Thoracic – TCAR Questions with Complete Solutions (Latest 2025) Blood supply upper 2/3 of trachea - Correct Answers ✅inferior thyroid arteries Blood supply lower 2/3 of trachea - Correct Answers ✅bronchial arteries Blood supply lung parenchyma - Correct Answers ✅bronchial arteries Pathway of azygous vein in the thorax - Correct Answers ✅runs along R side and dumps into superior vena cava Pathway of thoracic duct in the chest - Correct Answers ✅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 - Correct Answers ✅runs anterior to hilum Pathway of vagus nerve in thorax - Correct Answers ✅runs posterior to hilum What fissures exist in the lungs? - Correct Answers ✅Major oblique separates RLL from middle and upper lobe Minor separates upper from middle lobe 1 / 4
Thoracic – TCAR Questions with Complete Solutions (Latest 2025) Muscle used in quiet respiration - Correct Answers ✅Diaphragm 80%, intercostals 20% Accessory muscles of respiration - Correct Answers ✅SCM Levators Serratus posterior Scalenes Main surface active agent in surfactant - Correct Answers ✅phosphatidylcholine Alveolar, arterial, and venous pressures in lung zones in
upright person - Correct Answers ✅Zone I: PA > Pa > Pv
Zone II: Pa > PA > Pv
Zone III: Pa > Pv > PA
Normal pulmonary artery pressure - Correct Answers ✅25/10 (mean 15) What predicted value is needed for pulmonary resection? - Correct Answers ✅Predicted postop FEV1 > 0.8L (>40% predicted) 2 / 4
Thoracic – TCAR Questions with Complete Solutions (Latest 2025) What can be done if the predicted postop FEV1 is close to 0.8 (40% predicted)? - Correct Answers ✅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 - Correct Answers ✅FEV1 Minimum DLCO for lung resection - Correct Answers ✅>11-12 ml/min/mmHg CO (>50% predicted value) What six things effect DLCO? - Correct Answers ✅Pulmonary capillary surface area Hgb Alveolar architecture Dead space Low CO Pulmonary HTN What pCO2 is necessary for lung resection? - Correct Answers ✅<45 at rest What pO2 is necessary for lung resection? - Correct Answers ✅>60 at rest, not on O2 3 / 4
Thoracic – TCAR Questions with Complete Solutions (Latest 2025) What VO2max is needed for lung resection? - Correct Answers ✅>10 ml/kg/min (maximum o2 consumption) Overall PFTs required for pulmonary resection - Correct Answers ✅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 - Correct Answers ✅V/Q mismatch from atelectasis (shunt) MCC of hypercarbia after pulmonary resection - Correct Answers ✅alveolar hypoventilation (poor minute ventilation RR x TV) MC nerve injury after pulmonary resection - Correct Answers ✅brachial plexus injuries How can common peroneal nerve injuries be avoided durin pulmonary resection? - Correct Answers ✅flex dependent leg
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