Surgery

Question 1

define oscopy

Answer 1

examination of a hollow viscus

Question 2

define ectomy

Answer 2

removal of an organ

Question 3

define orraphy

Answer 3

repair of tissues

Question 4

define ostomy

Answer 4

an artificial communication between a hollow viscus and the skin

Question 5

define otomy

Answer 5

cutting open

Question 6

define plasty

Answer 6

reconstruction

Question 7

define pexy

Answer 7

relocation

Question 8

what types of anaesthesia are available ?

Answer 8

local, regional, epidural and spinal, intravenous sedation, general

Question 9

which factors make for good surgical practice ?

Answer 9

emotional neutrality,
surgical team,
informed consent and understanding,
avoidance of errors,
prophylactic measures,
operation notes,
postoperative course,
surgical audit and education

Question 10

how is the skin prepared and draped before an operation ?

Answer 10

0.5% chlorhexidine, double thickness lining sheets, disposable fabrics allow less penetration

Question 11

why should alcohol not be used to prepare skin for an operation ?

Answer 11

alcohol burns

Question 12

what factors should be considered when deciding where to place an incision ?

Answer 12

good access, orientation of skin tension lines, strength and healing potential of the tissues, anatomy of underlying structures, cosmetic considerations

Question 13

what are the 3 tissue layers ?

Answer 13

epidermis, dermis, hypodermis

Question 14

what are the 2 types of dissection ?

Answer 14

sharp

blunt - cleavage along natural tissue planes

Question 15

what are the principles of haemostasis ?

Answer 15

clipping, ligation, under running,
diathermy,
tourniquet and exangination,
pressure, 
hypotensive anaesthesia

Question 16

what is diathermy ?

Answer 16

cutting with electricity

Question 17

what is monopolar diathermy ?

Answer 17

charge begins at forcep and discharges out of the patient

Question 18

what is bipolar diathermy ?

Answer 18

charge contained within the forcep and does not excite any part of the patient

Question 19

which absorbable suture materials are available ?

Answer 19

dexon - polyglycolic acid
vicryl - polyglactin
slowly absorbed - PDS - polydioxanone

Question 20

which non absorbable suture materials are available ?

Answer 20

silk (irritant), nylon, prolene

Question 21

what is the purpose dressing a wound ?

Answer 21

maintain wound in a warm, moist state,
absorb/contain superficial bleeding or inflammatory exudate,
protect healing tissue, 
apply pressure to prevent haematoma,
conceal wounds form view

Question 22

how should infected tissues be treated during surgery ?

Answer 22

thorough cleaning,
excision of non-viable tissue,
loose open packing,
inspection of wound under anaesthesia,
delayed primary closure

Question 23

how are good skin grafts achieved ?

Answer 23

applied to well vascularised non infected wounds,
require immobility but not pressure,
match texture and colour

Question 24

what factors can cause a skin graft to be unsuccessful ?

Answer 24

avascular wounds e.g. bones without periosteum, tendons with peritenon, denuded cartilage,
hevy contamination with micro-organisms,
grafts can survive on plasma but not blood clots

Question 25

what are the 4 types of skin flap ?

Answer 25

random pattern flaps,
axial flaps,
myocutaneous flaps,
free flaps

Question 26

what are the features of random pattern flaps ?

Answer 26

no specific blood vessel,
2:1 ratio of length to width,
used to cover local defects

Question 27

what is the principle of axial flaps ?

Answer 27

skin supplied by a specific blood vessel and its accompanying venae comitans

Question 28

what is the principle of myocutaneous flaps ?

Answer 28

skin overlying a muscle will survive if the pedicle to the muscle is not divided

Question 29

what is the purpose of microvascular free flaps ?

Answer 29

reconstruct complex wounds with complex tissue loss