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Surgical Tech 200 > Minimally invasive/ General surgery Test 2 > Flashcards

Minimally invasive/ General surgery Test 2 Flashcards

1
Q

What is a minimally invasive surgery?

A

treatment of pathologies while causing as little trauma to the patient as possible

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2
Q

What are some advantages to minimally invasive surgeries?

A

reduce pain
reduce scarring
shorter procedure times
less infection potential
faster recovery
-accessing areas otherwise unsafe to operate on

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3
Q

What are some disadvantages of minimally invasive surgeries?

A

-not everyone is a candidate
-complex and expensive
-exposure and working space
-has potential to convert to an open case

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4
Q

Define endoscopy

A

broad term referring to looking inside the body with a scope

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5
Q

What cavity is a colonoscopy?

A

colon cavity

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6
Q

What cavity is the laparoscopy?

A

abdominal cavity

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7
Q

What cavity is the thoracoscopy?

A

thoracic cavity

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8
Q

Describe a rigid endoscope

A

metal scope
5MM or 10MM
0,30,45,70 degree

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9
Q

Describe a flexible endoscope

A

bends and snakes through the system aka flexible

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10
Q

What are the attachments to the endoscope?

A

-camera head- ability to zoom and focus
-light cord- fiberoptic and loosely coiled

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11
Q

What are parts to the camera head?

A

coupler connects camera to scope
focus and zoom buttons
white balancing button

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12
Q

What is fluid distension?

A

fluid pumped into organ to create distension
ex-bladder, uterus, joints

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13
Q

What is gas distension?

A

Insufflation: CO2 pumped into body cavity to create distension
ex-pneumoperitoneum- abdomen
Veress needle used

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14
Q

Advantages of robotic surgery

A

-provides movement but with improved range of motion
-eliminates tremors of hands
-complex and precise movement
-3-D view
-theoretically can perform surgery from different locations

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15
Q

Disadvantages of robotic surgery

A

-Expensive
-Equipment has limited # of uses
-potential to convert to open
-learning curve for all

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16
Q

What are the 2 DaVinci systems at Reading?

A

XI- in 3 rooms
X- in 1 room

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17
Q

What are the 3 components of the DaVinci robot?

A

-Surgeon console: 3D image, control station, non-sterile
-Patient cart: where arms are connected
-Vision cart: image processing system, fiberoptic light system, mono and bipolar cautery generator

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18
Q

What are robotic EndoWrists?

A

exchangeable instruments
grasping, needle drivers, retractors, hemostatic clips
(saves position during instrument exchanges)

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19
Q

What are the robotic scopes and trocars?

A

scope 8mm0 and 8mm30
Trocars- 3-4 placed, 8 or 12mm, remote center- depth of perception

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20
Q

What are some specific things to have on your table setup?

A

Cutdown
lap set
endowrist set
scope
trocar
drapes Patient and robot

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21
Q

What are 2 things to never do during robot case?

A

-move robot when its docked to the patient
-adjust the bed when robot is docked

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22
Q

What is the alimentary system and what is the pathway?

A

Gi tract- the entire path that food travels through the body

esophagus
stomach
small/ large intestines
appendix
rectum/ anus

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23
Q

What are the abdominopelvic quadrants?

A

right upper
left upper
right lower
left lower

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24
Q

What are the abdominopelvic regions?

A

right hypochondriac
epigastric
left hypochondriac
right lumbar
umbilical
left lumbar
right iliac
hypogastric
left iliac

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25
Q

What organs are in the right hypochondriac region?

A

liver
gallbladder
right kidney
small intestine

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26
Q

What organs are in the epigastric region?

A

stomach
liver
pancreas
duodenum
spleen
adrenal glands

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27
Q

What organs are in the left hypochondriac region?

A

spleen
colon
left kidney
pancreas

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28
Q

What organs are in the right lumbar?

A

gallbladder
liver
right ascending colon

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29
Q

What organs are in the umbilical region?

A

umbilicus
some small intestine
duodenum

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30
Q

What organs are in the right iliac region?

A

appendix
cecum

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31
Q

What organs are in the hypogastric region?

