Gastrointestinal Surgery Flashcards

1
Q

Which section contains the majority of the small intestines?

A

hypogastric region

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2
Q

Identify the five major segments of the stomach and the purpose for each section

A
  1. Cardia– secretes mucous to ease passage of food.
  2. Fundus– produces hydrochloric acid.
  3. Corpus– produces acid & secretes pepsinogen & mucous.
  4. Antrum– non-acid producing secretes mucous & gastrin.
  5. Pylorus– food storage area before is passes in the duodenum.
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3
Q

What sphincter of the stomach prevents gastric reflux?

A

lower esophageal sphincter

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4
Q

What sphincter controls the exit of food from the stomach?

A

pyloric sphincter

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5
Q

What would be the consequences for the patient if the sleeve was too tight? Too loose?

A

Food will not be able to processed causing reflux if too tight, too lose and won’t hold structure

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6
Q

Identify the location and purpose of the greater and lesser omentum

A

The greater omentum is located at the peritoneal fold that hangs down from the stomach in front of the transverse colon. The function of the greater omentum is fat deposition, provide wound and infection isolation, and physically limit spread of intraperitoneal infections.

The lesser omentum is the double layer of the peritoneum that is extended from the liver to the lesser curvature of the stomach as well as part of the duodenum (between stomach and proximal duodenum and liver). The lesser omentum helps cover some of these organs to protect them.

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7
Q

Parasympathetic innervation to the stomach is provided by the vagus nerve. This nerve and the main left and right gastric arteries run primarily along the ______ of the stomach

A

superior portion of the lesser curvature

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8
Q

Name the four layers of the wall of the digestive tract

A

The innermost layer is the mucosa, underneath is the submucosa, then the muscularis propria, and then the outermost layer called the adventitia.

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9
Q

The enzyme pepsinogen (pepsin) secreted in the stomach begins digestion of the food substance _____.

A

proteins

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10
Q

The small intestine is responsible for the digestion and absorption of ______.

A

nutrients

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11
Q

The large intestine is responsible for the absorption of _____.

A

water

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12
Q

The movement of food through the intestines by the muscles of the alimentary canal is called _____.

A

peristalsis

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13
Q

What is the purpose of the mesentery?

A

The mesentery holds the small intestines to the back of the abdominal wall. It is a fold of tissue attaching organs to the wall.

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14
Q

Describe the typical location of the appendix. What is the purpose of the mesopendix?

A

The appendix is located generally at the lower right quadrant of the abdomen (near the right hip bone).

The mesoappendix is the part of the mesentery that connects the ileum to the appendix. It closes the appendicular artery & vein, lymphatic vessels, nerves, and a lymph node.

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15
Q

The Nissen fundoplication is performed to:

A

treat gastroesophical reflux disease (GERD) and hiatal hernia (via laparoscopic surgery)—it treats GERD

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16
Q

A percutaneous endoscopic gastrostomy is used to:

A

place a tube for feeding without having to perform an open surgery on the abdomen to help treat patients that struggle taking food in by the mouth - enteral feedings

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17
Q

What procedure establishes a permanent communication between the proximal jejunum and either the anterior or the posterior stomach:

A

gastrojejunostomy

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18
Q

The formation of a temporary or permanent opening into the ileum:

A

ileostomy

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19
Q

Resection of the right half of the colon, including a portion of the transverse colon, ascending colon, and cecum:

A

hemicolectomy

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20
Q

Incision and ligation of dilated veins in the anal region:

A

hemorrhoidectomy

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21
Q

A Billroth I is the resection of a diseased portion of the stomach and the establishment of an anastomosis between:

A

stomach and duodenum

22
Q

A McBurney incision is commonly used for:

A

appendectomy

23
Q

A Billroth II is the resection of a diseased portion of the stomach and the establishment of an anastomosis between:

A

stomach and jejunum

24
Q

This is the main surgical treatment for esophageal cancer. The surgeon removes all the parts of the esophagus through an incision that is located in the chest, abdomen, or even both.

