LE5 Surgery Feeds Flashcards
- *
A. Dorsal penile nerve block
B. EMLA application
C. Anterior penile nerve block
D. Ring block technique
A. Dorsal penile nerve block
-
Dorsal Penile Nerve Block Technique:
- Also referred to as pudendal nerve block.
- An effective method for local anesthesia in infant circumcision procedures.
- The maximum safe dose of lidocaine for children is 3 mg/kg of body weight.
- Use a 27-gauge fine needle for the procedure.
- Perform injections at the 10 o’clock and 2 o’clock positions of the penis.
- Always aspirate before injecting to ensure the needle is not in a blood vessel.
- Do not mix lidocaine with epinephrine for this procedure to avoid the risk of tissue necrosis due to vasoconstriction.
- The block anesthetizes only the prepuce or foreskin, leaving the possibility of pain in the glans.
2.
A. Mixter forceps
B. Kelly forceps
C. Ochsner forceps
D. Mosquito forceps
B. Kelly
- Mixter forceps are typically long with a right-angle curve at the end, often used to grasp or retract structures in deep or narrow spaces.
- Kelly forceps have a transverse striation only at the tip of the jaws and are often used to clamp larger vessels or tissue.
- Ochsner (Kocher) forceps have interlocking teeth at the tip of the jaws, designed to hold heavy tissue, and often used for grasping tough structures like fascia or bone.
- Mosquito forceps are smaller and finer than the others, with a delicate and straight or curved profile, primarily used for clamping small vessels.
- The big toes are usually affected with onychocryptosis *
A. True
B. False
C. Maybe
D. None of above
True.
Onychocryptosis, commonly known as an ingrown toenail, most frequently affects the big toes. This condition occurs when the edge of the toenail grows into the skin of the toe, which can cause pain, redness, and swelling.
- For the suture selection: In the urinary tract, absorbable sutures are used. *
A. True
B. False
C. Both
D. None of the above
True.
Specific Tissue Repairs:
- Urinary tract: typically repaired with absorbable sutures.
- Skin: the choice of suture depends on a balance of healing requirements.
- Cardiovascular:
- Monofilament propylene is often used for vascular anastomosis.
- Polyester sutures are used for artificial heart valves, myocardium, and vascular prosthesis.
- A Jackson-Pratt Drain is an active and closed drain. *
A. True
B. False
True.
A Jackson-Pratt (JP) Drain is an active, closed suction drain. It consists of a flexible tube placed into a body cavity or surgical site to remove blood, pus, or other fluids, connected to a bulb that creates suction. This design helps to reduce the risk of infection and promotes healing by keeping the area dry.
-
Jackson-Pratt Drain Overview:
- A drainage device used to pull excess fluid from the body through constant suction.
- Features a flexible plastic bulb that connects to a plastic drainage tube placed within the body.
-
Mechanism of Action:
- Operates on the principle of negative pressure vacuum.
- Removing the plug and squeezing the bulb evacuates air, creating a vacuum that draws fluid into the bulb from the drainage tube.
-
Indications:
- The design prevents intraabdominal contents such as the omentum or intestines from being aspirated into the tube.
-
Usage Instructions:
- To drain fluid, the plug is removed, and the bulb is compressed to expel the air.
- When the bulb is released and the plug is reinserted while the bulb is still compressed, negative pressure is maintained.
- This negative pressure is necessary for the drain to function correctly.
-
Usage Analogy:
- The process of creating negative pressure in the JP drain is likened to squeezing, emphasizing the need to maintain negative pressure for effective drainage.
- In this time of pandemic the most important preventive measure to minimize transmission? *
A. Use of sanitizer
B. Social distancing of 2 meters
C. Hand wash with alcohol
D. Handwashing with hand soap
E. Use of properly fitted N95 mask
E. Use of properly fitted N95 mask
7.*
A. Incisional biopsy
B. Aspiration biopsy
C. Core needle biopsy
D. Excisional biopsy
D. Excisional biopsy
-
Excisional Biopsy Overview:
- This procedure involves the removal of an entire mass or suspicious tissue area, applicable to small lesions, not whole organs or limbs.
- The goal is the complete removal of the lesion.
-
Indications:
- Ideal for small lesions less than 1 cm in diameter.
- Suitable for lesions that appear benign and can be entirely removed with a margin of normal tissue without causing mutilation.
- The decision on the biopsy type is based on the patient’s history and physical examination, along with these indications.
-
Procedure:
- Excise the entire lesion along with 2-3 mm of surrounding normal tissue if the lesion is benign.
- Make an incision in the skin or mucosa around the base of the lesion in an elliptical shape to facilitate complete removal and adequate margins.
