TCAR POST-TEST FINAL PAPER 2026
COMPLETE QUESTIONS AND SOLUTIONS
100% CORRECT
● Blood supply lower 2/3 of trachea . Answer: bronchial arteries
● Blood supply lung parenchyma . Answer: bronchial arteries
● Pathway of azygous vein in the thorax . Answer: runs along R side and
dumps into superior vena cava
● Pathway of thoracic duct in the chest . Answer: runs along R side,
crosses midline at T4-T5, goes into L neck and dumps into L subclavian
vein at junction with LIJ
● Pathway of phrenic nerve in thorax . Answer: runs anterior to hilum
● Pathway of vagus nerve in thorax . Answer: runs posterior to hilum
● What fissures exist in the lungs? . Answer: Major oblique separates
RLL from middle and upper lobe
,Minor separates upper from middle lobe
● Muscle used in quiet respiration . Answer: Diaphragm 80%,
intercostals 20%
● Accessory muscles of respiration . Answer: SCM
Levators
Serratus posterior
Scalenes
● Main surface active agent in surfactant . Answer: phosphatidylcholine
● Alveolar, arterial, and venous pressures in lung zones in upright
person . Answer: Zone I: PA > Pa > Pv
Zone II: Pa > PA > Pv
Zone III: Pa > Pv > PA
● Normal pulmonary artery pressure . Answer: 25/10 (mean 15)
● What predicted value is needed for pulmonary resection? . Answer:
Predicted postop FEV1 > 0.8L (>40% predicted)
,● What can be done if the predicted postop FEV1 is close to 0.8 (40%
predicted)? . Answer: Obtain a V/Q scan and see how much that segment
actually contributes
● Single best predictor of being able to wean off ventilator after
pulmonary resection . Answer: FEV1
● Minimum DLCO for lung resection . Answer: >11-12 ml/min/mmHg
CO (>50% predicted value)
● What six things effect DLCO? . Answer: Pulmonary capillary surface
area
Hgb
Alveolar architecture
Dead space
Low CO
Pulmonary HTN
● What pCO2 is necessary for lung resection? . Answer: <45 at rest
● What pO2 is necessary for lung resection? . Answer: >60 at rest, not
on O2
, ● What VO2max is needed for lung resection? . Answer: >10 ml/kg/min
(maximum o2 consumption)
● Overall PFTs required for pulmonary resection . Answer: FEV1 >0.8L
(>40% predicted)
DLCO >11-12 ml/min/mmHg CO (>50% predicted, or 40% postop)
pCO2 <45 at rest
pO2 >60 at rest, not on O2
VO2 >10 ml/kg/min
● MCC of hypoxemia after pulmonary resection . Answer: V/Q
mismatch from atelectasis (shunt)
● MCC of hypercarbia after pulmonary resection . Answer: alveolar
hypoventilation (poor minute ventilation RR x TV)
● MC nerve injury after pulmonary resection . Answer: brachial plexus
injuries
● How can common peroneal nerve injuries be avoided durin pulmonary
resection? . Answer: flex dependent leg
● Most common resection resulting in persistent air leak . Answer:
segmentectomy/wedge
COMPLETE QUESTIONS AND SOLUTIONS
100% CORRECT
● Blood supply lower 2/3 of trachea . Answer: bronchial arteries
● Blood supply lung parenchyma . Answer: bronchial arteries
● Pathway of azygous vein in the thorax . Answer: runs along R side and
dumps into superior vena cava
● Pathway of thoracic duct in the chest . Answer: runs along R side,
crosses midline at T4-T5, goes into L neck and dumps into L subclavian
vein at junction with LIJ
● Pathway of phrenic nerve in thorax . Answer: runs anterior to hilum
● Pathway of vagus nerve in thorax . Answer: runs posterior to hilum
● What fissures exist in the lungs? . Answer: Major oblique separates
RLL from middle and upper lobe
,Minor separates upper from middle lobe
● Muscle used in quiet respiration . Answer: Diaphragm 80%,
intercostals 20%
● Accessory muscles of respiration . Answer: SCM
Levators
Serratus posterior
Scalenes
● Main surface active agent in surfactant . Answer: phosphatidylcholine
● Alveolar, arterial, and venous pressures in lung zones in upright
person . Answer: Zone I: PA > Pa > Pv
Zone II: Pa > PA > Pv
Zone III: Pa > Pv > PA
● Normal pulmonary artery pressure . Answer: 25/10 (mean 15)
● What predicted value is needed for pulmonary resection? . Answer:
Predicted postop FEV1 > 0.8L (>40% predicted)
,● What can be done if the predicted postop FEV1 is close to 0.8 (40%
predicted)? . Answer: Obtain a V/Q scan and see how much that segment
actually contributes
● Single best predictor of being able to wean off ventilator after
pulmonary resection . Answer: FEV1
● Minimum DLCO for lung resection . Answer: >11-12 ml/min/mmHg
CO (>50% predicted value)
● What six things effect DLCO? . Answer: Pulmonary capillary surface
area
Hgb
Alveolar architecture
Dead space
Low CO
Pulmonary HTN
● What pCO2 is necessary for lung resection? . Answer: <45 at rest
● What pO2 is necessary for lung resection? . Answer: >60 at rest, not
on O2
, ● What VO2max is needed for lung resection? . Answer: >10 ml/kg/min
(maximum o2 consumption)
● Overall PFTs required for pulmonary resection . Answer: FEV1 >0.8L
(>40% predicted)
DLCO >11-12 ml/min/mmHg CO (>50% predicted, or 40% postop)
pCO2 <45 at rest
pO2 >60 at rest, not on O2
VO2 >10 ml/kg/min
● MCC of hypoxemia after pulmonary resection . Answer: V/Q
mismatch from atelectasis (shunt)
● MCC of hypercarbia after pulmonary resection . Answer: alveolar
hypoventilation (poor minute ventilation RR x TV)
● MC nerve injury after pulmonary resection . Answer: brachial plexus
injuries
● How can common peroneal nerve injuries be avoided durin pulmonary
resection? . Answer: flex dependent leg
● Most common resection resulting in persistent air leak . Answer:
segmentectomy/wedge
