Exam 2 Flashcards
1
Q
What 3 things are taken into consideration for a H&P before abdominal GYN surgery?
A
menstrual, obstetrical history, contraceptive use
2
Q
what is obstetrical history?
A
of pregnancies and outcome of each
3
Q
what is a bimanual exam?
A
one hand inside vagina with the other palpating the abdomen
4
Q
whats the most imaging technique is reproductive area
A
ultrasound
5
Q
what is good to use for imaging of soft tissues of pelvis
A
MRI
6
Q
what 2 incisions are typical for abdominal GYN surgeries
A
midline and pfannenstiel
7
Q
what wound class are all GYN lap cases and why?
A
II because you need access to the cervix
8
Q
what position is used for lap GYN surgeries
A
low lithotomy
9
Q
What order do you drape for low lithotomy?
A
legs, under butt, abdomen
10
Q
what instrument is used to cut the fallopian tubes during a laparoscopic case
A
Hook scissors
11
Q
what is used to seal off bleeding tissue or coagulate the fallopian tubes?
A
Kleppinger bipolar forceps
12
Q
what self-retaining retractor is typical in GYN abdominal cases?
A
O’Connor-O’sullivan
13
Q
what is unique about a heaney clamp?
A
it has a tooth part-way down the jaw
14
Q
what is a heaney clamp used for
A
clamping heavy uterine vessels
15
Q
What is the Lahey or Goiter clamp used for in abdominal GYN surgery?
A
hold the uterus or fibroid growth
16
Q
What does a Jorgenson scissor look like?
A
a right angled mayo
17
Q
what is the Jorgenson scissor used for?
A
cutting tight corners, such as the cervix
18
Q
What blade goes on a #3 long angled knife handle
A
15
19
Q
what does a sponge on a stick get used for?
A
blunt dissection
20
Q
what does a functional cyst result from?
A
a normal function of the menstrual cycle
21
Q
what is a follicular cyst?
A
when a cyst growths instead of the follicle releasing an egg
22
Q
what kind of cyst may contain tissue (hair, skin, teeth)
A
dermoid
23
Q
what are dermoid cysts formed from
A
cells that produce human eggs
24
Q
what is endometriosis
A
uterine endometrial cells develop outside the uterus
25
what is ovarian torsion
when the ovary and portion of tube rotate
26
what is a leiomyoma uteri?
fibroid
27
where do leiomyoma uteri develop?
smooth muscle of uterus
28
what does a pap smear sample
cervical cells
29
what is a hysteroscopy
direct visualization of the inside of the uterus
30
what is a colposcopy?
direct visualization of the vaginal area
31
what prep should not be used when using Lugols
betadine
32
what holds the vagina open without assistance
auvard weighted speculum
33
what is used most commonly in the doctors office or when a patient is awake for a vaginal GYN surgery
graves speculum (duckbill)
34
what hand held retractor is used to elevate the top and side walls of the vagina?
Sims
35
what does a uterine sound do?
measure the depth from the cervix to the fundus of the uterus
36
what needle holder is unique to vaginal GYN?
Heaney needle holder
37
which cervical dilators have a right part way up the shaft?
Hank dilators
38
which cervical dilators are smooth?
hegar dilators
39
what is used to remove tissue from the endocervical canal?
Kevorkian endocervical curette
40
what shape is the kevorkian endocervical curette?
box like
41
which curette is used to scrape along the sides of the uterus?
endometrial or sims curetter
42
which area in the uterus needs to be sampled first to avoid samples being mixed?
endocervical
43
what 2 things are commonly used to ID abnormal cells in GYN
acetic acid and lugols
44
what 2 items are used to stop bleeding in the cervix?
monsel's solution or silver nitrate sticks
45
what is it called when a period has an abnormally heavy flow/prolonged bleeding
menorrhagia
46
what does pelvic inflammatory disease typically come from?
bacteria, gonorrhea or chlamydia
47
what is a uterine descensus
uterine prolapse, protrudes out vagina
48
what is cystocele
prolapsed bladder pushing into vagina
49
what is rectocele
prolapsed rectum, pushes against vagina
50
what is the STD trichomoniasis caused by?
a parasite
51
What is a Hysterosalpingogram (HSG)
injection of dye into uterus and tubes to check patency, usually involves x-ray
52
what is looked for in a pregnancy test?
