Surg 102--Review (Chapters 16 and 17) Flashcards
1
Q
Case planning is a _____ skill that develops with experience.
A
learned
2
Q
_____ combines knowledge of surgical procedure and surgical techniques.
A
Case planning
3
Q
Surgical procedures can be classified into _____ categories.
A
five
4
Q
What are the five categories of case planning.
A
- Diagnosis
- Reconstruction
- Repair
- Removal
- Replacement or Implantation
5
Q
The results of a diagnostic procedure provide information about the nature of a _____ and the options available for _____.
A
medical problem
treatment
6
Q
Questions for planning diagnostic procedures includes, “What is the target _____ or _____?”
A
structure or tissue
7
Q
Questions for planning diagnostic procedures includes, “What _____ will be used to perform the diagnosis?”
A
technique
8
Q
Questions for planning diagnostic procedures includes, “What _____ is needed for the planned technique?”
A
special equipment
9
Q
Questions for planning diagnostic procedures includes, “How will the information be _____?”
A
documented
10
Q
Questions for planning diagnostic procedures includes, “Is the procedure scheduled to take place in a _____ or in the _____?”
A
procedure room
operating room
11
Q
Questions for planning diagnostic procedures includes, “Will the surgeon need other _____ or _____ during surgery and are those available in the room?”
A
diagnostic films or reports
12
Q
Questions for planning diagnostic procedures includes, “What kind of _____ will be required?”
A
anesthesia
13
Q
In _____, tissue is remodeled or replaced for functional or aesthetic reasons.
A
surgical reconstruction
14
Q
In reconstructive surgery the procedure may be performed in a _____ or may require _____.
A
single operation
multiple surgeries
15
Q
The goal of _____ is to restore function to a structure, organ, or system.
A
repair
16
Q
The type of _____ and the _____ involved determine what instruments or special equipment is needed.
A
repair
tissue
17
Q
Questions for reconstructive surgery includes, “What _____ are needed for the surgery?”
A
specialty instruments
18
Q
Questions for reconstructive surgery includes, “What _____ will be used?”
A
patient position
19
Q
Questions for reconstructive surgery includes, “What _____ will be taken? What tissue will be selected?”
A
grafts
tissue
20
Q
Questions for reconstructive surgery includes, “Does the procedure require more than _____ operative site?”
A
one
21
Q
Questions for reconstructive surgery includes, “What is the _____ of the patient?”
A
age
22
Q
Questions for reconstructive surgery includes, “Does the reconstruction require _____, such as special dressings, a rigid cast, or traction?”
A
external support
23
Q
Questions for reconstructive surgery includes, “If _____ are to be used, are they available?”
A
implants
24
Q
Questions for repair planning includes, “What will be _____?”
A
repaired
25
Questions for repair planning includes, "What _____ are needed?"
special instruments
26
Questions for repair planning includes, "What _____ will be used to to make the repair?"
materials
27
Questions for repair planning includes, "How will the repair be _____?"
held in place
28
Questions for repair planning includes, "Does the patient have recent _____ and _____?"
injuries
| movement limitations
29
Questions for repair planning includes, "Will _____ be required?"
radiographs
30
Questions for repair planning includes, "Is the repair area particularly _____?
vascular
31
_____ may involve tissue, an organ, or a foreign body?
Removal
32
Questions for removal planning includes, "What will be _____, and what _____ is involved?"
removed
| tissue
33
Questions for removal planning includes, "What surgical _____ will be used?"
approach
34
Questions for removal planning includes, "Will a specimen be taken for _____ analysis?"
frozen section
35
Questions for removal planning includes, "is the wound _____?"
contaminated
36
_____ involves implantation of an organ or other anatomical structure that has lost function through disease or trauma.
Tissue replacement
37
An implant is usually a _____ or _____ prosthesis or medical device.
metal or synthetic
38
A _____ is an implant derived from the patient or from another person or an animal, or bio-synthetic material.
graft
39
Questions for replacement or implantation planning includes, "What will be _____ or _____?"
replaced or implanted
40
Questions for replacement or implantation planning includes, "What _____ or tissue is involved?"
organ system
41
Questions for replacement or implantation planning includes, "What is the nature of the _____?"
implant
42
Questions for replacement or implantation planning includes, "If _____ is to be removed, how will this be done?"
non-functioning tissue
43
Questions for replacement or implantation planning includes, "How will the implant be _____?"
held in place
44
Specific instruments sets, equipment, and supplies needed for a procedure are listed on the _____.
surgeon's preference card
45
The data on the surgeon's preference card includes:
1. Instruments sets and special instruments required for the case
2. Special equipment
3. Suture preferences
4. Glove and gown size
5. Skin prep and draping routine
6. Intraoperative drugs, including dose and strength
7. Surgeon's individual techniques
8. Dressings
46
Sterile supplies are opened in sequence from _____ to _____.
