Basics of Surgery - Written Flashcards by Guy Ben Arie

Wiener knot is fast to make and is suitable in cases of

less tension.

T/F

TRUE

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Write the missing words on the dotted line!

For skin closure …….…….- clips are used with the it’s clip applicator and remover. ……………………………. is a circumscribed injury which is due to an external force and can involve any tissue or organ. It can be mild, severe, or even lethal.

Michel-clips

A Wound

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How do we distinguish between different types of sutures depending on their characteristics:

_______________ and ______________.

How do we distinguish between different types of sutures depending on their characteristics:

Monofilament and multifilament)

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What is the name of the type of wound healing in latin`

Sanatio per primam intentionem

Sanatio per secundam intentionem

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True or false

Taper cutting needle is used to suture the sclerotic calcified tissues

True or false

Taper cutting needle is used to suture the sclerotic calcified tissues

True

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3 thrombosis prophylaxis mechanisms

Heparin derivatives
Aspirin
Coumarin

Can also mention compression socks, elevated the legs, etc.

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LASER (Light Amplification by Stimulated Emission of Radiation) is used for vaporization and palliative treatment of the non resectable gastrointestinal

tumours.

T/F

TRUE

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The optics are a lens system built into a rigid case, ranging in length from 15 to 50 cm and 2 to 12 mm i n diameter.

T/F

FALSE

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True or false

In the past, we used natural suture materials such as human hair

True or false

In the past, we used natural suture materials such as human hair

True

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What word is used to describe this?

Long-handled, ring-ended instrument, which is bended 90° at its distal part. It may or may not have the interlocking teeth. We use them to dissect and prepare the tissues atraumatically (straight from e-book but supposedly there is a past-paper fill in the blank question about it)

Dissector

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10 Straight Blunt-Sharp Scissors

11 Laparoscopic camera head

11/A Laparoscopic telescope/optic

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For laparoscopic irrigation warm water is used.

T/F

TRUE

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One side of the ______ is smooth while the other is spherical. The semicircle of it is a little sharp.

It is useful in the blunt separation of _______ and ________ from the surface of the bone.

One side of the raspatory is smooth while the other is spherical. The semicircle of it is a little sharp.

It is useful in the blunt separation of periosteum and connective tissue from the surface of the bone.

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What is the absorption type of natural suture materials?

Enzymatic absorption

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What is this machine?

(sorry for the shitty image but it’s the one from e-book and lecture)

Suction set and suction tips

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Swab together with the Pean hemostatic forceps is called the handled swab.

T/F

FALSE

Swab+Sponge forceps

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What is the name of the shot wound in latin?

vulnus sclopetarium

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What can be used to remove blood and fluid during surgery?

suction apparatus

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List 6 devices present in the operating room!

Operating table

Vital signs monitor

operating lamp

Suction device

X-ray device

Sonnenburg table

Air condition

Trash can

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What do you call the instrument closer to the letter A?

And to letter B?

What is the word used to describe their handle?

What other thing might be included in the test with these? (sorry there is no picture, just going off word of mouth)

A: Flamingo laparoscopic needle holder

B: Parrot laparoscopic needle holder

They have a linear “coaxial” handle

There is supposedly also a laparoscopic clamp in the picture, but can’t find any clear pictures of these from the department

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What is injured in a simple wound?

(This is a MCQ question, so just look at the answer)

Skin, Mucus membrane, Subcutanaeous tissue, superficial follicle, muscle (partially)

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Scalpels are used for :

a. dissecting the connective tissue
b. To grip skin and subcutaneous tissues
c. Making an incision on the skin
d. Preparation of a scarred tissue

c. Making an incision on the skin

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Basic types of surgical needles today:

a. Atraumatic needles
b. French eyed needles
c. Close eyed needles
d. Traumatic needles

a. Atraumatic needles
b. French eyed needles
c. Close eyed needles

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Choose the WRONG answer:

What are the general rules of sepsis:

A. Only sterile instruments can be used to perform surgical procedures

B. A scrubbed-in person can handle only sterile instruments and eqipment

C. The sterile instrument preserves its sterility if only the sterile person touch it

D. Isolation of the operating field is a desinfection procedure

E. The operation field is never considered absolutely sterile but applying aseptic operation techniques …… (rest is missing)

Choose the WRONG answer:

What are the general rules of sepsis:

D. Isolation of the operating field is a desinfection procedure

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List 3 instruments used for hemostasis:

List 3 instruments used for hemostasis: Péan clamp, Mosquito clamp, Abdominal clamp, diathermy knife, CUSA, LASER

True or False (although I think this question is actually an MCQ, the student could only remember this part of it) Compared to open surgery, in laparoscopy there are more fluctuations in patient's blood pressure

FALSE

# Choose the WRONG answer: The groups of suture materials should be A. Natural and synthetic B. Monofilament and multifilament C. Rigid and flexible D. Absorbable and non-absorbable E. Monofilament and twisted/braided

# Choose the WRONG answer: The groups of suture materials should be C. Rigid and flexible

True or False: The first attendant ties the gown

FALSE should be the scrub nurse

What is this called?

