31 Thoracic and Pulmonary Surgery
CHAPTER LESSON PLANS & OBJECTIVES
Lesson 31.1: Anatomy, Case Planning, and Procedures
- 1. Identify key anatomical features of the respiratory structures in the thoracic cavity
- 2. Describe diagnostic procedures of the respiratory system
- 3. Discuss pathology of the respiratory system
- 4. Discuss specific elements of case planning in surgery of the thoracic cavity and respiratory system
- 5. List and describe common thoracic procedures of the respiratory system
Classroom Preparation
Lesson 31.1: Anatomy, Case Planning, and Procedures
INSTRUCTOR PREPARATION
Textbook Objectives Covered
- 1. Identify key anatomical features of the respiratory structures in the thoracic cavity
- 2. Describe diagnostic procedures of the respiratory system
- 3. Discuss pathology of the respiratory system
- 4. Discuss specific elements of case planning in surgery of the thoracic cavity and respiratory system
- 5. List and describe common thoracic procedures of the respiratory system
National Standards Covered
- • See the Fuller 8e/AST Core Curriculum Mapping Guide on Evolve instructor resources.
Classroom Preparation
Lesson 31.1: Anatomy, Case Planning, and Procedures
STUDENT PREPARATION (1 hr)
| 1 | READ – Chapter Heading(s) • Introduction • Surgical Anatomy Upper Respiratory Tract Pharynx Larynx Trachea Bronchi Lungs Mechanism of Breathing ANSWER – Textbook • Review Question 1 ANSWER – Workbook • Chapter 31 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 2 | READ – Chapter Heading(s) • Diagnostic Tests Pulmonary Function Laboratory Tests Imaging Studies ANSWER – Workbook • Chapter 31 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 3 | READ – Chapter Heading(s) • Surgical Procedures Insertion of Chest Tubes Flexible Bronchoscopy Navigational Bronchoscopy Rigid Bronchoscopy Mediastinoscopy Video-Assisted Thoracoscopic Surgery (VATS) VATS Lung Biopsy Acute Pulmonary Thromboembolectomy Lung Volume Reduction surgery (LVRS): Open Technique Thoracotomy Lobectomy: VATS Open Pneumonectomy Decortication of the Lung Lung Transplantation ANSWER – Textbook • Review Questions 5, 6 ANSWER – Workbook • Chapter 31 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 4 | READ – Chapter Heading(s) • Case Planning Instruments Drugs and Solutions Prepping and Draping Closed Chest Drainage ANSWER – Textbook • Review Questions 2, 7 ANSWER – Workbook • Chapter 31 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
| 5 | READ – Chapter Heading(s) • Surgical Procedures Insertion of Chest Tubes Flexible Bronchoscopy Navigational Bronchoscopy Rigid Bronchoscopy Mediastinoscopy Video-Assisted Thoracoscopic Surgery (VATS) VATS Lung Biopsy Acute Pulmonary Thromboembolectomy Lung Volume Reduction surgery (LVRS): Open Technique Thoracotomy Lobectomy: VATS Open Pneumonectomy Decortication of the Lung Lung Transplantation ANSWER – Textbook • Review Questions 3, 4 ANSWER – Workbook • Chapter 31 PREPARE – Evolve Student Resources • Mock Certification Exam • Review Questions |
50-Minute Lesson Plan
Lesson 31.1: Anatomy, Case Planning, and Procedures
LECTURE OUTLINE (50 min)
| POWERPOINT SLIDES | CHAPTER HEADING(S) | |
| 1 | ANATOMY: SLIDES 4-6 | • Introduction • Surgical Anatomy Upper Respiratory Tract Pharynx Larynx Trachea Bronchi Lungs Mechanism of Breathing |
| 2 | DIAGNOSTICS: SLIDE 7 | • Diagnostic Tests Pulmonary Function Laboratory Tests Imaging Studies |
| 3 | PATHOLOGY: SLIDES 10-11 | • Surgical Procedures Insertion of Chest Tubes Flexible Bronchoscopy Navigational Bronchoscopy Rigid Bronchoscopy Mediastinoscopy Video-Assisted Thoracoscopic Surgery (VATS) VATS Lung Biopsy Acute Pulmonary Thromboembolectomy Lung Volume Reduction surgery (LVRS): Open Technique Thoracotomy Lobectomy: VATS Open Pneumonectomy Decortication of the Lung Lung Transplantation |
| 4 | CASE PLANNING: SLIDES 8-9 | • Case Planning Instruments Drugs and Solutions Prepping and Draping Closed Chest Drainage |
