General Flashcards
(167 cards)
1
Q
simplist abdominal incision offering good exposure
A
vertical midline
2
Q
how is a vertical midline reinforced
A
single layer continuous absorbable suture
3
Q
incision for appendectomy
A
McBurnery
4
Q
describe McBurney
A
8cm oblique in RLQ
5
Q
incision right or left under ribs
A
subcostal
6
Q
subcostal incision structures
A
right: gallbladder, pancreas, biliary tree
left: spleen
7
Q
incision for pelvic surgery .5 in. above symphysis pubis
A
pfannensteil
8
Q
incision for operations on proximal stomach and distal esophagus
A
thoracoabdominal
9
Q
2 functions of organs in alimentary canal
A
mechanical/chemical breakdown of food
Peristalsis
10
Q
what structures does esophagus lie between in neck
A
trachea
cervical spine
11
Q
3 parts of stomach
A
fundus
body
pylorus
12
Q
upper margin of stomach
A
cardia
13
Q
lower margin of stomach
A
pyloris
14
Q
what is attached to greater curvature of stomach
A
greater omentum
15
Q
what is attached to lesser curvature of stomach
A
lesser omentum
16
Q
what is omentum
A
double fold of peritoneum attached to stomach and viscera
fatty, prevent friction, wall off infection
17
Q
what attaches intestines to posterior abdominal wall?
A
mesentery
18
Q
start and end of small intestine
A
pyloric sphincter to large intestine
19
Q
3 sections of small intestine
A
duodenum
jejunum
ileum
20
Q
what portion of small intestine do CBD and pancreatic duct enter
A
duodenum at ampulla of vater
21
Q
ligament stabilizing the duodenojejunal flexure and landmark for abdominal orientation
A
Treitz
22
Q
the ileum empties into large intestine via what valve
A
ileocecal
23
Q
start and end of large intestine
A
cecum to anus
24
Q
3 portions of large intestine
A
cecum
colon
rectum
25
what structure projects from the blind pouch of the cecum
appendix
26
4 parts the colon is divided into
ascending
transverse
descending
sigmoid
27
the rectum begins and ends where
sacrum to coccyx
28
rectum lies behind what
bladder
29
sphincters of anus
internal
external
30
what is bowel technique
isolation to prevent cross-contamination of wound/abdomen w/ bowel bacteria
31
non-traumatic grasping forceps used on intestine
DeBakey
Wagonstein
Singley
32
forceps used on skin
Adson
33
process by which food is moved through stomach and intestine
peristalsis
34
function of small intestine
absorb nutrients
barrier for harmful, injected substances
35
function of large intestine
absorb water and electrolytes
36
2 suction tips in GI
yankeaur
frazier
poole
37
what is bariatric surgery
weight loss/reduction
38
what is Barrett's esophagus
lining of esophagus damaged by stomach acid and changed to lining like stomach
39
during EGD what position is used to view fundus & cardia of stomach
left lateral
40
what is a colonoscopy
visualization of large intestine with a colonoscope
41
what is a sigmoidoscopy
visualization of sigmoid colon and rectum
42
what preop prep is done before colonoscopy and sigmoidoscopy
bowel clean/enema
43
and is another name for esophageal diverticulum
Zenker's diverticulum
44
what is an esophageal diverticulum
weakening in wall of cervical esophagus
collects small food and sensation of fullness in nexk
45
what position is used for an esophageal diverticulum
supine w/ shoulder roll
46
over which muscle is the incision for zenker's diverticulum made
sternocleidomastoid
47
what is hiatal hernia
portion of stomach enters throacic cavity
congenital or accidental
48
what is hiatal hernia repaired
lap nissen fundoplication
49
lap nissen fundoplication were developed why?
hiatal hernia
50
how many trocars are used for lap nissen?
5
lithotomy with rev. trendelenburg (CHECK)
51
what is esophagomyotomy?
Incision into esophageal muscle to treat a food obstruction
52
incision for esophagomyotomy
abdominal midline
53
why is esophageal dilation done
stricture
54
dilators for esophageal dilation
Hurst
Malony
55
what does interrupting the parasymphathetic innervation during vagotomy do
reduce gastric acid generation in patients with duodenal ulcers
56
incision for vagotomy
midline
57
what is the more frequent reason a pyloroplasty is done?
peptic ulcer, midline incision
58
what is a gastrostomy and why is it done?