A

urinary bladder
sigmoid colon
reproductive organs

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32
Q

What organs are in the left iliac region?

A

descending colon
sigmoid colon

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33
Q

Is the abdominal cavity sterile?

A

yes

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34
Q

What is the peritoneum in the peritoneal cavity?

A

a serous membrane lining the walls and organs of the abdomen

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35
Q

The peritoneal cavity includes what intraperitoneal organs?

A

digestive system
lymphatic system
vessels
adipose tissue

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36
Q

What is the first section of the alimentary canal?

A

mouth
Oropharynx: back of tongue, tonsils, and throat

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37
Q

After the mouth, what is the next section of the alimentary system?

A

Esophagus including the lower esophageal sphincter

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38
Q

After the esophagus, what is the next section of the alimentary canal and its parts?

A

Stomach: cardia, fundus, greater/lesser curvatures, Pylorus “funnel”, pyloric sphincter, rugae (folds on inside)

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39
Q

* what are the 3 things inside the stomach aiding in digestion?*

A

Gastrin- hormone stimulating stomach to make acid
hydrochloric acid- breaks down and kills bacteria
pepsinogen- enzyme for protein digestion

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40
Q

After the stomach, what is the next section of the alimentary canal and its parts?

A

small intestine (majority of nutrient absorption)
duodenum- shortest section
jejunum
ileum
~22 feet long

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41
Q

After the small intestine, what is the next section of the alimentary canal and its parts?

A

Large intestine/ colon (fluid absorption)
ileocecal valve
cecum/ appendix
ascending colon
transverse colon
descending colon
sigmoid colon

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42
Q

What are the corners of the large intestine called?

A

right and left colic flexures

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43
Q

What is the name of the right flexure and what it near?

A

Hepatic- liver

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44
Q

What is the name of the left flexure and what is it near?

A

splenic- spleen

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45
Q

After the large intestine, what is the next section of the alimentary canal?

A

rectum
anus

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46
Q

What is the mesentery?

A

under layer
connects small and large intestines
blood supply
structural support- no twisting
lymph activity

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47
Q

What is the omentum?

A

Outer fatty layer to protect organs- like a drape
on top of mesentary

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48
Q

What are the 5 layers of the GI tract?

A

Serosa
Muscularis
Submucosa
mucosa
Villi (small intestine)
(SMSMV)

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49
Q

What is the serosa layer of the Gi tract?

A

outer layer- protection, serous lubricant

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50
Q

What is the muscularis layer of the GI tract?

A

muscular layer- contraction/relaxation
peristalsis- wavy movement of food

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51
Q

What is the submucosa layer of the GI tract?

A

intermediate layer- connective, blood supply, glandular

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52
Q

What is the mucosa layer of the GI tract?

A

inner layer (deepest)- absorption and secretion

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53
Q

What are the villi and where are they located in the GI tract?

A

finger like hairs for absorption
small intestine only

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54
Q

What is in the biliary tract of the digestive system?

A

creation, storage, and transport of bile

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55
Q

What organs make up the biliary tract?

A

pancreas- secrets hormones
liver- makes bile
gallbladder- storage

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56
Q

What is the biliary duct system?

A

tubes connecting gallbladder, liver, and pancreas.
delivers bile and digestive juices to duodenum

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57
Q

What are the 6 “ducts” of the biliary tract?

A

cystic duct
hepatic duct
common bile duct
pancreatic duct
ampulla of Vater
Sphincter of Oddi

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58
Q

What organ does the cystic duct go into?

A

gallbladder

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59
Q

What organ does the hepatic duct go into?

A

liver

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60
Q

The common bile duct connects what two organs/ducts?

A

cystic and hepatic (gallbladder and liver)

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61
Q

Where is the pancreatic duct located?

A

in the pancreas

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62
Q

What does the ampulla of Vater do?

A

joins the pancreatic duct and the common bile duct

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63
Q

What is the sphincter of Oddi?

A

located at the ampulla of Vector
controls bile excretion into the duodenum

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64
Q

What is the falciform ligament?

