Study Guide Review (Chapters 23 and 33)

Question 1

Two techniques currently used for laparoscopic approach to a direct inguinal hernia are:

Answer 1

1. transabdominal preperitoneal (TAPP) laparoscopy

2. Total extraperitoneal (TEP) surgery

Question 2

In the TAPP approach, a _____ is created, and the inguinal canal is entered via the _____.

Answer 2

pneumoperitoneum

abdominal cavity

Question 3

In the TEP approach, instead of a pneumoperitoneum, the _____ is inflated with a balloon dissector, which expands the tissue planes.

Answer 3

peritoneal space

Question 4

A _____ is performed to remove a section of diseased colon and restore continuity to the intestine.

Answer 4

partial colectomy

Question 5

The colon is removed to treat _____, _____, _____, and _____.

Answer 5

carcinoma, ulcerative colitis, diverticulitis, and intestinal obstruction

Question 6

A _____ is the general term applied to removal of the large intestine.

Answer 6

colectomy

Question 7

During a colectomy, the _____ and _____ are not removed.

Answer 7

sigmoid colon and rectum

Question 8

What are the 7 abdominal incisions?

Answer 8

1. midline
2. paramedian
3. subcostal
4. flank
5. inguinal
6. McBurney
7. lower transverse (Pfannenstiel)

Question 9

When is a midline incision used?

Answer 9

1. laparotomy
2. percutaneous endoscopic gastronomy
3. partial gastrectomy
4. Billroth I
5. Billroth II
6. transhiatal esophagectomy
7. segmental resection of the small intestine
8. resection of the colon
9. colectomy
10. abdominoperineal resection
11. liver transplantation

Question 10

When is a paramedian incision used?

Answer 10

1. percutaneous endoscopic gastronomy
2. loop colostomy
3. colectomy
4. segmental resection of the liver

Question 11

When is a subcostal incision used?

Answer 11

1. segmental resection of the liver

2. liver transplantation

Question 12

When is a flank incision used?

Answer 12

??

Question 13

When is an inguinal incision used?

Answer 13

1. open repair of an indirect inguinal hernia

Question 14

When is a McBurney incision used?

Answer 14

1. appendectomy

Question 15

When is a lower transverse (Pfannenstiel) incision used?

Answer 15

??

Question 16

Direct inguinal hernia is a protrusion of abdominal or inguinal tissue through the _____.

Answer 16

tranversalis fascia

Question 17

A direct hernia protrudes through a weakness in the abdominal wall in the region between the _____ and _____ and medial to the inferior epigastric artery.

Answer 17

rectus abdominis muscle and inguinal ligament

Question 18

The _____ is the most difficult type to repair.

Answer 18

direct inguinal hernia

Question 19

With an _____ hernia, the peritoneal sac containing intestine protrudes through the internal inguinal ring and passes down the inguinal canal outside Hesselbach’s triangle.

Answer 19

indirect inguinal

Question 20

An _____ hernia is more common in males, but can occur in females.

Answer 20

indirect inguinal

Question 21

A _____ procedure may be used to repair either an indirect or direct reducible inguinal hernia using mesh behind the hernial defect.

Answer 21

laparoscopic

Question 22

A _____ involves repairing the defect in the transversalis fascia below the inguinal ligament and removing the peritoneal sac protruding through the femoral ring. (more common in women)

Answer 22

femoral herniorrhaphy

Question 23

Repair of an _____ consists of closing the peritoneal opening and uniting the fasciae above and below the defect to reconstruct the abdominal wall surrounding the umbilicus. (most often is children/congenital, some women after childbirth)

Answer 23

unbilical hernia

Question 24

An _____ is an abdominal wall defect occurring in the linea alba at the umbilical ring.

Answer 24

umbilical hernia

Question 25

Impaired healing of a previous surgical incision, usually a vertical abdominal incision, may cause a _____.

Answer 25

ventral (incisional) hernia

Question 26

An _____ is sometimes the aftermath of postoperative hematoma, infection, or undue strain.

Answer 26

incisional hernia

Question 27

A _____ has a high recurrence rate when mesh is placed on the outside of a large repair.

Answer 27

ventral hernia

Question 28

What is the duct of Wirsung?

Answer 28

is a duct joining the pancreas to the common bile duct to supply pancreatic juices which aid in digestion

Question 29

The _____ are sections of the small bowel suspended from the abdominal wall by a sheet of vascular tissue called the mesentery.

Answer 29

jejunum and ileum

Question 30

The pancreatic duct (duct of Wirsung) and the common bile duct from the liver drain their contents into the _____ section of the small intestine.

Answer 30

duodenum

Question 31

During a _____, the entire breast is removed. Axillary lymph nodes are not removed. The muscles of the chest wall are preserved.

Answer 31

simple mastectomy

Question 32

The peritoneum is usually closed with a/an _____ suture line.

Answer 32

continuous

Question 33

The peritoneum is usually closed with _____.

Answer 33

absorbable suture swaged to a taper needle, size 0 or 2-0

Question 34

When entering the abdominal cavity, the _______________is lifted with hemostats and a small incision made with the deep knife or Metzenbaum

Answer 34

peritoneum

Question 35

What type of breast biopsy involves removing the entire mass?

Answer 35

excisional biopsy

Question 36

Which type of breast biopsy involves a needle being inserted into the mass and tissue is retrieved for histologic examination?

Answer 36

core biopsy

Question 37

A mastectomy where a wedge or quadrant of breast tissue is removed.

Answer 37

segmental mastectomy

Question 38

Signs of gallstones or cancer near the gallbladder are:

Answer 38

swelling, pain, and infection; obstructive jaundice may occur

Question 39

What is the function of a t-tube?

Answer 39

drain bile

Question 40

When is a tube used?

Answer 40

cholecystectomy and operative cholangiography

Question 41

What does the surgeon use to irrigate a mastectomy wound?

Answer 41

antibacterial solution

Question 42

What instruments are used in a common bile duct exploration?

Answer 42

- four trocars (umbilical 10mm, midline 10mm, 2 at axillary line 5mm) - 30 degree telescope - laparoscope - straight locking grasper - scissors - esu hook - surgical clips

Question 43

What is a vagotomy?

Answer 43

performed to reduce gastric enzymes by severing the nerves that control their release

Question 44

What is pyloroplasty?

Answer 44

enlarging the pyloric opening between the stomach and the duodenum

Question 45

What is gastrectomy?

Answer 45

the stomach may be totally or partially resected