HCG (human chorionic gonadotopin)
53
what is used to remove large tissues from the uterus, such as the placenta?
placenta forcep, Kelly placenta forcep
54
what is it called when an egg implants something other the the main cavity of the uterus?
ectopic pregnancy
55
whats another name for a miscarriage?
spontaneous abortion
56
whats it called when a gestational sac develops without an embryo
blighted ovum
57
what is a threatened miscarriage?
any vaginal bleeding during early pregnancy
58
when does a threatened miscarriage progress to an inevitable miscarriage
when cervical dilation occurs
59
what is an incomplete miscarriage
when bleeding has begun but there is still products of conception in the uterus
60
what is the treatment for an incomplete miscarriage
D&C
61
what is a complete miscarriage
when all contents of conception have emptied from the uterus
62
what is a missed miscarriage?
when the fetus dies but the body doesnt recognize it
63
what is another name for preeclampsia
toxemia
64
what is abruptio placenta?
when the placenta peels away from wall, fully or partially
65
what is placenta previa?
when the placenta partially or completely covers the opening of the cervix
66
what is cephalopelvic disproportion?
when the pelvis is too small for the babies head
67
what is nuchal cord?
when a loop of the umbilical cord is wrapped around babies neck
68
what is a prolapsed cord?
when the umbilical cord comes out of the uterus with or before the fetus
69
What is PKU disease?
rare, inherited disorder that causes amino acid build up in body
70
What happens in Tay-sachs
an enzyme that breaks down fatty substances is absent
71
What x-ray is used to show the kidneys, ureters and bladder?
KUB
72
whats it called with you just look at and test the urine itself
urinalysis
73
what does a uroflowmetry test?
the rate of flow, amount, and length of time of urine
74
what is a digital rectal exam?
when a finger is inserted into the rectum of someone bending over to feel the prostate
75
what does a cysto OR have that a normal one doesnt
a drain on the floor
76
what is cystitis
inflammation of the bladder
77
what is the cystitis usually caused from?
UTI
78
what is pyelonephritis
a kidney infection
79
where does a kidney infection start from
a UTI
80
what is neurogenic bladder
dysfunction of bladder caused by neurologic damage
81
what are calculi?
stones
82
what is hydronephrosis
kidneys swell, due to failure of normal drainage
83
what is benign prostatic hypertrophy?
enlarged prostate
84
what is prostatitis?
swelling and inflammation of prostate gland
85
what is urinary reflux?
flow of urine from bladder back up ureters
86
what is a straddle injury
an injury that occurs when a person falls while straddling something
87
what blood test measures how much of a substance can be removed from the blood by the kidneys in a given length of time?
renal clearance
88
blood urea nitrogen (BUN) levels reflect what?
filtration and urine concentrating capacity of the kidneys
89
What builds up in the plasma when the filtration of the kidneys falter
creatinine
90
what is a cystometrogram
a test that measures the bladders ability to hold urine
91
when is ovarian cancer typically caught?
when its too late
92
what does a veress needle do?
creates a pneumoperitoneumm
93
when does a uterine manipulator get placed?
before procedure starts
94
what is a diagnostic laparoscopy
only when you are looking around
95
what is a myomectomy
removal of fibroids
96
what meds is used for hemostasis in the uterus
vasopressin
97
what are the 5 ligaments of the uterus
broad, round, infundibulopelvic, cardinal, uterosacral
98
What is taken in a total hysterectomy?
everything, including the cervic
99
what is the vaginal cuff?
where the cervix is attached
100
what happens once an instrument comes in contact with the vaginal cuff?
they are dirty
101
what surgery is done for a women who wants kids, but has fibroids
myomyectomy
102
what muscle is incised in an abdominal hysterectomy
anterior rectus
103
what is the last ligament detached in a hysterectomy
uterosacral ligament
104
what is removed in a posterior pelvic exoneration
lower part of large bowel and internal reproductive organs
105
what STD is most common?
chlamydia
106
what is the ablation of condyloma used to remove
genital warts
107
what procedure do you get if someone has hypertophied labia
labioplasty
108
what is marsupialization of bartholins gland?
