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Surgery > GI Surgery > Flashcards

GI Surgery Flashcards

1
Q

What is the main cause of GERD?

A

Obesity

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2
Q

Which way do clasps (sling fibers) wrap around the esophagus?

A

From medial to lateral

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3
Q

What is normal LES pressure?

A

13-48 mmHg

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4
Q

What are two mechanisms that natually prevent GERD?

A

Resting pressure

Diaphragmatic crura

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5
Q

When is a Bravo-pH study used? What is it? What pH is considered a positive finding?

A

When symptoms don’t support GERD
pH capsule placed in a esophagus
pH <4 = GERD

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6
Q

What is the most common surgical correction for GERD? How does it differ from a Dor, Toupet, Transoral?

A

Nissen Fundoplication - 360 degree wrap of stomach around esophagus
Dor - fundus brought anterior to esophagus and stapled
Toupet - 180 degree wrap
Transoral - 270 degree wrap

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7
Q

When is a GERD surgery indicated? (5 reasons)

A 
Incomplete response to PPIs
Document reflux with modalities
Unwilling to take lifelong medications
Extraesophageal manifestations
Adequate esophageal motility
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8
Q

Do PPIs treat GERD?

A

No, they just treat symptoms

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9
Q

How long is the esophagus? From where to where?

A

40cm from incisor to GE junction

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10
Q

What is Lusoria’s Dysphagia? Is it aquired or an anatomical variant?

A

Pressure of right subclavian artery on esophagus

Anatomic variant

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11
Q

The lack of what layer in the esophagus increases risk for esophageal damage?

A

Serosa

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12
Q

What fails resulting in GERD?

A

Pharyngoesophageal ligaments

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13
Q

Describe the difference between oropharyngeal and pharyngoesophageal dysphagia

A

Oropharyngeal - trouble getting food bolus from mouth to esophagus
Pharyngoesophageal - issue moving food down esophagus

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14
Q

What is the primary cause of esophageal stricture?

A

Caustic injury

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15
Q

What are the three types of achalasia?

A

Type 1 - without esophageal pressure
Type 2 - with a little esophageal pressure
Type 3 - with esophageal spasm

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16
Q

What is the main tissue type disrupted in a hernia?

A

Muscle fascia

17
Q

When are inguinal hernias repair in kids? Adults?

A

Kids - when noted

Adults - When large or symptomatic

18
Q

What are ventral hernias repaired? Why?

A

When present, as they always get larger

19
Q

What arethe differences between a herniotomy, herniorrhaphy, and hernioplasty?

A

Herniotomy - removal of hernia sac only
Herniorrhaphy - removal of sac and repair of posterior wall defect
Hernioplasty - herniotomy with reinforcement of posterior wall using mesh

20
Q

In relation to the spermatocord, where is an indirect hernia sac found? Direct hernia sac?

A

Indirect - anteromedial

Direct - posterior

21
Q

What are the borders of Hesselbach’s triangle?

A

Inferior gastric vessels - lateral
Rectus muscle - medial
Inguinal ligament - inferior

22
Q

What is the surgical repair for an inguinal hernia?

A

lichtenstein repair

23
Q

What is standard treatment for bleeding diverticulitis?

A

Conservative, IV antibiotics and bowel rest

24
Q

Is Hartman’s procedure a standard of care for diverticulitis?

A

No, it is for damage control only

25
Q

Is a primary anastomosis preferred when repairng diverticuli?

A

Yes, for the stable patient

26
Q

What is the difference between the surgical anal canal and anatomic anal canal?

A

Surgical - 4-5cm

Anatomic - 2.5-3cm

27
Q

What is the primary cause of colonic obstruction and volulus?

A

Adenocarcinoma

28
Q

Will air be present in the rectum if you have a colonic obstruction/volvulus?

A

No

29
Q

What type of bowel sounds to you expect to hear during a colonic obstruction?

A

High pitched/rushing

30
Q

How do you treat grade 1 hemorrhoids? Grade 3/4?

A

1 - bulking agents

3/4 - surgery

31
Q

What is the #1 cause of severe anal pain?

A

Anal fissue - primarily due to malignancy, Crohns disease, leukemia, STD

Surgery (10 decks)

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