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Thoracic – TCAR Prep Exam Questions And Correct Complete Answers.
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Blood supply upper 2/3 of trachea - Answer inferior thyroid arteries 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 v...

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  • August 21, 2024
  • 29
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

Subjects

  • blood supply

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  • TCAR
  • TCAR

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Thoracic – TCAR Prep Exam Questions
And Correct Complete Answers.
Blood supply upper 2/3 of trachea - Answer inferior thyroid arteries



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



MC resection resulting in atelectasis - Answer lobectomy



MC resection resulting in arrhythmias - Answer pneumonectomy (R MC)



MC resection resulting in postop TEF - Answer pneumonectomy (R MC)



MC resection resulting in postop bronchopleural fistula - Answer pneumonectomy (R MC)



MC resection resulting in mortality - Answer pneumonectomy (R MC)

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