A

fibrous ligament diving right and left lobes of the liver
connects liver to anterior abdominal wall

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65
Q

What are the layers of the abdominal tissues? (hint there 6)

A

skin
subcuticular
subcutaneous fat
muscle
fascia- (holds organs)
peritoneum (lining of interior walls)

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66
Q

What are the muscle layers of the abdominal wall?

A

internal and external oblique
rectus abdominus “6 pack”
transversus abdominus

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67
Q

What is the fascia layer of the abdominal tissues?

A

tough fibrous connective tissue (allows muscles to move)

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68
Q

What is the Linea alba layer of the abdominal tissues?

A

white
fibrous tissue running down midline from xyphoid to pubis
connects rectus muscles

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69
Q

What is the Linea Semilunaris layer of the abdominal tissues?

A

lateral fascial border of rectus muscles
(right and left side)

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70
Q

What is the difference between the visceral and parietal peritoneum?

A

visceral- inner layer closer to organ
parietal- outer layer closer to the wall

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71
Q

What is the simplest abdominal incision? What organs can be gotten to?

A

median/ midline vertical incision
Upper- stomach, duodenum, pancreas
lower- uterus, bladder, lower intestine

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72
Q

Where is the paramedian rectus incision located? What organs can be exposed with each incision?

A

Lateral to the midline
right upper- stomach, duodenum, pancreas
right lower- pelvic structures, proximal colon
left upper- spleen, stomach
left lower- pelvic structures, distal colon

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73
Q

Where is the McBurney oblique incision?

A

right lower quadrant at 45 degree angle
splits external & internal oblique and transversalis muscles
used for appendectomy

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74
Q

Where is the subcostal oblique incision located? what organs are exposed when incised?

A

left and right side starts at midline between xiphoid & umbilicus
extends laterally to below the rib cage
right- gallbladder & biliary system
left- spleen

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75
Q

Where is the lower oblique inguinal incision?

A

Lower then McBurneys incision
right or left side
Inguinal hernia repair

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76
Q

Where is the thoracoabdominal incision made?

A

patient in lateral position
left or right side
provides access to thoracic and abdominal cavity

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77
Q

Where is the midabdominal transverse incision located?

A

right or left side
umbilicus to lateral
stomach, pancreas, biliary system
not as common

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78
Q

In what order to wound closures occur? (same as incision or reverse)

A

reverse order of incision

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79
Q

What are the 3 layers of closing skin for a laparotomies? By

A

deep fascial layer- majority of wound support (1 or 0 PDS; 1 or 0 Vicryl)
Subcutaneous layer- closing fatty dead space or muscle (3-0 Vicryl)
skin- staples ; 4-0 Monocryl

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80
Q

What is an anoscopy?

A

examination of mucous of the anal canal

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81
Q

What is a choledochoscopy?

A

exam of common bile duct

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82
Q

What is a colonoscopy?

A

exam entire colon from anus to ileocecal valve
(may obtain tissue specimens or remove polyps)

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83
Q

What is an esophagoscopy?

A

exam of the esophagus

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84
Q

What is a gastroscopy?

A

exam of gullet, stomach and duodenum

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85
Q

What is an egd?

A

esophagogastroduodenoscopy
exam of esophagus, stomach, and duodenum

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86
Q

What is an ERCP?

A

endoscopic retrograde cholangiopancreatography
scope goes down mouth to duodenum
catheter passed into biliary ducts for x-ray of ducts
obstructions removed

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87
Q

What is a proctoscopy?

A

exam of the mucosa of rectum and anal canal

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88
Q

What is a sigmoidoscopy?

A

exam of sigmoid and rectum
remove polyps/ tissue specimens

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89
Q

What is a laparoscopy?

A

exam abdominal cavitiy
trocars placed
instruments through trocars
diagnostic or treatment

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90
Q

What is pneumoperitoneum?

A

insufflation/ gas in the body
CO2 introduced into abdomen
provide visualization and working room

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91
Q

What is a hernia?

A

protrusion of organ through a defect
usually in a sac
contents of sac may be abdominal or pelvic viscera or mesentery

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92
Q

What are the different types of hernias?

A

congenital
traumatic
acquired

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93
Q

What is a congenital hernia?

A

a hernia formed at birth

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94
Q

What is an acquired hernia?

