Scrub Out/Anatomy Flashcards
Batista procedure
Partial left ventriculectomy
Treatment for heart failure after medical management
Procedure of choice for pyloric stenosis
Fredt-Ramstedt
Palpable olive in the midepigastrium
Adult remnants:
Ductus venosus Foramen ovale Ductus arteriosum Umbilican vein Left umbilical artery Remnant of urachus
Ligamentum venosum Fossa ovale Ligamentum arteriosum Ligamentum teres Medical umbilical ligament Medical umbilical ligament
Procedure for bleeding esophageal varices
Segura procedure
Gold standard: endoscopic band ligation
Vein involved in esophageal varices
Left gastric vein
Most common sclerosing agent
Tetradecyl sulfate
Cheapest: alcohol
Layer where sclerosing agent is injected
Submucosa
Type of gastric tube inserted for bleeding esophageal varices
Sengstaken-Blakemore tube
What are the blood supply of the following segments of the esophagus:
1) Cervical (C6-T1)
2) Thoracic (T3-T10)
3) Abdomen
1) Inferior thyroid (5-6 cm)
2) Bronchial arteries (15 cm)
3) Left gastric, Inferior phrenic (5-6 cm)
Portal pressure to say that it is portal hypertension
> 12 mmHg
In refractory bleeding, what procedure is done in acute variceal bleeding
TIPS
Which vessels are blocked by the Sengstaken-blakemore tube
Left gastric
Esophageal
Vasa brevia (branch of splenic artery that supplies the greater curvature)
Largest branch of the celiac trunk
Splenic artery
What type of obstruction in schistosomiasis
Pre-sinusoidal obstruction
Whipple’s procedure is also known as a
Pancreatico-Duodeno-Jejunostomy
Procedure of choice for pancreatic CA
Procedure for chronic pancreatitis
What is a Peustow procedure
Lateral pancreaticojejunostomy
Chain of lakes appearance is seen in?
Chronic pancreatitis
Surgical procedure of choice for biliary atresia
Kasai procedure
Hepato-porto-enterostomy
What is Bilroth I? Bilroth II?
I: Antrectomy + Gastroduodenostomy
II: Antrectomy + Gastrojejunostomy
Procedure of choice for duodenal atresia
Ladd’s procedure
Procedure of choice for Barette’s esophagus
Nissen’s fundoplication
Most common predisposing condition factor to a Barette’s esophagus
GERD
Most common primary esophageal motility disorder
Nutcracker/supersqueezer esophagus
What is Lichenstein herniorrhaphy
Tension free with mesh
Mesh has a low recurrence rate
Pringle maneuver temporarily occludes which blood vessels?
Porta hepatis (hepatic artery + portal vein)
Portal veins supplies how many percent of blood to the liver
70%
Procedure of choice for a ruptured peptic ulcer
Graham omental patch
Bleeding of peptic ulcer is secondary to which artery?
Gastroduodenal artery
Procedure of choice for ascending aortic aneurysm
Bentall procedure
Most common cause of aortic aneurysm in pediatrics? adults?
Pedia: Kawasaki
Adults: Marfan
Most common type of aortic aneurysm
DeBakey I or Standford A (Proximal)
Surgical procedure of choice for a full rectal prolapse
Thiersh procedure
Procedure of choice for achalasia
Heller’s mymotomy
Myotomoy +/- Partial fundoplication
Radiology: bird’s beak appearance
Achalasia
Strongest layer of the esophagus
Submucosa
Most common site of squamous cell CA of the esophagus?
Middle third
Most common benign tumor of the esophagus?
Leiomyoma
Most common benign tumor of the stomach
Leiomyoma
What is the triad of Plummer-Vinson syndrome
Esophageal webs + atrophic glossitis + iron deficiency anemia
What type of CA is most commonly associated with Plummer-Vinson syndrome
Squamous cell CA
What is the other name of Plummer-Vinson syndrome?
Patterson-Brown-Kelly Syndrome
Most common esophageal hernia
Sliding esophageal hernia
Most common site of Mallory-Weiss Tear
Distal third of the esophagus (GEJ)
Mallory-Weiss ~ alcoholic
What is Boerhaave’s syndrome?
Pressure rupture of the esophagus
Most common site of perforation in the esophagus?
