Chapter 22 : Cardiothoracic Surgery

Which instrument is a rib shear?

Select one:

Davidson

Satinsky

Bethune

Alexander

Bethune

What is the medical term for visible changes in density on chest x-ray that indicates pulmonary pathology?

Select one:

hilum

hemoptysis

infiltrate

inspiration

Infiltrate

How many lobes are there in the right lung?

Select one:

five

four

two

three

three

What is the name of the device that is attached to suction for collection of mucous or bronchial washing specimens?

Select one:

myringotomy tube

Lukens tube

insufflation tubing

aerobic culture tube

Lukens Tube

What is the average lifespan of biologic and mechanical heart valve replacements?

Select one:

1 to 5 years

10 to 15 years

5 to 10 years

indefinite

10 to 15 years

In the event that a VATS procedure had to be converted to an open procedure, which open case would be performed?

Select one:

tracheotomy

thoracotomy

laparoscopy

coronary artery bypass

Thoracotomy - (surgical procedure in which a cut is made between the ribs to see and reach the lungs or other organs in the chest or thorax)

(VATS - video-assisted thoracic surgery)

Which instrument is used to make a small opening into the ascending aorta after the Satinsky partial occlusion clamp is placed?

Select one:

5 mm trocar

aortic punch

Potts-Smith scissors

#11 blade

Aortic Punch

What is the name of an air-filled sac that has the appearance of a blister on the surface of lung tissue?

Select one:

bleb

alveolar sac

germ cell

bronchiole

Bleb

Which diagnostic study is MOST useful for verification of thoracic aortic dissection?

Select one:

stress test

CT scan

AP chest x-ray

MRI scan

CT Scan

Which statement regarding the anatomical placement of the heart is CORRECT?

Select one:

a. It is positioned in the thoracic cavity with nearly its entirety on the left side.

b. It is positioned in the mediastinum with approximately 2/3 of the heart on the right side.

c. It is positioned in the mediastinum with approximately 2/3 of the heart on the left side.

d. It is positioned exactly midline in the thoracic cavity.

It is positioned in the mediastinum with approximately 2/3 of the heart on the left side.

The drainage and collection device attached to chest tubes relies on a water seal to reestablish negative pressure in the pleural cavity.

Select one:

True

False

True

Which of the following are the final branchings of the respiratory tree?

Select one:

lobes of the lung

bronchi

bronchioles

alveoli

Alveoli

Which structure within the respiratory tract is the proximal and superior?

Select one:

diaphragm

trachea

larynx

bronchus

Larynx

Which of the following is a commonly used method of preserving the heart by reducing its metabolic needs?

Select one:

warming with heat exchanger

hypothermia

lung deflation

left ventricular venting

Hypothermia

Which instrument has the appearance of a misshapen pancake spatula?

Select one:

Lovelace lung grasping forceps

Allison lung retractor

Davidson scapula retractor

Bailey rib contractor

Davidson scapula retractor

Which one of the following is NOT one of the cardiac valves?

Select one:

aortic

tricuspid

mitral

septal

Septal

The coronary arteries originate from the:

Select one:

ascending aorta

pulmonary artery

descending aorta

subclavian artery

Ascending Aorta

What is the first step in the formation of an atheroma?

Select one:

accumulation of cholesterol and lipids

growth of new smooth muscle tissue

injury to endothelial lining

collagen deposition and scar tissue formation

Injury to endothelial lining

What is the term for a localized stricture of the aorta found in a pediatric patient?

Select one:

stenosis

prolapsed

coarctation

arteriosis

Coarctation

Which surgical approach is used for repair of coarctation of the aorta and patent ductus arteriosus?

Select one:

supine

frog-legged

posterolateral

prone

Posterolateral

The apex of the lung is located:

Select one:

medially just above the diaphragm

medially where the bronchus enters

superiorly and just above the clavicle

inferiorly and laterally

Superiorly and just above the clavicle

Which chamber of the heart is responsible for pumping blood into the pulmonary artery?

Select one:

left atrium

right atrium

right ventricle

left ventricle

Right Ventricle

Aortic valve stenosis and aortic regurgitation are often as a result of :

Select one:

heart block

angina

tuberculosis

rheumatic fever

Rheumatic Fever

What is the name of the procedure performed to release constriction of the lungs by fibrin layers?

Select one:

pneumonectomy

lung decortication

upper lobectomy

pectus excavatum

Lung Decortication

Which congenital defect has four components and is characterized by cyanosis causing appearance of "blue babies"?

Select one:

coarctation of the aorta

patent ductus arteriosus

tetralogy of Fallot

ventricular septal defect

Tetralogy of Fallot

Which of the following thoracic procedures would require the patient to be put on cardiopulmonary bypass?