A

a hernia that forms at anytime

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95
Q

What is a traumatic hernia

A

hernia caused by blunt force

96
Q

What are the purposes of hernia repair?

A

return contents to correct anatomical location
strengthen and support structures
suture or mesh

97
Q

Why use mesh when doing a hernia repair?

A

reinforces peritoneum
allows tissue ingrowth

98
Q

What material do meshes come in?

A

prolene
PTFE
Vicryl

99
Q

When do you start the counts when doing a hernia repair?

A

closing count starts when mesh is halfway sutured- not at beginning of

100
Q

What is an incarcerated hernia?

A

contents of hernia trapped in a sac
can not be returned to anatomical location

101
Q

What is a strangulated hernia?

A

contents of hernia trapped in sac
blood supply is cut off
sac contents die/ necrosis
immediate surgery
may need to do a bowel resection

102
Q

What are the 4 types of ventral hernias?

A

incisional
epigastric
umbilical
spigelian

103
Q

What is an incisional hernia?

A

postoperative
weakness in abdominal wall and incise location

104
Q

What is an epigastric hernia?

A

protrusion of fat through abdominal wall between xiphoid and umbilicus

105
Q

What is an umbilical hernia?

A

small fascial defect at umbilicus

106
Q

What is a spigelian hernia?

A

defect through the linea semilunaris

107
Q

What is a hiatal hernia?

A

part of stomach protrudes through diaphragm &into chest
emergency for newborns

108
Q

What symptoms occur with a hiatal hernia?

A

trouble swallowing
GERD/ acid reflux

109
Q

What is type 1 hiatal hernia?

A

sliding hernia-
stomach and distal esophagus up into chest

110
Q

What is type 2 hiatal hernia?

A

paraoesophageal hernia
fundus protrudes through diaphragmatic defect
(worst hernia)

111
Q

What does the bougie/ Maloney dilator look like?

A

Blue snake with holes and measurements. Can be green

112
Q

What is scarpa’s facia?

A

white layer (looks like underwear) membranous layer

113
Q

What structures are in a inguinal hernia for a male?

A

spermatic cord
vas deferens
spermatic veins and artery
cremaster muscle
*penrose drain often used to drain during procedure

114
Q

What structures are in an inguinal hernia for a female?

A

round ligaments
supports uterus

115
Q

In an inguinal hernia, where do structures enter?

A

internal ring
natural opening in transversalis fascia

116
Q

In an inguinal hernia, where do structures exit?

A

external ring continues into genitals
opening is in external oblique aponeurosis

117
Q

What are two classifications of an inguinal hernia.

A

direct
indirect
or both

118
Q

What is Hesselbach’s Triangle?

A

Anatomical landmark to determine direct or indirect hernia

119
Q

What are the anatomical landmarks that make up Hesselbach’s Triangle?

A

Lateral-deep epigastric vessels
inferior- inguinal ligament
medial- rectus abdominus muscle

120
Q

Where is a direct hernia located? How is one acquired?

A

located within Hesselbach’s triangle
weakness in transversalis fascia
heavy lifting
chronic coughing
straining to pee/ defecate

121
Q

Where is an indirect hernia located?

A

protrudes through (IN) internal ring and follows spermatic cord down inguinal canal
congenital or acquired

122
Q

What is a TEP hernia repair?

A

Total Extraperitoneal Patch
abdominal cavity not entered
defect is sealed from outside of peritoneum

123
Q

What is a TAPP hernia repair?

A

Transabdominal Preperitoneal Patch
abdominal cavity IS entered
sealed from inside peritoneum

124
Q

What is a cholecystectomy?

A

removal of the gallbladder

125
Q

What is cholecystitis?

A

inflammation of the gallbladder

126
Q

What is cholelithiasis?

A

stones

127
Q

What wound class are most cholecystectomies?

A

Class 1- no spillage/ leakage

128
Q

What wound class is a gross spillage of bile going to be?

A

Wound class 3

129
Q

In a cholecystectomy what are the major structures to identify?

A

cystic artery
cystic duct

130
Q

What is Calot’s Triangle?

A

Hepatobiliary
anatomical landmark to locate the cystic artery- in the middle of the triangle-

131
Q

What is a choledochostomy?

