Final Exam Flashcards
GI anatomy
Major structures:
Mouth
Pharynx
Esophagus
Responsible for ingesting food
Stomach
Secreting, mixing food, digestion
Small intestine (duodénum, jejunum, ilium)
Absorption of nutrients
Large intestine (cecum, ascending colon, transverse colon, descending colon, sigmoid colon)
Adsorption of water (electrolytes)
Rectum and anus
Elimination
Define endoscopy
Visual exam of the bronchus/bronchi
Anatomy/physiology
Paphysiology/Indication Endoscopy
Epiglottis, true vocal cords, trachea, carina, right and left main stem of the bronchi
Performed to diagnose hemoptysis, infection, carcinoma. It is also performed to treat foreign bodies.
peristalsis
tylectomy
parenchyma
A progressive (involuntary), wave-like movement in a tubular structure Excision of palpable breast lesion Essential or functional parts of an organ
Types of Hernias
Inguinal
Direct (usually acquired)-Within Hesselbach’s Triangle
Indirect (usually congenital)-Outside of Hesselbach’s Triangle
Femoral
Umbilical
Epigastric AKA ventral or incisional
Hiatal (diaphragm)
Reducible
Non-reducible AKA incarcerated
Strangulated
Pantaloon hernia
Contents will go back in
Contents will not go back in, “stuck” inside hernia sac
Loop of bowel stuck in sac, blood supply compromised–On call case; plan for bowel resection
When both direct and indirect hernias are present (not Common)
Hesselbach’s Triangle
Rectus abdominus muscle medially (RAMM)
Inguinal ligament inferiorly (ILI)
Deep epigastric vessels laterally (DEVL)
Volvulus
Intussusception
A twisting of the intestine
A telescoping of the intestine
Define Thyroidectomy
Excision of both lobes of the thyroid gland and all thyroid tissue
Anatomy/physiology
Pathop[hysiology/Indication Thyroidectomy
Excision of both lobes of the thyroid gland and all thyroid tissue
Thyroid gland (and parts)
2 lobes and isthmus
Parathyroid glands, Recurrent laryngeal nerve (RLN; see procedure step 4), Trachea, Thyroid and cricoid cartilages
Endocrine gland
Metabolism; growth and development in fetuses and infants
Produce hormones T4; T5
Malignant tumors of the thyroid gland
Procedure steps for thyroidectomy
I/H/D/R
Identify thyroid gland and dissect it, ligating appropriate blood vessels
Identify RLN and preserve it; preserve parathyroid glands if possible
Remove thyroid gland
I/H/drain PRN/C/D
Define Laparoscopic cholecystectomy
Excision of gallbladder with the use of minimally invasive technique
Anatomy/physiology
Pathop[hysiology/Indication Laparoscopic cholecystectomy
Gallbladder; cystic duct; cystic artery, Liver; hepatic duct & artery, Common bile duct; duodenum
Storage/concentration of bile to emulsify ingested fat
Cholecystitis; cholelithiasis
Define TEP herniorrhaphy
Totally extra-peritoneal patch
Repair of a tear in the transversalis fascia through a minimally invasive approach
Anatomy/physiology
Pathop[hysiology/Indication TEP herniorrhaphy
Transversalis fascia, Inguinal canal; inguinal ligament; Cooper ligament, Internal and external rings, Hesselbach triangle(RAMM, ILI, DEVL) ilioinguinal nerve, Spermatic cord (Vas deferens, Testicular vessels, Cremaster muscle)
Inguinal hernia; direct or indirect
Procedure for TEP herniorrhaphy
I/H/dissect with balloon
Insufflate, place other ports
Continue dissection to identify and reduce hernia
Place mesh and secure (with staples/tacks)
I/H/remove ports/C/D
Define Laparoscopic Roux-en Y gastric bypass
Creation of a small gastric pouch connected to a segment of jejunum with connection of the duodenal limb to the lower jejunum using MIS techniques.
Anatomy/physiology
Pathop[hysiology/Indication Laparoscopic Roux-en Y gastric bypass
Stomach, Duodenum, Ligament of Treitz, Jejunum, Omentum, and Mesentery
Digestion ; absorption of nutrients
Procedure for Laparoscopic Roux-en Y gastric bypass
Establish laparoscopic access
Create gastric pouch with staplers
Identify ligament of Treitz by retracting away theOmentum and transverse colon
Transect jejunum with stapler
Create gastrojejunostomy (pass jejunum up to stomach and staple or sew)
Perform duodenojejunostomy (biliary limb)Check for leaks; close mesenteric defect;
I/H/C/D
Define Colon resection (open approach)
Excision or resection of the colon
Anatomy/physiology
Pathop[hysiology/Indication Colon resection (open approach)
Colon (Cecum, Ascending, Transverse, Descending, Sigmoid colon, Rectum), Mesentery, Liver, Spleen, and Ureters
Absorption of water; defecation
Colon cancer
Procedure steps for Colon resection (open approach)
I/H/D/R
Mobilize colon, isolate from mesentery (blood supply)
Clamps placed on colon, transect colon (stapler x 2 fires)
Perform anastomosis (1 GIA; 1 TA)
Remove contaminated items to prepare for clean closing
Close mesentery; I/H/C/D
Anatomy for Inguinal Hernia:
Transversalis fascia Inguinal canal Cremaster muscle Spermatic cord In females; the round ligament is in place of the spermatic cord Inguinal ligament Cooper ligament Ilioinguinal nerve Internal inguinal ring External inguinal ring
List the 6 main structures of the female reproductive system.
Vulva Vagina Cervix Uterus Tubes Ovaries
List the 4 supporting ligaments of the uterus:
Round, broad, cardinal, uterosacral ligaments
List the 3 parts of cervix:
List 4 parts of the uterus:
List the three layers of the uterine body
Internal os; external os; endocervical canal
Fundus, cornua, body (corpus), cervix
Endometrium, myometrium, perimetrium
Adnexa menstrual; Dyspareunia PID (CIS) Dysplasia Intraepithelial Neoplasia Pruritus Ectopic pregnancy
accessory structures: Tubes and Ovaries Pertaining to to the menses or menstruation Difficult or painful sexual intercourse Pelvic inflammatory disease Carcinoma in situ Condition; ill, bad, or poor; growth Pertaining to; within; epithelium Condition; new; growth Severe itching A fertilized egg attached outside the uterus
Physiology of the: Vulva Vagina Cervix Uterus Tubes Ovaries
Vulva–Facilitate sexual intercourse
Vagina –Intercourse; menstrual discharge, and delivery of infant
Cervix–Holds developing fetus inside uterus
Uterus–Support developing embryo/fetus
Tubes–Fertilization, peristalsis of zygote (fertilized ovum) to uterus
Ovaries–Store, mature, and release ovum “egg”
Define Laparoscopic hysterectomy (robotic)
Excision of uterus through the vagina, with MIS techniques for dissection from pelvic cavity