A

Esophagectomy

25
Q

An operation that creates an opening at the colon or the large intestines through the abdomen that can be temporary or permanent. Transverse can be done to treat colon cancers.

A

Transverse colectomy

26
Q

Name and describe all of the variations for large bowel anastomosis.

A

a. 1. end-to-end: two ends of approximately the same size structures are attached.
2. end-to-side: the end of one section of bowel is attached to the side of another section
3. Side-to-side: creation of parallel openings in two sections of bowel with anastomosis.
4. Roux-en-Y: specific technique of anastomosis that allows a variety of applications in gastric, intestinal, biliary, and pancreatic surgery.

27
Q

Describe the patient position that is necessary when a thoracoabdominal approach is planned.

A

placed in lateral or supine position

28
Q

What are the three major sections of the stomach?

A

Fundus (upper)
Body (middle)
Antrum (lower or distal)

29
Q

What is assessed during an esophagogastroscopy?

A

The esophagus, stomach, and upper part of small intestines (duodenum) is assessed.

30
Q

What is used to ligate the vagus nerve and how many vagus nerve branches are ligated or resected?

A

The nerve is ligated with metal surgical clips.

31
Q

What health conditions have a Roux-en-Y procedure traditionally been used to treat?

A

Gastric Bypass

32
Q

What stapling devices will be used to perform a Roux-en-Y procedure?

A

TA-90 stapler, GIA stapler, and a TA-55 stapler

33
Q

protrusion of abdominal tissue through one or more abdominal layers is an

A

incisional hernia

34
Q

in a _________ hernia, tissue protruding from the hernia may be swollen and squeezed

A

strangulated

35
Q

A hernia in which abdominal viscera slides into the inguinal canal from the deep inguinal ring is an

A

indirect hernia.

36
Q

protrusion of abdominal or inguinal tissue directly through the transversalis fascia is a

A

direct inguinal hernia

37
Q

A rare hernia occurring between the transverse abdominis and rectus muscles is a

A

Spigelian hernia

38
Q

This occurs most often as a postoperative complication or a result of pelvic or back injury and peritonitis,

A

paralytic ileus

39
Q

Telescoping of the intestines, occurring mainly in children, and resulting in ischemia and necrosis of the bowel is

A

intussusception

40
Q

Twisting of the bowel on itself is

A

volvulus

41
Q

During a laparoscopic cholecystectomy, which two structures are occluded?

A

cystic duct and cystic artery

42
Q

venous drainage from the esophagus empties into

A

subclavian veins, azygos vein on the right, hemiazygos vein on the left, and through the coronary vein in the portal circulation

43
Q

blood supply to the esophagus

A

branches of the inferior thyroid arteries, bronchial arteries, thoracic aorta, and branches of the left gastric and inferior phrenic arteries

44
Q

what is the omentum

A

omentum is a double layer of fatty peritoneum attached to the greater curvature of the stomach. it drapes loosely over the intestines, folds posteriorly on itself, sweeps upward to attach along the transverse colon

45
Q

what is the landmark for the beginning of the jejunum

A

ligament of Treitz: supports the duodenojejunal flexure

46
Q

blood supply to ascending, transverse, descending, and sigmoid colon

A

ascending: ileocolic and middle colic arteries
transverse: middle colic artery
descending/sigmoid: left colic and sigmoid arteries

47
Q

layers of the abdominal wall

A

skin, camper’s fascia, scarpa’s fascia, external oblique, internal oblique, transversus, transversalis fascia, preperitoeal fat, peritoneum

48
Q

what is a billroth 1

A

truncal vagotomy, antrectomy, and gastroduodenostomy (one limb off remnant)

49
Q

what is a billroth 2?

A

truncal vagotomy, antrectomy, and gastro gastrojejunstomy (2 limbs off)

50
Q

what is the kocher maneuver?

A

dissect the left lateral peritoneal attachments to the duodenum to allow visualization of posterior duodenum

51
Q

most common metastasis from colorectal cancer is to

A

liver