A

an incision into the common bile duct
remove stones in common bile duct

132
Q

What is used for drainage in a choledochostomy?

A

whalen-moss T-tube

133
Q

What does the liver do?

A

create and balance of nutrients
metabolism of drugs
filtration/ detoxification -> bile creation

134
Q

Whay does the spleen do?

A

blood cell storage
removal of damaged blood cells
-does not heal so can be removed

135
Q

Why have a liver surgery?

A

hepatic resection
segmental resection
lobectomy- disease

136
Q

Why have spleen surgery?

A

Splenectomy- removal
traumatic injury
tumor
extra spleen
hypersplenism
Hodgkins cancer

137
Q

What does the pancreas do?

A

enzymes to aid in digestion
hormones to control blood sugar (insulin and Glucagon)
head, neck, body, and tail

138
Q

What is another name for a whipple?

A

pancreaticoduodenectomy

139
Q

What id another name for a pancreaticoduodenectomy?

A

Whipple

140
Q

Why is a whipple procedure done?

A

treat cancer at the head of the pancreas

141
Q

What is removed during a whipple procedure?

A

head of pancreas
entire duodenum
portion of jejunum
distal 1/3 of stomach
gallbladder
cystic duct
common bile duct
peripancreatic lymph node
hepatoduodenal duct

142
Q

What 3 systems need to be reestablished during a whipple procedure? And what are the attached to?

A

biliary
pancreatic
gastrointestinal

The jejunum

143
Q

What is the name of the 3-anastomosis made in a whipple procedure?

A

gastrojejunostomy
hepaticojejunostomy
pancreatojejunostomy

144
Q

What is a distal pancreatectomy?

A

Tx of cancer in the tail of the pancreas

145
Q

What happens in a procedure of an esophagectomy with esophagogastrostomy? Where is incision made?

A

-tumor removed from cardia of stomach or distal esophagus
-anastomosis between stomach and esophagus
-thoracoabdominal

146
Q

What is a gastrotomy?

A

incision into stomach
to remove an object

147
Q

What is a gastrostomy?

A

creation of an opening between the stomach and the body surface- Feeding tube

148
Q

What is a total gastrectomy? And what is main reason to perform?

A

removal of entire stomach
malignant cancer

149
Q

What needs to be connected after a total gastrectomy?

A

anastomosis of the jejunum and esophagus

150
Q

What is a subtotal gastrectomy?

A

removal of distal portion of stomach

151
Q

What is a Billroth1 procedure? and what is the procedure name for it?

A

remaining stomach is anastomosed to duodenum
gastroduodenostomy

152
Q

What is a Billroth2 procedure? And what is the procedure name for it?

A

remaining stomach anastomosed to the jejunum.
gastrojejunostomy

153
Q

What is a pyloromyotomy

A

incision through pyloric muscle to release a stricture

154
Q

What is a vagotomy?

A

treat/prevent gastric ulcer
extreme cases of peptic ulcer
resection of vagus nerve at esophagus
decreases gastric juices

155
Q

What is a gastric band?

A

creation of small pouch/ stomach
near esophagus

156
Q

What is a gastric sleeve?

A

portion of stomach removed via stapler
stomach is smaller so feel less hungry

157
Q

What is a Roux-en-Y gastric bypass?

A

procedure to bypass portion of stomach and entire duodenum

158
Q

What is a brief explanation of Roux-en-Y gastric bypass

A

create small stomach pouch
divide duodenum and jejunum
gastrojejunostomy performed (stomach to jejunum)
duodenojejunostomy performed (duodenum to jejunum)

159
Q

What is diverticulosis?

A

formation of small sacs in the wall of the large intestine, usually

160
Q

What is diverticulitis?

A

inflammation or infection of the small sacs in the wall of the intestine

161
Q

What is Meckel’s diverticulum?

A

congenital diverticulum occurring in the small bowel

162
Q

What is intussusception?

A

“telescoping” of bowel into itself ( folds into itself)
mostly in kids
high mortality if not treated within 24 hours

163
Q

What is volvulus?

A

twisting of bowel upon itself
causes obstructions
blood supply possibly compromised

164
Q

What are polyps?

