Week 4 - General Surgery Flashcards Preview

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Flashcards in Week 4 - General Surgery Deck (33):
1

The head and neck in general surgery consist of:

Thyroid
Para-thyroid
Larynx

2

Breast surgeries can consist of:

Biopsy (simple)
Wide excision and hook wire biopsy
Sentinal Node biopsy
Mastectomy (simple, total, radical, modified)
+/- lymph node dissection

3

Signs and symptoms of breast cancer

Palpable lump
Swelling in or around the breast, clavicle or armpit
Skin thickening or redness
Nipple changes
Nipple discharge
Pain

4

What is DCIS (non-invasive - contained - easier to treat)?

DCIS (Ductal Carcinoma In-Situ): abnormal cells contained within the milk ducts

5

What is LCIS (non-invasive - contained - easier to treat)?

LCIS (Lobular Carcinoma In-Situ): abnormal cells form within the lobules or milk glands within the breast.

6

What is IDC (invasive) in breast cancer?

Invasive Ductal Carcinoma: abnormal cells that originated from the milk ducts have now invaded surrounding tissue.

Large incision - for clearer margins

7

What are types of peptic ulcers?

Gastric ulcers
Duodenal ulcers
Stress ulcers

8

Common causes of IBS?

IBS, diverticulitis, peptic ulcer disease, chronic pancreatitis, hepatitis, cholecystitis, pelvic inflammatory disease, valvular insufficiency

9

Precipitating factors of IBS

Stress, psychological factors, prior gastroenteritis, specific food intolerances

10

Inflammatory disorders can be treated by:

Drug therapy, surgical therapy, nutritional therapy

11

Anorectal problems

Anal fissure
Anorectal abscess
Anal fistula
Pilonidal sinus

12

Laryngectomy

Removal of the larynx (voice box) - partial, total or permanent

13

Signs and symptoms of breast cancer

Palpable lump
swelling in and around the breast, clavicle or armpit
skin thickening or redness
nipple changes
nipple discharge
pain

14

Lumpectomy

is also called breast-conserving surgery or wide local excision. It is to remove cancer or other abnormal tissue from the breast.

15

Radiotherapy

Becoming decreasingly invasive - more specific targeting
Side effects: scarring
E.g if it's hitting the chest wall, it can hit the heart and lungs e.g/
Pain on inspiration, SOB.

16

TRAM (Transverse Rectus Abdominus Muscle flap) - e.g of reconstructive surgery post-mastectomy

Large operation
Lower abdomen - incision
Take muscle fat and blood supply
Tunnelled from the abdomen underneath the skin and comes into the chest

17

Hernia

Occurs when it becomes weakens and then separates and then moves
When under pressure contents from the peritoneal cavity through the muscle wall
The risk is if the small bowel is moving through the muscle wall, it can become stuck (incarcerated - necrotic)
Reduced blood supply.
Painful
Can occur anywhere along the abdominal wall.

18

Types of Hernias

* Epigastric hernia
* Umbilical hernia
* Massive Ventral Hernia (straight up the midline)
* Inguinal Hernia (usually male dominated) - repaired by a small opening - laparoscopic or open. Trochar through abdomen. Trochar to gas - distend the abdomen. Mesh inserted as a layer to prevent contents to move up through the gap. The mesh will adhere to the abdominal wall. Scarring will occur.

19

Cholelithiasis

Chole = Gall
Lithiasis = Stones
= Gallstones

20

Cholecystitis

inflammed gallstones

21

Hiatus Hernia

Portion of the stomach that moves up and down the diaphragm. It can become stuck and a pouch develops. Food and fluid can collect there and over time it can become inflammed and irritation and this is where oesophagitis occurs and reflux.
Traumatic to a patient.

22

Hiatus Hernia

Portion of the stomach that moves up and down the diaphragm. It can become stuck and a pouch develops. Food and fluid can collect there and over time it can become inflammed and irritation and this is where Oesophagitis occurs and reflux.
Traumatic to a patient.
Pt with gastric reflux or hiatus hernia are at risk of aspiration!!
Simple procedure - laparoscopic
Extended fasting needed
need good pre op preparation
Nasogastric tube

23

Peptic ulcer disease

Gastric ulcers
Duodenal ulcers
Stress ulcers

Complications
haemmorage
perforation
gastric outlet obstruction

24

Colorectal

IBS, diverticulitis, peptic ulcer disease, chronic pancreatitis, hepatitis, cholecystitis, pelvic inflammatory disease, valvular insufficiency

25

Factors of Colorectal disorders

stress, psychological, prior gastroenteritis

26

Polyps of the large intestine

Removed in a colonoscopy with loop, diathermy to seal a bleed

27

Colorectal Cancer

Lower incidence in Vegans
Surgical therapy
Potential for radiotherapy or chemotherapy

28

Right and left hemicolectomy

right or left side removed

29

Transverse colectomy

The middle removed

30

Subtotal or Total Colectomy

Most or all of the bowel removed

31

Ostomy Surgery

Ascending Colostomy
Descending " "
Ileostomy
Sigmoid Colostomy
Transverse Colostomy

32

Hartmann's procedure

Surgical resection of the rectosigmoid colon with closure of the rectal stump and formation of an end colostomy. It was used to treat colon cancer or inflammation (proctosigmoiditis, proctitis, diverticulitis, etc.).
Can be temporary or permanent

33

Anorectal problems

Anal fissures
Anorectal abcess
Anal fistula
Pilonidal Sinus

More common in males. Not usually detected early. Usually from an ingrown hair.