Select one:

upper lobectomy

pneumonectomy

pulmonary thromboendarterectomy

decortication of the lung

Pulmonary Thromboendarterectomy

What is the general term for incurable diseases of the heart for which the only treatment would be heart transplantation?

Select one:

cardioplegia

cardiomyopathies

arrhythmias

atherosclerosis

Cardiomyopathies

Lung reduction surgery is performed for patients with emphysema.

Select one:

True

False

True

Prior to the closure of a lobectomy procedure, the anesthesia provider performs a Valsalva maneuver to check for:

Select one:

bleeding from the dissection bed

functionality of the diaphragm

air leakage from bronchial closure

perfusion of the unaffected lobes

Air leakage from bronchial closure

For which of the following procedures would the rigid bronchoscope be preferred?

Select one:

transbronchial lung biopsy

removal of foreign body in children

visualization of the upper lobe bronchi

bronchial washings

Removal of foreign body in children

Thymomas, neurogenic tumors, and pleuropericardial cysts can be biopsied during which procedure?

Select one:

thoracoscopy

bronchoscopy

laryngoscopy

mediastinoscopy

Mediastinoscopy

Which of the following regarding blood flow is correct?

Select one:

right ventricle, pulmonary artery, lungs, pulmonary vein, left atrium

right ventricle, pulmonary vein, lungs, pulmonary artery, left atrium

right atrium, pulmonary artery, lungs, pulmonary vein, left ventricle

right atrium, pulmonary vein, lungs, pulmonary artery, left ventricle

Right ventricle, pulmonary artery, lungs, pulmonary vein, left atrium

What is the name of the device used for patients who are unable to be weaned off of cardiopulmonary bypass?

Select one:

intra-aortic balloon pump

cardiac pacemaker

vena cava filter

left ventricular vent

intra-aortic balloon pump

Which artery accounts for approximately 50% of occlusive coronary lesions?

Select one:

left anterior descending

circumflex branch

mammary

right coronary

Left anterior descending

Where is a Swan-Ganz catheter placed?

Select one:

pulmonary artery

vena cava

ascending aorta

coronary artery

Pulmonary Artery

In which part of the respiratory system does the exchange of oxygen and carbon dioxide take place?

Select one:

alveoli

pulmonary vein

bronchioles

bronchi

Alveoli

Which type of incision is made for a pneumonectomy?

Select one:

Chevron

posterolateral

epigastric

McBurney

Posterolateral

Which device is used for patients awaiting heart transplant that allows them to be ambulatory and has both internal and external components to the system?

Select one:

ventricular assist device

vena cava filter

cardiac pacemaker

left ventricular vent

Ventricular Assist Device

What is the term for a collapsed lung?

Select one:

atelectasis

decortication

emphysema

pneumonitis

atelectasis

With what is the median sternotomy closed?

Select one:

heavy gauge stainless steel wire

fine gauge polypropylene

heavy gauge chromic gut

fine gauge surgical silk

Heavy gauge stainless steel wire

Which singular congenital defect involves failure of closure of the connection between the pulmonary artery and aorta?

Select one:

ventriculo septal defect

tetralogy of Fallot

patent ductus arteriosus

atrial septal defect

Patent Ductus Arteriosus

How many ribs are considered "true" ribs with direct connection to the sternum with costal cartilage?

Select one:

twelve

three

nine

seven

Seven

What is the name of the area between the visceral and parietal pleura that contains serous fluid to prevent friction?

Select one:

pericardial window

pleural space

mediastinum

hilum

Pleural Space

In which procedure would an incision NOT be required for insertion of the endoscope?

Select one:

mediastinoscopy

pectus excavatum via VATS

video-assisted thoracic surgery

bronchoscopy

Bronchoscopy

Which of the following is a crushing clamp with sharp spikes in the jaw used on the bronchus?

Select one:

Doyen

Mixter

Sarot

Bailey

Sarot

All of the following structures are found within the mediastinum EXCEPT:

Select one:

esophagus

thymus

diaphragm

heart

Esophagus

What is the thickest part of the heart?

Select one:

pericardium

epicardium

myocardium

endocardium

Myocardium

What is a commonly used rib self-retaining retractor available in adult and pediatric sizes?

Select one:

Bookwalter

Finochietto

Balfour

Greenburg

Finochietto

Which suture is frequently used for anastomosis of the saphenous vein or internal mammary artery in CABG?

Select one:

a. 2-0 or 3-0 poliglecaprone

b. 2-0 or 3-0 polyester

c. 6-0 or 7-0 polyglactin

d. 6-0 or 7-0 polypropylene

6-0 or 7-0 polypropylene

Lung tissue has what kind of consistency?

Select one:

slimy

calcified

friable

elastic

Friable

Which structure is considered the "pacemaker" of the heart?

Select one:

Purkinje fibers

bundle of His

SA node

AV node

SA node

Following lung transplantation, the surgeon will perform which procedure to aspirate secretions and check for leaks?