A

growth of the mucosa (intestinal lining) of the intestine

165
Q

What are 2 types of polyps?

A

pedunculated- have a stalk
sessile- “mound”/ no stalk

166
Q

Do polyps need resection?

A

benign- no
malignant or family history of- yes

167
Q

What happens in a bowel resection?

A

resection of all or part of small or large bowel/colon

168
Q

What are the 3 types of anastomoses?

A

end to end- EEA stapler
side to side- common
end to side

169
Q

What is an ostomy?

A

diversion of bowel to skin

170
Q

What is a stoma?

A

bowel sutured to the skin

171
Q

What are the 3 types of ostomies?

A

ileostomy
jejunostomy
colostomy

172
Q

What is a duodenectomy?

A

removal of all or part of the duodenum

173
Q

What is a jejunectomy?

A

removal of all or part of the jejunum

174
Q

What is a ileectomy?

A

removal of all or part of the ileum

175
Q

What is a colon (large bowel) resection?

A

excision of the colon

176
Q

What is a total colectomy?
What does it treat? What is usually the result?

A

removal of the entire colon
tx of colitis and polyposis
ileostomy

177
Q

What is a sub-total colectomy?

A

removal of a portion of the colon

178
Q

What are the 5 type of sub-total colectomies?

A

right
right hemi
transverse
left
left hemi

179
Q

What is a sigmoid colectomy?

A

removal of diseased portion of sigmoid and rectum
and resection

180
Q

What is the ileoanal endorectal pouch?

A

recreation of rectum after removal of entire colon and proximal rectum

181
Q

What is an abdominoperineal resection?

A

removal of distal sigmoid, rectum, and anal sphincter
anus sutured close- ostomy required
tx of rectal cancer

182
Q

What is an appendectomy? What suture used in open cases?

A

removal of the appendix
McBurney’s incision

183
Q

What is a hemorrhoidectomy?

A

excision and ligation of rectal veins

184
Q

Where are hemorrhoids located? What position is used for these cases?

A

external on anal sphincter
internal in the anus
Kraske or lithotomy

184
Q

What wound class is a bowel technique in a good case?

A

class 2- clean contaminated

185
Q

What wound class is a gross spillage of contents in a bowel case?

A

class 3- contaminated
emergency surgery

186
Q

What is done with instruments used in a contaminated bowel procedure?

A

instruments used are separated from other instruments

187
Q

What are advantages to using staplers?

A

faster
more reliable than suture

188
Q

What are 4 categories of staplers?

A

linear
linear cutting
ligating/ dividing
circular

189
Q

What is a GIA stapler? what category is it? How does it work?

A

Gastrointestinal anastomosis
linear cutting
places two parallel rows of staples and cuts between the rows
-bowels, vessels, thoracic tissue

190
Q

What is a TA stapler? What category is it? How does if work?

A

Thoracoabdominal
linear
1 row of staples
used on thicker tissues ex- esophagus/ esophagectomy
(use 10 blade)
(looks like a T shape)

191
Q

What is an EEA stapler? What category is it? How does it work?

A

end-to-end anastomosis
circular
places circular staples and cuts away excess tissue
esophagectomy or deep colon resection

192
Q

What is an LDS stapler? What category is it? How does it work?

A

ligating/ dividing stapler
only fires 2 parallel staples and cuts between them
appendectomy or splenic vessel ligation

193
Q

What is a purse string stapler? How does it work?

A

places a nylon purse string suture line around a lumen.
Tie it to seal the organ

194
Q

What are breasts?

A

mammary glands that lie on the pectoralis major muscle

195
Q

How many lobes are in a breast? What are the lobes separated by?

A

12-20 lobes
adipose and connective tissue

196
Q

What is a breast lobe divided up into? What is the name of the duct that drains to the nipple?

A

lobules- alveoli
lactiferous duct

197
Q

What is the area around the nipple called?

A

areola

198
Q

The central and upper portion of the breast is made up of what?

A

glandular tissue

199
Q

What is the peripheral portion of the breast mostly made up of?

A

adipose tissue

200
Q

How many lymph nodes are in the axillary area?