Purse String Suture

Types of Superficial wound infection (write the type AND an example):

Types of Superficial wound infection (write the type AND an example): 1. A diffuse, erysipelas 2. Localized ,abscess

Name of instrument in picture: \_\_\_\_\_\_\_\_\_\_\_\_\_ What is part A? What part is B? What part is C?

Name of instrument in picture: Telescope A: Ocular (camera connection) B: Light cable connection C: Objective Lens

What is the order you prepare for surgery

What is the order you prepare for surgery Masking, Scrubbing, Disinfecting, Gowning, Gloving, Isolation

What is the late complication of the wound healing? A. Hypographic scar B. Erythema C. Keloid D. Seroma

What is the late complication of the wound healing? C. Keloid

What is this? What can we put on A? What is B? What is the outer part? What is the inner part?

What is this? Veres Needle What can we put on A? Insufflator What is B? Valves What is the outer part? Needle part What is the inner part? Insufflator tube (blunt)

The extension of the surgery determines the risk. T/F

TRUE

What is the absorption of the following materials: Silk Polypropylene

What is the absorption of the following materials: Silk - Enzymatic Polypropylene - Hydrolysis

Haemostats are suitable for tissue preparation (dissecting instruments), grasping ( grasping instruments), and haemostasis as well. T/F

TRUE

Chronic wound healing means that the normal wound healing fails after two weeks T/F

FALSE 3 months

The value of pneumoperitoneum is optimally 0 mmHg .because it does not cause visceral compression T/F

FALSE should be less than 15-20 mmHg

Which is the right order of wound healing? A. Remodeling - hemostasis-infiltration – granulation-proliferation B. Granulation-proliferation - hemostasis-infiltration - Remodeling C. Hemostasis-infiltration - granulation-proliferation - remodeling D. Granulation-proliferation – Remodeling - Hemostasis-infiltration

Which is the right order of wound healing? C. Hemostasis-infiltration - granulation-proliferation - remodeling

Which statements are true for thoracolaparotomy? a. the incision line runs in the 12th intercostal space b. the incision line run s in the 7th intercostal space c. it is built up of an upper transverse or transrectal laparotomy (d. it is mostly used in thoracosurgery (e.g., lung tumors

c. it is built up of an upper transverse or transrectal laparotomy b. the incision line run s in the 7th intercostal space

What gas is used in a pneumoperitoneum? | (also an MCQ)

Carbon Dioxide

What are the two ways of starting a laparoscopy?

Closed access by Veres needle Blind technique and most commonly practiced way of access by surgeons worldwide. Open access (Hasson-technique) Direct entry without creating previous pneumoperitoneum

What is the thinnest htread in the USC classification? A. 11/0 B. 10 C. 0 D. 1/0

What is the thinnest htread in the USC classification? A. 11/0

True or false Metric system measures the suture in tenth of milimeter

True or false Metric system measures the suture in tenth of milimeter TRUE

The disadvantage of a running suture is that if the sewing material breaks, the whole suture line will unfold. T/F

TRUE

Which factors increase the surgical risk? Give 3 of them!

E.g.:Overweight, anorexia, pregnancy, diabetes mellitus, high blood pressure, alcoholism, smoking, ect.

Verorab injection is applied against Tetanus infection. T/ F

TRUE

Clips are metal or plastic. Applied with the help of disposable or non disposable devices. T/F

TRUE

What kind of circular string is used in the GI tract

What kind of circular string is used in the GI tract Purse string suture

Which type of wound has the best healing?

Incised wound

# Fill in the blank Use to gauge depth or direction of a sinus or cavity by inserting ............. in there

Use to gauge depth or direction of a sinus or cavity by inserting ............. in there Round-ended probe

Label this diagram

What are the main parts of the "trocar-port assembly?" (not sure if this is a labeled diagram on the test, also from word of mouth. Taking this from e-book.)

1. Spit (or obturator or trocar) 2. Cannula (or port) 3. Valve (picture is from the university in Szeged)

What is this called?

Thread Memory

The parts of the laparoscopic trocars: a. cannula b. shaft c. light cable connection part d. coaxial handle

b. shaft a. cannula

True or False: You shave the patient the day before the operation

FALSE: should be the day of the operation

Into which category “steri-strip” belong to?

