O&G theatre Flashcards
What is removed in a subtotal hysterectomy?
Uterus
Performed if the cervix is inaccessible e.g. adhesions, due to patient choice, and for severe endometriosis
What is removed in a total hysterectomy?
Uterus, cervix
Indications: uterine fibroids, endometriosis, adenomyosis, heavy/dysfunctional menstrual bleeding
What is removed in a radical hysterectomy?
Uterus, cervix, part of the vagina, entire parametria
Indication: cervical cancer
What are the two main types of caesarean sections?
Lower segment (transverse incision through lower part of the uterus)
Upper segment (vertical incision through the fundus and body of the uterus)
What two types of incisions can be performed for a lower segment caesarean?
Pfannenstiel - 2-3cm above the symphysis pubis and slightly curved
Joel-Cohen - 3cm below the ASIS line and straight
What are the advantages of a lower over upper segment caesarean section?
Relatively avascular → less blood loss
Good healing → less adhesions, better cosmesis
Vaginal births are possible in subsequent pregnancies, access to the presenting part of the foetus
What are the advantages of an upper over lower segment caesarean section?
Can be performed in the presence of lower segment pathologies
Foetus can be delivered regardless of lie (lower only transverse)
Easy extension of incision intraoperatively
Shorter incision to delivery time
Why is an acidic solution applied to the cervix during a vaginal examination?
Dehydrates cells → cells with large or dense nuclei reflect light and appear white
e.g. metaplastic cells, dysplastic cells, cells infected with HPV
Why is a green light filter sometimes used to visualise the cervix?
Accentuates abnormal vasculature
What structures are passed through when giving spinal anaesthesia?
- Skin
- Subcutaneous tissue
- Supraspinal ligament
- Interspinal ligament
- Ligamentum flavum
- Epidural space
- Dura mater
- Arachnoid space
What is a colposcopy?
Diagnostic procedure
Colposcopy (miscroscopy) provides an illuminated, magnified view of the cervix, vaginal, vulva or anus
To identify precancerous and cancerous lesions
What is the impact of operative management of CIN lesions on future fertility?
No effect
Which maternal infections are an indication for caesarean section?
Primary genital HSV (reduces transmission)
NOT HBV, HCV, HIV if controlled
What layers are dissected in a caesarean?
- Skin
- Fatty liver
- Fascia
- Rectus abdominus
- Peritoneum
- Bladder flap
- Uterus
What antibiotic is given prophylactically for a caesarean section?
Cefazolin
