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Exam (elaborations)

TCAR Thoracic Exam Questions and Answers 100% Pass | Latest Update

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TCAR Thoracic Exam Questions and Answers 100% Pass | Latest Update Blood supply upper 2/3 of trachea - inferior thyroid arteries Blood supply lower 2/3 of trachea - bronchial arteries Blood supply lung parenchyma - bronchial arteries Pathway of azygous vein in the thorax - runs along R side an...

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  • October 27, 2024
  • 37
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • TCAR
  • TCAR
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NinjaNerd
©NINJANERD 2024/2025. YEAR PUBLISHED 2024.
TCAR Thoracic Exam Questions and

Answers 100% Pass | Latest Update


Blood supply upper 2/3 of trachea - ✔✔inferior thyroid arteries

Blood supply lower 2/3 of trachea - ✔✔bronchial arteries

Blood supply lung parenchyma - ✔✔bronchial arteries

Pathway of azygous vein in the thorax - ✔✔runs along R side and dumps

into superior vena cava

Pathway of thoracic duct in the chest - ✔✔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 - ✔✔runs anterior to hilum

Pathway of vagus nerve in thorax - ✔✔runs posterior to hilum

What fissures exist in the lungs? - ✔✔Major oblique separates RLL from

middle and upper lobe

Minor separates upper from middle lobe

Muscle used in quiet respiration - ✔✔Diaphragm 80%, intercostals 20%

,©NINJANERD 2024/2025. YEAR PUBLISHED 2024.
Accessory muscles of respiration - ✔✔SCM

Levators

Serratus posterior

Scalenes

Main surface active agent in surfactant - ✔✔phosphatidylcholine

Alveolar, arterial, and venous pressures in lung zones in upright person -

✔✔Zone I: PA > Pa > Pv

Zone II: Pa > PA > Pv

Zone III: Pa > Pv > PA

Normal pulmonary artery pressure - ✔✔25/10 (mean 15)

What predicted value is needed for pulmonary resection? - ✔✔Predicted

postop FEV1 > 0.8L (>40% predicted)

What can be done if the predicted postop FEV1 is close to 0.8 (40%

predicted)? - ✔✔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 - ✔✔FEV1

Minimum DLCO for lung resection - ✔✔>11-12 ml/min/mmHg CO (>50%

predicted value)

,©NINJANERD 2024/2025. YEAR PUBLISHED 2024.
What six things effect DLCO? - ✔✔Pulmonary capillary surface area

Hgb

Alveolar architecture

Dead space

Low CO

Pulmonary HTN

What pCO2 is necessary for lung resection? - ✔✔<45 at rest

What pO2 is necessary for lung resection? - ✔✔>60 at rest, not on O2

What VO2max is needed for lung resection? - ✔✔>10 ml/kg/min (maximum

o2 consumption)

Overall PFTs required for pulmonary resection - ✔✔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 - ✔✔V/Q mismatch from

atelectasis (shunt)

, ©NINJANERD 2024/2025. YEAR PUBLISHED 2024.
MCC of hypercarbia after pulmonary resection - ✔✔alveolar hypoventilation

(poor minute ventilation RR x TV)

MC nerve injury after pulmonary resection - ✔✔brachial plexus injuries

How can common peroneal nerve injuries be avoided durin pulmonary

resection? - ✔✔flex dependent leg

Most common resection resulting in persistent air leak -

✔✔segmentectomy/wedge

MC resection resulting in atelectasis - ✔✔lobectomy

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

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

MC resection resulting in postop bronchopleural fistula -

✔✔pneumonectomy (R MC)

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

What is post-pneumonectomy syndrome? - ✔✔MC after R

pneumonectomy

mediastinal shift causing main bronchial compression

How is post-pneumonectomy syndrome treated? - ✔✔Silicone issue

expanders on pneumonectomy side to shift mediastinum back

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