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surgical procedures II > Exam 2 > Flashcards

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

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2
Q

what is obstetrical history?

A

of pregnancies and outcome of each

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3
Q

what is a bimanual exam?

A

one hand inside vagina with the other palpating the abdomen

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4
Q

whats the most imaging technique is reproductive area

A

ultrasound

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5
Q

what is good to use for imaging of soft tissues of pelvis

A

MRI

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6
Q

what 2 incisions are typical for abdominal GYN surgeries

A

midline and pfannenstiel

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7
Q

what wound class are all GYN lap cases and why?

A

II because you need access to the cervix

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8
Q

what position is used for lap GYN surgeries

A

low lithotomy

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9
Q

What order do you drape for low lithotomy?

A

legs, under butt, abdomen

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10
Q

what instrument is used to cut the fallopian tubes during a laparoscopic case

A

Hook scissors

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11
Q

what is used to seal off bleeding tissue or coagulate the fallopian tubes?

A

Kleppinger bipolar forceps

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12
Q

what self-retaining retractor is typical in GYN abdominal cases?

A

O’Connor-O’sullivan

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13
Q

what is unique about a heaney clamp?

A

it has a tooth part-way down the jaw

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14
Q

what is a heaney clamp used for

A

clamping heavy uterine vessels

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15
Q

What is the Lahey or Goiter clamp used for in abdominal GYN surgery?

A

hold the uterus or fibroid growth

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16
Q

What does a Jorgenson scissor look like?

A

a right angled mayo

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17
Q

what is the Jorgenson scissor used for?

A

cutting tight corners, such as the cervix

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18
Q

What blade goes on a #3 long angled knife handle

A

15

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19
Q

what does a sponge on a stick get used for?

A

blunt dissection

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20
Q

what does a functional cyst result from?

A

a normal function of the menstrual cycle

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21
Q

what is a follicular cyst?

A

when a cyst growths instead of the follicle releasing an egg

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22
Q

what kind of cyst may contain tissue (hair, skin, teeth)

A

dermoid

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23
Q

what are dermoid cysts formed from

A

cells that produce human eggs

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24
Q

what is endometriosis

A

uterine endometrial cells develop outside the uterus

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25
Q

what is ovarian torsion

A

when the ovary and portion of tube rotate

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26
Q

what is a leiomyoma uteri?

A

fibroid

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27
Q

where do leiomyoma uteri develop?

A

smooth muscle of uterus

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28
Q

what does a pap smear sample

A

cervical cells

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29
Q

what is a hysteroscopy

A

direct visualization of the inside of the uterus

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30
Q

what is a colposcopy?

A

direct visualization of the vaginal area

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31
Q

what prep should not be used when using Lugols

A

betadine

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32
Q

what holds the vagina open without assistance

A

auvard weighted speculum

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33
Q

what is used most commonly in the doctors office or when a patient is awake for a vaginal GYN surgery

A

graves speculum (duckbill)

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34
Q

what hand held retractor is used to elevate the top and side walls of the vagina?

A

Sims

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35
Q

what does a uterine sound do?

A

measure the depth from the cervix to the fundus of the uterus

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36
Q

what needle holder is unique to vaginal GYN?

A

Heaney needle holder

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37
Q

which cervical dilators have a right part way up the shaft?

A

Hank dilators

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38
Q

which cervical dilators are smooth?

A

hegar dilators

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39
Q

what is used to remove tissue from the endocervical canal?

A

Kevorkian endocervical curette

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40
Q

what shape is the kevorkian endocervical curette?

A

box like

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41
Q

which curette is used to scrape along the sides of the uterus?

A

endometrial or sims curetter

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42
Q

which area in the uterus needs to be sampled first to avoid samples being mixed?

A

endocervical

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43
Q

what 2 things are commonly used to ID abnormal cells in GYN

A

acetic acid and lugols

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44
Q

what 2 items are used to stop bleeding in the cervix?

