SurgFinal Flashcards
transverse abdominus to thompsons ligament / and internal oblique aponeurosis conjoined to ingunal ligament
Bassini
repair of the posterior wall of the ingunal canal
ii. Shouldice
connects the edge of the transvers abdominus aponeurosis to coppers ligament.
Mcvay
non tension procedure so there is low recurrence
it uses a mesh so there is no tension
lichtenstein
- small ducts that drain bile from the liver into the gall bladder.
- can be the source of bile leaking causing biliary peritonitis
Ducts of Luschcka
Ducts of Luschcka
- small ducts that drain bile from the liver into the gall bladder
- can be the source of bile leaking causing biliary peritonitis
signs of splenic rupture
orthostatic symptom
Kehr’s sign
hesselbachs triangle
Epigastric vessels
Inguinal ligament
Lateral border of the rectus sheath
what sex is femoral henna more common in?
females
most common form of inguinal hernia?
indirect
Kehr’s sign
the occurrence of acute pain in the tip of the shoulder due to the presence of blood or other irritants in the peritoneal cavity when a person is lying down and the legs are elevated. Kehr’s sign in the left shoulder is considered a classical symptom of a ruptured spleen
calculation for corrected calcium?
Normal albumin is 4
normal calcium is 8.5 - 10.2
If the albumin is low, at a level of 2, you can correct it with Ca++. if the calcium is 8 -
Correct w/ a 1: .8 ratio.
increase the level of albumin to 4 so you correct the calcium by 1.6 (2 x .8)
the corrected calcium is 9.6.
Max doses of lidocaine and Marcaine
a. lidocaine only 5ml
b. lidocaine w/ epi 7 ml
c. Bicarb as a buffer
d. Marcaine - last longer. max dose =2.5
a. BAT (Blunt Abdominal Trauma Algorithm
If stable and have a + FAST exam - do a CT
if stable and have a - FAST exam - observe and consider a CT
if Unstable with a + Fast - move to laparoscopy to determine the extent of bleeds
if unstable with a - fast - consider other sources of blood loss, non hemorrhagic shock - consider laparoscopy and additional FAST Exam.
most common type of gallstone?
mixed
c1 fracture
jeffersons fracture
c2 fracture
hangmans fracture
c7 fracture
clay shovelers fracture
nexus criteria
- There is no posterior midline cervical tenderness
- There is no evidence of intoxication
- The patient is alert and oriented to person, place, time, and event
- There is no focal neurological deficit (see focal neurological signs)
- There are no painful distracting injuries (e.g., long bone fracture)
polysorb
3 weeks of wound supprot 2 months to absorb
Maxon
longest wound support - 6 weeks, 6 months to absorb
evisceration vs dehiscence
Dehiscence - midline inscision wound separation
Evisceration - bowels start coming out of wound
blood at the meatus
retrograde urethrogram
chest tube insertion area?
5-6 intercostal space mid axillary line
IV general anesthesia?
propofol
Gas general anesthesia?
isoflorine
ASA classifications
- Healthy person.
- Mild systemic disease.
- Severe systemic disease.
- Severe systemic disease that is a constant threat to life.
- A moribund person who is not expected to survive without the operation.
- A declared brain-dead person whose organs are being removed for donor purposes.
mallampati classification
class 1 best class 4 worst
resuscitation fluids for burn
Use (4mls / kg) LR x % of burn surface area
50% in the first 8 hours
25% in the second 8 hours
25% in the third 8 hours
maintenance fluids post op
4-2-1
4 mLs/kg for first 10 kg
2 mLs/kg for second 10 kg
1 mLs/kg for third 10 kg
Desired U/O
- 5 mL/kg/hr for adults
- 0 mL/kg/hr for children
- 5 ml/kg/hr for electrical burn patients
Transducer frequencies
- 5 htz for FAST (used in blunt abdominal trauma)
- 0 for Vascular
- 5 for thyroid visualization
Branching vein tear?
subdural hemorrhage
father of modern hernia repair
eduardo bassini
3 types of Odontoid fracture
Type 1: evulsion , tip
Type 2: thru base, most unstable
Type 3: thru body
what class of hemorrhage are they confused and decreased BP?
class III 1500-2000mL
Tx for malignant hyperthermia
dantrolene
What type of drain is a closed drain connected to a suction device? a. Blake and/or JP b. Davol c. Penrose
Blake and/or JP
What type of drain uses a sump with an airflow system to keep the lumen of the drain open when fluid isn’t passing through it? a. Blake/JP b. Davol c. Penrose
b. Davol
What type of drain is open passively? a. Blake/JP b. Davol c. Penrose
c. Penrose
