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exam 1 Flashcards

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1
Q

laparotomy

A

a surgical incision through the skin layer and abdominal wall into the peritoneal cavity

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2
Q

laparoscopy

A

a surgical procedure in which a fiber-optic instrument is inserted through the abdominal wall to view the organs in the abdomen or to permit a surgical procedure.

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3
Q

anastomosis

A

a connection made surgically between adjacent blood vessels, parts of the intestines, or other channels of the body, or the operation in which this is constructed.

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4
Q

anatomy of the gallbladder

A

-located in the fossa on the inferior surface of the right lobe of the liver
-A muscular sac attached to the liver that secretes bile and stores it until needed for digestion

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5
Q

anatomy of the liver

A

-located in the right upper abdominal quadrant of the abdominal cavity beneath the diaphragm and directly above the stomach.
-divided into 8 segments
-covered by a fibrous and serous coat called “Glisson’s Capsule” and divided by the falcifrom ligament
-highly vascular and friable organ

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6
Q

anatomy of the spleen

A

-located in the upper left abdominal cavity
-protected by the 10th, 11th/12th rib and directly beneath the dome of the diaphragm

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7
Q

anatomy of the large bowel (colon)

A

-divided into 7 sections
-cecum
-ascending colon
-transverse colon
-descending colon
-sigmoid
-rectum
-anal canal

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8
Q

alimental canal

A

-the digestive system
-what general surgery is mainly aboout

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9
Q

anatomy of the stomach

A

-fundas
-cardia
-body
-antrum
-pylorus

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10
Q

Laparotomy Tray (Major Tray)

A

foundation for many major surgeries

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11
Q

Maloney (Bougie) dialator

A

Esophageal dilator
- used in procedures like fixing a hiatal hernia
-Anesthesiologist can use these since they have access to the head/mouth of the patient

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12
Q

Vagotomy

A

cutting of certain branches of the vagus nerve, performed with gastric surgery to reduce the amount of gastric acid produced and thus reduce the recurrence of ulcers

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13
Q

Veress needle

A

A spring-loaded needle used to deliver carbon dioxide gas during insufflation.

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14
Q

Hasan method

A

Using a Trokar to poke through to deliver CO2 during laparoscopic surgery

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15
Q

exploratory laparotomy

A

abdominal operation for the purpose of examining the abdominal organs and tissues for signs of disease or other abnormalities

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16
Q

Bilroth 1

A

Removal of the distal portion of the stomach and plyorus

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17
Q

Bilroth 2

A

is the removal of the distal portion of the stomach and the pylorus, reanastomosis is the jejunum, cuts ends of duodenum are closed

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18
Q

subtotal gastrectomy

A

partial removal of the stomach AKA Billroth procedures.

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19
Q

Harmonic scalpel

A

Use: cutting and cauterizing tissue

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20
Q

Trocars

A

Instruments used to puncture and enter the abdomen for a laparoscopic procedure

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21
Q

Gastrostomy

A

-surgical creation of an opening through the abdominal wall into the stomach

-Performed to provide nutrition (feeding tube)

-may be performed in conjunction with gastrectomy

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22
Q

Bookwalter retractor

A

Used to retract wound edges and internal organs during abdominal procedures

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23
Q

Meckel’s diverticulum

A

outpouching of distal ileum (small intestine)

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24
Q

Bowel technique

A

• “Confinement and containment” of instruments and supplies that encounter the inside of
the bowel which is dirty (to prevent postoperative surgical site infections (SSI)
• Practiced when entry into a structure or removal of a structure(s) along the alimentary canal is
performed
Begins when the GI tract is opened and ends once the tract is closed
• The instruments on the contaminated basin/Mayo should be isolated from the clean Mayo
and sterile back table
• Wound protector may be utilized
• When closure of the GI tract is complete, the sterile surgical team should change Gowns and
gloves