a cyst in the vaginal lip
109
what do you do with the wound after surgery for a marsupualiation of bartholins gland?
leave it open, heals by second intention
110
does a D&C use suction?
no
111
what is a fractional D&C
removal of endometrial and endocervical separatley
112
what is a D&E used for?
abortion or miscarriage
113
what would you use to bring the cervix into view
tenaculum
114
what does a hysterscopy diagnose or treat?
menorrhagia
115
what kind of scope does a hysterscopy use?
rigid
116
anytime someone used a rigid scope, what position is used
high lith
117
what is an endometrial ablation and what is it use for?
coag the inside of uterus, heavy bleeding
118
why is a cervical cone biopsy done?
precancerous or cancerous cells were found
119
what kind a knife is used in a cone biopsy
a cold knife, less damage to cells
120
what is LEEP
loop electrosurgical procedure
121
what does a LEEP do
take biopsy with different shaped tips
122
what does cryotherapy use?
nitrous oxide or CO2
123
what is cervical cerclage
stitch the cervix closed
124
what anesthesia should not be used for cervical cerclage
general (pt is prego)
125
what is brachytherapy?
radioactive radionuclides that get implanted in or around tumors
126
what are anterior and posterior repairs done for?
cystocele or rectocele
127
what do you spare in a vulvectomy
clit and perineum
128
what do you use a plastic hooded speculum?
LEEP cone procedures bc of use of bovie
129
what 2 thing do HPV cause
cervical cancer, genital warts
130
whats the initial test for cervical cancer
pap smear
131
how do you correct menstrual flow? (3)
birth control, ablation, hysterectomy
132
what does the abnormal cell look like when using logol's solution
looks pale, other cells are brown
133
what is gravida
of times a women has been pregnant
134
what is parity
of births reglardless of outcome
135
what meds might be given to a mother with toxemia
meds that help with lung development
136
what is an episiotomy?
the incision of the forced tear before giving birth
137
3 ways to "tie" tubes
clipping, cutting, burning
138
when does HCG become positive?
1 week after conception
139
what is the hysteroscopic technique for sterilization?
blocks the fallopian tubes with a coil, not effective for 3 months
140
what is a tuboplasty
re-anastomoses of the tubes
141
whats the cure for preeclampsia
delivering the baby
142
what 5 things predispose an extopic pregnancy
previous one, failed tubal ligation/re-anastomosis, endometriosis, PID, having an IUD before
143
what is a salpingostomy
leaving the tube open
144
what is a salpingectomy
removing the tube
145
What is the obturator?
the blunt object that goes into the sheath
146
what does the sheath control
a hollow tube, controls inflow and outflow
147
what 3 degree scopes are there?
0, 30, 70
148
what 2 things dilate the urethra
bougie or metal sounds
149
what dilator is best for males
metal sounds
150
What is this? small caliber, straight or spiral tip, catheters and have no lumen
filiforms
151
which scope? better optics, larger working channel, larger lumen (better visualization), better oriented, general or regional
rigid
152
which scope? greater comort for patients, supine position, ease of passing instrument, direct local,
flexibile
153
what distends the bladder? (2)
either a pump or gravity
154
what 3 parts are there to the camera?
bridge, scope, and obturator
155
what is hydronephrosis
kidney filled with urine
156
what does retrograde pyelography treat?
hydronephrosis
157
what is used to drain the kidney
catheters
158
what is inject into the kidney during a retrograde pyelography?
IV contrast
159
what dilates the ureters?
the ureteroscope
160
what is lithotripsy
destruction of stones
161
what are the steps to a lithotripsy? (3)
access, dilation, manipulation
162
what is the most common stone treatment
electrohydrolic lithotripsy ( EHL)
163
what are the 4 lithotripsys?
