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Rapid Review > Pre-op 101 & Procedures > Flashcards

Pre-op 101 & Procedures Flashcards

1
Q

When can a patient eat prior

to major surgery?

A

Patient should be NPO after midnight
the night before or for at least 8 hours
before surgery

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2
Q

What risks should be discussed
with all patients and
documented on the consent
form for a surgical procedure?

A

Bleeding, infection, anesthesia, scar;
other risks are specific to the individual
procedure (also MI, CVA, and death if
cardiovascular disease is present)

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3
Q

If a patient is on antihypertensive
medications, should
the patient take them on the
day of the procedure?

A

Yes, (remember clonidine “rebound”)

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4
Q

If a patient is on an oral
hypoglycemic agent (OHA),
should the patient take the
OHA on the day of surgery?

A

Not if the patient is to be NPO on the

day of surgery

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5
Q

If a patient is taking insulin,
should the patient take it on
the day of surgery?

A

No, only half of a long-acting insulin
(e.g., lente) and start D5 NS IV; check
glucose levels often preoperatively,
operatively, and postoperatively

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6
Q

Should a patient who
smokes cigarettes stop
before an operation?

A

Yes, improvement is seen in just 2 to

4 weeks after smoking cessation

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7
Q

What laboratory test must
all women of childbearing
age have before entering
the O.R.?

A

-HCG and CBC because of the possibility

of pregnancy and anemia from menses

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8
Q

What is a preop colon

surgery “bowel prep”?

A

Bowel prep with colon cathartic (e.g.,
GoLYTELY), oral antibiotics (neomycin
and erythromycin base), and IV antibiotic
before incision

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9
Q

Has a preop bowel prep
been shown conclusively to
decrease postop infections
in colon surgery?

A

No, there is no data to support its use

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10
Q

What preoperative
medication can decrease
postoperative cardiac events
and death?

A

-blockers!

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11
Q

What must you always order
preoperatively for your
patient undergoing a major
operation?

A
  1. NPO/IVF
  2. Preoperative antibiotics
  3. Type and SCREEN blood (PRBCs)
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12
Q

What electrolyte must you
check preoperatively if a
patient is on hemodialysis?

A

Potassium

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13
Q

Who gets a preoperative

ECG?

A

Patients older than 40 years of age

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14
Q

Roux-en-Y limb

A

Jejunojejunostomy forming a Y-shaped
figure of small bowel; the free end can
then be anastomosed to a second hollow
structure (e.g., esophagojejunostomy)

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15
Q

Brooke ileostomy

A

Standard ileostomy that is folded on
itself to protrude from the abdomen
2 cm to allow easy appliance placement
and collection of succus

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16
Q

CEA

A

Carotid EndArterectomy; removal of atherosclerotic

plaque from a carotid artery

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17
Q

Bassini herniorrhaphy

A

Repair of inguinal hernia by approximating
transversus abdominis aponeurosis
and the conjoint tendon to the reflection
of Poupart’s (inguinal) ligament

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18
Q

McVay herniorrhaphy

A 
Repair of inguinal hernia by
approximating the transversus abdominis
aponeurosis and the conjoint tendon to
Cooper’s ligament (which is basically the
superior pubic bone periosteum)
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19
Q

Lichtenstein

herniorrhaphy

A

“Tension-free” inguinal hernia repair using

mesh (synthetic graft material)

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20
Q

Shouldice herniorrhaphy

A 
Repair of inguinal hernia by imbrication
of the transversalis fascia, transversus
abdominis aponeurosis, and the conjoint
tendon and approximation of the transversus
abdominis aponeurosis and the
conjoint tendon to the inguinal ligament
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21
Q

Plug and patch hernia

repair

A

Prosthetic plug pushes hernia sac in and
then is covered with a prosthetic patch to
repair inguinal hernias

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22
Q

APR

A 
AbdominoPerineal Resection; removal
of the rectum and sigmoid colon through
abdominal and perineal incisions (patient
is left with a colostomy); used for low
rectal cancers 8 cm from the anal verge
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23
Q

LAR

A

Low Anterior Resection; resection of
low rectal tumors through an anterior
abdominal incision

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24
Q

Hartmann’s procedure

A
  1. Proximal colostomy
  2. Distal stapled-off colon or rectum that
    is left in peritoneal cavity
25
Q

Mucous fistula

A

Distal end of the colon is brought to the
abdominal skin as a stoma (proximal end
is brought up to skin as an end colostomy)

26
Q

Kocher (“koh-ker”)

maneuver

A

Dissection of the duodenum from the
right-sided peritoneal attachment to
allow mobilization and visualization of
the back of the duodenum/pancreas

