staging (tumor size, nodal involvement, metastasis) 0 = \_\_\_ 1 = \_\_\_ 2 = \_\_\_ 3 = \_\_\_ 4 = \_\_\_
0 = in situ 1 = localized to tissue 2 = spread to lymph nodes close by 3 = more extensive lymph node involvement 4 = spread to other distal tissues and organs
Symptoms from tumor may occur in one or more category:
1) ___ = involve lung; cough, dyspnea
2) ___ = tumor growth beyond confines of the lung; pleural effusion, chest wall pain, dysphagia
3) ___ = tumor spread outside the thorax; brain, skeletal, kidney
4) ___ = Paraneoplastic syndrome: endocrine or endocrine like syndrome; cushings disease, hypercalcemia
5) ___ = weight loss, anorexia, anemia, malaise, vague cold-like syx
1) Bronchopulmonary
2) Extrapulmonary Intrathoracic
3) Extrathoracic Metastatic
4) Extrathoracic Non-metastatic
5) Nonspecific
Answer the question of “How operational or functional will the remaining lung be after resection?”
PFTs
*Major factor associated with postop pulmonary problems?
- These 2 patients definitely need PFTs preoperatively??
- PFTs identify patients with?
- Preexisting lung dysfunction
- Thoracic surgery candidates, patients over the age of 70
- abnormal lung function
First test they do? Deep maximal inspiration followed by maximal expiration
- Most common measurement of ?
- Values vary with ___ and ___.
- Normal is ___ predicted value for height and age.
- VC decreased by (4)
Vital Capacity
- lung function
- height and age
- > /= 80%
- going from sitting to supine position, restrictive lung disease, loss of distensible lung tissue, max inspiration or exhalation not achieved
- Reflects flow resistance in the airway?
- ___ measured in ___ and must not be interrupted by (3)
- Forced vital capacity (max inspiration followed by rapid forceful expiration)
- Exhalation
- time
- cough, closure of glottis, mechanical obstruction
Whole Lung Testing/Phase 1 Testing: 2 components
- Detect abnormalities of ___
- Detect abnormalities of the (3)
- gas exchange
- lung
- chest wall
- mechanical aspects of ventilation
- ___ is reduced by the same conditions that decrease VC
- ___ = forced expiratory volume in the first second of the FVC measurement (3 Spirograms and best FEV1 and best FVC recorded to make the ratio)
- Normal FEV1/FVC ratio is?
- FVC
- FEV1
- 75-80% or above
These 2 can help to determine postop outcome??
FEV1 and maximum ventilatory ventilation
Largest volume that can be breathed per minute by voluntary effort?
**requires high rate of ___, changes in ___ will alter this
Maximum ventilatory ventilation
- *air flow
- *airway resistance
MVV is reduced in ?
MVV correlates with ? (Equation?)
Obstructive disease
FEV1
(FEV1 X 35 = ~MVV)
- FVC only normal in ___
* FEV1/FVC ratio only decreased in ___
*Obstructive disease
(decreased in restrictive and muscle weakness)
*Obstructive disease
