Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

VM733: SURGERY > Abdominal Surgery > Flashcards

Abdominal Surgery Flashcards

1
Q

Layers: Ventral Midline Approach

A

Skin
SQ
Linea Alba (Holding Layer)
Peritoneum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Layers: Paramedian Approach

A

Skin
WQ
External Rectus Sheath (Holding Layer)
Rectus Abdominus Muscle
Internal Rectus Sheath
Peritoneum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Layers: Flank Approach

A

Skin
SQ
External Abdominal Oblique Fascia (Holding Layer)
External Abdominal Oblique Muscle
Internal Abdominal Oblique Muscle
Transverse Abdominus Muscle
Peritoneum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Holding Layer: Ventral Midline

A

Linea Alba

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Holding Layer: Paramedian

A

External Rectus Sheath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Holding Layer: Flank

A

External Abdominal Oblique Fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Compare the time it takes for the following tissue types to heal: skin, bladder, colon, stomach

A

Fastest: bladder
Stomach
Colon
Slowest: skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Pros/Cons: Simple Interrupted Pattern for Body Wall Closure

A

More time, suture material
Good knot security

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Pros/Cons: Simple Continuous Pattern for Body Wall Closure

A

Faster, stronger
Suture line breakage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Appositional Suture Patterns

A

Simple Interrupted
Simple Continuous
Cruciate
Near-Far-Far-Near

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Everting Suture Patterns

A

Vertical Mattress
Horizontal Mattress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q
A

Near-Far-Far-Near

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q
A

Near-Far-Far-Near

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q
A

Vertical Mattress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q
A

Vertical Mattress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q
A

Horizontal Mattress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q
A

Horizontal Mattress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Compare the suture sizes recommended for holding layers vs subcutaneous layers vs skin

A

Largest suture in holding layer
Small suture in SQ to close dead space
Big enough in skin to hold, small enough to be cosmetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Define: Non-Strangulating Bowel Obstruction

A

Vascular supply is intact
Lumen of bowel is obstructed (within lumen, mass in lumen wall, extra-intestinal compression)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Define: Strangulating Bowel Obstruction

A

Vascular supply is involved (venous or venous + arterial)
Leads to more pain, increased HR, more systemic sickness than non-strangulating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the anatomical layers of the intestinal tract?

A

Serosa
Muscular
Submucosa (Holding Layer)
Mucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the holding layer of the intestinal tract?

A

Submucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are characteristics of the submucosa of the intestinal tract?

A

Strength from collagenous fibers
Integrity from vascular plexi
Holding layer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the functions of the mucosal layer of the intestinal tract?

A

Absorptive and secretory functions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are clinical intra-operative criteria for determining intestinal viability?

A

Bowel color
Presence/absence of peristalsis
Bleeding from the cut edge of the bowel
Presence/absence of mesenteric artery pulsation

26
Q

How can surface oximetry determine intestinal viability?

A

Pso2 > 50% of normal baseline
Can only assess small areas of bowel at a time

27
Q

How can doppler ultrasonography determine intestinal viability?

A

Measure arterial blood flow at the antimesenteric surface - if the arterial signals are present, the bowel is probably viable
Best for straight venous obstruction

28
Q

How can sodium fluorescein stain determine intestinal viability?

A

Injected IV, fluoresce under wood’s lamp
Viable if: hyperemic, normal, or fine granular pattern present
Nonviable if: patchy, perivascular, or non-fluorescent pattern present
Probably the best method in humans and other animals - questionable in horses

29
Q

What are the stages of bowel/bladder/uterus healing?

A
  1. Sealed by blood clot
  2. Granulation tissue begins @ 24-48h (dependent on proximity of tissue edges and amount of inflammation)
  3. Blood vessels emerge @ 72h (hypervascularization by 7 days, normal by 14d)
  4. Blood clot replaced by fibrous tissue by 14d
30
Q

In relation to bowel anastamosis strength, how long do we need suture to hold in the intestinal tract? Why?

A

Need suture to hold strong for at least 7 days!

31
Q

What factors associated with surgical technique influence intestinal healing? (7)

A

Tissue handling
Hemostasis
Preservation of vascular supply
Minimizing fecal contamination
Decreasing fecal load to anastamosis
Avoiding anastamotic tension
Minimizing peritonitis

32
Q

What factors associated with the host influence intestinal healing? (6)

A

Hypoproteinemia
Endotoxemia
Septicemia
Coagulopathies
Age ileus
Catabolic nutritional state

33
Q

When comparing everting, appositional, and inverting suture patterns, how likely are each to form adhesions?

A

Everting > Appositional > Inverting
Higher incidence with interrupted

34
Q

What causes intestinal adhesion formation?

A

Leakage
Fecal contamination
Exposed suture material
Inflamed peritoneal surfaces

35
Q

Adhesions form within first ___ days.

A

7

36
Q

What is the best suture material for intestines?

A

Monofilament
Absorbable (understand absorption profile)
Generally only recommend stainless steel or titanium staples for non-absorbable

37
Q

Compare the absorption times of the following suture materials: maxon, polysorb, dexon, biosyn, caprosyn

A
38
Q

Compare the absorption times of the following suture materials: vicryl, vicryl rapide, monocryl, PDS

A
39
Q

Compare the suture strengths

A
40
Q

Compare the dissolution of chromic gut, dexon, and vicryl in vivo

A
41
Q

What are (5) examples of inverting suture patterns for anastamotic alignment?

A

Cushing
Connell
Lembert
Modified Gambee
Stapling Devices

42
Q

What are (2) examples of appositional suture patterns for anastamotic alignment?

A

Simple Interrupted
Simple Continuous

43
Q
A

Inverting - Cushing
Does not penetrate the lumen

44
Q
A

Inverting - Cushing
Does not penetrate the lumen

45
Q
A

Inverting - Connell
Penetrates the lumen

46
Q
A

Inverting - Connell
Penetrates the lumen

47
Q
A

Inverting - Lembert
Inverts too much

48
Q
A

Inverting - Lembert
Inverts too much

49
Q
A

Inverting/Appositional - Modified Gambee
Pigs only

50
Q
A

Inverting - End to End
Staples

51
Q
A

Inverting - Gastrointestinal Anastamosis
Staples

52
Q

End to End Anastamosis

A

Benefit: normal orientation

53
Q

Transverse Enterotomy Closure

A
54
Q

Stapled Side to Side Anastamosis

A
55
Q

Functional End to End Stapled Anastamosis

A
56
Q

End to Side Anastamosis

A
57
Q

What is the best suture material for bladder/uterus surgery?

A

Monofilament
Absorbable - nonabsorbable contraindicated due to quick healing and development of bladder stones
Biosyn, caprosyn, monocryl

58
Q

Characteristics of uterus healing

A

Rapid involution
Fast healing time

59
Q

Label each suture type

A
60
Q

What is the best suture pattern type for bladder/uterus closure?

A

Single layer appositional

61
Q

What are examples of absorbable suture materials along with their relative tensile strengths?

A

VM733: SURGERY (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions