GENERAL #2 Flashcards
1
Q
hemorrhoidectomy
A
excision of either external or internal hemorrhoids or both, dilated anal veins
2
Q
excision of anal fistula
A
excision of tissue surrounding a draining sinus tract in anal area
3
Q
excision of pilonidal cyst
A
in the sacrococcygeal region, congenital defect causing tissue to be trapped below the skin
4
Q
pediatric atresia
A
congenital condition where there is a problem with the development in the rectum/anus
5
Q
trauma to the rectum
A
insertion of foreign body, sexual assault or accidents
6
Q
two accessory organs of the GI tract
A
spleen, gallbladder
7
Q
muscular ring located between the stomach and small intestine
A
pyloric sphincter
8
Q
when the gallbladder contracts, bile is ejected into what
A
cystic duct
9
Q
union of the cystic duct and the hepatic duct form what?
A
common bile duct
10
Q
where is bile produced?
A
liver
11
Q
where is bile stored?
A
gallbladder
12
Q
bile and pancreatic enzymes are released through this opening into the duodenum
A
ampulla of vater
13
Q
incision for cholecystectomy
A
right subcostal
14
Q
xray performed during a cholecystectomy to identify any stones in the common bile duct
A
intra op cholangiogram
15
Q
dye used during cholangiogram
A
hypaque
16
Q
why is it important to expel the air from the saline syringes prior to cholangiogram?
A
air looks like stone on xray
17
Q
can a cholangiogram be performed if it is a lap chole?
A
yes
18
Q
oschner trocar
A
open chole to deflate the gallbladder
19
Q
forceps used to remove stones during biliary surgery
A
randall stone forceps
20
Q
choledochotomy
A
incision of the common bile duct to get stones out
21
Q
largest organ in the abd cavity?
A
liver
22
Q
main digestive function of the livver?
A
produce bile
23
Q
glissons capsule covers what organ?
A
liver
24
Q
2 functions of the spleen
A
filter for blood, fight bacteria
25
operation where the spleen is removed
splenectomy
26
incision for splenectomy
midline
27
why is a splenectomy performed?
trauma, tumors, cysts
28
what must be readily available when the peritoneum is entered?
suction, laps, cell saver
29
wher are the islets of langerhans located and what are their functions?
pancreas, blood sugar levels
30
pancreaticojejunostomy is performed for?
early pancreatic cancers
31
a whipple procedure includes surgery on what organs?
pancreas, stomach, duodenum, jejunum, common bile duct ***en bloc
32
technical name for whipple
pancreaticoduodenectomy
33
procedure done to correct intrahepatic obstruction
portacaval shunt
34
biopsy need used for a liver biopsy
tru-cut, silverman
35
what type of suture is used on liver? type of needle?
chromic, blunt
36
cholelithiasis
hardened deposit within the fluid in the gallbladder
37
insturment used to grasp the mass/tumor during a breast biopsy?
allis
38
how is a frzoen section sent to the lab during a breast biopsy?
dry container
39
needle localization
doing in radiology prior to biopsy, fine wire placed
40
type of breast surgery which could be performed for a benign breast tumor
lumpectomy
41
removal of the entired breast and axillary contents, but preserves the pectoral muscles
modified radical mastectomy
42
why is it important to perform the surgical prep gently for a mastectomy?
avoids dislodging cancer cells
43
prep parameters for a modified radical mastectomy
neck to umbilicus to midline, circumferiental upper arm to mid forearm
44
type of irrigation used during a mastectomy
sterile water
45
2 nerves which must be identified and preerved
thorocodorsal, long thoracic
46
type of drain used after a mastectomy
JP
47
pathological enlargement of the male breast
gynemastia
48
type of set up pack for vein stripping for adequate draping?
universal drape pack
49
large vein that is often removed during a vein stripping?
greater saphenous vein
50
why are legs wrapped with elastic wrap after vein stripping?
compression dressing
51
how many lobes does the thyroid gland have?
2
52
vocal cords are located?
larynx
53
what is the larynx located between?
pharynx and trachea
54
item used in positioning a patient for a thyroidectomy
shoulder roll
55
why is a shoulder roll used?
hyper extends neck for better exposure
56
what drainage system is preferred for a radical neck dissection?
jackson pratt
57
how many parathyroid glands does a person have?
4
58
instrument used during a tracheostomy used to pull the trachea close to the surface before inserting the trach tube
jacson tracheal hook
59
what must be sent with the patient to the PACU following a tracheostomy?
obturator
60
where are the parotid glands located?
in front of ear
61
laryngoscopy
visualization of larynx using laryngoscope
62
microlaryngoscopy
more precise visualization
63
you would find osteotomes, mallet, rongeurs and elevators on a set up for a total laryngectomy?
true
64
tracheostomy incision
below the cricoid cartilage
65
how is the trach tube held in place?
suture, cloth tape
66
when would a nerve stimulator be found?
parotidectomy, thyroidectomy
67
3 structures that would be resected during a radical neck dissection
sternoclidomastoid muscle, internal jugular vein, submandibular gland
68
what nerve is identified and preserved during a thyoidectomy?
recurrent laryngeal nerve
69
possible post op complication following a thyroidectomy?
swelling- end up having a trach
70
normal bowel fuction
open lumen for intestinal contents, adequate circulation
71
bowel obstruction
any that interrupts normal flow of contents
72
where are 80% of intestinal obstructions found?
small bowel
73
pathophysiology of bowel surgery
inflammatory, vascular, celiac disease, pseudomembranous
74
bowel technqiue
used on any GI surgery where the bowel is entered, any contact with the GI mucosa can't be used on any other tissue
75
diagnostic interventions
chest xray, barium enema, CT scan
76
bowel prep/intestinal antisepsis
must be done to cleanse inside of bwel, antibiotics
77
complications of bowel surgery?
DVT, short gut syndrome
78
class II
controlled spillage
79
class III
non controlled spillage
80
class IV
frank pus/infection
81
meckels diverticulectomy
| surgery/purpose/instruments
excision of congenital duct occurring at the umbilicus
PURPOSE: prevent inflammation from intussusception of diverticulum
INSTRU: kochers, bookwalter
82
small bowel resection
| surgery/purpose
excise segment of small intestine
| PURPOSE: remove an obstruction
83
3 anastomosing techniques
end to end, side to side, end to side
84
posterior serosal layer
3-0 silk SH CR interrupted
85
mucosal layer
3-0 chromic/vicryl SH continuous
86
anterior serosal layer
3-0 silk SH cr
87
what does the 3-0 silk prevent?
post op obstruction
88
appendectomy
| surgery/purpose/instruments
excision of appendix
PURPOSE: remove inflamed appendix to prevent rupture
INSTRU: babcocks
89
lap appendectomy
| surgery/instruments
endoscopic excision of appendix
| INSTRU: endo GIA to cut off appendix
90
reducation of intussusception
telescopic invagination of a portion of intestine into an adjacent part
91
most common site for intussusception
ileocecal junction
92
resection and pull through for hirschsprung diease
lack of paristalsis due to absence of ganglion cells in distal bowel
93
repair of imperforate anus
surgery indicated within 24-48 hours after birth
94
colostomy
| surgery/purpose
mobilization of a loop of colon through a right rectus incision to expose the transverse colon
PURPOSE: obstruction in the sigmoid colon from cancer
95
temporary colostomy
rest bowel following colon resection-gives suture line time to heal
96
transverse loop colostomy
most frequently used for a temporary colostomy
97
sigmoid colostmy
most common type of permanent colostomy
98
colostomy closure
| surgery/purpose
reestablish internal intestinal continuity with repair of abd wall
PURPOSE: when temp. colostomy is no long necessary
99
when is stoma prepped?
last
100
right hemicolectomy and ileocolostomy
| surgery/purpose
resection of the right half of the colon with creation of an ileostomy
PURPOSE: remove malignant lesion of the right colon
101
what will right hemicolectomy and ileocolostomy result in?
permanent ileostomy
102
transverse colectomy
| surgery/purpose
excision of the transverse colon though an upper midline or transverse incision
PURPOSE: malignancy
103
low anterior resection of sigmoid colon and rectosigmoidostomy
surgery/purpose
removal of lower sigmoid colon and proximal 2/3 of rectum
| PURPOSE: benign conditions or cancer
104
abdominoperineal resection- miles resection
| surgery/purpose
excision of rectum and portion of sigmoid colon through both an abd and perineal approach
PURPOSE: treat rectal malignancy
105
abdominoperineal resection- miles resection incisions
vertical or transverse abd incision, elliptical perineal incision, colostomy incision
106
lap assisted colon resection
excision of large colon segment combining endoscopy and mini laparotomy or large bore lap port
107
excision of anal fissure and sphincterotomy
involves anal sphincter dilatation and removal of anal fissure/lesion/ulcer
108
anal fissue
benign lesions of the anal wall
109
open chole
| surgery/purpose
excision of the gallbladder
| PURPOSE: acute cholecystitis
110
how many steps in intra op cholangiogram?
5
111
what is done before cholangiogram to check for leaks?
saline injected into catheter to check for patency
112
exploration of common bile duct
| purpose/instruments
PURPOSE: remove stones causing obstruction
INSTRU: randall stone forceps
113
chole
bile
114
choledoch
common bile duct
115
cholecyst
gallbladder
116
ostomy
forming a permanent opening
117
otomy
making an incision into
118
oscopy
viewing using a lighted scope
119
types of pancreatic cysts
pseudocyst
neoplasms
simple
120
pseudocyst
localized collections of pancreatic secretions in a cystic structure-most common
121
pancreatic transplatation
implantation of a donor pancreas for patients with type 1 diabetes
122
pancreas-kidney transplant
renal failure
123
gaol of pancreatic transplant
stave off debilitating side effects of diabetes
124
splenectomy
| surgery/purpose
excision of spleen
| PURPOSE: trauma
125
lap splenectomy
not done for trauma!!!!
126
liver biopsy
evaluating suspected liver disease
127
repair of liver laceration
blunt or penetrating abd trauma
128
what should you have for liver laceration repair?
hemostatic agents, blunt needle
129
liver resection
trauma
130
portal hypertension
high blood pressure in the portal vein system
131
liver transplantation
done for end stage liver disease
132
breast biopsy
determine presence of cancer-frozen section
133
breast biopsy when cancer is diagnosed?
mastectomy performed immediately or later after consulting with patient
134
breast biopsy with needle localization rule
pt remains on or table with sterile field until confirmation given that lesion has been excised
135
sentinal node biopsy
determine if cancer has spread to any axillary lymph nodes, if need for additional surgery or tx
136
radioactive isotope sentinal node biopsy
injected 1 hour prior in radiology, concentrates in tumor
137
isosulfan sentinal node biopsy
injected in the operating room nodes are stained blue
138
axillary node dissection
removal of axillary nodes though incision in axilla, allows for staging
139
lumpectomy-segmental
removal of mass with 1 in margin of surrounding tissue, done to control spread of breast cancer
140
subq mastectomy
removal of all breast tissue only, leaving overlying skin and nipple intact
141
simple total mastectomy
removal of entire breast, no lymph node dissection
142
what is a simple total mastectomy done for?
cancer confined to breast only
143
modified radical mastectomy
removal of breast and all axillary contents including axillary lymph nodels
144
what is left intact during modified radical mastectomy?
pectoral muscle
145
irrigating with warm water during mastectomy?
decrease cancer cell survival
146
radical mastectomy
removal of entire breast, pectoralis major and minor, facia, axillary nodes and adjacent tissue
147
parathyroidectomy
removal of 1 or more of the glands
| PURPOSE: hyperplasia/hyperparathyroidism
148
what does the parathyroid do?
regulates calcium and phosphorous concentrations
149
can you remove all 4 parathyroid glands?
no!!! will die from tetany
150
where is the incision for parathyroidectomy?
transverse incision in natural neck fold
151
new technique for parathyroidectomy
1 gland is transplanted to other accessible area for later removal depending on blood levels
152
partial thyroidectomy
1 lobe removed
153
subtotal thyroidectomy
most of gland removed
154
total thyroidectomy
entire gland removed
155
what does thyroidectomy treat?
hyperthyroidism
156
anatomy of thyroid
2 lobes connected by an isthmus
157
thyroid function
regulates energy production
158
instruments for thyroidectomy
lahey tenaculum
159
parotidectomy
| surgery/purpose
excision of parotid gland
| PURPOSE: inflammatory disease
160
structures identified and preserved during parotidectomy
facial nerve, auricular nerve
161
excision of submandibular gland
remove gland-tumors
162
nerves for submandibular gland excision
hypoglossal and facial lingual nerve
163
most common congential cyst found in neck
thyroglossal duct cystectomy
164
thyroglossal duct cystectomy
excise all portions of cyst, duct and hyoid bone to avoid cyst re occurrance
165
tracheostomy
| surgery/purpose/instruments
opening made into trachea with insertion of cannula to facilitate breathing
PURPOSE: treats upper respiratory tract obstruction
INSTRU: jackson tracheal hook
166
incision for trach
between 3rd and 4th tracheal rings with 15 blade
167
larynx function
air passageway
168
laryngectomy
| surgery/purpose/instruments
excision of larynx, hyoid bone, strap muscles, epiglottis
PURPOSE: neoplasms
INSTRU: trach set and trach tubes,
169
what would be done first beofre laryngectomy to manage airway?
tracheostomy
170
ST job for laryngoscopy
keep all specimens separate and labeled correctly
171
radical neck dissection
resection of cancerous tumor and surrounding structures
172
when is radical neck dissection done?
only if there is a reasonable chance of controlling the cancer
173
modified neck dissection
removes tumor and lymph nodes suspected of cancer but allows patient minimal defect
174
main function of large intestine
reabsorb water and elctrolytes
175
mesoappendix suture
3-0 chromic
176
appendix base suture
2-0 chromic tie
177
appendix stump suture
2-0 chromic pursestring
178
breast biopsy anesthesia
local with IV sedation