large to small
47
The _____ containing towels, drapes, and gowns is centered on the back table.
basic pack
48
The basic pack is opened using _____.
aseptic technique
49
Wrapped basins are opened in the _____.
ring stand
50
Anticipate the need for _____ for supplementary instrument trays, and orthopedic components as needed.
smaller tables
51
After the case has been opened, the surgical technologist performs the _____.
surgical scrub
52
After the surgical scrub, the ST re-enters the surgical suite (without contaminating the hands or arms) and proceeds to _____.
gown and glove
53
Immediately after gowning and gloving, the ST must organize the sterile items an the _____ and _____.
back table and Mayo stnd
54
As you first approach the pile of sterile equipment, do not move anything until you have a _____.
plan
55
During sterile setup, increase the size of the _____.
sterile working area
56
Before organizing and preparing supplies, increase the size of the _____.
sterile area
57
To increase the size of the sterile field _____ first.
drape the Mayo stand
58
During sterile setup avoid _____ around from one place to another.
shifting items
59
During sterile setup try to handle an item only _____.
once
60
During sterile setup prepare items that are _____ of the procedure first.
needed at the beginning
61
During sterile setup try avoid doing _____.
several things at once
62
During sterile setup _____ and _____ strategically.
think and act
63
During sterile setup using a _____ to all setups improves efficiency.
methodical approach
64
Instruments should be placed in a _____.
specific place
65
If instrument trays must be stacked, place _____.
heavier ones on the bottom
66
When organizing instruments make sure you know each instruments _____ or _____ location.
specific or general
67
The _____ is used for instruments and supplies that are needed frequently during surgery.
Mayo stand
68
Supplies are exchanged from the _____ to the _____ as the case progresses.
back table to the Mayo stand
69
The best method to setup the Mayo stand is the method _____.
that works best for the individual
70
Some health facilities use a _____ for the Mayo stand so that personnel taking over at shift changes or breaks know the location of all supplies and instruments.
standardized setup
71
The Mayo stand should be kept _____ and _____.
clean and orderly
72
Irrigation and soaking solutions usually are distributed after _____ or just before _____.
the case is underway
| the case begins
73
Solution are distributed into _____, _____, or a _____.
basins in a ring stand, a solution warmer, or a slush basin
74
Medications are distributed into _____ on the back table.
labeled containers
75
_____ are responsible for ensuring that no item is left in a patient.
All team members
76
The active responsibility for the surgical count lies with the _____ and _____.
scrub and circulating nurse
77
Every surgical sponge is sewn or impregnated with a _____.
radiopaque strip
78
Laparotomy sponges are usually moistened with _____ before use.
warm saline
79
All instruments are passed in their _____ position unless the surgeon request otherwise.
closed (locked)
80
When passing instruments they should be oriented _____ so the the person using the instrument does not have to re-position it or look away from the operative site to receive it.
spatially
81
Used laparotomy and Raytec sponges are dropped into the _____.
kick bucket
82
_____ are placed on a small container or towel on the back towel or on a separate prep table near the back table.
Neurosurgical sponges
83
As additional sponges are needed during surgery, they are counted _____ the scrub receives them.
as soon as
84
During surgery, tissue, fluid, or objects often are removed for _____
pathological analysis
85
It is the _____ duty to correctly identify, with the surgeon, the tissue of origin, the orientation of margins for malignancy, and the correct side.
scrub's
86
Anything removed from a patient is a _____.
specimen
87
_____ is the removal of tissue or cells for analysis by a pathologist.
Biopsy
88
_____ biopsy is used when a large, deep section of tissue is required for analysis.
Extensional (incisional)
89
_____ uses a long, fine needle to aspirate (suction) small pieces of tissue from a tumor.
Fine-needle aspiration (FNA)
90
_____ is similar to FNA, but a large-bore, hollow trocar or needle is used to collect tissue.
Needle biopsy
91
_____ is performed during flexible endoscopic procedures.
Brush biopsy
92
During a brush biopsy a fine brush is used to collect cells on the surface of _____.
mucous membrane tissue
93
Suture materials are used to _____ tissues while healing takes place.
approximate
94
Sutures are used to _____ blood vessels or tubal structures.
ligate
95
Suture material is made from _____, _____, _____, and _____.
synthesized chemicals, animal protein, metal, and natural fibers
96
The _____ the suture is made of is one of the factors that determine how and where the suture is used in the body.
material
97
What are the two main structural categories of suture?
monofilament and multifilament
98
_____ is a single continuous fiber made of a polymer chemical that is extruded and stretched.
Monofilament
99
_____ is many filaments that together form one strand of suture.
Multifilament
100
What are the two types of multifilament suture?
twisted and braided
101
Multiple fibers twisted in the same direction.
Twisted
102
Multiple fibers that are intertwined.