electrohydrolic, ultrasonic, pneumatic, laser
164
What are 2 reasons to use a ureteral stent
potential for damage or just in case
165
what does a ureteral stent facilitate
urine flow
166
what happens in a percutaneous nephrolithotomy? (PNL)
drainage of urine through incision in skin
167
what is PNL facilitated by
fluoroscopy
168
what size calculi are more effectively treated with PNL
2 cm
169
what medication is on board in a PNL and why
methylene blue to make sure youre in the right cone
170
which scope is the operative scope in a PNL
J-scope
171
up to what size can a stone be removed through the sheath in a PNL
1 cm
172
what can you lithotrip through in a PNL
j-scope and amplatz dilators
173
what is prostatitis
inflamed prostate
174
what procedure is done for benign prostatic hypertrophy (BPH)
TURP transurethral resection of prostate
175
what can fluids not do in a TURP
conduct electricity
176
what 3 fluids can you use in a TURP
glycine
sorbitol
mannitol
177
a resectoscope is used in a TURP, what does it have on it?
a wire to shave
178
what is brachytherapy
short-term radioactive seed therapy
179
what is a TURBT
transurethral resection of bladder tumor
180
what is the tumor removed with in a TURBT
rectoscope
181
when is a suprapubic prostatectomy done?
when a TURP isnt enough
182
how is the prostate removed?
blunt dissection
183
after the prostate is removed, what gets sewn together
fossa and bladder
184
what position is used in a robotic assisted prostatectomy
low lithotomy
185
what are 2 disadvantages to robotic assistant prostatectomy
time under general and cost
186
what surrounds the kidney
gerotas fascia
187
what are the 2 vessels involved with the kidney
renal artery and vein
188
what incision may be used in a nephrectomy
subcostal flank
189
how many closing counts does a nephrectomy have
3
190
what is a specific instrument needed for a nephrectomy
long tip bovie
191
what is used to place kidney in for transport for transplant
collins solution
192
what is used to prepare the vessels for the kidney transplant?
sterile ice slush, benching
193
what can happen if you get a straddle injury?
damage to urethra that can leak urine into body
194
why is a kidney transplant done?
end stage renal failure
195
how many kidneys does a person who receives a kidney transplant have?
3
196
what is re-anastomosed first in a kidney transplant
vein
197
what is unattached first from the donor of a kidney?
artery
198
what tells you that a transplanted kidney is working?
urine output
199
what is used to inject methylene blue during a kidney transplant to make sure the ureter has sealed with the blatter
3-way foley
200
what disease has these symptoms? central body obesity, too much cortisol, glucose intolerant, osteoporosis, kidney stones, hypertension
cushings
201
what disease? under production of cortisol, adrenals too weak, suffer weight loss, fatigue, GI problems, hypotension, hair loss
Addisons
202
what is a pheochromocytoma
benign tumor in the adrenal gland
203
where are the adrenal glands
on top of the kidneys
204
what incision is made in an adrenalectomy
intercostal incision, may have to take a rib
205
what instrument is used to grasp the adrenal glands
babcocks
206
what 3 arteries are in the adrenal glands
aortic, renal and adrenal arteries
207
how do remove the adrenal glands
blunt dissection
208
what treatment is used for stress urinary incontinence?
cystectomy with ileal conduit
209
what is an ileal conduit?
making a new bladder with ileum
210
what is stress urinary incontinence?
urine leakage from laughing or sneezing, pressure on bladder
211
what is total urinary incontinence?
no control
212
what is urinary incontinence overflow
a constant dribble
213
when is urge urinary incontinence
sudden urge, then involuntary void
214
what is a precipitate void urinary incontinence?
voiding with no urge before
215
what may be placed in a women surgically to treat stress urinary incontinence?
trans-vaginal tape, mesh, sling
216
what is removed in a circumcision
prepuce
217
what is an orchipexy
brings the undescended teste down
218
what gets attached to what in an orchioplexy?
tunica albuginea and dartos muscle
219
what is a orchiectomy
removal of testes
220
where is a hydrocele located
behind testicle in scrotum
221
what is hypospadias
the urethral opening is on the underside of the penis shaft
222
what is the procedure that fixes a hypospadias?
meatoplasty
223
what is a granuloplasty
repositioning of the glans penis
224
what is an orthoplasty
straightening of the penis
225
what is a urethroplasty
recon of urethra
226
what is scrotoplasty
recon of scrotum
227
where is the incision for a penial implant
underside of penis
228
where is a pump inserted in the penis
in the scrotum
229
are both testicle secured in an orchiopexy?
es
230
are implants used in the penis to increase size?
no
231
what wound class is an ileal conduit?
II
