-
Course of azygous vein; what it drains into
Right thorax along esophagus; drains into SVC
-
Course of thoracic duct
Right side, crosses at T5-7, dumps into LSC at junction of LIJ
-
Longest mainstem bronchus
Left
-
Longer main pulmonary artery trunk
Right
-
Nerve running anterior to lung hilum
Phrenic
-
Nerve running posterior to lung hilum
Vagus
-
Normal lung volume of right lung
55%
-
Normal lung volume of left lung
45%
-
Accessory respiratory muscles
SCM, scalenes, levators
-
Pnuemocytes important in gas exchange
Type I pneumocytes
-
Pneumocytes important in surfactant production
Type II pneumocytes
-
Openings allowing direct exchange of air between alveoli
Pores of Kahn
-
Amount of pleural fluid produced per day
1-2L
-
Needed predicted postop FEV1 to justify lung resection
>0.8
-
Diagnostic test if FEV1 is lower than expected
VQ scan
-
Needed DLCO to justify lung resection
>11-12
-
Needed predicted postop FVC
>1.5L
-
Needed preop PCO2 and PO2
<45 and >50
-
Most common cause of cancer-related death in us
Lung cancer
-
Most common site of lung metastasis
Brain
-
Overall lung ca 5-year survival rate
10%
-
Most common type of lung cancer
Adenocarcinoma
-
Primary types of non small cell cancer (2)
Squamous, adenocarcinoma
-
Cancer type found more often centrally
Squamous
-
Cancer type found more often peripherally
Adenocarcinoma
-
NSCLC with more common local recurrence
Squamous cell
-
NSCLC with more common distant metastasis
Adenocarcinoma
-
T staging for lung cancer
T1<3cm, T2>3cm, T3 invasion of chest wall, pericardium, diaphragm or <2cm from carina, T4 invasion of mediastinum, esophagus, trachea, vertebra, heart, malignant effusion
-
N staging for lung cancer
N1 ipsi hilar nodes, N2 ipsi mediastinal nodes, N3 contralateral nodes or supraclav nodes
-
Type of cancer causing 20% of lung ca; typically neuroendocrine
Small cell
-
Treatment of SCLC
Chemotherapy and XRT
-
Paraneoplastic syndrome associated with squamous cell CA
PTH-related peptide
-
Paraneoplastic syndrome associated with SCLC
ACTH, ADH release
-
Most common paraneoplastic syndrome in SCLC
ACTH production
-
Lung tumor associated with asbestos
Mesothelioma
-
Standard chemotherapy in NSCLC
Carboplatin, taxol
-
Standard chemotherapy in SCLC
Cisplatin, etoposide
-
Tumors in which mediastinoscopy is used
Central, LN>0.8cm, subcarinal LN>1.0cm
-
Left sided structures when looking down a mediastinoscope
RLN, esophagus, aorta, main PA
-
Right sided structures when looking down a mediastinoscope
Azygous, SVC
-
Anterior structures when looking down a mediastinoscope
Innominate vein and artery, right PA
-
Surgical technique to assess aortopulmonary window nodes
Chamberlain procedure
-
Tumor invading the apex of the chest wall; often causes horner�s syndrome
Pancoast tumor
-
Cancer type that mimics pneumonia; grows along alveolar walls
Bronchialveolar carcinoma
-
Neuroendocrine tumor with 90% 5-year survival
Carcinoid
-
Malignant bronchial tumors (3)
Adenoid cystic adenoma, mucoepidermoid adenoma, mucous gland adenoma
-
Most common benign adult lung tumor
Hamartoma
-
Popcorn lesion on CT of chest
Hamartoma
-
Most common site for mediastinal tumors
Thymus
-
Tumors found in anterior mediastinum (4)
Thymoma, Tcell lymphoma, Teratoma, parathyroid adenoma
-
Tumors found in middle mediastinum (4)
Bronchiogenic cyst, pericardial cyst, enteric cyst, lymphoma
-
Structures found in middle mediastinum (3)
Heart, trachea, ascending aorta
-
Structures found in posterior mediastinum (2)
Esophagus, descending aorta
-
% of thymomas that are malignant
50
-
% of thymoma patients with myasthenia gravis
50
-
% of patients with myasthenia gravis with thymoma
10
-
% of patients with myasthenia gravis who get improvement with thymectomy
80
-
Most common form of lymphoma
Tcell
-
