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SFA 201 - Fundamentals of SFA > Midterm Examination Prep > Flashcards

Midterm Examination Prep Flashcards

1
Q

NOTES

A

Natural orifice transluminal endoscopic surgery

Surgeon must open a closed viscera intentionally to access the abdomen. Complications related to the failure of that opening to heal after closure can result in peritonitis.

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2
Q

The head of the pancreas is fixed to the:

A

Duodenum.

The pancreas is a fixed structure lying transversely behind the stomach in the upper abdomen. The head of the pancreas is fixed to the curve of the duodenum.

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3
Q

Potential risk associated with pneumoperitoneum

A

Gas embolus into an exposed blood vessel during the procedure

Elevated CO2 levels and respiratory acidosis may occur because CO2 diffuses into the patient’s bloodstream during laparoscopy

Subcutaneous emphysema has a characteristic crackling-feel to the touch, a sensation that has been described as similar to touching warm Rice Krispies.

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4
Q

Inguinal ligament, rectus abdominis muscle, deep epigastric vessels

A

Boundaries of the Hesselbach triangle

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5
Q

TEP Repair

A

Totally extraperitoneal patch (TEP) laparoscopic hernia repair technique

A balloon dissector is placed on the anterior surface of the posterior rectus sheath and inflated, thereby creating an optical cavity.

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6
Q

Identify A in the Diagraph

A

Bartholin’s Glands

Bartholin’s glands and ducts are located on each side of the lower end of the vagina at the 5 and 7 o’clock positions, secrete mucus.

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7
Q

Identify A in the Diagrapm

This structure is the flexure at the junction of the duodenum and jejunum. Maybe referred to as the suspensory ligament.

A

Ligament of Treitz

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8
Q

Identify the area within the red line

A

Triangle of Doom

During the placement of the mesh it is vital that the surgeon does not place any staples in the shaded triangle area

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9
Q

This structure provides the arterial supply to the bladder

A

Internal iliac

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10
Q

Identify A (blue line) in the diagram.

This structure is the anatomical division between the inguinal and femoral regions. Also, may be referred to an inguinal ligament.

A

Poupart’s ligament

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11
Q

Identify A in the diagram

The cystic artery arises from this structure.

A

Right hepatic artery

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12
Q

Identify A in the diagram

This ligament encloses the round ligament and extends from the lateral surface of the uterus to the pelvic wall.

A

Broad

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13
Q

Name the 3 anatomic sites of abdominal wall weakness with a potential for hernias

A

Inguinal canal
Femoral rings
Umbilicus

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14
Q

Identify the Blue Structure

A

Spleen

A total spleen is performed for multiple reasons, including trauma to the spleen

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15
Q

Stores and concentrate bile

A

Gallbladder

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16
Q

Reason a laparoscopic adjustable gastric banding (LAGB) would be performed

A

Obesity

Bariatric surgery, also termed weight loss or weight reduction surgery, is surgical treatment of obesity

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17
Q

What does triangulation mean:

A

Laparoscopic port incisions

Traditional laparoscopic port placement, via triangulation, is the fundamental concept of laparoscopic surgery.

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18
Q

Identify the type of incision

A

McBurney

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19
Q

Identify A in the Diagram

A

Pilonidal cyst

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20
Q

Removal of the head of the pancreas, the entire duodenum, a portion of the jejunum, the distal third of the stomach

A

Whipple procedure

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21
Q

Advantages of Robotic Surgery

A

The robot extends the surgeon’s skills by providing a 360-degree range of motion that is not possible with traditional laparoscopic instruments

Other advantages include:

Reduced post-surgery pain
Less blood loss
Fewer and smaller scars
Increased precision for more accurate joint replacements
Faster recovery
Shorter hospital stay
Less risk of infection

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22
Q

Identify A in the Diagram

A

Femoral Hernia

Femoral hernias occur much more frequently in women, and only 2% of women will develop inguinal hernias in their lifetime

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23
Q

What type of hernia occurs within the Hesselbach triangle

A

Direct inguinal hernia

Hernias that occur within the Hesselbach triangle are called direct inguinal hernias. Indirect inguinal hernias occur laterally to the deep epigastric vessels.

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24
Q

Why would surgeon have to perform an open common bile duct (CBD) exploration

A

Prior biliary surgery.

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25
Q

What has happened it the diagram

A

Incarcerated hernia

Patients with incarcerated hernias may have signs of intestinal obstruction, such as vomiting, abdominal pain, and distention.

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26
Q

Identify the fascia in the diagram (labeled A)

Key landmark of the roof of inguinal canal

A

Transversalis fascia

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27
Q

Which laparoscopic hernia repair provides access to the preperitoneal space without entering the peritoneum

A

TEP - Totally extraperitoneal

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28
Q

What action does the ova travel through the fallopian tubes toward the uterus

A

Peristalsis

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29
Q

What can be inquired if the arms are extended beyond the 90 degree angle

A

Brachial plexus injury.

