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Chapter 23--Part 1 (Fuller) Flashcards

1
Q

The category of general surgery encompasses procedures of the _____ and non-cosmetic procedures of the _____.

A

abdomen

breast

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2
Q

The organs and organ systems involved in general surgery are:

A
  1. abdominal wall
  2. gastrointestinal system
  3. biliary system (gallbladder)
  4. spleen
  5. pancreas
  6. hepatic system
  7. breast
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3
Q

The body is divided into semiclosed compartments called _____.

A

cavities

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4
Q

The abdominal cavity contains the _____.

A

abdominal viscera

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5
Q

The pelvic cavity contains structures of the _____.

A

reproductive, genitourinary, and lower gastrointestinal systems

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6
Q

The retroperitoneal cavity contains the _____

A

kidneys, adrenal glands, and ureters

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7
Q

The abdomen is divided into four quadrants, they are:

A
  1. right upper quadrant (RUQ)
  2. left upper quadrant (LUQ)
  3. right lower quadrant (RLQ)
  4. left lower quadrant (LLQ)
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8
Q

The abdomen is divided into nine regions, they are:

A
  1. left and right hypochondriac regions (rib area)
  2. left and right lumbar regions (flank area)
  3. left and right iliac regions (inguinal area)
  4. epigastric region: upper abdomen (literally “above the stomach”)
  5. umbilical region (area near umbilicus)
  6. hypogastric region: lower abdomen (“below the stomach”)
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9
Q

The abdominal wall is composed of distinct tissue layer, which support the viscera; these layers comprise the following:

A
  1. skin
  2. subcutaneous fatty tissue
  3. fascia
  4. muscle
  5. peritoneum
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10
Q

The _____ layer lies directly under the skin.

A

subcutaneous

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11
Q

The subcutaneous layer is composed of _____, which varies in thickness from _____ inch to more than _____ inches.

A

lobulated adipose (fat)
1/4 (0.63 cm)
8 (20 cm)

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12
Q

The _____ is a strong serous membrane that lines the abdominal cavity.

A

abdominal peritoneum (also called the parietal peritoneum)

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13
Q

The _____ protects the viscera in the _____ and secretes serous fluid, which lubricates the viscera.

A

peritoneum

abdomen

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14
Q

The _____ is an extension of the peritoneum that attaches to the posterior abdominal wall and fans out to cover the small intestine.

A

mesentery

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15
Q

The _____ is the area bounded by the rectus abdominis muscle, the inguinal ligament, and the inferior epigastric vessels.

A

Hesselbach triangle

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16
Q

The Hesselbach triangle is associated with an _____.

A

inguinal hernia

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17
Q

The Hesselbach triangle is larger in the _____ than in the _____.

A

male

female

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18
Q

The spermatic cord in the male follows the inguinal canal and contains the following structures:

A
  1. spermatic fascia
  2. cremaster muscle
  3. genitofemoral nerve
  4. ductus deferens
  5. lymph vessels
  6. testicular vein and artery
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19
Q

The most common pathology of the abdominal wall is a _____.

A

hernia

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20
Q

A _____ set is used for procedures involving the abdominal wall.

A

laparotomy

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21
Q

_____ and _____ are commonly used to repair defects in the fascia.

A

braided synthetic sutures

surgical mesh

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22
Q

Most surgeons use a _____ although _____ may also be used.

A

tapered needle

surgical staples

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23
Q

Surgical mesh is used for _____.

A

hernia repairs

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24
Q

Biosynthetic mesh is made of _____ similar to suture. (examples are _____, _____, and _____)

A

synthetic material
Prolene
Dacron
Mersilene

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25
Q

Mesh is available in _____ or _____ which are fitted at the edge of the defect.

A

sheets or patches

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26
Q

A _____ usually is measured and cut during surgery, although precuts are available.

A

patch

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27
Q

Gastrointestinal surgery includes procedures of the _____.

A

lower esophagus, stomach, small intestine, large intestine, rectum, and anus

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28
Q

The _____ is a tubular structure that extends from the pharynx to the stomach.

A

esophagus

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29
Q

The stomach is located under the _____ in the left upper abdomen.

A

diaphragm

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30
Q

The three contiguous anatomical sections of the stomach are the _____, the _____, and the _____.

A
  1. fundus (upper portion)
  2. body (midsection)
  3. antrum (distal or lower portion)
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31
Q

The _____ is approximately 8 to 10 inches long (20 to 25 cm)

A

duodenum

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32
Q

The duodenum receives _____.

A

chyme (liquefied food broken down by the stomach)

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33
Q

The _____ is approximately 9 feet (2.7 m) long.

A

jejunum

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34
Q

The jejunum and the ileum are suspended from the abdominal wall by a sheet of vascular tissue called the _____.

35
Q

During _____ of the jejunum or the ileum, the mesentery must be clamped and divided from the intestine.

36
Q

The _____ extends from the distal ileum to the rectum.

A

large intestine

37
Q

The large intestine is divided into five distinct sections, they are:

A
  1. the ascending colon
  2. the transverse colon
  3. the descending colon
  4. the sigmoid colon
  5. the rectum
38
Q

The colon measures about _____.

A

5 feet (1.5 m)

39
Q

The distal 4 to 5 inches (10 to 12.5 cm) of the intestine is the _____.

40
Q

The rectum terminates in the _____.

A

anal canal

41
Q

The presence of GI disease is confirmed primarily by _____, ______, and _____.