A

monsel’s solution or silver nitrate sticks

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45
Q

what is it called when a period has an abnormally heavy flow/prolonged bleeding

A

menorrhagia

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46
Q

what does pelvic inflammatory disease typically come from?

A

bacteria, gonorrhea or chlamydia

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47
Q

what is a uterine descensus

A

uterine prolapse, protrudes out vagina

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48
Q

what is cystocele

A

prolapsed bladder pushing into vagina

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49
Q

what is rectocele

A

prolapsed rectum, pushes against vagina

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50
Q

what is the STD trichomoniasis caused by?

A

a parasite

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51
Q

What is a Hysterosalpingogram (HSG)

A

injection of dye into uterus and tubes to check patency, usually involves x-ray

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52
Q

what is looked for in a pregnancy test?

A

HCG (human chorionic gonadotopin)

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53
Q

what is used to remove large tissues from the uterus, such as the placenta?

A

placenta forcep, Kelly placenta forcep

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54
Q

what is it called when an egg implants something other the the main cavity of the uterus?

A

ectopic pregnancy

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55
Q

whats another name for a miscarriage?

A

spontaneous abortion

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56
Q

whats it called when a gestational sac develops without an embryo

A

blighted ovum

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57
Q

what is a threatened miscarriage?

A

any vaginal bleeding during early pregnancy

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58
Q

when does a threatened miscarriage progress to an inevitable miscarriage

A

when cervical dilation occurs

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59
Q

what is an incomplete miscarriage

A

when bleeding has begun but there is still products of conception in the uterus

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60
Q

what is the treatment for an incomplete miscarriage

A

D&C

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61
Q

what is a complete miscarriage

A

when all contents of conception have emptied from the uterus

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62
Q

what is a missed miscarriage?

A

when the fetus dies but the body doesnt recognize it

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63
Q

what is another name for preeclampsia

A

toxemia

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64
Q

what is abruptio placenta?

A

when the placenta peels away from wall, fully or partially

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65
Q

what is placenta previa?

A

when the placenta partially or completely covers the opening of the cervix

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66
Q

what is cephalopelvic disproportion?

A

when the pelvis is too small for the babies head

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67
Q

what is nuchal cord?

A

when a loop of the umbilical cord is wrapped around babies neck

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68
Q

what is a prolapsed cord?

A

when the umbilical cord comes out of the uterus with or before the fetus

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69
Q

What is PKU disease?

A

rare, inherited disorder that causes amino acid build up in body

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70
Q

What happens in Tay-sachs

A

an enzyme that breaks down fatty substances is absent

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71
Q

What x-ray is used to show the kidneys, ureters and bladder?

A

KUB

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72
Q

whats it called with you just look at and test the urine itself

A

urinalysis

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73
Q

what does a uroflowmetry test?

A

the rate of flow, amount, and length of time of urine

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74
Q

what is a digital rectal exam?

A

when a finger is inserted into the rectum of someone bending over to feel the prostate

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75
Q

what does a cysto OR have that a normal one doesnt

A

a drain on the floor

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76
Q

what is cystitis

A

inflammation of the bladder

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77
Q

what is the cystitis usually caused from?

A

UTI

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78
Q

what is pyelonephritis

A

a kidney infection

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79
Q

where does a kidney infection start from

A

a UTI

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80
Q

what is neurogenic bladder

A

dysfunction of bladder caused by neurologic damage

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81
Q

what are calculi?

A

stones

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82
Q

what is hydronephrosis

A

kidneys swell, due to failure of normal drainage

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83
Q

what is benign prostatic hypertrophy?

A

enlarged prostate

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84
Q

what is prostatitis?

A

swelling and inflammation of prostate gland

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85
Q

what is urinary reflux?

A

flow of urine from bladder back up ureters

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86
Q

what is a straddle injury

A

an injury that occurs when a person falls while straddling something

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87
Q

what blood test measures how much of a substance can be removed from the blood by the kidneys in a given length of time?