| 5 | PROCEDURES: SLIDES 10-11 | • Surgical Procedures Insertion of Chest Tubes Flexible Bronchoscopy Navigational Bronchoscopy Rigid Bronchoscopy Mediastinoscopy Video-Assisted Thoracoscopic Surgery (VATS) VATS Lung Biopsy Acute Pulmonary Thromboembolectomy Lung Volume Reduction surgery (LVRS): Open Technique Thoracotomy Lobectomy: VATS Open Pneumonectomy Decortication of the Lung Lung Transplantation |
Learning Activities (choose one or more to equal 50 min)
| 1 | DISCUSS (30 min) • As a class, discuss the importance of negative pressure in the thoracic cavity. Discuss the causes and complications of losing the negative pressure and other factors that affect breathing. Appropriate Settings: Traditional/online/flipped classroom |
| 2 | DISCUSS (30 min) • Discuss with the class common diagnostic procedures of the respiratory system. • Break the class into small groups. Assign each group a thoracic or pulmonary condition, such as emphysema, hemothorax, or sarcoidosis. Using the Internet or other classroom resources, each group should briefly research their disease, emphasizing diagnostic tests used to identify the disease and any related thoracic treatments. Ask each group to present its findings to the class. Appropriate Settings: Traditional/online/flipped classroom |
| 3 | DISCUSS (30 min) • Discuss pathologies involved in thoracic and pulmonary surgery. Appropriate Settings: Traditional/online/flipped classroom |
| 4 | DEMONSTRATE (50 min) • Demonstrate the specific elements of case planning for thoracic surgery. Include room setup and instruments. Appropriate Settings: Traditional classroom DISCUSS (30 min) • Position a student volunteer or a mannequin in the lateral and semilateral positions. Students should also identify the locations of incisions, trocar ports, and prep areas. Ask students to identify problem-prone areas for these positions. Appropriate Settings: Traditional/online/flipped classroom |
| 5 | PRACTICE (50 min) • Break the class into small groups. Have a chest drainage system available for each group to practice with. If possible, have different brands and ask the groups to rotate between stations. Be sure to have chest tube clamps available and emphasize their purpose. Appropriate Settings: Traditional classroom DISCUSS (30 min) • Break the class into small groups. Provide each group with a blank transparency and a marker. Each group should draw a rectangle suggestive of a Mayo tray. The groups should depict a setup for a thoracotomy by drawing or writing instrument names on the “tray.” Have a spokesperson from each group share the group’s work and the rationale for the selections. Appropriate Settings: Traditional classroom |
Critical Thinking Question
Defibrillators are among the items included on the crash carts present in operating rooms (ORs). Why is it important to have a defibrillator present in the OR during thoracic procedures?
Discussion Guidelines: In thoracic surgery, the likelihood of cardiac arrhythmia is heightened. One reason is the proximity of the procedures to the great vessels. Manipulation of the great vessels can trigger arrhythmias. Also, these patients may have other medical conditions that predispose them to cardiac complications.
Why is video-assisted thoracoscopy preferred over the traditional approach to the thorax?
Discussion Guidelines: There is decreased tissue trauma, less postoperative pain, and a shorter recovery time associated with video-assisted thoracoscopy. At times, a patient’s anatomy or pathology may preclude use of the approach.
Assessments
Chapter 31: Thoracic and Pulmonary Surgery
ASSESSMENTS BY OBJECTIVE
| 1-5 | Workbook • Chapter 31 Evolve Instructor Resources • Test Bank Create a quiz using ExamView; sort by objective. Evolve Student Resources • Mock Certification Exam • Review Questions |
| All | Elsevier Adaptive Quizzing • Chapter 31 – Graded quizzes (Mastery Levels 1, 2, and 3) |