A

imaging studied, blood and metabolic studies, and physical examination

42
Q

An _____ is often performed before open or laparoscopic surgery.

43
Q

A _____ and _____ of the inner surface of the intestine and stomach are performed to rule out or confirm carcinoma and provide tissue for further tests.

A

biopsy

visual examination

44
Q

During laparotomy and laparoscopy, patients are at high risk for _____.

A

hypothermia

45
Q

Therefore _____ is a high priority for patient safety during all abdominal procedures.

A

thermoregulation

46
Q

Compression _____ or a sequential compression device is used during all lengthy _____ procedures to prevent _____.

A

stockings
laparotomy
deep vein thrombosis (DVT)

47
Q

The patient is placed in the _____ position for most laparoscopic and open surgery of the GI system.

48
Q

The _____ position may be used in procedures that require perineal access, such as abdominoperineal resection.

A

low lithotomy

49
Q

The operating table must be able to accommodate up to _____.

A

800 pounds (360 kg)

50
Q

A _____ is used for GI surgery.

A

basic laparotomy

51
Q

During GI surgery, sharp dissection is made with _____scissors, an _____, _____, and _____.

A

Metzenbaum
ESU
ultrasound shears (Harmonic system)
a high-frequency coagulator (LigaSure)

52
Q

During GI surgery, _____ and _____ claps are used to grasp intestinal tissue.

A

Babcock and Allis

53
Q

Resection of the bowel or stomach is performed with _____ clamps or with surgical _____ instruments.

A

atraumatic

stapling

54
Q

When the bowel, omentum, and mesentery have been exposed, a _____ suction tip should be available.

55
Q

Surgical stapling instruments frequently are used in _____ and _____.

A

resection

anastomosis

56
Q

Special equipment that might be required during GI surgery are:

A
  1. High-frequency (HF) vessel-sealing system (LigaSure)
  2. Ultrasound scalpel
  3. Vessel loops for large vessel dissection
  4. Ultrasound probe
  5. Bowel bag
  6. Temporary ostomy bag
57
Q

The GI system is a continuous “tube” attached to the _____ and _____ wall by a complex system of vascular membranes.

A

abdominal

pelvic

58
Q

A procedure in which one section of tissue is cut away from another.

A

division (differs from resection, where a portion of the organ is removed)

59
Q

To place one or more clamps at a right angle to a tube or vessel.

A

cross-clamp

60
Q

To place two clamps over a section of tissue to prevent bleeding when the tissue is severed.

A

double-clamp (this prevents hemorrhage and the release of fluids from the intestine or stomach)

61
Q

To both double-clamp and divide tissue.

A

clamp and divide

62
Q

During _____ instruments and supplies used while the bowel is open are kept separate from all other sterile items.

A

bowel technique (also called isolation technique)

63
Q

After closure of the bowel, all _____ instruments and supplies are removed from the field.

A

contaminated

64
Q

Before the abdomen is closed, the surgical team _____.

A

dons fresh gloves

65
Q

An _____ is an outpatient procedure, and the surgery is performed with the patient under sedation.

66
Q

Preparation for endoscopy includes _____.

A

a period of fasting

67
Q

Upper GI studies require limitations on _____.

A

oral intake

68
Q

Lower GI endoscopy requires _____ and an _____

A

dietary restrictions

enema

69
Q

GI endoscopy is performed for the following purposes:

A
  1. establish or confirm a diagnosis
  2. to perform selected surgical procedures
  3. to allow postoperative inspection of the surgical site from within the lumen of the GI tract
70
Q

Esophagoduodenoscopy (EGD), is a diagnostic endoscopy of the _____.

A

esophagus, stomach, and proximal duodenum

71
Q

Goals of the EGD are:

A
  1. direct diagnostic observation of the inside of the esophagus and duodenum, with biopsy
  2. treatment of varices
  3. sclerotherapy of esophageal varices
  4. polyp removal
  5. endoscopic gastronomy for insertion of a feeding tube
  6. placement of a stent for an esophageal stricture
72
Q

Colonoscopy is an endoscopy of the _____.

A

large intestine

73
Q

A colonoscopy is used for diagnostic purposes and for minor surgery such as:

A
  1. removal of polyps
  2. biopsy or removal of lesions that do not require resection
  3. coagulation of small bleeding diverticula
  4. laser treatment of small tumors
  5. routine screening for colon cancer
74
Q

Sigmoidoscopy is performed to examine tissue and/or obtain biopsy specimen of the _____ and _____.

A

sigmoid colon

rectum

75
Q

During a sigmoidoscopy, the patient is placed in the _____ or _____ position.

A

prone

lithotomy

76
Q

A surgical procedure in which two hollow organs are joined.

A

anastomosis

77
Q

A gastroduodenostomy, or surgical anastomosis, of the stomach and the duodenum.

A

Billroth I procedure

78
Q

A gastroduodenostomy, or surgical anastomosis, of the stomach and the jejunum.

A

Billroth II procedure

79
Q

A technique or process in which the stomach contents are continually drained into a collection device. Required after gastric surgery or disease.

A

decompression

80
Q

To surgically free up an organ or other structure by dissecting its attachments to other tissue. Often includes dividing and ligating attached blood vessels.

81
Q

Flexible tube inserted through the nose and advanced into the stomach. Used to decompress the stomach or means to feed the patient.

A

Nasogastric (NG) tube

82
Q

Surgical removal of an organ

83
Q

An opening created in a hallow organ and sutured to the skin to drain the organ’s contents. May be temporary or permanent.

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