27
Q

Highly selective

vagotomy

A 
Transection of vagal fibers to the body
of the stomach without interruption of
fibers to the pylorus (does not need
pyloroplasty or other drainage procedure
because the pylorus should still function)
28
Q

Enterolysis

A

Lysis of peritoneal adhesions

29
Q

LOA

A

Lysis Of Adhesions (enterolysis)

30
Q

Appendectomy

A

Removal of the appendix

31
Q

Lap appy

A

Laparoscopic removal of the appendix

32
Q

Cholecystectomy

A

Removal of the gallbladder

33
Q

Lap chole

A

Laparoscopic removal of the gallbladder

34
Q

Nissen

A

Nissen fundoplication; 360 wrap of the
stomach by the fundus of the stomach
around the distal esophagus to prevent
reflux

35
Q

Lap Nissen

A

Nissen fundoplication with laparoscopy

36
Q

Simple mastectomy

A

Removal of breast and nipple without

removal of nodes

37
Q

Choledochojejunostomy

A 
Anastomosis of the common bile duct to
the jejunum (end to side)
38
Q

Graham patch

A

Placement of omentum with stitches over
a gastric or duodenal perforation (i.e.,
omentum is used to plug the hole)

39
Q

Heineke-Mikulicz

pyloroplasty

A

Longitudinal incision through all layers of
the pylorus, sewing closed in a transverse
direction to make the pylorus nonfunctional
(used after truncal vagotomy)

40
Q

Pringle maneuver

A

Temporary occlusion of the porta hepatis
(for temporary control of liver blood flow
when liver parenchyma is actively bleeding)

41
Q

Modified radical

mastectomy

A 
Removal of the breast, nipple, and axillary
lymph nodes (no muscle is removed)
42
Q

Lumpectomy and

radiation

A

Removal of breast mass and axillary
lymph nodes; normal surrounding breast
tissue is spared; patient then undergoes
postoperative radiation treatments

43
Q

I & D

A

Incision and Drainage of pus; the wound

is then packed open

44
Q

Exploratory laparotomy

A

Laparotomy to explore the peritoneal cavity
looking for the cause of pain, peritoneal
signs, obstruction, hemorrhage, etc.

45
Q

TURP

A

TransUrethral Resection of the Prostate;
removal of obstructing prostatic tissue via
scope in the urethral lumen

46
Q

Fem pop bypass

A

FEMoral artery to POPliteal artery
bypass using synthetic graft or saphenous
vein; used to bypass blockage in the
femoral artery

47
Q

Ax Fem

A

Long prosthetic graft tunneled under the
skin placed from the AXillary artery to
the FEMoral artery

48
Q

Triple A repair

A

Repair of an AAA (Abdominal Aortic
Aneurysm): Open aneurysm and place
prosthetic graft; then close old aneurysm
sac around graft

49
Q

CABG

A 
Coronary Artery Bypass Grafting; via
saphenous vein graft or internal mammary
artery bypass grafts to coronary arteries
from aorta (cardiac revascularization)
50
Q

Hartmann’s pouch

A

Oversewing of a rectal stump (or distal
colonic stump) after resection of a
colonic segment; patient is left with a
proximal colostomy

51
Q

PEG

A 
Percutaneous Endoscopic Gastrostomy:
Endoscope is placed in the stomach,
which is then inflated with air; a needle is
passed into the stomach percutaneously,
wire is passed through the needle
traversing the abdominal wall, and the
gastrostomy is then placed by using the
Seldinger technique over the wire
52
Q

Ileoanal pull-through

A

Anastomosis of the ileum to the anus

after total proctocolectomy

53
Q

Hemicolectomy

A

Removal of a colonic segment

i.e., partial colectomy

54
Q

Truncal vagotomy

A 
Transection of the vagus nerve trunks;
must provide drainage procedure to
stomach (e.g., gastrojejunostomy or
pyloroplasty) because after truncal
vagotomy, the pylorus does not relax
55
Q

Antrectomy

A

Removal of stomach antrum

56
Q

Whipple procedure

A 
Pancreaticoduodenectomy:
Cholecystectomy
Truncal vagotomy
Pancreaticoduodenectomy—removal
of the head of the pancreas and
duodenum
Choledochojejunostomy
Pancreaticojejunostomy (anastomosis
of distal pancreas remnant to the
jejunum)
Gastrojejunostomy (anastomosis of
stomach to jejunum)
57
Q

Excisional biopsy

A 
Biopsy with complete excision of all
suspect tissue (mass)
58
Q

Incisional biopsy

A 
Biopsy with incomplete removal of
suspect tissue (incises tissue from mass)
59
Q

Tracheostomy

A

Placement of airway tube into trachea

surgically or percutaneously

Rapid Review (13 decks)

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