A

renal clearance

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88
Q

blood urea nitrogen (BUN) levels reflect what?

A

filtration and urine concentrating capacity of the kidneys

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89
Q

What builds up in the plasma when the filtration of the kidneys falter

A

creatinine

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90
Q

what is a cystometrogram

A

a test that measures the bladders ability to hold urine

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91
Q

when is ovarian cancer typically caught?

A

when its too late

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92
Q

what does a veress needle do?

A

creates a pneumoperitoneumm

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93
Q

when does a uterine manipulator get placed?

A

before procedure starts

94
Q

what is a diagnostic laparoscopy

A

only when you are looking around

95
Q

what is a myomectomy

A

removal of fibroids

96
Q

what meds is used for hemostasis in the uterus

A

vasopressin

97
Q

what are the 5 ligaments of the uterus

A

broad, round, infundibulopelvic, cardinal, uterosacral

98
Q

What is taken in a total hysterectomy?

A

everything, including the cervic

99
Q

what is the vaginal cuff?

A

where the cervix is attached

100
Q

what happens once an instrument comes in contact with the vaginal cuff?

A

they are dirty

101
Q

what surgery is done for a women who wants kids, but has fibroids

A

myomyectomy

102
Q

what muscle is incised in an abdominal hysterectomy

A

anterior rectus

103
Q

what is the last ligament detached in a hysterectomy

A

uterosacral ligament

104
Q

what is removed in a posterior pelvic exoneration

A

lower part of large bowel and internal reproductive organs

105
Q

what STD is most common?

A

chlamydia

106
Q

what is the ablation of condyloma used to remove

A

genital warts

107
Q

what procedure do you get if someone has hypertophied labia

A

labioplasty

108
Q

what is marsupialization of bartholins gland?

A

a cyst in the vaginal lip

109
Q

what do you do with the wound after surgery for a marsupualiation of bartholins gland?

A

leave it open, heals by second intention

110
Q

does a D&C use suction?

A

no

111
Q

what is a fractional D&C

A

removal of endometrial and endocervical separatley

112
Q

what is a D&E used for?

A

abortion or miscarriage

113
Q

what would you use to bring the cervix into view

A

tenaculum

114
Q

what does a hysterscopy diagnose or treat?

A

menorrhagia

115
Q

what kind of scope does a hysterscopy use?

A

rigid

116
Q

anytime someone used a rigid scope, what position is used

A

high lith

117
Q

what is an endometrial ablation and what is it use for?

A

coag the inside of uterus, heavy bleeding

118
Q

why is a cervical cone biopsy done?

A

precancerous or cancerous cells were found

119
Q

what kind a knife is used in a cone biopsy

A

a cold knife, less damage to cells

120
Q

what is LEEP

A

loop electrosurgical procedure

121
Q

what does a LEEP do

A

take biopsy with different shaped tips

122
Q

what does cryotherapy use?

A

nitrous oxide or CO2

123
Q

what is cervical cerclage

A

stitch the cervix closed

124
Q

what anesthesia should not be used for cervical cerclage

A

general (pt is prego)

125
Q

what is brachytherapy?

A

radioactive radionuclides that get implanted in or around tumors

126
Q

what are anterior and posterior repairs done for?

A

cystocele or rectocele

127
Q

what do you spare in a vulvectomy

A

clit and perineum

128
Q

what do you use a plastic hooded speculum?

A

LEEP cone procedures bc of use of bovie

129
Q

what 2 thing do HPV cause

A

cervical cancer, genital warts

130
Q

whats the initial test for cervical cancer

A

pap smear

131
Q

how do you correct menstrual flow? (3)

A

birth control, ablation, hysterectomy

132
Q

what does the abnormal cell look like when using logol’s solution

A

looks pale, other cells are brown

133
Q

what is gravida

A

of times a women has been pregnant

134
Q

what is parity

A

of births reglardless of outcome

135
Q

what meds might be given to a mother with toxemia

A

meds that help with lung development

136
Q

what is an episiotomy?