A

average of 53

201
Q

Where and what is the tail of spence?

A

section of breast, adipose, and lymph nodes extending into axilla

202
Q

What % of women have an abnormality of the breast at some time in their life?

A

80%

203
Q

What is a fibroadenoma?

A

benign firm, round, moveable lump in breast
monitored
shrink post menopause- possible hormone related

204
Q

What is an intraductal papilloma?

A

wart-like growth in a lactiferous duct at edge of areola
benign

205
Q

What is a galactocele?

A

milk filled cyst that forms in lactiferous duct

206
Q

What is a mastitis?

A

inflammation of the breast
occurs during lactation from dirty hands or infection from infant

207
Q

What is gynocomastia?

A

hypertrophy of breast tissue in a male
either puberty or over 50
caused by excessive hormone production or alteration in hormonal balance

208
Q

How many women will develop breast cancer? What percent are men?

A

1 in 7
3%

209
Q

Leading cancer death is in women at what age?

A

40-55

210
Q

What is Paget’s disease?

A

discharge, flaking, and color changes in nipple/ areola

211
Q

Malignant breast tumors are evaluated for what? What is normally used?

A

estrogen and progestin binding abilities
positive might be able to use hormone Tx
Tamoxifen (antiestrogen)

212
Q

What types of incisions are used?

A

radial
peri areolar
inframammary
trans axillary

213
Q

What is an incision and drainage of the breast procedure?

A

incision into infected area
drainage of pus

214
Q

What is a needle biopsy procedure of the breast?

A

core tissue withdrawn by large bore needle

215
Q

What is an excisional biopsy/ lumpectomy?

A

incision over lesion
entire lesion removed
incision closed with

216
Q

What is a wire localization? What is used to make sure mass is removed?

A

guided by imaging-percutaneously placed
helps identify mass
Faxitron machine used intra-op to ensure mass removed

217
Q

What is a partial mastectomy? What is a disadvantage?

A

removal of tumor with 1Inch of normal tissue
to many nodes removed could lead to lymphedema

218
Q

What is a simple mastectomy?

A

removal of entire breast
including nipple and areola

219
Q

What is a subcutaneous mastectomy?

A

Removal of all breast tissue
(leave nipple and areola

220
Q

What is a radical mastectomy?

A

removal of:
breast, nipple, areola
overlaying skin
axillary nodes
minor/ major pectoral muscle
fat, fascia, tissues

221
Q

What is a modified radical mastectomy?

A

Removal of:
breast, nipple, areola
overlaying skin
axillary node

222
Q

What 2 ways are used to reduce regrowth of malignant cancer cells?

A

H2O- hypotonic solution
isolate supplies- 2 sets if needed

223
Q

What are margins of breast tissue?

A

samples of “clean” tissue around site of removal

224
Q

What methos do we use to organize the margins on our field?

A

SMILAP
superior
medial
inferior
lateral
anterior
posterior

225
Q

What is a sentinel node biopsy?
Where is it located in a breast?

A

main lymph node to absorb cancer cells as it leaves an organ
the axilla

226
Q

What does doctor use to hear and see the location of the sentinel node?

A

blue dye (isosulfan) before surgery
Geiger counter

227
Q

What is reconstructive mammoplasty?

A

insertion of inert prosthesis
tissue expander

228
Q

What are the 2 types of flaps used to reconstruct a breast?

A

Tram flap
back flap

229
Q

What muscle is used in the back flap breast reconstruction?

A

latissimus dorsi

230
Q

What is a TRAM flap?

A

transverse rectus abdominis myocutaneous flap
rectus abdominus and blood supply are flipped upwards

231
Q

What is a reduction mammoplasty?

A

excision of excessive breast tissue
reconstruct symmetrically

232
Q

What is a port-a-cath placement procedure?

A

long term central venous catheter- administer meds
subclavian vein into superior vena cava

233
Q

What is a Taut Catheter used for?

A

Cholangiography to explore common bile duct

234
Q

What is a Maloney/ Bougie dilator used for?

A

Used to dilate the esophagus

235
Q

What is used to insufflate the abdomen?

A

cardon dioxide (CO2)

Surgical Tech 200 (7 decks)

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