- Is this the proper way of handling this instrument? *
A. Yes
B. No
A. Yes
Forceps = Pencil Grip
- Rake retractor is an example of a handheld retractor. *
A. True
B. False
A. True
RETRACTING AND EXPOSING INSTRUMENT
Hand- Held (Manual)
* Deaver retractor
* Richardson retractor
* Richardson appendectomy retractor
* Harrington retractor
* Army navy retractor
* Goulet retractor
* Malleable retractor
* Senn retractor
* Volkman retractor (rake)
* Green retractor
* Rectal speculum
Self- retaining
* Weitlaner retractor
* Gelpi retractor
* Balfour with blade retractor
10.
A. Goulet Retractor
B. Richardson Retractor
C. Army-Navy Retractor
D. Volkmann Retractor
C. Army-Navy
Army Navy: (+) hole, flat blade/end
Goulet: (-) hole, round blade/end
- A box lock is a particular kind of clamp used to stop blood flow through a vessel. *
A. True
B. False
B. False
A box lock is a component of many surgical instruments, particularly forceps and clamps, but it is not a type of clamp itself. It refers to the hinge mechanism that allows the instrument to be locked in place. Hemostatic clamps or hemostats are used to stop blood flow through a vessel.
12.
A. Bandage scissors
B. Metzenbaum scissors
C. Mayo scissors
D. Episiotomy scissors
C. Mayo scissors
- These are type of interrupted suturing technique used to provide additional support to wound edges in abdominal surgery. *
A. Retention sutures
B. Suture ligature
C. Tie on a passer
D. Stick tie
A. Retention sutures.
Retention sutures are a type of interrupted suturing technique used specifically to provide additional support to wound edges, particularly in abdominal surgery where there is a risk of increased abdominal pressure that could lead to wound dehiscence.
C. SPECIALTY USES OF SUTURE
Retention Suture:
- A technique employing an uninterrupted suture style.
- Provides enhanced support to wound edges, particularly in abdominal surgeries.
- Often used to prevent dehiscence in high-tension areas or in patients at risk for wound healing complications.
Suture Ligature (Stick Tie):
- Utilized specifically to ligate large bleeding vessels.
- Purpose: Ensures that the ligature remains securely in place on the vessel and does not slip off.
- Procedure:
- The surgeon inserts the needle through the midpoint of the vessel.
- An additional loop is made around the vessel’s exterior with the suture.
- After removing the needle, the ligature is tied tightly to control bleeding.
- The ends of the suture are typically clamped and left uncut until the surgeon is confident there is no further bleeding.
Utilized specifically to ligate large bleeding vessels.
A. Retention sutures
B. Suture ligature
C. Tie on a passer
D. Stick tie
B. Suture ligature
Suture Ligature (Stick Tie):
- Utilized specifically to ligate large bleeding vessels.
- Purpose: Ensures that the ligature remains securely in place on the vessel and does not slip off.
- Procedure:
- The surgeon inserts the needle through the midpoint of the vessel.
- An additional loop is made around the vessel’s exterior with the suture.
- After removing the needle, the ligature is tied tightly to control bleeding.
- The ends of the suture are typically clamped and left uncut until the surgeon is confident there is no further bleeding.
14.
A. Poole Abdominal Suction Tip
B. Yankauer Tonsil Suction Tip
C. Frazier Suction Tip
D. Andrews Pynchon Suction Tip
A. Poole, abdominal
-
POOLE SUCTION TIP:
- Designed to remove large quantities of fluid from the abdomen efficiently.
- Commonly utilized in general suction applications during surgical procedures.
- Features a large number of small holes to facilitate the evacuation of fluids without clogging.
- Can be disassembled into two pieces to allow for thorough cleaning and sterilization.
- Includes a removable perforated guard, which is essential for preventing injury to the bowel and other intestinal organs during suction in abdominal surgery.
15.
A. Weitlaner Retractor
B. Balfour Retractor
C. Gelpi Retractor
D. Deaver Retractor
C. Gelpi
- The physician uses a clean (non-sterile) gloves for NGT insertion. *
A. True
B. False
False.
Sterile gloves are recommended for NGT insertion to minimize the risk of introducing infections into the nasal passage, throat, and ultimately the stomach. While some procedures may allow for clean gloves under certain conditions, best practices and infection control protocols typically call for sterile gloves in this context.
- The following are non absorbable sutures. *
A. Chromic
B. Polypropylene
C. None of the above
D. Polydioxanone suture
B. Polypropylene.
Polypropylene is a type of non-absorbable suture material used in situations where prolonged suture support is needed. Chromic is a form of absorbable suture material, and Polydioxanone suture (PDS) is also absorbable.
EX:
Absorbable: Catgut, monocryl, chromic, PDS (polydioxanone suture), vicryl.
Non absorbable : Prolene (Polypropylene), Ethibond, nylon, steel, silk (commonly used).
- Universal blood and body fluid precautions or universal precautions *
A. All surgical patients are considered to be couriers of blood-borne pathogens
B. During all surgical procedures with the possible exception of microsurgery, all team personnel
C. Must wear protective goggles or a face shield
D. Both of the above
E. None of the above
D. Both of the above.
Universal precautions include treating all patients as if they are carriers of blood-borne pathogens and requiring all team personnel to wear protective gear, such as goggles or a face shield, during surgical procedures to prevent exposure to blood and body fluids.