A

the incision of the forced tear before giving birth

137
Q

3 ways to “tie” tubes

A

clipping, cutting, burning

138
Q

when does HCG become positive?

A

1 week after conception

139
Q

what is the hysteroscopic technique for sterilization?

A

blocks the fallopian tubes with a coil, not effective for 3 months

140
Q

what is a tuboplasty

A

re-anastomoses of the tubes

141
Q

whats the cure for preeclampsia

A

delivering the baby

142
Q

what 5 things predispose an extopic pregnancy

A

previous one, failed tubal ligation/re-anastomosis, endometriosis, PID, having an IUD before

143
Q

what is a salpingostomy

A

leaving the tube open

144
Q

what is a salpingectomy

A

removing the tube

145
Q

What is the obturator?

A

the blunt object that goes into the sheath

146
Q

what does the sheath control

A

a hollow tube, controls inflow and outflow

147
Q

what 3 degree scopes are there?

A

0, 30, 70

148
Q

what 2 things dilate the urethra

A

bougie or metal sounds

149
Q

what dilator is best for males

A

metal sounds

150
Q

What is this? small caliber, straight or spiral tip, catheters and have no lumen

A

filiforms

151
Q

which scope? better optics, larger working channel, larger lumen (better visualization), better oriented, general or regional

A

rigid

152
Q

which scope? greater comort for patients, supine position, ease of passing instrument, direct local,

A

flexibile

153
Q

what distends the bladder? (2)

A

either a pump or gravity

154
Q

what 3 parts are there to the camera?

A

bridge, scope, and obturator

155
Q

what is hydronephrosis

A

kidney filled with urine

156
Q

what does retrograde pyelography treat?

A

hydronephrosis

157
Q

what is used to drain the kidney

A

catheters

158
Q

what is inject into the kidney during a retrograde pyelography?

A

IV contrast

159
Q

what dilates the ureters?

A

the ureteroscope

160
Q

what is lithotripsy

A

destruction of stones

161
Q

what are the steps to a lithotripsy? (3)

A

access, dilation, manipulation

162
Q

what is the most common stone treatment

A

electrohydrolic lithotripsy ( EHL)

163
Q

what are the 4 lithotripsys?

A

electrohydrolic, ultrasonic, pneumatic, laser

164
Q

What are 2 reasons to use a ureteral stent

A

potential for damage or just in case

165
Q

what does a ureteral stent facilitate

A

urine flow

166
Q

what happens in a percutaneous nephrolithotomy? (PNL)

A

drainage of urine through incision in skin

167
Q

what is PNL facilitated by

A

fluoroscopy

168
Q

what size calculi are more effectively treated with PNL

A

2 cm

169
Q

what medication is on board in a PNL and why

A

methylene blue to make sure youre in the right cone

170
Q

which scope is the operative scope in a PNL

A

J-scope

171
Q

up to what size can a stone be removed through the sheath in a PNL

A

1 cm

172
Q

what can you lithotrip through in a PNL

A

j-scope and amplatz dilators

173
Q

what is prostatitis

A

inflamed prostate

174
Q

what procedure is done for benign prostatic hypertrophy (BPH)

A

TURP transurethral resection of prostate

175
Q

what can fluids not do in a TURP

A

conduct electricity

176
Q

what 3 fluids can you use in a TURP

A

glycine
sorbitol
mannitol

177
Q

a resectoscope is used in a TURP, what does it have on it?

A

a wire to shave

178
Q

what is brachytherapy

A

short-term radioactive seed therapy

179
Q

what is a TURBT

A

transurethral resection of bladder tumor

180
Q

what is the tumor removed with in a TURBT

A

rectoscope

181
Q

when is a suprapubic prostatectomy done?

A

when a TURP isnt enough

182
Q

how is the prostate removed?