Into which category “steri-strip” belong to? Group 5 (if you remember them by order) Tissue unifying instruments and materials

# Fill in the blank ..................... is made from xyphoid process to the syphysis pubis.

..................... is made from xyphoid process to the syphysis pubis. Total median laparotomy

2 ways of holding the scalpel

2 ways of holding the scalpel Fiddle-bow and pencil

What is the characteristic of monofilament surgical thread ? a. It has thread memory b. It keeps the knots well (knot security) c. Due to having a smooth surface, the friction is less d. It is stronger than a multifilament (braided) thread

a. It has thread memory c. Due to having a smooth surface, the friction is less

# Fill in the blank .................. is caused by a sharp pointed tool. It is misleading and sometimes seems to be negligible

.................. is caused by a sharp pointed tool. It is misleading and sometimes seems to be negligible Puncture wound (Vulnus Punctum)

Sharp, sharp-straight scissors Lister bandage scissors splinter forceps amputation knife Rake retractor

6 different types/categories of surgical instruments

1. Dissecting/cutting 2. Grasping 3. Hemostatic 4. Retracting 5. Tissue unifying 6. Special

:According to the tip, circular needles can be a. Reverse cutting needles b. Taper point needles c. Blunt taper needles d. Taper cutting needles

b. Taper point needles c. Blunt taper needles d. Taper cutting needles

What do these things mean? ## Footnote 1. 2-0: . 2. Coated: . 3. 75cm: . 4. 24 mm: .

What do these things mean? ## Footnote 1. Width of the thread in USP units 2. Prevents tissue from getting into the thread 3. length of thread 4. length of needle

Which conditions increase surgical risk? ## Footnote a. Diabetes mellitus b. Paraneoplastic Syndromes c. Haemophillia d. Thromboembolitic predisposition

a. Diabetes mellitus b. Paraneoplastic Syndromes c. Haemophillia d. Thromboembolitic predisposition

What type of incision is used for open cholecystectomy? A. Pfannenstiel incision B. Muscle-splitting incision C. Upper median laparotomy D. Right subcostal incision E. Right pararectal laparotomy

What type of incision is used for open cholecystectomy? D. Right subcostal incision

## Footnote What to expect from disinfectant? a. Reduce the number of pathogenic bacteria b. Clean the skin surface fro dirt c. Not damage the skin d. Reduce the virulence of the remaining bacteria

a. Reduce the number of pathogenic bacteria d. Reduce the virulence of the remaining bacteria

When was ether day?

16th October 1846

What is the name of the bite wound in latin?

Vulnus morsum

Which incisions have the higher risk for later herniation? a. lateral transmuscular b. Pfannenstiel incision c. upper transverse d. pararectal

a. lateral transmuscular d. pararectal

# Fill in the blank! The Payer probe is used to dissect the area which is located beneath the vessel. Following this, it is kept under the vessel and the ...............A.................... is directed under the vessel and above the probe. Suture material is passed through the hole found at the end of the ............A................ which is then directed back from under the vessel. In this manner, we can ligate the desired vessel

Deschamp ligation needle

What is the name of the bite wound in latin?

What is the name of the bite wound in latin? vulnus morsum (Just imagine Fredrik Morsund biting you)

True for the scrubbed person a. No Jewels b. Nail pulish and artificial nails are not forbiden c. watches and rings should be removed d. Fingers and nails should be clean

a. No Jewels c. watches and rings should be removed d. Fingers and nails should be clean

# Choose the WRONG answer: What is true about the operating room? A. The room is spacious. B. Natural light source C. The tiles are up to the ceiling D. The surgeon must pass through a special room… E. Artificial ventilation & air conditioning

# Choose the WRONG answer: What is true about the operating room? B. Natural light source

Lumintzer clamp: A. the teeth of the instrument prevent tissue from sliping B. The grasping part is straight or curved, and there are teeth in the inner portion C. are traumatic have haemostatic forceps D. are the smallest clamps

B. The grasping part is straight or curved, and there are teeth in the inner portion C. are traumatic have haemostatic forceps

Which can be classified as a mechanical methods of haemostasis? a. Suturing b. Ligation c. Laser application d. Epinephrine

b. Ligation

True or False Vertical mattress is used to suture skin, subcutaneous tissue, muscle

True or False Vertical mattress is used to suture skin, subcutaneous tissue, muscle FALSE (we think)

Mention 3 different wounds (english and latin)

Abraded wound (vulnus abrasum) Punctured wound (vulnus punctum) Incised wound (vulnus scissum) Cut wound (vulnus caesum) Crush wound (vulnus contusum) Torn wound (vulnus lacerum) Bite wound (vulnus morsum) Shot wound (vulnus sclopetarium)

# Choose the WRONG answer: What is true about laparoscopic instruments? A. Normal size is 5mm/10mm B. Non insulated & insulated exists C. Pelican & parrot retractors D. Hook scissors used to cut tissue E.