Killian’s triangle
Most common site of Zenker’s diverticulum
Killian’s triangle
Pharyngoesophageal diverticulum
Zenker’s diverticulum
Killian’s triangle involves which 2 muscles?
Between the Inferior pharyngeal constrictor and cricopharyngeus
Surgical incision: low longitudinal incision of the uterus used to the deliver babies abdominally
Kronig incision
Transverse: Kerr incision
Procedure of choice in Hirschsprung’s disease
Rectal pullthrough
Best age to do a rectal pullthrough
6 months - 12 months (12 months is the best)
Mile’s procedure is also known as an?
Abdominoperineal resection (APR)
Done in colorectal CA
Surgical procedure of choice in colorectal CA
Mile’s procedure
Low Anterior Resection: the closer you are to the rectus
Procedure pertaining to a esphagectomy through a right thoracotomy
Ivor Lewis procedure
To access squamous cell CA of the esophagus in the middle third
Heinz-Mikulicz procedure pertains to what?
Longitudinal pyloric incision
McIndoe procedure pertains to a
Vaginal reconstructive surgery
“Mc-INDAY”
Brook ileostomy pertains to a
Brooke ileostomy
Done in ulcerative colitis
Procedure of choice in refractory ascites
Denver shunt
Procedure of choice in a thyroglossal duct cyst
Sistrunk procedure
Procedure of choice in rectal CA less than 8cm from the anal verge
APR (Mile’s procedure)
Stages of decubitus ulcer that extends into muscle and bone
Stage IV
Full thickness burns involves which layers?
3rd degree burn
All layers of skin + entire dermis
Bochdalek’s hernia
Left posterior diaphragmatic hernia
Most common
Morgagni: anterior diaphragmatic hernia
Gold standard for the diagnosis of glaucoma
Tonometry
Ideal pre-op bowel prep antibiotic
Netilmycin
What is Dakin solution
Dilute sodium hypochlorite (bleach) used in contaminated wounds
Amyand’s hernia pertains to a?
Hernial sac that contains a ruptured appendix
Accepted sclerosant for pleural effusion?
TALC
Flap used in a deep pressure ulcer
Gluteus maximus flap
Best management for a 3cm basal cell CA of the nose?
Excision with 2-4 mm margin
A small thick antectubital scar from a 2nd degree flame burn is constricting movement. To relieve the constriction, the appropriate procedure of choice to refashion the scar?
Z-plasty (CONTRACTURE)
Radio: Coral reef appearance
Colonic angiodysplasia
Common cause of lower GI bleed in the elderly
Most common site of rupture in the colon
Cecum (most dilated portion)
Law of Laplace’s: wall tension = pressure x radius
Most common cause of lower GI bleeds in adults? Pedia?
Adults: Diverticulosis
Pedia: Meckel’s diverticulum
Most common source of extra adrenal pheochromocytoma
Organs of Zuckerkandl
Located near the abdominal aorta
Ecchymosis over the mastoid process pertaining to a basilar skull fracture
Battle’s sign
Never insert an NGT
Bilateral black eyes pertaining to a basilar skull fracture
Raccoon eyes
Blood vessel of choice for CABG
Left internal mammary artery
Due to superior patency rates vs. greater saphenous vein
Most common site of a carcinoid tumor
Appendix
When is the best time to perform a surgery for undescended testis
6-12 months
Most common site of squamous cell CA in the esophagus
Middle third
Normal amount of pericardial fluid
30-50mL
Most commonly fractured in the body
Clavicle
Most commonly fractured facial bone
Nasal bone
Hangman’s fracture involves
Fracture of C2
Jefferson fracture
Fracture of C1
Arrest of respiration occurs at which cervical level?
C2-C3
Clay Shoveller’s fracture
Fracture of C7
Blue sclerae
Osteogenesis imperfecta
Defect in type I collagen
Dangers of porcelain gallbladder
Risk of CA is 30-65%
In a thyroidectomy, if the inferior thyroid artery is injured, what is affected?
Recurrent laryngeal nerve
In a thyroidectomy, if the superior thyroid artery is injured, what is affected?
