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Surgical Recall > Chapter 1 - Introduction > Flashcards

Chapter 1 - Introduction Flashcards

1
Q

What do you do if you have to sneeze in the OR?

A

Back up STRAIGHT; do not turn your head

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2
Q

What do you do if you feel faint in the OR?

A

Say you feel faint and ask to sit down

N.B. Always a good idea to eat before going into the OR

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3
Q

What should you say when you first enter the OR?

A

Introduce yourself as the student, state that you’ve been invited to scrub, ask if you need to get out your gloves/gown

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4
Q

Should you wear your I.D. into the OR?

A

Yes

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5
Q

Can you wear nail polish in the OR?

A

Yes, as long as it isn’t chipped

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6
Q

Can you wear rings or a watch when scrubbed in to the OR?

A

No

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7
Q

Can you wear earrings in the OR?

A

No

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8
Q

When scrubbed, are your back or underarms sterile?

A

No; do not put your hands under your arms or behind your back

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9
Q

How far down the gown is considered part of the sterile field?

A

Just to the waist

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10
Q

How far up the gown in considered sterile?

A

Up to the nipples

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11
Q

How do you stand while waiting for the case to start?

A

Hands together in the front, above your waist

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12
Q

Can I button up a surgical gown (when not scrubbed) with bare hands?

A

Yes (remember: the back of the gown is not sterile)

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13
Q

How many layers of gloves should you wear when scrubbed?

A

2 layers

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14
Q

What is the normal order of sizes of gloves?

A

Larger size pair with the smaller pair on top

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15
Q

What items compromise the sterile field in the OR?

A

Instrument table, Mayo tray, and anterior drapes on the patient

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16
Q

What is the tray with the instruments in the OR called?

A

Mayo tray

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17
Q

Can you grab things off the Mayo tray?

A

No, ask the scrub nurse/tech for permission

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18
Q

How do you remove blood with a laparotomy (lap) pad?

A

Dab; don’t wipe because it will remove the platelet plugs

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19
Q

Can you grab the skin with DeBakey pickups?

A

No, pickups for the skin must have teeth (e.g. Adson, rat-tooth); it’s better to cut the skin than crush it

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20
Q

How should you cut the sutures after tying a knot?

A
  1. Rest cutting hand on non-cutting hand

2. Slip scissors down to the knot and cant scissors at a 45 degree angle so you don’t cut the knot itself

21
Q

What should you do when you are scrubbed and someone is tying a suture?

A

Ask the scrub nurse for a pair of suture scissors so you are ready if you’re asked to cut the suture

22
Q

What is Allen’s test?

A

Test for patency of ulnar artery prior to placing a radial arterial line or performing an ABG

Examiner concludes both ulnar and radial arteries with fingers as patient makes a fist; patient opens fist while examiner releases ulnar artery occlusion to assess blood flow to hand
(20% of population have complete radial artery dominance)

23
Q

Ballance’s sign

A

Constant dullness to percussion in the left flank/LUQ and resonance to percussion in right flank seen with splenic rupture/hematoma

24
Q

Battle’s sign

A

Ecchymosis over the mastoid process in patients with basilar skull fractures

25
Q

Beck’s triad

A

Seen in patients with cardiac tamponade

  1. JVD
  2. Decreased or muffled heart sounds
  3. Decreased blood pressure
26
Q

Blumer’s shelf

A

Metastatic disease to the rectouterine pouch (of Douglas) or rectovesical pouch creating a “shelf” that is palpable on rectal examination

27
Q

Carcinoid triad

A

Seen with carcinoid syndrome (think FDR)

  1. Flushing
  2. Diarrhea
  3. Right-sided heart failure
28
Q

Charcot’s triad

A

Seen with cholangitis

  1. Fever (chills)
  2. Jaundice
  3. Right upper quadrant pain
29
Q

Chvostek’s sign

A

Twitching of facial muscles upon tapping the facial nerve in patients with hypocalcemia

30
Q

Courvoisier’s law

A

Enlarged, non-tender gallbladder seen with obstruction of common bile duct, most commonly with pancreatic cancer

N.B.: Not seen with gallstone obstruction because gallbladder is scarred secondary to chronic cholelithiasis

31
Q

Cullen’s sign

A

Bluish discoloration of periumbilical area due to retroperitoneal hemorrhage tracking around to the anterior abdominal wall through fascial planes (e.g. acute hemorrhagic pancreatitis)

32
Q

Cushing’s triad

A

Signs of increased intracranial pressure

  1. Hypertension
  2. Bradycardia
  3. Irregular respirations
33
Q

Goodsall’s rule

A

Anal fistulae course in a straight path anteriorly and a curved path posteriorly from midline

Think of a dog with a straight anterior nose and curved posterior tail

34
Q

Hamman’s sign/crunch

A

Crunching sound on auscultation of the heart resulting from emphysematous mediastinum; seen with Boerhaave’s syndrome, pneumomediastinum, etc.

35
Q

Howship-Romberg sign

A

Pain along the inner aspect of the thigh

Seen with obturator hernia as the result of nerve compression

36
Q

McBurney’s point

A

One third the distance from the anterior iliac spine to the umbilicus on a line connecting the two

37
Q

Meckel’s diverticulum rule of 2’s

A

2% of the population, 2% are symptomatic, occur within 2 feet from the ileocecal valve

38
Q

Murphy’s sign

A

Cessation of inspiration while palpating under the right costal margin; patient cannot continue to inspire deeply because it brings an inflamed gallbladder under pressure (seen in acute cholecystitis)

39
Q

Obturator sign

A

Pain upon internal rotation of the leg with the hip and knee flexed

Seen in patients with appendicitis/pelvic abscesses

40
Q

Pheochromocytoma symptoms triad

A
  1. Palpitations
  2. Headache
  3. Episodic diaphoresis

Think of the “PHE” in pheochromocytoma

41
Q

Psoas sign

A

Pain elicited by extending the hip with the knee in full extension

Seen with appendicitis and psoas inflammation

42
Q

Raccoon eyes

A

Bilateral black eyes as a result of basilar skull fracture

43
Q

Reynold’s Pentax

A
  1. Fever
  2. Jaundice
  3. Right upper quadrant pain
  4. Mental status changes
  5. Shock/sepsis

Thus, Charcot’s triad plus #4 and #5; seen in patients with suppurative cholangitis

44
Q

Rovsing’s sign

A

Palpation of LLQ resulting in pain in the RLQ

Seen in appendicitis

45
Q

Virchow’s node

A

Metastatic tumor to the left supraclavicular node (classically due to gastric cancer)

46
Q

Virchow’s triad

A

Risk factors for thrombosis:

  1. Stasis
  2. Abnormal endothelium
  3. Hypercoagulability
47
Q

Trousseau’s sign

A

Carpal spasm after occlusion of blood to forearm with a BP cuff in patients with hypocalcemia

48
Q

Valentino’s sign

A

Right lower quadrant pain from a perforated peptic ulcer due to succus/pus draining into the RLQ

49
Q

Whipple’s triad

A

Evidence for insulin a

  1. Hypoglycemia (<50)
  2. CNS and vasomotor symptoms (e.g. syncope, diaphoresis)
  3. Relief of symptoms with administration of glucose

Surgical Recall (6 decks)

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