What is true about laparoscopic instruments? I have no idea, i think they use Flamingo and Parrot, though, not Pelican So C is wrong

What colour of suture mat erial we do not use in surgery? a. Red b. Orange c . Black d. Green

Orange

What can increase the risk of bleeding? a. Thrombocytopenia b. Haemophilia c. Sinus Tachycardia d. Hypotension

a. Thrombocytopenia b. Haemophilia

When does granulation take place? MCQ

3-7 days

What are 6 parts of the laparoscopic tower?

Monitor Insufflator Light source Electrocautery device Video device Irrigation/suction device

Which can be classified as localized bleeding symptom? a. Increase in intracranial pressure (skull) b. Increased g astric HCL secretion (stomach) c. Cardiac insufficiency (pericardium) d. Compartment syndrome (between muscles)

a. Increase in intracranial pressure (skull) b. Increased g astric HCL secretion (stomach) c. Cardiac insufficiency (pericardium) d. Compartment syndrome (between muscles)

The light cable is: a. flexible b. twist it before storing c. fibre optic d. connected to a camera

a. flexible b. twist it before storing c. fibre optic d. connected to a camera

Write 4 advantages of laparascopic procedure vs. open surgery

Write 4 advantages of laparascopic procedure vs. open surgery 1. Lower risk for hernias 2. Less postoperative pain, less analgesics needed 3. Cosmetically better (unless you think scars are badass) 4. Shorter hospitalization

Treatment of combustio:(Burn Injury) A.cooling B.Keeping warm C.Remodelling bullas D.Closing the wound

A.cooling D.closing the wound

The transverse laparotomies provide more considerable exposure than vertical ones. T/F

FALSE

To what does the following sentence refer? It is an early complication of wound healing, due to an ineffective bleeding control, a short period of drainage or anti-coagulation therapy

To what does the following sentence refer? It is an early complication of wound healing, due to an ineffective bleeding control, a short period of drainage or anti-coagulation therapy hematoma

What is the most commo nly used disinfectant for skin? a. 4 % quaternary ammonium compound b. 100% povidone iodine c. 70% isopropanol d. 30% H2O2

b. 100% povidone iodine ??also maybe 3%H2O2???

What are the superficial wound infection types? A. Cut wound and wounds contaminated with soil B. Laminal spreading and localized infection C. Systemic infection and infection spreading along the tissue borders D. Abrasion and incised wound

What are the superficial wound infection types? B. Laminal spreading and localized infection

What does pneumoperitoneum mean and where do we use it?

Air in the peritoneum. During laprascopy gas, most common CO2 is pumped into the abdomen of the patient

Which one is NOT a muscle splitting incision? a. Kocher incision b. The upper lateral muscle splitting incision c. Upper median muscle splitting incision d. Pfannenstiel incision

a. Kocher incision

Signs of bleeding a. Pale skin b. Cyanosis c. Hypotension d. Tachycardia

a. Pale skin b. Cyanosis c. Hypotension d. Tachycardia

True or False? Simple continuous suture is the proper suture type of the stomach, the intestines and the mucosa.

True or False? Simple continuous suture is the proper suture type of the stomach, the intestines and the mucosa. True

Which kind of indication the following statements are refering to? 1. The patient can be treated only with an immediate, life-saving operation. 2. Surgery is a possible choice of treatment. The time of the operation can be delayed. 3. The disease can be treated with an operation. The time of operation can be chosen between narrow limits.

Which kind of indication the following statements are refering to? 1. vital indication 2. relative indication 3. absolute indication

Macrophages are the first immune cells that appear after injury. T/F

FALSE

What is the name of the crush wound in latin?

What is the name of the crush wound in latin? vulnus contusum

How many times should you disinfect the skin of the patient?

3 times

During a surgical hand scrub, hands can be made sterile. T/F

FALSE

Hopefully can see this picture.. what is it? What is A? What can be attached to B? What are C and D?

Trocar A: valve B: insufflator tube/hose C: reducer D: tap

True or false Atraumatic needle, disadvantages: re-serialization, harmful for tissue etc

Atraumatic needle, disadvantages: re-sterialization, harmful for tissue etc FALSE

What is characteristic of atraumatic needle-suture materials? A. Double thread diameter B. Less tissue damage C. Drilled connection of needle and thread D. It takes a long time to prepare for use

B. Less tissue damage C. Drilled connection of needle and thread

Properties of the ideal suturing material: a. Monofilament b. Minimal tissue reaction c. Doesnt need to be sterilized d. Easy to handle

a. Monofilament b. Minimal tissue reaction d. Easy to handle

What word describes this? The wound cavity is filled with serous fluid, lymph or blood. Signs: fluctuation, swelling, redness, tenderness and subfebrility. Treatment: sterile puncture ad compression; if repeated, then use a suction drain. It is common after the breast operations. (straight from e-book but supposedly there is a past-paper fill in the blank question about it)

**Seroma**