External laryngeal nerve
Most common site of a cholecysenteric fistula
Duodenum
Part of the male urethra that offers the greatest resistance
Membranous urethra
Prostatic urethra will only cause resistance if there is BPH/enlargement
Most dilatable portion of the male urethra
Prostatic urethra
Widest part of the Fallopian tube
Ampulla
Narrowest part of the Fallopian tube
Isthmus
Where is lumbar tap done
L4-L5
L3-L4
Where does the spinal cord end in adults? Children?
Adults: L1
Children: L2-L3
Platelet level for OR in emergency situation? In elective surgery?
Stat: 50,000
Elective: 100,000
Only motor innervation of the diaphragm
Phrenic nerve
C3, C4, C5
Origin of the diphargm
Septum transversum
or Pleuroperitoneal fold/membrane
C3, C4, C5
Nerve responsible for erection
Pudendal
S2, S3, S4
Winging of the scapula
Long thoracic nerve
C5, C6, C7
Serratus anterior muscle
Most allergenic fluid
Dextran
Hartmann’s solution
Compound sodium lactate that is isotonic with blood, intended for IV administration
Most common severe complication of liver abscess
Amoebic pericarditis (rupture into the pericardium)
How is Hirschsprung disease diagnosed?
Proctosigmoidoscopy + deep rectal biopsy
When is meconium passed?
24-48 hours of life
Management of a pregnant patient at 7 months AOG + Grade III hemorrhoids
Hot sitz bath
Hemorrhoids that can be manually reduced
Grade III
How to manage acute cholecystitis in pregnant patients
20 weeks: open cholecystectomy
Most common site of metastasis in Wilm’s tumor
Lungs
Wilms tumor + macroglossia
Beckwidth-Wiedemann syndrome
Macroglossia is seen in 2 conditions:
Hypothyroidism
Beckwidth-Weidemann syndrome
Most common site of metastases for neuroblastoma
Bone
Stratum basale is also known as
Stratum germinativum
Most common benign parotid mass
Pleomorhpic adenoma
Most common malignant parotid mass
Mucoepidermoid
Most common presenting sign of anal fissures
Pain > bleeding
Most common sign of Meckel’s diverticulum
Bleeding
Most common source or primary tumor that leads to malignant pleural effusion
Lung CA
Intraaortic ballon pump is inserted where?
Distal to brachiocephalic
Most common site of rupture of colonic obstruction
Cecum
Law of Laplace: rupture occurs in areas with the greatest diameter
Most common organism in acute appendicitis
E. coli > Klebsiella and Bacteroides
Veins of Retzius and Sappey are found in which condition?
Portal hypertension
In facial nerve injury, which graft is used?
Sural nerve
It is accessible, long, with low rejection
Least foreign body reaction in closing a surgical wound in the face
Staples (titanium-based)
Cotton, nylon, and prolene are not used
Chronic lesion from a wound
Marjolin’s ulcer
Nerve responsible for recurrent ulcers
Criminal nerve of Grassi
From proximal branch of the posterior vagus nerve
Psoas sign is
Pain on extending the hip with knee in full extension
Detects retrocecal appendicitis
Most common manifestation of appendicitis
Anorexia (hamburger sign)
Most posterior cavity in the peritoneal cavity
Morrison’s pouch
Hepatorenal recess
During normal breathing, what is the position of the vocal cords
Wide open (to allow easy passage of air)
Seen in laryngoscope
Most common artery hit in pericardiocentesis
Internal thoracic artery
Best access in performing pericardiocentesis
Subxiphoid approach
Most common level of tracheal stenosis
Tracheal ring 1 (C1)
Tracheostomy is placed at what cervical level?
C2-C4
Longest portion of the fallopian tube
Ampulla
Site of the major papilla in the second part of the duodenum
Posteromedial wall
Zone of the neck where most traumatic injury occurs
Zone II
Most common site of abdominal aortic aneurysm?
Infrarenal
Most common type of thoracic aneurysm
DeBakey 1
Left gastric vein drains to the
Portal vein
Portal vein = splenic vein + IMV
Where is the site of weakness in a diaphragmatic hernia
Septum transversarium or pleuroperioneal membrane
Least painful agent for pleurodesis
TALC (poweder)
Most commonly involved cranial nerve in NPCA
CN V
Causes dilatation of vessels for erection
Nitric oxide
Gluteus maximus is innervated by which nerve?
Inferior gluteal nerve
Undescended thesis
Cryptorchidism