Most common form of Hodgkins lymphoma
Nodular sclerosing
-
Most common germ cell tumor in mediastinum
Seminoma
-
Cyst posterior to carina
Bronchiogenic cyst
-
Treatment of bronchigenic cyst
Resection
-
Cyst found at right costophrenic angle
Pericardial cyst
-
Most common neurogenic tumor
Neurolemoma
-
Neurogenic tumors that produce catecholamines
Paraganglioma
-
% of symptomatic mediastinal masses that are malignant
50
-
% of asymptomatic mediastinal masses that are benign
90
-
Most common benign tracheal tumors in adults
Papilloma
-
Most common benign tracheal tumor in children
Hemangioma
-
Most common malignant tracheal tumor
Squamous cell
-
Most common late complication after tracheal surgery
Granulation tissue
-
Treatment of laryngeal edema
Intubation, racemic epi, steroids
-
Potential treatments of postintubation stenosis (2)
Resection, laser ablation
-
Risk of tracheostomy, esp when below 3rd cricoid ring
Tracheoinnominate fistula
-
Most common area of lung abscess
Posterior segment of RUL, superior segment of RLL
-
Common cause of empyema
Pneumonia
-
First phase of empyema, lasts 0-24h
Exudative phase
-
Second phase of empyema, lasts 24-72 hours
Fibroproliferative phase
-
Third phase of empyema, >72h
Organized phase
-
Treatment of organized phase empyema
Decortication or Eloesser
-
Treatment of exudative and fibroproliferative phase of empyema
Chest tube, antibiotics
-
Lab tests that diagnose chylothorax
Lymphocytes and TAGs
-
Location where thoracic duct crosses from right to left
T5-7
-
Conservative therapy for chylothorax
Chest tube, octreotide, TPN (or low-fat diet)
-
Optimal location to ligate thoracic duct
Low in mediastinum
-
Most common source of massive hemoptysis
Bronchial arteries
-
Treatment of massive hemoptysis
Mainstem intubation of unaffected side, OR for lobectomy or pneumonectomy, bronchial artery embolization
-
Recurrence risk of spontaneous PTX after first occurance
20%
-
Recurrence risk of spontaneous PTX after second occurance
60%
-
Recurrence risk of spontaneous PTX after third occurance
80%
-
Most common side of spontaneous PTX
Right
-
Treatment of multiple spontaneous PTX
Thoracoscopy, blebectomy, mechanical pleurodesis
-
Most common mediastinal cyst
Bronchiogenic cyst
-
Abnormal lung tissue not connected into bronchial system
Bronchiogenic cysts
-
Lung tissue not connected to bronchial vasculature
Sequestration
-
Treatment of pulmonary sequestration
Lobectomy
-
Solitary pulmonary nodule with h/o sarcoma or melanoma: new primary or met??
More likely to be met
-
Solitary pulmonary nodule with h/o breast or H&N cancer: new primary or met??
More likely to be new primary
-
Most likely cause of arrest after blunt trauma
Tension pneumothorax
-
Endometrial implants on visceral lung pleura that causes PTX in relation to menstruation
Catamenial PTX
-
Treatment of residual hemothorax despite 2 well-placed chest tubes
Thoracoscopic drainage
-
Whiteout on CXR with mediastinal shift toward whiteout: dx and tx
Atelectasis: do bronch
-
Whiteout on CXR with mediastinal shift away from whiteout: dx and tx
Effusion: chest tube
-
Causes of bronchiectasis (3)
Infection, tumor, cystic fibrosis
-
Parenchymal lung lesion + enlarged hilar nodes in TB
Gohn complex
-
Noncaseating granulomas common in:
Sarcoidosis
-
Caseating granulomas common in:
TB
-
Protein level in exudate
>3
-
LDH pleural fluid:serum in exudate
>0.6
-
-
Treatment of recurrent pleural effusion
Mechanical pleurodesis
-
Treatment of malignant pleural effusions
Talc pleurodesis
-
Connections between pulmonary arteries and veins; common in Osler Weber Rendu
AVMs
-
Tx of lung AVMs
Embolization
-
Most common benign chest wall tumor
Osteochondroma
-
Most common malignant chest wall tumor
Chondrosarcoma
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