19.
A. Allis Forceps
B. Gallstone Scoop
C. Babcock Forceps
D. Doyen Intestinal Clamp
A. Allis
- Shears are used to cut and extract tissue and is distinguished by having a spring loaded hinge. *
A. True
B. False
True.
Shears, particularly in a surgical context, often have a spring-loaded hinge to facilitate easier cutting and more precise control when cutting and extracting tissue. This feature distinguishes them from other cutting instruments that do not have this mechanism.
21.
A. Weitlaner Retractor
B. Babcock Forceps
C. Allis Forceps
D. Senn Retractor
D. Senn
SENN RETRACTOR
- Often referred to as a “Cat’s paw” retractor.
- Function: Primarily used for retracting surface tissue during surgical procedures.
- Usage: Common in plastic surgery, small orthopedic procedures involving bones and joints, thyroidectomies, and dissections of neck tissue.
-
Design: A handheld, double-ended retractor featuring two different ends for versatility:
- One end is atraumatic with a right angle for gentle tissue handling.
- The other end has sharp rake teeth for more aggressive retraction.
- Variants: Available with or without a rake on the blade end.
VOLKMANN RETRACTOR (RAKE)
- Known as a “Rake Retractor.”
- Function: Typically employed for retracting and grasping connective tissues.
- Design: Features sharp rakes or hooks that are designed to hold the undersurface of superficial tissues securely.
- Usage: Utilized for retraction in superficial wound exposure.
Senn vs Volkmann Retractor Comparison:
- Both retractors have rake-like ends suitable for certain types of tissue manipulation.
- Senn Retractor: Distinguished by its double-ended design with each end serving different retraction needs.
- Volkmann Retractor: Characterized by a single-blade/end with multiple sharp rakes or hooks for tissue engagement.
- Surgical hand scrub using stiff brush and a strong antiseptic is preferred over hand scrubbing with an alcohol based antiseptic *
A. True
B. False
B. False.
The preference for surgical hand scrubbing has evolved over time. Current guidelines and practices often favor alcohol-based hand rubs for surgical hand antisepsis due to their broad-spectrum efficacy, faster action, and less skin irritation compared to traditional scrubbing with a stiff brush and antiseptic. The use of a brush can cause microabrasions on the skin, potentially increasing the risk of infection.
23.
A. Harrington Retractor
B. Balfour Abdominal Retractor
C. Deaver Retractor
D. Murphy Retractor
B. Balfour, abdominal
BALFOUR WITH BLADE RETRACTOR
- Function: Designed for retracting wound edges during deep abdominal surgeries. It is primarily used to provide exposure by opening up the abdominal cavity.
- Type: A self-retracting retractor, which means it stays open without the need for manual holding, allowing for hands-free operation by the surgical team.
- Bladder Blade: When the Balfour retractor includes a component to retract the bladder, it is often specifically termed a “Balfour with bladder blade.” If this component is absent, it is referred to simply as a Balfour retractor.
- Harrington Retractor is also called a sweetheart retractor. *
A. True
B. False
A. True.
The Harrington retractor, known for its distinctive heart-shaped end, is often referred to as a “sweetheart” retractor. It is commonly used in abdominal surgeries to retract and hold back organs, such as the liver, to provide better visibility and access to the surgical site.
- EMLA *
A. Eutectic Mixture of Local Anesthetics
B. Eunited Mixture of Local Anesthetics
C. Enteral Mixture of Local Analgesia
D. Eutectic Mixture of Locoregional Anesthetics
A. Eutectic Mixture of Local Anesthetics.
Composition:
Contains two amide-type local anesthetics:
25mg/g Lidocaine = 2.5%
25mg/g Prilocaine = 2.5%
Availability:
30g tubes = 750mg
5g tubes = 125mg
EMLA cream contains a combination of lidocaine and prilocaine, each at a concentration of 25mg per gram of cream. This concentration translates to 2.5% of each anesthetic.
For a 30g tube of EMLA:
- Each gram contains 25mg of lidocaine and 25mg of prilocaine.
- Therefore, the entire tube contains 30g * 25mg/g = 750mg of lidocaine and 750mg of prilocaine.
For a 5g tube of EMLA:
- Each gram contains 25mg of lidocaine and 25mg of prilocaine.
- Therefore, the entire tube contains 5g * 25mg/g = 125mg of lidocaine and 125mg of prilocaine.
The percentage of the anesthetic components remains the same in both tube sizes, which is 2.5% for lidocaine and 2.5% for prilocaine.
26.
A. Malleable (Ribbon) Retractor
B. Goulet Retractor
C. Deaver Retractor
D. Parker Retractor
A. Malleable (ribbon)
27.
A. Epispadias
B. Paraphimosis
C. Phimosis
D. Hypospadias
D. Hypospadias
28.