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25
Herniorrhaphy
- hernia repair - McVay (Coopers Ligament) inguinal herniorrhaphy
26
what instruments would you need for a laparotomy?
major instrument tray, self-retaining retractor (Balfour or Bookwalter), Handheld retractor(sweetheart, rich, deavers), specialty instruments, have poole suction tip available
27
Whipple procedure (pancreaticoduodenectomy)
removal of the head of the pancreas, the entire duodenum, the very proximal portion of the jejunum, the distal third of the stomach, and the distal half of the common bile duct, with the reestablishment of continuity of the biliary, pancreatic and gastrointestinal tracts
28
nissen fundoplication
a surgical procedure to treat gastroesophageal reflux disease (GERD) and hiatal hernia)
29
anal fistula
a small tunnel with an internal opening in the anal canal and an external opening in the skin near the anus. Anal fistulas form when an anal abscess, that's drained, doesn't heal completely
30
cholecystectomy
a surgical procedure to remove the gallbladder
31
glisson's capsule
a layer of fibrous and serous capsule surrounding the liver
32
hemorrhoid
swollen, dilated and inflamed veins that lines the anal canal
33
breast biopsy
– Used for diagnostic purposes – Removal of tissue from the breast to determine the nature of a breast lesion – Aids the surgeon in determining the stage and course of treatment if the biopsy is considered malignant
34
breast biopsy surgical considerations
– Skin prep: PAINT ONLY, scrub is not performed in order to avoid spreading cancer cells – Patient may be under local anesthesia and awake ( be aware of conversations) – Incision: circum-areolar if centrally located mass – Lesion may be grasp with Allis, DeBakey or Babcock – Specimen may be sent for frozen section (do not place in formalin) use Telfa or specimen cup (dry) – Wound is not closed until pathologist communicate results to MD – Drain may be inserted
35
mastectomy
– Removal of breast tissue; the amount of tissue excised is determined by the extent, type and size of the malignancy and the elected procedure
36
breast cancer stage 1
-tumor 2 cm or less, no evidence of distal spread
37
breast cancer stage 2
-tumor greater than 2 cm but no more than 5 cm in greatest diameter
38
breast cancer stage 3a
-tumor up to 5 cm- , 4-9 axillary lymph nodes suspicious regional
39
breast cancer stage 3b
any size dimension- may spread into chest wall ability lymph nodes
40
breast cancer stage 4
tumor any size mythical detection
41
gastric bypass (Roux en Y)
• Small pouch is created by removing/bypassing most of stomach • Connecting the newly created pouch directly to the small intestines
42
side to side anastomosis
– Creation of parallel opening in two sections of bowel with anastomosis
43
Roux en Y anastomosis
– An end to side anastomosis of bowel used to reconstruct the GI tract – Biliary and pancreatic surgery – Used in partial or total gastrectomy with pancreatic resection, – Surgery of the bile duct and is an integral part of the Whipple proc. (pancreaticoduodenectomy)
44
cholecystectomy (open)`
• An excision of the gallbladder (procedure 14-10) Equipment • OR table compatible with xray cassettes or C-arm • Major instruments • Long and deep instruments • Gallbladder instrument set (Randall stone extraction forceps, Bakes dilator) • Thompson retractor
44
cholecystectomy (open)`
• An excision of the gallbladder (procedure 14-10) Equipment • OR table compatible with xray cassettes or C-arm • Major instruments • Long and deep instruments • Gallbladder instrument set (Randall stone extraction forceps, Bakes dilator) • Thompson retractor
45
CHOLECYSTECTOMY (lap)
• 30 degree scope • Trocars (MD pref) 12mm, 11mmm, 5mm x2 • Video tower with slave tower • Insufflator • Major tray on standby • Laparoscopic instrument tray – Maryland dissector – Blunt graspers – L/J hook – Claw/ mother in law – Endoscopic stapler – Endobag – Verres needle or Hasson trocar (MD pref)
46
cholangiogram
• If cholangiogram is to be performed, do not clip and ligate the cystic duct – Inform radiology dept to sent an Xray tech to the room – Prepare supplies necessary – Use #11 blade on a long handle to create a stab wound into the cystic duct – Potts-Smith scissors angled 45 degrees will be used for choledochotomy. – Insert cholangiogram catheter – After verifying contrast with MD, mix contrast with inj. Saline (50/50 – Label syringe with solution that is drawn up – Inject saline through cholangiogram catheter prior to the contrast media to TEST PATENCY OF THE CYSTIC DUCT – when mixing up syringe with solution, make sure NO BUBBLES ARE PRESENT IN THE SYRINGE. tap the syringes gently to make the bubbles rise to the top – AIR BUBBLES CAN RESEMBLE STONES ON AN XRAY
47
liver resection
• A small wedge biopsy, the local excision of tumors, or a major segmentectomy of the liver • Position/incision – Supine, modified lateral – Subcostal – Thoracoabdominal
48
Intestinal Clamps
Doyen, Allen, Glassman, Bainbridge
49
Bookwalter retractor
Used to retract wound edges and internal organs during abdominal procedures
50
Pressure dressing
external dressing used to eliminate dead space
51
Paramedian incision
– 2-5 cm lateral to midline – Not for trauma – Lower left for sigmoid surgery – Upper right- access much of the kidneys, spleen and adrenal glands
52
• Kocher/Rt. Subcostal
– For biliary tract surgery especially for cholecystectomy
53
• Left subcostal
– For splenectomy
54
• McBurney
– Appendectomy
55
• Lanz
– Appendectomy – Better cosmetic scar on healing
56
• Pfannenstiel
– GYN procedures – Pelvic surgeries (suprapubic prostatectomy)
57
• Lower oblique incision
– inguinal
58
Thoracoabdominal/Lateral incision
– Access for extensive esophagogastric surgery (left) – Emergency hepatic resection (right) – Nephrectomy
59
• Chevron- Roof top incision
– gastrectomy – Adrenalectomy, bilateral – Hepatic transplantation/resection
60
• Appendectomy
– Performed for acute appendicitis or incidentally during other surgery as a prophylactic measure
61
EEA
end to end anastomosis
62
EEA stapler
-disposable circular staple designed to hold two tubular structures together after resection
63
colon resection
clamp clamp cut tie cut tie cut
64
small intestine
-duodenum -jejunum -illeum
65
colectomy with colostomy
A colectomy is the surgery done to remove either all or part of the colon. It can also be called a large bowel resection. In some cases, a colostomy is needed after colectomy. A colostomy is an opening to the outside of the body that lets stool (bowel movements) exit the body into a bag.
66
abdominal layers
•Skin •Subcutaneous fatty layer (Camper's fascia) •Muscle (if cut) •Deep membranous fascial layer (Scarpa's) •Linea alba. •External oblique •Internal oblique •Transverse abdominis •Transversalis fascia. •Preperitoneal fat. •Parietal peritoneum.

surg specs 1 (4 decks)

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