Braided
103
Sutures made of multifilament strands moisture and holds body fluids called _____.
wicking or capillary action
104
If bacteria are present, suture materials with high capillarity are able to retain and spread infection by means of the _____.
suture fibers
105
Suture with _____ is preferred in surgery when the risk of infection is high.
low capillarity
106
Some multifilament suture is coated to reduce _____ and _____.
tissue drag and wicking
107
The size of the suture is based on its _____.
diameter
108
The greater the diameter of suture, the _____ the designated size.
larger
109
The _____ indicates the sutures outside diameter.
USP numbering system
110
Stainless steel suture historically has used the _____ sizing system.
Brown and Sharp (B&S)
111
The _____ of suture refers to the amount of force needed to break the suture.
tensile strength
112
Suture material becomes _____ to _____ weaker when knotted.
10% to 40%
113
Suture material vary in strength when exposed to _____.
body fluids
114
The presence of _____ affects the strength of most suture materials.
inflammation
115
Sutures must be _____ to maintain tensile strength.
uniform in diameter
116
_____ describes how the suture reacts in the presence of body tissue.
Absorption
117
Both _____ and _____ are available in natural and synthetic form.
absorbable suture and nonabsorbable suture
118
The ideal suture would be one that retains its _____ throughout the healing period and the _____ when healing is complete.
strength
| dissolves
119
The ideal suture does _____.
not exist
120
Absorbable, protein-based suture is attacked by _____ lysosomes that digest the suture.
enzyme-digesting
121
Absorbable synthetic sutures are degraded by _____.
hydrolysis
122
_____ is a chemical reaction that occurs in the presence of water.
Hydrolysis
123
All sutures, except _____, can degrade if infection is present.
stainless steel
124
Polypropylene sutures:
Deklene II
Prolene
Pronova
Surgipro
125
_____ is an extremely inert monofilament suture.
Polypropylene
126
_____ smooth surface makes it popular for plastic, ophthalmic, and vascular surgery.
Polpropylene's
127
Polypropylene has a high _____ and is used for retention sutures, particularly in abdominal wall closure.
tensile strength
128
Polypropylene can be used when _____ is present and can be left in place for _____ periods.
infection
| extended
129
Polypropylene is _____ or _____ in color and is available in sizes 10-0 to 2.
clear or blue
130
Suture manufactured with the suture pre-attached is called a _____ or _____.
swaged or atraumatic suture
131
A nearly seamless connection between the needle and the suture and also allows faster suturing with minimal tissue trauma.
Swaged (Atraumatic) Suture
132
In _____, the suture can be detached from the needle by pulling it straight back from the swage.
control-release
133
A _____ is one with a needle swaged to each end.
double-armed suture
134
This type of suture is used for circular tissue, such as in ophthalmic surgery, or for hollow structures, such as blood vessels or the intestine.
double-armed suture
135
One suture-needle combination is provided per pack.
suture-needle combination
136
One suture package contains multiple pre-cut strands of suture.
Multiple suture strands
137
A spool of suture material is wound into a round reels.
Suture reel
138
One package contains many suture-needle combinations in detachable format.
multiple suture-needle combinations
139
One pack contains a single suture strand with a needle attached at each end.
double-armed suture
140
A _____ is a single long suture length that is anchored at one end of the tissues.
continuous suture
141
Continuous suture:
-Does not allow the surgeon to make adjustments in aligning the wound edges, which tend to pucker when a continuous (running) suture is used
142
Interrupted suture
-Easy to place, high tensile strength, less potential for causing wound edema and impaired cutaneous circulation
143
_____ are individually placed, knotted, and cut.
Interrupted sutures
144
The _____ is used for cosmetic closure and in pediatric patients.
subcuticular suture
145
This technique brings the skin edges together in close approximation and no suture material is visible from the outside.
subcuticular suture
146
This technique produces a very fine scar or no scar.
subcuticular suture
147
The _____ is a special continuous suture technique for closing the end of a tubular structure, such as the appendix, its most common application.
Purse-string suture
148
The _____ provides added strength to a running suture line.
locking stitch
149
This technique equalizes the tension between each loop of the suture and provides increased hemostasis on the wound edges
locking stitch
150
_____ are a type of interrupted technique used to provide additional support to wound edges in abdominal surgery.
Retention sutures
151
Plastic or rubber bolsters, or small length of tubing, are threaded through the suture to prevent it from cutting into the patient's skin.
Retention sutures
152
The cut tissue edges are in direct contact.
primary intention
153
A wound that is not sutured must heal by _____.
secondary intention
154
_____ is a process in which an infected or a contaminated wound is treated and the wound space is packed to prevent serum accumulation and to protect against its environmental exposure.
Third intention
155
Chemical or mechanical removal of necrotic tissue after infection or trauma.
debridement
156
Separation of the layers of a surgical wound.
dehiscence
157
The protrusion of abdominal viscera through a wound or surgical incision.
Evisceration
158
Scar formation, particularly of the abdominal viscera
adhesion