A. Russian Forceps
B. Adson Toothed Forceps
C. Cushing Toothed Forceps
D. Thumb Forceps, Toothed
B. Adson, Toothed
ADSON FORCEPS
- Also known as “Adson pickups.”
-
Variants:
- Smooth/Without Teeth: Designed for handling delicate tissues gently to avoid causing damage.
- With Teeth: Typically used for securely grasping skin.
-
Features:
- Notable for having a wider “belly” or grip handle, which can provide a more comfortable and secure grasp for the user.
-
Identification:
- When identifying Adson forceps, it’s important to specify whether they are with or without teeth, as this determines their specific use in medical procedures.
- This is a special continuous suture technique for closing the end of a tubular structure (lumen), such as the appendix. *
A. subcuticular suture
B. purse-string suture
C. locking suture
D. suture ligature
B. Purse-string suture.
CONTINUOUS SUTURE
- Overview: Involves a single strand of suture material running continuously along the wound edge.
- Technique: The needle alternates from one side of the tissue edge to the other.
- Advantages: Quick to place and uses less suture material.
- Disadvantages: Less strength than interrupted sutures; if one section breaks, the entire suture may unravel.
SUBCUTICULAR SUTURE
- Type: A running suture placed within the dermis.
- Use: Ideal for cosmetic closure, including pediatric patients.
- Outcome: Results in close approximation of skin edges without external suture visibility, producing a minimal scar.
PURSE-STRING SUTURE
- Application: Special technique for closing the end of a tubular structure, like the appendix.
- Procedure: Sutures are placed circularly around the lumen’s opening, then drawn tight and knotted to close.
LOCKING SUTURE
- Purpose: Adds strength to a running suture line and enhances hemostasis.
- Technique: After each pass through the wound edges, the needle goes under the previous loop, effectively ‘locking’ each segment.
- Innovation: “Self-locking” or barbed sutures, which contain projections that prevent the suture from loosening, offer a modern alternative to traditional locking sutures.
- Type: A running suture placed within the dermis.
- Use: Ideal for cosmetic closure, including pediatric patients.
- Outcome: Results in close approximation of skin edges without external suture visibility, producing a minimal scar.
A. subcuticular suture
B. purse-string suture
C. locking suture
D. suture ligature
A. subcuticular suture
- Overview: Involves a single strand of suture material running continuously along the wound edge.
- Technique: The needle alternates from one side of the tissue edge to the other.
- Advantages: Quick to place and uses less suture material.
- Disadvantages: Less strength than interrupted sutures; if one section breaks, the entire suture may unravel.
A. continuous (running) suture
B. purse-string suture
C. locking suture
D. suture ligature
A. continuous (running) suture
30.
A. Two handed surgical knot tying
B. Reef knot tying
C. Instrument tying
D. One handed surgical knot tying
C. Instrument tying
- One-Handed Square Knot: A technique where the surgeon ties a square knot using one hand, which is useful in situations with limited space or when the other hand is occupied.
- Two-Handed Square Knot: A basic and commonly used knot in surgery where both hands are used to tie a square knot, which ensures the knot is secure and lies flat against the tissue.
- Surgeon’s Knot: Similar to the square knot but with an additional throw or loop which adds security to the knot, making it less likely to slip before the knot is tightened, particularly in situations where the tissue is slippery.
- Instrument Tie: A knot-tying technique that uses a surgical instrument, like a needle holder, to assist in the formation of the knot, offering precision and control, particularly in deep or narrow surgical fields.
- A contaminated surface is one that has potentially or actually come in contact with a non-sterile object *
A. True
B. False
A. True.
In the context of infection control and surgical procedures, a surface is considered contaminated if it has come into contact with any non-sterile item or substance, potentially introducing pathogens that could lead to infection.
- Sterile gloves are needed in the insertion of an indwelling foley catheter. *
A. True
B. False
A. True.
The insertion of an indwelling Foley catheter is a sterile procedure to prevent urinary tract infections. Using sterile gloves, along with other sterile techniques, minimizes the risk of introducing bacteria into the urinary tract.
33.
A. Iris Scissors
B. Metzenbaum Scissors
C. Mayo Scissors, Curved
D. Mayo Scissors, Straight
B. Metzenbaum
Straight (Suture) Mayo
curveD (Dissecting) Mayo
meTzenbaum (delicate Tissue)
Iris (fIne tissure/sutures)
-
Straight Mayo Scissors:
- Commonly referred to as “Suture Scissors.”
- Primarily used for cutting sutures.
- Not recommended for cutting tissue as they can dull quickly from cutting suture material.
-
Curved Mayo Scissors:
- Known as “Dissecting Scissors.”
- Used for cutting through heavy tissue or muscle and for dissecting heavy tissue.
-
Metzenbaum Scissors:
- Often abbreviated as “Metz.”
- Should not be used for cutting sutures to maintain their delicate edges.
- The most commonly used scissors in general surgery for cutting or dissecting delicate tissue.
- They have round-tipped, thin, and more delicate blades suitable for precision work but not for cutting sutures, drains, or heavy tissue.