Incision into stomach to insert a feeding tube
59
instrument used to retract tissue near the surface
Senn
Army/Navy
60
what does PEG stand for
percutaneous endoscopic gastrostomy
61
what is a Billroth I and between which 2 structures is the anastomosis
resect diseased portion of stomach
stomach + duodenum
62
what is a Billroth II and between which 2 structures is the anastomosis
resect distal portion of stomach
stomach + jejunum
63
between which 2 structures is the anastomosis in a total gastrectomy
jejunum + esophagus
64
instrument for cross-clamp stomach
Payr
autosuture
65
what is a Meckel's diverticulum
Congenital outpouch of sm. intestine (ileum)
66
what is appendectomy
removal of appendix with McBurney incision
67
surute on appendiceal base
nonabsorbable
68
why would a drain be used on appendectomy
continuous drainage
69
how many trocars for lap appy
3
70
why is small bowel resection done
tumors, gangrene, volvulus, herniation
71
2 non traumatic forceps
platapus, wagonstein, singley
72
what is ileostomy and 2 reasons its done
temp or permanent opening into ileum
extensive lesions, reduce activity in colon by diversion
73
can large intestine be resected laparoscopically
yes
74
what is colostomy, what 2 parts of large intestine cna be used?
mobilize loop of colon and externalize
transverse/descending
75
why colostomy is done
obstruction, trauma
76
what is the closure of colostomy
reestablishment of internal intestinal continuity and repair of abdomen
77
2 reasons right hemicolectomy and ileocolostomy are done
remove malignant lesion or inflammatory lesion in right colon
78
incision for transverse colectomy
transverse, upper midline
79
what is abdominoperineal resection
mobilization and division of a diseased segmant of lower bowel
80
what is done to proximal and distal bowel in APR
proximal: colostomy
distal: closure
81
why is APR performed
cancer
82
positions for APR and incision
supine, modified lithotomy
midline incision
83
what is hemorrhoidectomy/positions
remove hemorrhoids
jacknife/buie
84
instrument to grasp bottom of hemorrhoid
pennington
85
suture to tie proximal end of hemorrhoid
2-0 synthetic absorbable
86
what are J, S, and Y pouches for rectal reconstruction
CHECK
87
what is the excision of pilonidal cyst and sinus. Do they recur?
intergluteal fold on posterior surface of lower rectum
they can recur
88
position for pilonidal cyst excision. how are tracts identified and marked
jacknife
probes and incision
89
how is incision from pilonidal cyst protected
left open and packed with a pressure dressing
90
what quadrant is liver located. what cells manufacture bile
RUQ
hepatocytes
91
hepatic ducts join to form which common duct
common hepatic duct
92
the cystic duct and common hepatic duct form which duct
common bile duct
93
what is gallbladder. it ends in which duct
RUQ on underside of liver
cystic duct
94
what is the function of the gallbladder. how does bile aid in digestion
store bile
emulsify fat in duodenum
95
what is blood supply of gall bladder
cystic artery
96
where is pancreas located. what structure is head of pancreas fixed to?
