Patho
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| the heart is located | in the L chest
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| which in worst, cut nerves or compressed nerve | compressed nerve remains mid-line and can't open or close
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| what is the major conducting artery in the system | aorta
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| what is the most important nerve that runs around the aorta and comes back up | recurrent larengeal nerve
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| mechanisms for aneurysm formation | HTN, Aterosclerosis, Deceleration injury, syphilis (#1 cause of ascending aneurysm
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| S/s of ascending thoracic aorta | Trachea:inspir. stridor, esophagus:dysphagia, laryngeal nerve:hoarseness, carotids:occl.,coronary:occl., cardiac tamponade, acute aortic regurg
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| txment of ascending | pulse wave, amplitude, freq. or surg. intervention
decrease HR BETA BLOCKERS dimish pulsewave, amplit., freq.
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| preop & post op management of ascending thoracic aorta | L radial aline, EEG, carotid doppler
post: HTN, tachycardia, CNS dys,
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| aneurysm of the ascending thoracic aorta | type I and II, usually middle aged
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| aneurysms of the descending thoracic aorta is what type | III , usually asymptomatic, deceleration injury, myocardial contusion,
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| txment of type III dissection | conservation medical managment, surgical intervention
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| a dissection is a | tear in the intimal wall;longer to live
if tear media will die quicker
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| type I | arise from the ascending aorta
70% of all cases(syhphilis)
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| type II | arise from the ascending aorta, collagen weakness (Marfans syndrome)
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| type III | begin distal to the L SC artery
20% pts(decel)
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| pt with clavicle and rib fx check for | aortic dissection
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| repairing the anterior ascending aorta | sternum
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| repairing the descending aorta | left side of the chest
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| aortic arch supply bld to | all the bld to the upper chest, head, and upper extrem.
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| do you put a pt to sleep with a tamponade | no; percardialcentesis
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| how do you dx aneurysms | CT, MRI
echo doesn't pick up arch of arota
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| what is the innominate artery and what does it branch off of and convert into | innominate/brachicephalic artery branches off R SC artery and R common carotid artery
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| where does the L recurrent laryngeal nerve originate from | vagus nerve
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| where does the descending aorta supply bld to | branching arteries that come back at every thoracic verebrel level, 2 holes at each level
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| what are the 3 different types of aneurysms and what type is common in the aorta | saccular, fusiform(usually found aorta), ruptured:hole thru all 3 layers of the artery, serious, mortality is high 90%
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| mortality rate difference b/n suprarenal AAA and infrarenal AAA | suprarenal has the greater mortality rate and kidneys aren't perfused
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| what are the hemodynamic effects of dissection one of the layers | increase SVR, decreased bld vol
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| which aneury. will there be diff. swallowing | descending
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| where do you place a A/line in a descend. and ascend. | descend.=R
ascend=L
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| what's most important during intraop | control BP <120
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