-
Iris Scissors:
- Ideal for cutting and dissecting fine tissue and fine sutures.
- Frequently used for extremely fine dissection, particularly in plastic surgery.
- Characterized by their small size and sharp, pointed tips, with both straight and curved blade options available.
Each type of scissor is designed for specific tasks to ensure precision and to avoid damage to the instrument and the tissue. It’s important for surgical personnel to use the appropriate scissors for their intended purpose to maintain surgical efficacy and tool longevity.
34.
A. Incisional biopsy
B. Aspiration biopsy
C. Excisional biopsy
D. Core needle biopsy
A. Incisional biopsy
A. Incisional Biopsy: This is a type of biopsy in which only a sample of tissue is removed for examination, rather than the entire lesion or tumor.
B. Aspiration Biopsy: Also known as fine-needle aspiration (FNA), this involves using a thin needle to withdraw fluid or small tissue fragments from a mass or lump to be examined.
C. Excisional Biopsy: In this procedure, the entire lump or suspicious area is removed for diagnostic examination, often used when a lump is smaller and can be completely removed.
D. Core Needle Biopsy: This biopsy uses a larger needle than that used in FNA to remove a core of tissue from a lump or mass for examination under a microscope.
35.
A. Pean Hemostatic Forceps
B. Mayo-Hegar Needle Forceps
C. Kelly Hemostatic Forceps
D. Mosquito Hemostatic Forceps
D. Mosquito Hemostatic Forceps
MAYO-HEGAR NEEDLE FORCEPS
- Primary Use: Designed for holding needles during suturing procedures.
- Secondary Function: Capable of being used to load blades into blade holders.
-
Design Features:
- Possesses a shorter, blunt beak, distinguishing it from hemostats, which have a longer beak.
- Resembles a mosquito forceps but is characterized by a thicker and heavier box lock and jaw, making it more robust.
- The Poole suction tip is designed for superficial areas in the neck, face and ear. *
A. True
B. False
B. False.
The Poole suction tip is actually designed for the rapid removal of large volumes of fluid from the abdominal cavity during surgery. It has a removable outer sheath with multiple holes to prevent blockage by tissue, making it unsuitable for delicate areas like the neck, face, and ear.
37.
A. Collin Tongue Forceps
B. Towel Clamp
C. Sponge Forceps
D. Malleable Probe
B. Towel clamp
38.
A. Jackson-pratt drain
B. Penrose drain
C. Chest tube
D. Redivac drain
A. Jackson-pratt drain
Jackson-Pratt Drain Overview:
- A drainage device used to pull excess fluid from the body through constant suction.
- Features a flexible plastic bulb that connects to a plastic drainage tube placed within the body.
-
Mechanism of Action:
- Operates on the principle of negative pressure vacuum.
- Removing the plug and squeezing the bulb evacuates air, creating a vacuum that draws fluid into the bulb from the drainage tube.
-
Indications:
- The design prevents intraabdominal contents such as the omentum or intestines from being aspirated into the tube.
-
Usage Instructions:
- To drain fluid, the plug is removed, and the bulb is compressed to expel the air.
- When the bulb is released and the plug is reinserted while the bulb is still compressed, negative pressure is maintained.
- This negative pressure is necessary for the drain to function correctly.
-
Usage Analogy:
- The process of creating negative pressure in the JP drain is likened to squeezing, emphasizing the need to maintain negative pressure for effective drainage.
- The Flank is the area of a surgical instrument between the jaws and the finger ring. *
A. True
B. False
B. False.
Shanks:
Also referred to as the “legs” of the instrument.
The area that extends between the box lock and the finger rings.
40.
A. T-tube
B. Pigtailed catheter
C. Indwelling foley catheter
D. Chest tube
C. Indwelling foley catheter
- Precise method by which all team members who will be working in sterile attire scrub their hands and arms before performing an operation *
A. Surgical scrub
B. Hand washing
C. Aseptic technique
D. Biological control
A. Surgical scrub.
A surgical scrub is a specific procedure performed by healthcare professionals to clean their hands and arms before a surgery, using antiseptic agents to significantly reduce the number of microorganisms.
*42.
A. Chest tube
B. Jackson-pratt drain
C. Redivac drain
D. Penrose drain
D. Penrose drain
PENROSE DRAIN
- Composition: Made of a soft rubber tube.
- Function: Used to facilitate drainage in a wound area, helping to prevent fluid accumulation.
- Indications: Typically used for superficial wounds.
- Technique: Employs a double exit strategy to prevent subcutaneous (SC) emphysema, particularly in areas of high motion, where a single exit point might allow air to be drawn into the wound.
- The area of an atraumatic suture where the suture strand is fused to the needle. *
A. circle
B. body
C. swage
D. point
C. swage.
The swage is the part of an atraumatic suture where the suture material is bonded to the needle, creating a smooth transition that minimizes tissue trauma during suturing.
