Chapter 14 Flashcards

1
Q

During cholangiography, bubbles in the contrast media would likely:
a. cause a pulmonary embolus
b. give the appearance of a stone on x-ray
c. pass undetected through the biliary system
d. rupture the cystic duct from pressure exerted during injection

A

b. give the appearance of a stone on x-ray

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2
Q

a Whipple procedure is done for treatment of a tumor in which abdominal organ?

A

Pancreas

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3
Q

WHat are the 7 stages of bowel anastomosis

A
  1. Mobilized
  2. Bad pathology removed HM HM
  3. Good blood supply
  4. Equal diameter
  5. Tension free
  6. Mesentery repaired
  7. Functional anatomy
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4
Q

what term describes a benign condition of breast enlargement in men?
a. gynecomastia
b. hypoplasia
c. macromastia
d. micromastia

A

a. gynecomastia

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5
Q

which stage of breast cancer is characterized by evidence of distal metastasis?
a. stage I
b. stage II
c. stage III-b
d. stage IV

A

d. stage IV

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6
Q

which anatomical structure is the largest mass of lymphatic tissue in the body?
a. axillary sentinel node
b. palatine tonsil
c. spleen
d. thymus

A

c. spleen

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7
Q

The triangle of Calot is anatomical space bounded by structures in which surgical procedure?
a. appendectomy
b. cholecystectomy
c. herniorrhaphy
d. thyroidectomy

A

b. cholecystectomy

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8
Q

what is achieved by insufflation of carbon dioxide into the abdominal cavity?

A

pneumoperitoneum

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9
Q

where is the gallbladder located in relation to the liver?

A

Inferior surface of the right lobe

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10
Q

for which surgical procedure would the Buie pile forceps be used?
a. appendectomy
b. breast biopsy
c. cholecystectomy
d. hemorrhoidectomy

A

d. hemorrhoidectomy

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11
Q

in which of the following abdominal incisions would the linea alba be opened down to the peritoneum?
a. Kocher subcostal
b. McBurney
c. midline transverse
d. transverse

A

c. midline transverse

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12
Q

which incision is traditionally used for opening appendectomy?
a. McBurney
b. median vertical
c. paramedian
d. Pfannenstiel

A

a. McBurney

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13
Q

a Maloney bougie dilator is used in which anatomical structure?
a. common bile duct
b. esophagus
c. urethra
d. cervix

A

b. esophagus

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14
Q

Doyen, Kocher, Dennis, and Allen are names of which type of instrument?
a. abdominal retractors
b. intestinal clamps
c. laparoscopic graspers
d. tissue scissors

A

b. intestinal clamps

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15
Q

what term is used for surgical opening of the abdominal or peritoneal cavity/
a. gastrectomy
b. gastrostomy
c. laparoscopy
d. laparotomy

A

d. laparotomy

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16
Q

which type of hernia occurs below the abdominocrural crease and more frequently in females?
a. femoral
b. epigastric
c. direct inguinal
d. indirect inguinal

A

a. femoral

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17
Q

what is another way of saying β€œcephalad to caudad”
a. front to back
b. back to front
c. head to tail
d. inside to outside

A

c. head to tail

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18
Q

a gastrostomy can be created by all of the following methods EXCEPT:
a. open
b. endovascular
c. laparoscopic
b. percutaneous

A

b. endovascular

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19
Q

which fascial sheet is attached to the iliac creat, linea alba, and pubis?
a. innominate
b. interparietal
c. Scarpa’s
d. transversalis

A

c. Scarpa’s

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20
Q

which suturing techniques is often used on the appendiceal stump?
a. interrupted
b. horizontal mattress
c. vertical mattress
d. pursestring

A

d. pursestring

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21
Q

great care is taken to identify and preserve the long thoracic and thoracodorsal nerves in which surgical procedure?
a. laparoscopic cholecystectomy
b. laparoscopic Nissen fundoplication
c. modified radical mastectomy
d. subtotal gastrectomy

A

c. modified radical mastectomy

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22
Q

what is the name of a gastric mass of indigestible vegetable fiber and hair that mat require surgical extension?
a. bezoar
b. calculus
c. polyp
d. ulcer

