K
C
LO
THORACIC- TCAR POST EXAM
REVIEW QUESTIONS AND
YC
CORRECT DETAILED /
VERIFIED ANSWERS LATEST
D
UPDATE
U
ST
,Blood supply upper 2/3 of trachea - ANS inferior thyroid arteries
Blood supply lower 2/3 of trachea - ANS bronchial arteries
Blood supply lung parenchyma - ANS bronchial arteries
Pathway of azygous vein in the thorax - ANS runs along R side and dumps into superior vena
cava
K
Pathway of thoracic duct in the chest - ANS runs along R side, crosses midline at T4-T5, goes
into L neck and dumps into L subclavian vein at junction with LIJ
C
Pathway of phrenic nerve in thorax - ANS runs anterior to hilum
LO
Pathway of vagus nerve in thorax - ANS runs posterior to hilum
What fissures exist in the lungs? - ANS Major oblique separates RLL from middle and upper
lobe
Minor separates upper from middle lobe
YC
Muscle used in quiet respiration - ANS Diaphragm 80%, intercostals 20%
Accessory muscles of respiration - ANS SCM
Levators
Serratus posterior
D
Scalenes
Main surface active agent in surfactant - ANS phosphatidylcholine
U
Alveolar, arterial, and venous pressures in lung zones in upright person - ANS Zone I: PA > Pa
> Pv
ST
Zone II: Pa > PA > Pv
Zone III: Pa > Pv > PA
Normal pulmonary artery pressure - ANS 25/10 (mean 15)
What predicted value is needed for pulmonary resection? - ANS Predicted postop FEV1 > 0.8L
(>40% predicted)
What can be done if the predicted postop FEV1 is close to 0.8 (40% predicted)? - ANS 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 - ANS FEV1
Minimum DLCO for lung resection - ANS >11-12 ml/min/mmHg CO (>50% predicted value)
What six things effect DLCO? - ANS Pulmonary capillary surface area
Hgb
Alveolar architecture
Dead space
Low CO
Pulmonary HTN
K
What pCO2 is necessary for lung resection? - ANS <45 at rest
C
What pO2 is necessary for lung resection? - ANS >60 at rest, not on O2
What VO2max is needed for lung resection? - ANS >10 ml/kg/min (maximum o2 consumption)
LO
Overall PFTs required for pulmonary resection - ANS 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
YC
VO2 >10 ml/kg/min
MCC of hypoxemia after pulmonary resection - ANS V/Q mismatch from atelectasis (shunt)
MCC of hypercarbia after pulmonary resection - ANS alveolar hypoventilation (poor minute
ventilation RR x TV)
D
MC nerve injury after pulmonary resection - ANS brachial plexus injuries
U
How can common peroneal nerve injuries be avoided durin pulmonary resection? - ANS flex
dependent leg
ST
Most common resection resulting in persistent air leak - ANS segmentectomy/wedge
MC resection resulting in atelectasis - ANS lobectomy
MC resection resulting in arrhythmias - ANS pneumonectomy (R MC)
MC resection resulting in postop TEF - ANS pneumonectomy (R MC)
MC resection resulting in postop bronchopleural fistula - ANS pneumonectomy (R MC)
MC resection resulting in mortality - ANS pneumonectomy (R MC)
C
LO
THORACIC- TCAR POST EXAM
REVIEW QUESTIONS AND
YC
CORRECT DETAILED /
VERIFIED ANSWERS LATEST
D
UPDATE
U
ST
,Blood supply upper 2/3 of trachea - ANS inferior thyroid arteries
Blood supply lower 2/3 of trachea - ANS bronchial arteries
Blood supply lung parenchyma - ANS bronchial arteries
Pathway of azygous vein in the thorax - ANS runs along R side and dumps into superior vena
cava
K
Pathway of thoracic duct in the chest - ANS runs along R side, crosses midline at T4-T5, goes
into L neck and dumps into L subclavian vein at junction with LIJ
C
Pathway of phrenic nerve in thorax - ANS runs anterior to hilum
LO
Pathway of vagus nerve in thorax - ANS runs posterior to hilum
What fissures exist in the lungs? - ANS Major oblique separates RLL from middle and upper
lobe
Minor separates upper from middle lobe
YC
Muscle used in quiet respiration - ANS Diaphragm 80%, intercostals 20%
Accessory muscles of respiration - ANS SCM
Levators
Serratus posterior
D
Scalenes
Main surface active agent in surfactant - ANS phosphatidylcholine
U
Alveolar, arterial, and venous pressures in lung zones in upright person - ANS Zone I: PA > Pa
> Pv
ST
Zone II: Pa > PA > Pv
Zone III: Pa > Pv > PA
Normal pulmonary artery pressure - ANS 25/10 (mean 15)
What predicted value is needed for pulmonary resection? - ANS Predicted postop FEV1 > 0.8L
(>40% predicted)
What can be done if the predicted postop FEV1 is close to 0.8 (40% predicted)? - ANS 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 - ANS FEV1
Minimum DLCO for lung resection - ANS >11-12 ml/min/mmHg CO (>50% predicted value)
What six things effect DLCO? - ANS Pulmonary capillary surface area
Hgb
Alveolar architecture
Dead space
Low CO
Pulmonary HTN
K
What pCO2 is necessary for lung resection? - ANS <45 at rest
C
What pO2 is necessary for lung resection? - ANS >60 at rest, not on O2
What VO2max is needed for lung resection? - ANS >10 ml/kg/min (maximum o2 consumption)
LO
Overall PFTs required for pulmonary resection - ANS 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
YC
VO2 >10 ml/kg/min
MCC of hypoxemia after pulmonary resection - ANS V/Q mismatch from atelectasis (shunt)
MCC of hypercarbia after pulmonary resection - ANS alveolar hypoventilation (poor minute
ventilation RR x TV)
D
MC nerve injury after pulmonary resection - ANS brachial plexus injuries
U
How can common peroneal nerve injuries be avoided durin pulmonary resection? - ANS flex
dependent leg
ST
Most common resection resulting in persistent air leak - ANS segmentectomy/wedge
MC resection resulting in atelectasis - ANS lobectomy
MC resection resulting in arrhythmias - ANS pneumonectomy (R MC)
MC resection resulting in postop TEF - ANS pneumonectomy (R MC)
MC resection resulting in postop bronchopleural fistula - ANS pneumonectomy (R MC)
MC resection resulting in mortality - ANS pneumonectomy (R MC)