CHECK
97
an an exocrine gland, what does the pancreas secrete and through which duct
digestive enzyme
Wirshung
98
as an endocrine gland what 2 hormones does pancreas secrete and by which cells are they produced
insulin, glucagon
islets of Langerhan
99
where is spleen and what is its function
LUQ: defend body with phagocytosis
100
what does ERCP stand for and what is it
endoscopic retrograde cholangiopancreatography
visualization of biliary tree
101
during laparotomy the patient is at risk for hypothermia. how can you help prevent it with irrigation
warm solution for thermoregulation
102
what is applied to patient to help prevent DVT
sequential compression device TED stocking
103
train used after common duct exploration
t-tube
104
where do abdominal drains exit skin and why are they anchored
stab wounds
prevent retraction
105
what is cholecystectomy
remove gallbladder
stones/disease
106
position and 2 incisions for gallbladder
supine
right subcostal/upper midline`
107
hand held retractors used to retract liver
Harrington
Deaver
108
what is divided and what is left intact in cholecystectomy
cut artery/cystic duct
leave common bile duct
109
what is intraoperative cholangiogram
visualize CBD, hepatic duct branches
access patency of CBD
110
what is injected during cholangiogram to look for stones
contrast medium
remove bubbles b/c they look like stones
111
what is Hasson technique
open insufflation w/ blunt cannula
patients w' previous surgery or adhesions
112
max pressure for insufflation unit
15mmhg
113
trocar sites for lap chole
4
114
what is cholecystostomy and who is it performed on
open incision into gallbladder to drain/remove stones
advanced medical problems
115
instrument through purse-string to drain gallbladder
trocar
CHECK
116
what is another name for pancreatoduodenectomy, why is it done
whipple-cancer
117
pancreatic transplant is done to treat what
type 1 diabetes
118
how does CUSA work
dissect tissue with ultrasonic waves with fluid and suction
119
what is splenectomy done and what is the incision
trauma, malignancy, leukemia, jaundice
midline/subcostal
120
what is danger with incarcerated hernia and what additional procedure must you be prepared to do
become strangulated/ischemia
resect necrotic bowel
121
3 landmarks of Hasselbach's triangle
rectus abdominis, inguinal ligament, inferior epigastric vessels
has direct inguinal hernias
122
what hernia occurs laterally to deep epigastric vessels
indirect inguinal
123
direct and indirect hernias represent a weakness in what
transverse fascia
124
what hernia protrudes into inguinal canal but not into cord, rarely into scrotum
direct inguinal
125
what hernia results from heavy lifting
direct inguinal
126
what hernia leaves the abdominal cavity at internal ring and passes with cord structures into scrotum
indirect inguinal
127
what hernia is congenital or acquired
inguinal
128
what is a pantaloon hernia
indirect + direct
129
what incision is used for a hernia repair
inguinal
130
why is a moistened penrose drain used in hernia repair
retract spermatic cord
131
2 spontaneously occuring ventral hernias
epigastric
umbilical
132
name for a postop ventral hernia and what incisions is it found in
incisional hernia
vertical midline
133
examples of synthetic material in hernia repairs
mersilene, prolene, dacron
134
lobes of thyroid and what separates them
2, isthmus
135
blood supply to thyroid gland
superior thypoid/external carotid
136
how many parathyroid glands are there
4
137
what preop test provides info in diagonses of cancer in thyroid
Fine needle biopsy/ CT/ MRI
138
position for thyroidectomy, incision
supine, transverse
139
nerve in close proximity to thyroid
laryngeal
140
what knife handle holds a 10,11,12,15 blade
#3
141
what is the name of the most common congenital cyst in neck
thyroglassal duct
142
why does a parathyroid gland need to stay in the body
prevent hypocalcemia
143
what type of glands are there in the breasts, what is areola
mammory/pigmented area around nipple
144
what lesions are fibroademonas
benign
145
incisional vs. excisional breast biopsy
incisional: just part of mass
excisional: take whole mass
146
what are sentinal nodes
1st nodes along lymphatic channel from primary tumor site
147
if patient has positive lymph nodes what procedure is done (breast)
radical mastectomy
148
2 substances used in IDing sentinal nodes
isosulfan blue dye, radiocolloid
149
what radioactive material is used what device is used to detect it
Geiger counter/neoprobe
150
when axillary node dissection is done how is the arm positioned
extended on armboard less than 90 degrees
151
what is subcutaneous mastectomy
under skin removal
overlying skin + nipple remain
152
what is simple/total mastectomy
remove entire involved breast w/o lymph node dissection
153
what is modified radical mastectomy?
CHECk
154
clamp used to hold breast lumps
allis
155
incision for modified radical mastectomy
elliptical
156
drain in modified radical mastectomy
closed wound suction catheter
157
what is Nissen Fundoplication
wrap fundus around esophagus
GERD/hiatal hernia
158
what is pylormyotomy
CHECK
159
what age is pyloromyotomy done and what is the first sign of the condition
2-6 weeks
projectile vomiting
160
what is omphalocele
hernia where intestines and other organs are outside of body through belly button
161
what is intussusception?
CHECK
162
what is a frequent site for intestinal obstruction
ileocecal junction
163
what is an imperforate anus. describe anorectoplasty
no hole
make an anus
164
what is the most common hernia in pediatrics
umbilical
165
what is lumpectomy
remove lump for biopsy
166
what anesthesia is given for liver needle biopsy
general
167
2 needles for liver needle biopsy
tru-cut
silverman
franklin