A

a. bezoar

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23
Q

what type of hernia protrudes through the transversalis fascia in the area of Hesselbach’s triangle?
a. direct
b. femoral
c. indirect
d. umbilical

A

a. direct

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24
Q

what type of hernia results from a failure of the deep internal ring to close during fetal development and allows intestinal protrusion into the scrotum?
a. direct
b. femoral
c. indirect
d. umbilical

A

c. indirect

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25
Q

what is the name for the type of hernia in which both direct and indirect defects are present?
a. diaphragmatic
b. epigastric
c. incisional
d. pantaloon

A

d. pantaloon

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26
Q

for which type of hernia repair could a Penrose drain be used as a method of gentle traction of the spermatic cord?
a. laparoscopic Nissen fundoplication
b. McVay inguinal herniorrhaphy
c. totally extraperitoneal patch (TEP)
d. ventral/incisional herniorrhaphy

A

b. McVay inguinal herniorrhaphy

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27
Q

a vagotomy is a surgical treatment option for:
a. appendicitis
b. ductal carcinoma
c. gastric ulcers
d. pancreatitis

A

c. gastric ulcers

28
Q

which type of intestinal obstruction involves a telescoping of a portion of the intestine into another portion?
a. adhesive stricture
b. fecal impaction
c. intussusception
d. volvulus

A

c. intussusception

29
Q

which type of surgical procedure is used to release abnormal tissue connections in the abdominal viscera and layers?
a. anastomosis
b. fundoplication
c. herniorrhaphy
d. lysis of adhesions

A

d. lysis of adhesions

30
Q

end-to-end, end-to-side, side-to-side, and Roux-en-Y are techniques for:
a. bowel anastomosis
b. mastectomy wound closure
c. mesh placement in herniorrhaphy
d. surgical skin prep solution application

A

a. bowel anastomosis

31
Q

in a laparoscopic appendectomy, all of the following methods could be used for dissection of the appendix EXCEPT:
a. endoscopic linear stapler
b. ligating loop instrument
c. intraluminal circular stapler
d. intracorporeal suturing instrument

A

c. intraluminal circular stapler

32
Q

which statement is CORRECT regarding polyps and diverticula in the colon?
a. both protrude inward into the lumen of the intestine
b. both protrude outward from the lumen of the intestine
c. Polyps protrude inward, and diverticula protrude outward from the intestine
d. diverticula protrude inward and polyps protrude outward from the intestine

A

c. Polyps protrude inward, and diverticula protrude outward from the intestine

33
Q

β€œBowel technique” refers to steps used by the surgical team to prevent postoperative:

A

SSI

34
Q

an intestinal stoma is created at a point below the costal margin, above the belt line, and at the lateral edge of which muscle?

A

Rectus abdominus

35
Q

which of the following is the MOST common permanent colostomy?
a. end
b. loop
c. end-loop
d. sigmoid

A

sigmoid

36
Q

which surgical position is used exclusively for anorectal surgical procedures?
a. Kraske
b. supine
c. Trendelenburg
d. reverse Trandelenburg

A

a. Kraske

37
Q

which type of the viewing instrument would be used for surgical treatment of hemorrhoids?
a. anoscope
b. colonoscope
c. laparoscope
d. sigmoidascope

A

a. anoscope

38
Q

due to the vascular and friable nature of the liver, a surgeon may choose to use suture on which type of needle?
a. taper
b. blunt
c. spatula
d. cutting

A

b. blunt

39
Q

what is the incision routinely used for open cholecystectomy?
a. McBurney
b. Pfannenstiel
c. left subcos
d. open right subcostal

A

d. open right subcostal

40
Q

which of the following are endocrine-secreting glands of the pancreas that make up only 1% of the organ?
a. acini
b. ampulla of Vater
c. islets of Langerhans
d. uncinate process

A

c. islets of Langerhans

41
Q

What does the colon produce?