Different Needle Eyes:
-
Closed Eye:
- Resembles a traditional sewing needle.
- Rarely used in modern medical procedures.
- Potential use includes anchoring tubes to the skin.
-
French Eye:
- Designed specifically for soft tissue procedures.
- The needle’s shape is made to separate tissue gently rather than cutting through it.
-
Atraumatic (Swaged):
- Features a nearly seamless connection between the needle and suture, reducing tissue trauma.
- The design helps ensure smooth passage through tissue with minimal drag.
47.
A. Phimosis
B. Paraphimosis
C. Epispadias
D. Hypospadias
C. Epispadias
- In urinary catheterization, the smaller the Fr., the bigger the diameter of the catheter. *
A. True
B. False
B. False.
Directly Proportional: Inc. # = Inc. Diameter
FRENCH SCALE
- Function: Measures the size of tubes or catheters used in interventional radiology or surgery.
-
Scale Conversion:
- 1 French (Fr) unit equals 0.33 millimeters (mm).
- A 16 Fr catheter is approximately 5 mm in diameter.
-
Size Relationship:
- The French size is directly proportional to the diameter or lumen of the catheter. Smaller French sizes indicate smaller diameters.
-
Patient-Specific Considerations:
- Standard tube sizes often vary by race and gender, but individual patient assessments are crucial.
- Adjustments may be needed for non-standard sizes, such as for obese patients or those with larger anatomies.
-
Gender Differences in Sizing:
- Males typically require a larger French size due to having a longer urethra.
- Stiffer catheters may be used to ensure they reach the bladder effectively.
49.
A. Murphy Retractor
B. Deaver Retractor
C. Weitlaner Retractor
D. Gelpi Retractor
C. Weitlaner Retractor
Self- retaining
* Weitlaner retractor
* Gelpi retractor
* Balfour with blade retractor
- Narrow opening of the foreskin which prevents retraction from the glans *
A. Epispadias
B. Paraphimosis
C. Phimosis
D. Hypospadias
C. Phimosis
- There are no complications in the insertion of a nasogastric tube. *
A. True
B. False
B. False.
Contraindications for NG Tube Insertion:
* Esophageal strictures (narrowing of the esophagus).
* Recent alkali ingestion, caustic ingestions, or esophageal burns.
* Use in comatose patients due to the risk of aspiration.
* Trauma patients with cervical or intracranial bleeding, or those with increased intracranial pressure.
* Patients who have recently undergone surgery in the oropharyngeal, nasal, or gastric areas.
55.
A. Gomco circumcision method
B. Forceps guided method
C. Dorsal slit method
D. Sleeve resection method
C. Dorsal slit method
- Popularity: Recognized as the most widely used circumcision method globally.
-
Procedure Dynamics:
- Beneficial to have an assistant during the operation for efficiency and safety, though it can be performed solo if necessary.
-
Usage:
- Commonly employed in “Operation Tuli,” a Filipino community practice of mass circumcision.
-
Skill Level:
- Demands a higher degree of surgical skill compared to other circumcision methods.
-
Standardization:
- Endorsed by the World Health Organization (WHO) as a preferred technique, often referred to as the Coronal, German, or clean cut method.
56.
A. Groove director
B. Scalpel blade
C. Scalpel
D. Scalpel handle
D. Scalpel handle
SURGICAL BLADE/SCALPEL
-
Terminology:
- Referred to as a “knife” or “scalpel” when the blade is attached to the handle.
- Without the blade, it’s called a blade handle or holder.
-
Usage:
- Employed for tasks requiring razor-sharp precision in tissue dissection.
-
Handling:
- The blade is detachable from the knife handle.
- Direct contact with bare hands should be avoided when placing or removing the blade from the holder to prevent injury.
- A needle holder or similar instrument should be used for attaching or detaching the blade safely.
59.
A. Kelly Hemostatic Forceps
B. Mayo-Hegar Needle Forceps
C. Mosquito Hemostatic Forceps
D. Crile-Wood Needle Holder
B. Needle holder
61.
A. Langenbeck
B. Scalpel blade
C. Blade holder
D. Parker
C. Blade holder
SURGICAL BLADE/SCALPEL
-
Terminology:
- Referred to as a “knife” or “scalpel” when the blade is attached to the handle.
- Without the blade, it’s called a blade handle or holder.
-
Usage:
- Employed for tasks requiring razor-sharp precision in tissue dissection.
-
Handling:
- The blade is detachable from the knife handle.
- Direct contact with bare hands should be avoided when placing or removing the blade from the holder to prevent injury.
- A needle holder or similar instrument should be used for attaching or detaching the blade safely.
62.
A. Vertical mattress suturing
B. Simple interrupted suturing
C. Subcuticular suturing
D. Horizontal mattress suturing
SUBCUTICULAR SUTURE
- Type: Usually a running stitch.
- Cosmetic Result: Provides an optimal cosmetic result, especially for incisions such as a bikini cut in cesarean sections.
- Technique: Suture is passed horizontally through the dermis layer.