A

blunt dissection

183
Q

after the prostate is removed, what gets sewn together

A

fossa and bladder

184
Q

what position is used in a robotic assisted prostatectomy

A

low lithotomy

185
Q

what are 2 disadvantages to robotic assistant prostatectomy

A

time under general and cost

186
Q

what surrounds the kidney

A

gerotas fascia

187
Q

what are the 2 vessels involved with the kidney

A

renal artery and vein

188
Q

what incision may be used in a nephrectomy

A

subcostal flank

189
Q

how many closing counts does a nephrectomy have

A

3

190
Q

what is a specific instrument needed for a nephrectomy

A

long tip bovie

191
Q

what is used to place kidney in for transport for transplant

A

collins solution

192
Q

what is used to prepare the vessels for the kidney transplant?

A

sterile ice slush, benching

193
Q

what can happen if you get a straddle injury?

A

damage to urethra that can leak urine into body

194
Q

why is a kidney transplant done?

A

end stage renal failure

195
Q

how many kidneys does a person who receives a kidney transplant have?

A

3

196
Q

what is re-anastomosed first in a kidney transplant

A

vein

197
Q

what is unattached first from the donor of a kidney?

A

artery

198
Q

what tells you that a transplanted kidney is working?

A

urine output

199
Q

what is used to inject methylene blue during a kidney transplant to make sure the ureter has sealed with the blatter

A

3-way foley

200
Q

what disease has these symptoms? central body obesity, too much cortisol, glucose intolerant, osteoporosis, kidney stones, hypertension

A

cushings

201
Q

what disease? under production of cortisol, adrenals too weak, suffer weight loss, fatigue, GI problems, hypotension, hair loss

A

Addisons

202
Q

what is a pheochromocytoma

A

benign tumor in the adrenal gland

203
Q

where are the adrenal glands

A

on top of the kidneys

204
Q

what incision is made in an adrenalectomy

A

intercostal incision, may have to take a rib

205
Q

what instrument is used to grasp the adrenal glands

A

babcocks

206
Q

what 3 arteries are in the adrenal glands

A

aortic, renal and adrenal arteries

207
Q

how do remove the adrenal glands

A

blunt dissection

208
Q

what treatment is used for stress urinary incontinence?

A

cystectomy with ileal conduit

209
Q

what is an ileal conduit?

A

making a new bladder with ileum

210
Q

what is stress urinary incontinence?

A

urine leakage from laughing or sneezing, pressure on bladder

211
Q

what is total urinary incontinence?

A

no control

212
Q

what is urinary incontinence overflow

A

a constant dribble

213
Q

when is urge urinary incontinence

A

sudden urge, then involuntary void

214
Q

what is a precipitate void urinary incontinence?

A

voiding with no urge before

215
Q

what may be placed in a women surgically to treat stress urinary incontinence?

A

trans-vaginal tape, mesh, sling

216
Q

what is removed in a circumcision

A

prepuce

217
Q

what is an orchipexy

A

brings the undescended teste down

218
Q

what gets attached to what in an orchioplexy?

A

tunica albuginea and dartos muscle

219
Q

what is a orchiectomy

A

removal of testes

220
Q

where is a hydrocele located

A

behind testicle in scrotum

221
Q

what is hypospadias

A

the urethral opening is on the underside of the penis shaft

222
Q

what is the procedure that fixes a hypospadias?

A

meatoplasty

223
Q

what is a granuloplasty

A

repositioning of the glans penis

224
Q

what is an orthoplasty

A

straightening of the penis

225
Q

what is a urethroplasty

A

recon of urethra

226
Q

what is scrotoplasty

A

recon of scrotum

227
Q

where is the incision for a penial implant

A

underside of penis

228
Q

where is a pump inserted in the penis

A

in the scrotum

229
Q

are both testicle secured in an orchiopexy?

A

es

230
Q

are implants used in the penis to increase size?

A

no

231
Q

what wound class is an ileal conduit?

A

II

surgical procedures II (3 decks)

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