General sx Flashcards
Surgical safety checklist
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A soaked mop contain how much blood
100cc
1fist full of clots contain how much blood
500cc
5 mops soaked during surgery. 1200 cc in the suction but I litre was irrigation fluid No clots. Total Blood Loss is
Total blood loss is (5X100) + (200-1000) = 700cc of blood loss.
In lap chole which position is used
Reverse Trendelenburg position.
Fowler’s / sitting position used for
CNS Fossa (post fossa)
Breast reconstruction
What to do if we suspect air embolism
Immediately shift patient to left lateral decubitus position with foot end up. This is called as durants or the recovery position
Rose position used in
Thyroid surgery
Lloyd davies position is combination of
Trendelenburg and lithotomy position
- What is the best data to check the reliability of safety systems in a hospital?
Number of near miss events.
Function of Yellow and Blue button in monopolar cautery
Yellow button: Cutting
Blue button : coagulation
What is cutting current?
Low voltage continuous current.
Principle: Sufficient heat to cause cell water to explode into steam.
What is coagulation current
High voltage alternating current.
Principle: Cell death by dehydration and protein denaturation. Never applied to skin as it can burn the skin.
What is Fulgaration mode
Voltage higher than coagulation
What is Blend mode
Both cutting and Coagulation(combination)
Most common cause of OT related fire
Cautery Sources
What is ligasure?
uses heat + pressure to carry out coagulation.
• Can coagulate vessels upto 7 mm in diameter.
• uses body’s collagen and elastin to seal and divide.
Feedback, mechanism of Ligasure
Energy delivery is in a precise
manner and results in automatic discontinuation of energy once the vessel is completely sealed, then the vessel can be cut.
1st Generation ligasure only
Coagulation
2nd Generation ligasure only
Coagulation followed by cutting 
What does harmonic scalpel do?
It works on the ultrasonic principal oscillator blade that oscillate between 20,000 to 50,000 Hz that causes protein denaturation ; coagulation without heat production 
What is Thunderbeat S ?
It has features of ligasure, and harmonic scalpel
What is working principles of CUSA ?
Hepatocytes are particularly susceptible to oscillatory fragmentation due to high water content and low collagen.
It can also aspirate the gas which is produced better in a non-cirrhotic liver.
Which blade is use for Incision and drainage
No. 11 pointed / Stab blade. (Also used for areteriotomy) Incision in the artery.
Which blade is used for suture removal
No 12. Curved Blade
Which blades have belly ?
No 10 , 15, 20, 21, 22,23
Belly of the blade is the sharpest portion of a blade.
What is ABPI
The ankle-brachial pressure index (ABPI) or ankle-brachial index (ABI) is the ratio of the blood pressure at the ankle to the blood pressure in the upper arm (brachium). Compared to the arm, lower blood pressure in the leg suggests blocked arteries due to peripheral artery disease (PAD). The ABPI is calculated by dividing the systolic blood pressure at the ankle by the systolic blood pressure in the arm.[1]
When the drain is removed after mastectomy
When the output is <40cc/day for 2 consecutive day or else seroma can occur
Which drain is used for sentinel lymph node biopsy
Minivac
Which drain is mainly used for abdominal surgery
Jackson pratt drain
Which knot is secure
Square knot ( two square truths, make a square/reef knot) and surgeno’s knot
What are the suturing instrument?
Needle holder ,
tooth forceps,
straight scissors
Describe surgeons knot
This knot consist of two throws followed by one throw
Which suturing are cosmetically better
Subcuticular, suturing(3-0 monocryl needle is used most commonly)
Which suture used in cervical cerclage
Pursestring, suture 
Continuous sutures ends with
Aberdeen’s knot/ cobbler’s knot
Shoestring, method is used for
For fasciotomy wound closure in compartment syndrome. This is done for delayed closure to prevent cut through of sutures also known as delayed by tertiary intention.
Round body needles used for
Disney doll is relatively atraumatic. I need to split the tissue and does not cut through it so they use for delicate structures like bowel, blood vessel, bladder, common bile duct
Cutting reverse, cutting needles used for
Skins ; sheath ; fascia
Other needle and their usages 
• Half circle needles: Gl Tract.
• J Shaped needles: Vaginal surgery.
• Quarter circle needles: Eye.
• compound curvature: Oral cavity.
Example of natural sutures
Silk ; catgut
Example of synthetic suture
Nylon ; PDS ; prolene
 Which sutures are used for facelifts
Barbed vicryl: It has spikes therefore anchors in the tissue and can remain in place without a Knot. This can be used for face lifts.
It is very painful.
What is Carrel’s triangle
while repairing a vessel, bulldog clamps are placed on both sides of the vessel. After surgery, the distal clamp is removed first to let the blood fill the air gap retrogradely and then the proximal clamp is released.
Suture removal
• scalp: 5-7 days.
• Face: 3-5 days.
• Neck: 5-7 days.
• Thorax: 10-12 days.
• Abdomen: 12-14 days.
• Perineum: 10-12 days.
First layer in bowel anastomosis is
Albert layer: The first bite involves all the layers of the bowel using vicryl suture.
Second layer in bowel anastomosis is
Lembert layer: using silk suture and an
inversion is created.
Which is the strongest layer in bowel anastomosis
Submucosa
Linear stapler is used for
Sleeve gastrectomy
Circular stapler is used for
Low anterior resection LAR
, Steppler hemorrhoidopexy
; esophagojejunostomy
Absorbable suture
Catgut ; Polyglactin(vicryl) ; Polydioxanone ; Poliglecaprone(monocryl)
Non absorbable suture material
Silk ; surgical steel ; Nylon ; Polybutester ; Polyprolene(prolene)
Color, coding of suture material
Catgut : yellow
Silk : black
Prolene : blue