- Applications: Used in surgeries like cesarean sections, appendectomies, cholecystectomies, and for closing contaminated wounds.
- Advantages: No additional external scars as the suturing is done under the skin.
63.
A. Vertical mattress suturing
B. Simple interrupted suturing
C. Subcuticular suturing
D. Horizontal mattress suturing
B. Simple interrupted suturing
65.
A. Richardson Retractor
B. Goulet Retractor
C. Deaver Retractor
D. Army-Navy Retractor
C. Deaver
66
A. Paraphimosis
B. Epispadias
C. Phimosis
D. Hypospadias
B. Epispadias
- A 15 kg boy is for circumcision. 1% lidocaine is available. What is the maximum safe volume of your available anesthesia? *
A. 9 ml
B. 4.5 ml
C. 4 ml
D. 25 ml
B. 4.5 ml
Based on the formula provided in the table:
For a 15 kg boy using 1% lidocaine (10 mg per ml), the maximum safe volume is calculated as:
Patient weight x safe dosage (3 mg/kg) ÷ concentration of lidocaine (mg/ml)
15 kg x 3 mg/kg ÷ 10 mg/ml = 4.5 ml
So, the maximum safe volume of 1% lidocaine for a 15 kg boy is 4.5 ml.
69.
A. Weitlaner Retractor
B. Allis Forceps
C. Senn Retractor
D. Babcock Forceps
D. Babcock
BABCOCK FORCEPS
● Grasping delicate tissue (e.g., fallopian tube, bowel, vas deferens)
● Additional notes: atraumatic, fenestrated tips
- The more delicate Frazier tip is designed to suction in the chest cavity and throat. *
A. True
B. False
B. False.
The Frazier suction tip is indeed more delicate and is designed for precise suction in small areas, such as during neurosurgery or delicate procedures in the ear, nose, and throat (ENT), rather than the larger areas like the chest cavity. Its design allows for targeted suction in confined spaces.
FRAZIER SUCTION TIP
- Purpose: Primarily used for removing fluid or debris from confined surgical spaces.
- Suction Amount: Designed for use with a small amount of suction.
-
Design Features:
- A thin instrument that allows for precise control.
- Equipped with a single hole at the tip to provide effective suctioning capability.
71.
A. Paraphimosis
B. Epispadias
C. Hypospadias
D. Phimosis
A. Paraphimosis
72.
A. Nasogastric tube
B. Chest tube
C. Indwelling foley catheter
D. Straight catheter
A. Nasogastric tube
A. Nasogastric tube
B. Chest tube
C. Indwelling foley catheter
D. Straight catheter
D. Straight catheter
- When can I remove the sutures?
Face: #days
A. 10-12
B. 3-4
C. 7-10
D. 12-14
B. 3-4
- A T-Tube uses a double exit technique to prevent subcutaneous emphysema developing in areas of high motion. *
A. True
B. False
B. False.
A T-Tube is typically used for bile duct drainage after gallbladder surgery, not for preventing subcutaneous emphysema. The purpose of a T-Tube is to ensure bile flow when the duct needs to heal or when there’s a need to keep the duct open. It does not relate to the prevention of subcutaneous emphysema, which involves air trapped under the skin.
79.
A. Vertical mattress suturing
B. Subcuticular suturing
C. Simple interrupted suturing
D. Horizontal mattress suturing
A. Vertical mattress suturing
80.
A. Pigtailed catheter
B. Trocar Chest tube
C. T-tube
D. Indwelling foley catheter
B. Trocar Chest tube
CHEST TUBE
- Purpose: Utilized to drain air and fluid, restoring negative pressure in the pleural cavity.
- Design: A sterile tube equipped with multiple drainage holes for insertion into the pleural space.
- Use Case: Essential when pleural cavity pressure balance is disrupted, which can lead to respiratory distress.
-
Applications: Insertion is indicated for conditions including:
- Pleural effusion: accumulation of fluid in the pleural space.
- Pneumothorax: presence of air in the pleural space causing lung collapse.
- Hemothorax: accumulation of blood in the pleural space.
- Spontaneous pneumothorax: pneumothorax occurring without an apparent cause.
- Tension pneumothorax: a life-threatening condition where air accumulates under pressure in the pleural space.
- Traumatic pneumothorax: resulting from blunt or penetrating chest injury.
- Cardiac tamponade: pressure on the heart caused by fluid in the pericardium.
- Penetrating trauma: injuries where foreign objects have entered the chest.
- Chylothorax: accumulation of lymphatic fluid in the pleural space.
-
Contraindications:
- Generally, there are no absolute contraindications for chest tube placement, particularly when respiratory distress is present and immediate intervention is required.
A. Malecot catheter
B. Trocar Chest tube
C. T-tube
D. Indwelling foley catheter
A. Malecot catheter
82.