Select one:

laryngoscopy

bronchoscopy

mediastinoscopy

video-assisted thoracoscopy

Bronchoscopy

Video-assisted thoracic surgery procedures use carbon dioxide for distention.

Select one:

True

False

False

Medtronic OCTOPUS® and Guidant Ultima OPCAB® are what type of devices for coronary artery bypass done off-pump?

Select one:

grafts

cannulae

stabilizers

retractors

Stabilizers

Which of the following is the main underlying pathogenic cause of coronary atherosclerosis and clinical manifestations?

Select one:

age

ischemia

diet

hypertension

Ischemia

What is the medical term for coughing up blood?

Select one:

asthma

bronchitis

pneumonitis

hemoptysis

Hemoptysis

The main bronchi, pulmonary arteries, veins, and lymphatic vessels enter the lung on the medial surface through the:

Select one:

hilum

trachea

diaphragm

mediastinum

Hilum

Which portion of the heart is responsible for pumping blood into the ascending aorta?

Select one:

left atrium

left ventricle

right atrium

right ventricle

Left Ventricle

Which nerve could be damaged during lung decortication resulting in paralysis or partial paralysis of the diaphragm?

Select one:

vagus

accessory

phrenic

hypoglossal

Phrenic

Which instrument is a lung-grasping forceps that resembles a very large Pennington?

Select one:

Doyen

Duckbill

Lovelace

Langenbeck

Lovelace

Where are the cannulae MOST commonly placed for cardiopulmonary bypass procedures?

Select one:

a. carotid artery and subclavian vein

b. right ventricle and descending aorta

c. right atrium and ascending aorta

d. femoral artery and brachiocephalic vein

Right atrium and ascending aorta

The force and rate of contraction of the heart is controlled by which part of the central nervous system (CNS)?

Select one:

medulla oblongata

Purkinje system

phrenic nerve

vagus nerve

Medulla Oblongata

All of the following are components of the "heart-lung" machine EXCEPT:

Select one:

defibrillator

heat exchanger

pump

oxygenator

Defibrillator

What is the name of the acute condition in which heart muscle dies from ischemia and may lead to sudden cardiac death?

Select one:

atherosclerosis

heart block

cardiac tamponade

myocardial infarction

Myocardial Infarction

The saphenous vein used for coronary artery grafting must be reversed before anastomosis due to the presence of valves in the vein.

Select one:

True

False

True

What is frequently used to repair atrial and ventricular septal defects in pediatric patients?

Select one:

Dacron patch

fascia lata

fibrin glue

porcine valve

Dacron Patch

A heart murmur is often heard with auscultation and indicative of involvement of which structure?

Select one:

left ventricle

aortic valve

mitral valve

right ventricle

Mitral Valve

Where is the insertion point for the mediastinoscope?

Select one:

subxiphoid

suprasternal notch

oropharynx

umbilicus

Suprasternal Notch

Which diagnostic method provides the MOST extensive details regarding valvular disorders?

Select one:

CT scanning

MRI scanning

cardiac catheterization

electromyography

Cardiac Catheterization

Which membrane covers the surface of the lungs?

Select one:

pericardium

visceral pleura

ciliated mucosa

parietal pleura

Visceral Pleura

Which suturing technique maintains the aortic and venous cannulae?

Select one:

figure of eight

horizontal mattress

purse-string

vertical mattress

Purse-string

How many pulmonary veins are there?

Select one:

one

three

two

four

Four

Which heart valve is also known as the bicuspid valve?

Select one:

tricuspid

aortic

mitral

pulmonary

Mitral

The manubrium, body, and xiphoid process are portions of the:

Select one:

lungs

bronchial tree

sternum

ribs

Sternum

The name of the condition created when pus is not cleared from the pleural cavity and makes a fibrous constrictive layer is:

Select one:

pleurisy

empyema

COPD

pneumonia

Empyema

The ventricles of the heart have thicker myocardium than the atria.

Select one:

True

False

True

Which of the following will be required upon completion of any procedure in which the pleural cavity has been opened?

Select one:

a. compression dressing with Ace or tensor bandages

b. active wound drain such as a Jackson-Pratt

c. passive wound drain such as a Penrose

d. chest tube attached to a Pleur-evac system

Chest tube attached to a Pleur-evac system

Where is the apex of the heart located within the mediastinum?

Select one:

inferiorly on the left side

inferiorly on the right side

superiorly on the right side

superiorly on the left side

Inferiorly on the left side

Which additional pain control measure is taken for patients undergoing pectus excavatum repair by VATS?

Select one:

Bier block

local with epinephrine

epidural

topical Lidocaine jelly

Epidural

Commissurotomy is a surgical separation of the flaps of the:

Select one:

pulmonary valve

left ventricle

right atrium

mitral valve

Mitral Valve