Week 6 Flashcards by Iseoluwa Ojo

A fistula is an ______________ between a __________ and the __________ , or between ___________¹.

A wound sinus is a __________________________ that extends from the ___________ of an organ to an __________________ ”

abnormal passage

hollow organ ; skin surface;

discharging blind-ended tract

surface; underlying area or abscess cavity

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Kasai portoenterostomy is the classic operation for the condition of ______________ and consists of _________ of all _________ remnants and the _________ then using a _________ of mobilised _________ to anastomose to the denuded transected portal plate within the porta hepatis at the _________ of the liver.

congenital biliary atresia

excision

extrahepatic bile duct ;gallbladder

Roux loop ; jejunum

root

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One hb = ____gm of bilirubin

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Bile is _______ color then on exposure to line it becomes ________

golden yellow

Green

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5 major problems of obstructive jaundice

________________

___________ fixed with ____________

____________

_______________fixed by ____________ fluid

___________ tendencies

Hepatorenal syndrome

dehydration; dextrose water

sepsis

hypoglycemia; glucose containing

bleeding

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Retrograde ____________ intussusception is a rare complication of _________ and _________reconstruction

jejuno-gastric

gastrojejunostomy

Billroth II

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In a Billroth II reconstruction after a __________________, the ______________ is (opened or closed?) and a ____________________ is created

partial gastrectomy

duodenal stump

Closed ; gastrojejunostomy

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A choledochal cyst (CC) or biliary cyst is a congenital or acquired anomaly affecting the biliary tree. It involves the _________ of the __________ that could affect the ____________ and/or the ___________ segments.

dilation; biliary tree

extrahepatic ; intrahepatic

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The triangular cord sign is a triangular or tubular ___________ of ________ tissue, representing the _________ of the _____________________ , seen in the porta hepatis at ____________, and is relatively specific for the diagnosis of biliary atresia 1,2.

echogenic cord ; fibrous

ductal remnant; extrahepatic bile duct

ultrasonography

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Peak incidence of intussusception is e between ??

6th to 9th month after birth

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Diarrhea can cause intussusception

T/F

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Meckel’s rule of 2

Epidemiology: ________,___________,_______

Anatomical: _________,_________

Two types of _______________

2% of the population
presentation before the age of two.
2 times more common in males

2 feet from the ileocecal valve
2 inches in length

heterotopic Mucosa

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Primary causes of intussusception?

Change in diet at weaning
URTI

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Nonoperative reduction — Nonoperative reduction using ________ or _________ by enema

hydrostatic

pneumatic pressure

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17 pathologic lead points of Intussusception

Meckel’s Diverticulum
Acute appendicitis
Lymphoma
Intestinal polyps
Scar tissue/adhesions
Coeliac disease
Henoch schnolein purpura
Crohn’s disease
Waugh’s syndrome
Myelomeningocoele

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Most causes of cholestatic jaundice are a result of diseases of the _________ or ___________ , including intrahepatic forms caused by _______,_________,_________ , and destruction of the interlobular ducts.

liver or biliary tract

drugs, alcohol, infection

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Types of internal fixators include:

Mention 3

Plate and screws
Kirschner wires
Intramedullary nails

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An orthopedic plate is a form of __________ fixation used in orthopaedic surgery to hold __________ in place to allow __________ and to reduce the possibility of __________. Most modern plates include bone __________ to help the orthopedic plate stay in place.

internal ; fractures

bone healing

nonunion ; screws

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___________ wires or K-wires or pins are sterilized, sharpened, smooth stainless steel pins.
They come in different sizes and are used to ____________________ (
___________ fixation) or to provide an anchor for ___________.

The pins are often driven into the bone through the _______ (___________ fixation) using a ________ or _________ . They also form part of the ___________ apparatus.

Kirschner

hold bone ;pin

skeletal traction. ; skin

percutaneous pin ; power or hand drill

Ilizarov apparatus.

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An intramedullary rod, also known as an intramedullary nail (IM nail) or inter-locking nail or __________ nail , is a __________ forced into the __________ of a bone.

IM nails have long been used to treat fractures of _______ bones of the body.

Küntscher nail ; metal rod

medullary cavity ; long bones

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IM nails resulted in earlier return to activity for the soldiers, sometimes even within a span of a few weeks, since they _______________________, rather than entirely _______________

share the load with the bone

supporting the bone

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Open Reduction Internal Fixation (ORIF)

Open reduction refers to _____________________, as is necessary for some fractures.

Internal fixation refers to fixation of _____________________, _____________________, and other devices to enable or facilitate healing.

open surgery to set bones,

screws and/or plates

intramedullary rods

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Closed Reduction Internal Fixation (CRIF) is reduction without any ___________ , followed by __________.