A

Vitamin K

42
Q

Pancreaticoduodenectomy is also know as which of the following procedures?
a. Bassini-Shouldice
b. McVay
c. Nissen
d. Whipple

A

d. Whipple

43
Q

a needle-localization procedure may be performed in radiology for assistance in locating discrete masses in the:
a. breast
b. groin
c. liver
d. pancreas

A

a. breast

44
Q

what type of incision is made for excisional biopsy of a centrally located breast mass involving the lactiferous ducts?
a. circumareolar
b. elliptical
c. inframammary
d. paramedian

A

a. circumareolar

45
Q

what is the name for the first lymph node in the axillary chain that is frequently biopsied in conjunction with a breast biopsy, lumpectomy, or mastectomy?
a. attendant
b. guardian
c. leader
d. sentinel

A

d. sentinel

46
Q

the surgeon may request which of the following for irrigation to aid in destroying any residual tumor cells after dissection?
a. heparin
b. hydrogen peroxide
c. normal saline
d. sterile water

A

d. sterile water

47
Q

surgical removal of the entire breast without any lymph nodes in a(n):
a. excesional biopsy
b. simple mastectomy
c. segmental mastectomy
d. modified radical mastectomy

A

b. simple mastectomy

48
Q

if a mastectomy is scheduled to follow a breast biopsy and frozen section results indicate carcinoma, what is done?
a. Protect the field until second procedure begins
b. Bring up a Mayo stand with new instruments for the mastectomy
c. Use same instruments, but be sure to change all gloves first
d. Re-prep, redrape patient; team changes gowns and gloves; and use new instruments

A

d. Re-prep, redrape patient; team changes gowns and gloves; and use new instruments

49
Q

Dilation of the submucosal and subcutaneous venous plexus that lines the anal canal is called:
a. anal fissure
b. fistula-in-ano
c. hemorrhoid
d. pilonidal cyst

A

c. hemorrhoid

50
Q

Nissen funduplication is the procedure performed to correct a

A

Hiatal hernia

51
Q

The use of a Penrose drain (moistened penrose w/ pean) is often employed during inguinal herniorrhaphy to

A

retract spermatic cord

52
Q

What does the rule of 5s mean

A

Five ML of dye is injected at five sites spanning a 5 cm diameter and the site is massage for five minutes

53
Q

What is meckel’s diverticulum

A

congenital outpouching located in the ileum

54
Q

What is crohn’s disease

A

chronic condition with weight loss, abscess, or bleeding

55
Q

a communication of bowel with the outside of the abdominal cavity that is created to divert the fecal stream is

A

stoma

56
Q

The long, vertical straplike muscle of the abdominal wall is the ___.

A

rectus abdominus

57
Q

The inner layer of the digestive tract wall is called the ___.

A

mucosa

58
Q

Which of the following is a function of the omenta?

A

limit peritoneal infection

59
Q

The outer layer of the digestive tract wall is called the ___.

A

serosa

60
Q

The biliary tract terminates at the ___.

A

Sphincter of Oddi

61
Q

What is reanastomosed during a Whipple

A
  • pancreatojejunostomy
  • choledochojejunostomy OR hepaticojejunostomy
  • gastrojejunostomy
62
Q

What is 7 things are removed during a Whipple

A

1/3 Stomach
head of pancreas
whole duodenum
10 cm of jejunum
gallbladder & cystic duct or CBD
peripancreatic lymph node
hepatopancreatic lymph node

63
Q

layers of abd wall inside out

A

Peritoneum
transverse fascia
transverse abdominus muscle
internal oblique muscle
external oblique muscle
scarpa’s fascia
skin

64
Q

Stoma Site location is to

A

Provide maximum comfort for pt
Ideal placement is below costal margin, above belt line & lateral edge of rectus abdominis muscle

64
Q

Single aperture stoma are usually permanent and

A

MOST COMMON, sigmoid colostomy

64
Q

a T-tube or wound brain left in place following laparoscopic cholecystectomy would MOST likely be exit through:
a. a left subcostal stab wound
b. the umbilical port site incision
c. one of the 5 mm right port site incision
d. the subxiphoid 10 mm port site incision

A

c. one of the 5 mm right port site incision

65
Q

Which stage of breast cancer is Unequivocal homolateral metastatic supraclavicular or interclavicular nodes and edema of arm w/o distant metastases

A

Stage 3b