23.IR and IE/24.Lap and thoracoscopy Flashcards
What is the maximum insuflation of the abdomen with CO2
a. 10 mmhg
b. 12 mmhg
c. 15 mmhg
d. 17 mmhg
c 15 (but 10-12 is generally recommended)
8-10 mm Hg generally enough working space
14 cm H20 per the anesthesia for procedures chapter
What is false about Veress needles?
A) It contains a spring loaded trochar.
B) It is used to create a pneumothorax
C) It is used to create a pneumoperitoneum
D) It can be used to directly penetrate the abdomen without any incisions.
D false
Which of the following is true regarding abdominal access?
A The modified Hasson technique involves the use of a veress needle with a hanging drop
B Improper placement of a needle into the subcutaneous space will not result in SQ emphysema
C Initial intraabdominal pressure >6mmHg and low CO2 flow indicates malpositioning, likely in the SQ
D Falciform fat visualization is not a confirmatory mechanism of being within the abdomen
C is correct
A (false, blunt trochar with Hasson)
True or false: insufflation is not necessary for thoracoscopy
(TRUE)
What are the most common port sizes for laparoscopy? A. 5 and 10mm B. 4 and 12mm C. 5 and 12 mm D. 4 and 10mm
5 and 12mm
Which of the following statements is true?
A Drainage catheters are only available in non-locking loop conformations
B Guiding catheters are named for their inner diameter.
C Low pressure occlusion balloons are filled with contrast and used to dilate and efface strictures
D Locking loop or Cope loop catheters are preferred because of suture locking mechanism to secure the loop
D is true
A (also locking loop)
B(OUTER)
C (HIGH pressure)
Which of the following materials is reconstrainable?
a. Woven stents
b. Laser cut stents
c. Permanent metallic embolics
d. Polyvinyl alcohol embolic
c designed to fit anatomy
few exceptions with the Laser cut
mesh self-expanding also reconstrainable
what is the preferred light source for -scopy?
Xenon
Which of the following is NOT a feature of using CO2 for insufflation?
a. Rapidly excreted from circulation
b. Low solubility means there is a risk of gas emboli
c. Detrimental effects on cellular, hormonal and immunologic function
d. cheap and odorless
B. Highly soluble = low risk
true/false: Woven or braided stents are reconstrainable
false
Mesh self-expanding are
woven and laser cut are NOT reconstrainable
T/F
The Ho:YAG laser is used for extracorporeal lithotripsy
False
INTRAcorporeal - stone fragmentation and retrieval
can also be used for cutting and coagulation
t/f: Iohexal is a Low-osmolarity, nonionic, iodinated contrast media
true
True/false: Polyvinyl alcohol and NBCA are types of liquid embolics
False: polyvinyl alcohol comes in amorphous, granular or spherical forms (permanent particulate). Glue = NBCA = liquid
T/F concerning MIS?
Bipolar electrocautery should be used with great caution compared to monopolar, as several potentially hazardous problems can occur.
False caution with monopolar
• (Bipolar) electrosurgery is safer because it is usually of lower voltage current and energy passed between the tips
T/F: A defect in the insulation of the bipolar instrument shaft can result in the passage of current to tissues that are not in the visual field, leading to iatrogenic injury.
False:(monopolar)
T/F: Direct coupling injuries can occur when the monopolar instrument through which the electrical current is passed comes into contact with the telescope or other instrument, resulting in iatrogenic damage to tissues that may lie outside the visual field.
true
True or false: 3 chip cameras provide superior optical clarity and each process one color, red, blue, and yellow.
False: 3 chip = better, colors = red, blue, and GREEN
What pressure can cause cardiorespiratory depression in the thoracic cavity?
3 mm Hg
how can one lung ventilation be accomplished? (3)
selective intubation
bronchial blockers
double lumen endobronchial intubation
Which of the following is true for hemostasis/sealing in MIS?
A. Disposable hemostatic clips are more cost-effective than M/L-10 reusable multifire hemoclip applier
B. One of the strongest slip knots is the 4S modified Roeder knot
C. Vessel sealing devices work by application of monopolar or ultrasonic energy
D.For the ligasure thermal spread ranged from 1.5 to 3.2 and decreased as vessel size increased
A. more cost-effective = M/L-10 reusable multifire hemoclip applier
B. true
C. Vessel sealing devices=BIPOLAR or ultrasonic energy
D.For the ligasure thermal spread ranged from 1.5 to 3.2 and dIS GREATER as vessel size increased
True?
A. A hanging drop is used with the Hasson technique
B. The Veress needle technique can be used paramedian with little risk
C. Upon establishment of a pneumoperitoneum, the abdominal cavity should be tympanic
D. A blunt trochar is needed to penetrate the abdomen after using a verress needle
A. A hanging drop is used with the Veress needle
B. The Hasson technique can be used paramedian but it can be difficult to prevent leakage
C. true
D. A sharp trochar Could Be Used to penetrate the abdomen after using a verress needle (inflated)