It appears to be an acceptable alternative in unstable distressed _____________ fractures of the _________ in children, but if fracture displacement after closed reduction exceeds ________, open reduction and internal fixation is recommended.

open surgery

internal fixation

lateral condylar ; humerus

2 mm

5Rs of fracture management

Resuscitate
Radiology
Reduce
Retain
Rehabilitate

Atresia is __________ due to a _________

Failure of canalization Vascular accident

Most common type of TOF is???

Type C Distal fistula Proximal atresia

CHARGE syndrome is a disorder that affects many areas of the body. CHARGE: List all

coloboma, heart defects, atresia choanae , growth retardation, genital abnormalities, and ear abnormalities.

The 'double bubble' sign in prenatal diagnosis is most often associated with __________________

duodenal atresia

omphalocele defect This sac consists of an inner layer of ________ middle layer of _____________ outer layer of ___________.

peritoneum; Wharton's jelly amnion

Gastroschisis is a birth defect where a _______ in the _______________ beside the _________ allows the baby's ________ to extend outside of the baby's body.

hole; abdominal (belly) wall belly button intestines

What Is a PSARP? A _____________________ (PSARP), sometimes called a ________ surgery, is a procedure that repairs _________________, or defects of the ______ and/or ______.

posterior sagital anorectoplasty pull-through anorectal malformations rectum; anus

When there is unilateral undescended tetes, the percentage for fertility is _______ For bilateral, it’s _______

60-66% 33%

Placenta Previa When the ______________________________.

placenta covers the opening in the mother's cervix

Placenta praevia risk factors include a ___________, age older than _____ and a history of previous surgeries, such as a ____________ or ____________ removal.

previous delivery 35 caesarean section (C-section) uterine fibroid

Placenta Previa The main symptom is _______________ (with or without?) pain during the _______-half of pregnancy.

bright red vaginal bleeding Without second

5 tails of Lockwood

Perineum Root of the penis Femoral triangle Superficial inguinal pouch Scrotal

____________ is the absence of both testes at birth _____________ is the presence of only one testis _____________ is a very rare anomaly, which is defined by the presence of more than two testicles

Anorchia Monorchia Polyorchidism

Types of testes?

Ectopic Undescended Retractile Ascending Congenital Acquired

Laparotomy Is a part of emergency treatment T/F

A __________( _____________) is the most definitive initial treatment of a pneumothorax.

chest tube (or intercostal drain)

Immediate management of open pneumothorax is to __________ with a __________ sterile occlusive dressing that is closed securely with tape on __________. Thus, the dressing prevents ______________________________ during inspiration but allows _________________ during expiration.

cover the wound rectangular ; only 3 sides. atmospheric air from entering the chest wall any intrapleural air out during expiration.

Most moderate sized and all massive hemothoraxes should be treated with _________________ .

tube thoracostomy

Flail chest is a traumatic disorder that happens when ______________ located ___________ are ________ in _______________

three or more ribs next to each other fractured two or more places.

________________ to achieve chest cavity stabilization is the standard treatment for patients with both flail chest and lung damage. This treatment has a demonstrated ability to reduce mortality rates, but the possibility of developing ___________ increases the longer it is in place.

Mechanical ventilation neumonia

The definitive treatment for cardiac tamponade is _____________________________.

removal of the accumulated pericardial fluid

Definitive treatment of airway obstruction An ___________ or ________________ may be inserted into the airway. This can help get oxygen through swollen airways. A _____________ or ___________ are surgical openings made in the airway to bypass an obstruction.

endotracheal; nasotracheal tube tracheostomy and cricothyrotomy

X-rays you do in an emergency situation Mention3

Chest X-ray Pelvic X-ray Cross table lateral of the Cervical spine

Adjuncts of primary survey Mention 6

Vital signs Pulse oximeter and CO2 ECG Urine output Urinary/gastric catheters Arterial blood gases

Adjuncts to Primary Survey Diagnostic Tools ●_____________ ● _______________

Focused abdominal sonography in trauma(FAST) Diagnostic peritoneal lavage

When do I start the secondary survey? After ●_________ is completed ● ABCDEs are ___________ ● ____________ are returning to normal

Primary survey reassessed Vital functions

13 Pathological lead pouts of Intussusception

Meckel’s diverticulum Polyps Intestinal duplication Lymphoma Hemangioma Lymphosarcoma Enteric cysts Henoch-schloein purpura Cystic fibrosis Benign intestinal neoplasm Ectopic gastric mucosa Ectopic pancreatic mucosa Ascariasis

Clinical presentation of Intussusception •sudden onset of _____________ and _________ of the _______ •___________ •stool is initially _______ then _________

Intermittent Inconsolable cries; indrawing; legs Vomiting Mucoid; bloody

Abdominal USS in Intussusception Color duplex to detect ???

Viability

Non -operative management Hydrostatic reduction can be done in intussusception using _____,______,________

Saline Barium Gastrograffin

Contraindications to Non-operative reduction of intussusception Absolute: Signs of _____________, suspected ____________ Relative : ________ bleeding, symptoms > _________

Peritonitis; perforation Rectal; 24-48hrs