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30
Q

What surgical procedure is usually done to treat CIS (Carcinoma in situ) of the vulva when it is multicentric

A

Simple vulvectomy

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31
Q

Intravasation of the fluid during a hysteroscopy can lead to what disorder, marked by the sodium level in the blood is below normal

A

Hyponatremia

The absorption of glycine solution into the extracellular space will make the blood hypertonic with a higher volume, which will draw the fluid outside the cells. Both events, in turn, will cause hyponatremia due to the dilutional effect.

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32
Q

What drugs usually cause hormonal stimulation of the uterus

A

Oxytocics

Oxytocics are medications that increase motor activity within the uterus by hormonal stimulation or by direct stimulation on the smooth muscles, usually resulting in uterine contractions. They may be used intraoperatively and postoperatively. The following are some nursing considerations after their administration: monitor blood pressure, assess for continued bleeding, and monitor fundal response to the drug.

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33
Q

Identify A - this structure is located between the bladder neck and the urethra

A

Prostate

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34
Q

Endoscopy of the genitourinary tract is considered what wound classification

A

Class II (clean-contaminated)

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35
Q

What is the hormone that controls your body’s metabolism, the process in which your body transforms the food you eat into energy

A

Thyroid hormones

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36
Q

Condition where the thyroid doesn’t create and release enough thyroid hormone into your bloodstream. This makes your metabolism slow down. Also called underactive thyroid, can make you feel tired, muscle cramps, gain weight and be unable to tolerate cold temperatures

A

Hypothyroidism

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37
Q

Occurs when one or more milk ducts beneath your nipple widens. The duct walls may thicken, and the duct may fill with fluid. The milk duct may become blocked or clogged with a thick, sticky substance. The condition often causes no symptoms, but some women may have nipple discharge, breast tenderness or inflammation of the clogged duct

A

Ductal ectasia

38
Q

What is a FNAB

A

Fine-needle aspiration biopsy

Usually the fluid is sent for cytology study

39
Q

What organ is usually removed using the incision within the diagram

A

Spleen

40
Q

Identify A in the Diagram.

A

Inferior Rectal Artery

When the perineal dissection is being performed, the inferior rectal artery should be identified, ligated and divided

41
Q

Identify A and B in the Diagram

A

A = Cecum
B = Ileocecal value

During an open appendectomy, it is necessary to identify these 2 structures

42
Q

Identify A in the Diagram

A

Gastric artery

When assisting on a Nissen Fundoplication you don’t want to place too much medial traction, it will rip and start bleeding

43
Q

Identify A and B in the Diagram. These structures provide arterial blood supply to the thyroid

A

A = External Carotid
B = Superior Thyroid

44
Q

Identify A in the Diagram. This structure forms an envelope around the spermatic cord

A

Cremaster Muscle

The cremaster muscle arises from the internal oblique and inguinal ligament. It surrounds the spermatic cord and testis. The muscle is supplied by the genitofemoral nerve

45
Q

Identify A in the Diagram. This is connective tissue that surrounds the kidney

A

Gerota’s Fascia

46
Q

Identify drain. Can be placed in the CBD to allow drainage

A

T-Tube

47
Q

Sudden onset anterior chest pain, shortness of breath, and sweating profusely are signs of what condition.

A

Pulmonary embolism

A pulmonary embolism is a postoperative complication of laparoscopic Roux-en-Y. Sudden onset anterior chest pain, shortness of breath, and sweating profusely are all signs of pulmonary embolism.

48
Q

What part of the colon is likely to be affected by ulcerative colitis

A

Rectum
Transverse colon

49
Q

Lasers that are most often used in GYN surgery

A

CO2
Nd:YAG

50
Q

Why would the surgeon attach a loop of jejunum with the side of the esophagus after a total gastrectomy

A

Prevent regurgitation esophagitis

51
Q

This structure is formed by the cystic duct, common hepatic duct, and the lower edge of the liver.

A

Triangle of Calot

52
Q

Identify A in the diagram. This structure is likely to be injured when performing a CBD exploration.

A

Hepatic Artery

53
Q

These are a series of archades along the mesenteric border through the length of the colon.

A

Marginal Artery of Drummond

54
Q

These structures are parallel, equally distributed, and form a triple helix structure from the appendix to the sigmoid colon. Often used as a landmark when performing appendectomy.

A

Taeniae coli

55
Q

Identify A in the diagram. This nerve must be dissected from the lesser curvature of the stomach whenever performing a highly selective vagotomy

A

Nerves of Latarjet

56
Q

The right colic artery is a branch of what structure. This artery supplies the ascending colon. See A on the diagram.

A

Superior mesenteric artery

57
Q

There are two methods for creation of a pneumoperitoneum: open and closed. The closed method involves blind puncture using a Verres needle. What can be performed to help the surgeon know if he/she is within the abdominal cavity

A

Use a syringe with saline

58
Q

A ruptured appendix with no visual bowel contents represents what wound classification

A

Class IV - Dirty Infected

Perforated viscera indicate a class IV wound.