A. Rectal speculum
B. Harrington Retractor
C. Richardson appendectomy Retractor
D. Richardson (rich) Retractor
C. Richardson appendectomy
- There are 3 parts of a box lock instrument. *
A. True
B. False
B. False.
A box lock instrument typically has two main parts: the box lock itself, which is the hinge mechanism allowing the instrument’s jaws to open and close, and the handles or rings. The box lock is where the two halves of the instrument pivot. Some might consider the jaws and the shank as separate parts, leading to a different interpretation, but the box lock specifically refers to the pivot point.
85.
A. Simple interrupted suturing
B. Horizontal mattress suturing
C. Vertical mattress suturing
D. Subcuticular suturing
B. Horizontal mattress suturing
- Is this the proper way of handling this instrument? *
A. Yes
B. No
A. Yes
- After an exfoliative cytology, Class IV means *
A. Few cells with malignant or many cells with borderline changes
B. Intermediate
C. Obvious malignant
D. Normal
A. Few cells with malignant or many cells with borderline changes
- Thumb forceps often are called “pick ups”. *
A. True
B. False
A. True.
Thumb forceps, used for grasping, holding, and manipulating tissues during surgery, are commonly referred to as “pick-ups” in the surgical and medical fields.
- Is this the proper way of handling this instrument? *
A. Yes
B. No
A. Yes
- The recommended size of a chest tube for a child is 12-14 Fr. *
A. True
B. False
B. False
Child = 18 fr.
FRENCH SCALE
- Function: Measures the size of tubes or catheters used in interventional radiology or surgery.
-
Scale Conversion:
- 1 French (Fr) unit equals 0.33 millimeters (mm).
- A 16 Fr catheter is approximately 5 mm in diameter.
-
Size Relationship:
- The French size is directly proportional to the diameter or lumen of the catheter. Smaller French sizes indicate smaller diameters.
-
Patient-Specific Considerations:
- Standard tube sizes often vary by race and gender, but individual patient assessments are crucial.
- Adjustments may be needed for non-standard sizes, such as for obese patients or those with larger anatomies.
-
Gender Differences in Sizing:
- Males typically require a larger French size due to having a longer urethra.
- Stiffer catheters may be used to ensure they reach the bladder effectively.
98.
A. Two handed surgical knot tying
B. One handed surgical knot tying
C. Intracorporeal knot tying
D. Instrument tying
B. One handed surgical knot tying
A. ONE-HANDED KNOT
- Primarily, the square knot is tied with the two-handed technique, but situations may necessitate the use of one hand.
- Illustrations typically demonstrate the left-hand technique for tying single suture strands.
- Ensure the direction of hand movements is alternated with each throw to avoid half hitches and ensure a flat, square knot.
- The suture’s end is pulled through to complete the knot formation.
B. TWO-HANDED KNOT
- The two-handed square knot is the standard method for most sutures due to its reliability and simplicity.
- Applicable for various materials including surgical gut, silk, cotton, and stainless steel.
- Additional throws may be added as required by the surgical context.
- The suture’s end is pushed through to create the knot.
C. SURGEON’S KNOT
- Involves an extra turn compared to the square knot, effectively taking a “round turn” on the other line.
- It’s crucial to finish the knot properly to securely lock the two lines together.
- Known for ease and reliability, used for tying a wide range of suture materials.
D. INSTRUMENT TIE
- Frequently employed in laceration repair, especially when suture ends are short.
- Exercise care when using a needle holder with certain sutures like PANACRYL* to prevent breaking from repeated bending.
- A 40 kg boy is for circumcision. 1% lidocaine is available. What is the maximum safe volume of your available anesthesia? *
A. 6 ml
B. 3 ml
C. 24 ml
D. 12 ml
D. 12 ml
40 kg * 3 mg/kg = 120mg
120mg/10mg/mL = 12mL
Which surgical procedure involves the removal of a toenail to treat conditions such as onychocryptosis?
A) Ungiectomy
B) Bunionectomy
C) Osteotomy
D) Arthroplasty
A) Ungiectomy
Which of the following conditions is characterized by genital warts and is caused by HPV infection, making it one of the most common sexually transmitted infections?
A) Herpes simplex virus
B) Condyloma acuminata
C) Chlamydia trachomatis
D) Syphilis
B) Condyloma acuminata
Which type of nerve block is typically used for circumcision in adults and adolescents?
A) Brachial plexus block
B) Penile nerve block
C) Ring block
D) Femoral nerve block
C) Ring block
Which type of nerve block is commonly used for circumcision in infants?
A) Epidural block
B) Penile nerve block
C) Ring block
D) Spinal block
B) Penile nerve block
What is the process called where a needle and syringe are used to penetrate a lesion for the aspiration of its contents?
A. Fine needle biopsy
B. Core needle biopsy
C. Excisional biopsy
D. Incisional biopsy
A. Fine needle biopsy
Which biopsy method involves using a large-bore, hollow trocar or needle to collect tissue samples?
A. Core needle biopsy
B. Fine needle biopsy
C. Aspiration biopsy
D. Surgical biopsy
A. Core needle biopsy