59
Q

Identify A in the diagram. The cystic duct arises from this structure.

A

Right Hepatic Artery

60
Q

Trace urine from kidney to the bladder

A

Bowman’s capsule, collecting ducts, renal calyx, renal pelvis, and ureter

61
Q

The main nerve of the perineum

A

Pudendal nerve

62
Q

What artery serves as principal blood supply to the splenic flexure of the colon

A

Inferior Mesenteric Artery

63
Q

The anatomic region boarded by the cystic duct, the common hepatic duct, and the cystic artery is referred to as:

A

Calot’s Triangle

64
Q

Identify A in the diagram. These structures provide blood supply to the pancreas

A

Superior Mesenteric Artery/Vein

65
Q

Identify A in the diagram. Branch of the external carotid artery, and supplies blood to the thyroid

A

Superior Thyroid

66
Q

The major parenchymal cells in the liver, are responsible for a variety of cellular functions including carbohydrate, lipid and protein metabolism, detoxification and immune cell activation to maintain liver homeotasis. Recent studies show hepatocytes play a pivotal role in liver inflammation

A

Hepatocytes

67
Q

Describe the boundaries of the surgical skin prep for the patient about to receive a liver transplant.

A

From the neck to midthigh; bedline to bedline

68
Q

When both direct and indirect hernias are present, the defect is called:

A

Pantaloon Hernia

Also known as a saddlebag hernia

69
Q

Patient has a hernia with a short, wide neck, and a thick-walled sac, what type of hernia:

A

Congenital

In a congenital hernia, the hernia sac has a small neck , is … In an acquired indirect hernia the neck is wide, and the sac is both short and thick walled.

70
Q

The characteristic “reducible” hernia:

A

Visceral contents can be returned to the abdomen

71
Q

What’s the problem with prolonged Trendelenburg

A

Decreased pulmonary compliance and functional residual capacity

72
Q

A procedure to closely examine your cervix, vagina and vulva for signs of disease, often performed on patients who have an abnormal Pap smear

A

Colposcopy

73
Q

Identify A in the diagram, renal artery and vein enter and exit the kidney on the medial side

A

Hilum

74
Q

Surgical method of treating benign obstructive enlargement of the prostate gland

A

TURP

75
Q

What kind of urology catheters include the open-ended, whistle tip, cone tip, and olive tip

A

Ureteral

76
Q

Identify A in the diagram, a branch of the vagus nerve, innervates the intrinsic muscles of the larynx. During surgery, care is taken to identify and protect this nerve.

A

Recurrent Laryngeal Nerve

77
Q

The most common form of malignant thyroid nodule is a poorly encapsulated. Patient will have total thyroidectomy

A

Papillary carcinoma

78
Q

Breast surgery procedure is also called the nipple-sparing technique (NSM)

A

Subcutaneous mastectomy

79
Q

What part of the colon is the anvil of the EEA is inserted into

A

Sigmoid

80
Q

What angle of scope is most often used for a laparoscopic cholecystectomy

A

30 degree lens

81
Q

Involves resection of the head of the pancreas, duodenum, and segments of the stomach and jejunum

A

Pancreaticoduodenectomy

Segments of the stomach and jejunum with reconstruction of the duct of Wirsung, duct of Santorini, and Common bile duct

82
Q

The most common structure involved in a sliding left indirect hernia

A

Sigmoid Colon

83
Q

Identify A in the diagram, this muscle may be retracted during a thyroidectomy

A

Sternocleidomastoid

84
Q

During a cholecystectomy, it is important to isolate this ligament, consisting of the common bile duct, hepatic artery, and portal vein

A

Hepatoduodenal

Be sure to look at picture to see where the ligament is located

85
Q

During a rectocele repair this muscle can be used to build up the perineum

Identify A

A

Levator ani

86
Q

Complication of steep reverse Trendelenburg position

A

Deep Vein Thrombosis

87
Q

Identify A in the diagram. This structure can be injured in Lithotomy position, with the buttocks too far over the edge

A

Obturator Nerve

88
Q

Identify A in the diagram. During an abdominal hysterectomy, the surgeon initially isolates the uterus by separating it from this structure

A

Round Ligaments

89
Q

Identify A in the diagram. This is usually repaired in conjunction with a Nissen or Toupet Fundoplication

A

Hiatal Hernia

90
Q

Identify A in the diagram. The tissue expander is placed below this muscle.

A

Pectoralis Major

91
Q

Identify A in the diagram. Injury to this nerve can result in paralysis of the serratus anterior muscle, causing patient to have a winged scapula

A

Long Thoracic

92
Q

Using the diagram, identify the purple triangle area. During a laparoscopic cholecystectomy, the infundibulum of the gallbladder is retracted to expose this structure

A

Triangle of Calot

SFA 201 - Fundamentals of SFA (16 decks)

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