Week 6 Flashcards
A fistula is an ______________ between a __________ and the __________ , or between ___________¹.
A wound sinus is a __________________________ that extends from the ___________ of an organ to an __________________ ”
abnormal passage
hollow organ ; skin surface;
discharging blind-ended tract
surface; underlying area or abscess cavity
Kasai portoenterostomy is the classic operation for the condition of ______________ and consists of _________ of all _________ remnants and the _________ then using a _________ of mobilised _________ to anastomose to the denuded transected portal plate within the porta hepatis at the _________ of the liver.
congenital biliary atresia
excision
extrahepatic bile duct ;gallbladder
Roux loop ; jejunum
root
One hb = ____gm of bilirubin
35
Bile is _______ color then on exposure to line it becomes ________
golden yellow
Green
5 major problems of obstructive jaundice
________________
___________ fixed with ____________
____________
_______________fixed by ____________ fluid
___________ tendencies
Hepatorenal syndrome
dehydration; dextrose water
sepsis
hypoglycemia; glucose containing
bleeding
Retrograde ____________ intussusception is a rare complication of _________ and _________reconstruction
jejuno-gastric
gastrojejunostomy
Billroth II
In a Billroth II reconstruction after a __________________, the ______________ is (opened or closed?) and a ____________________ is created
partial gastrectomy
duodenal stump
Closed ; gastrojejunostomy
A choledochal cyst (CC) or biliary cyst is a congenital or acquired anomaly affecting the biliary tree. It involves the _________ of the __________ that could affect the ____________ and/or the ___________ segments.
dilation; biliary tree
extrahepatic ; intrahepatic
The triangular cord sign is a triangular or tubular ___________ of ________ tissue, representing the _________ of the _____________________ , seen in the porta hepatis at ____________, and is relatively specific for the diagnosis of biliary atresia 1,2.
echogenic cord ; fibrous
ductal remnant; extrahepatic bile duct
ultrasonography
Peak incidence of intussusception is e between ??
6th to 9th month after birth
Diarrhea can cause intussusception
T/F
T
Meckel’s rule of 2
Epidemiology: ________,___________,_______
Anatomical: _________,_________
Two types of _______________
2% of the population
presentation before the age of two.
2 times more common in males
2 feet from the ileocecal valve
2 inches in length
heterotopic Mucosa
Primary causes of intussusception?
Change in diet at weaning
URTI
Nonoperative reduction — Nonoperative reduction using ________ or _________ by enema
hydrostatic
pneumatic pressure
17 pathologic lead points of Intussusception
Meckel’s Diverticulum
Acute appendicitis
Lymphoma
Intestinal polyps
Scar tissue/adhesions
Coeliac disease
Henoch schnolein purpura
Crohn’s disease
Waugh’s syndrome
Myelomeningocoele
Most causes of cholestatic jaundice are a result of diseases of the _________ or ___________ , including intrahepatic forms caused by _______,_________,_________ , and destruction of the interlobular ducts.
liver or biliary tract
drugs, alcohol, infection
Types of internal fixators include:
Mention 3
Plate and screws
Kirschner wires
Intramedullary nails
An orthopedic plate is a form of __________ fixation used in orthopaedic surgery to hold __________ in place to allow __________ and to reduce the possibility of __________. Most modern plates include bone __________ to help the orthopedic plate stay in place.
internal ; fractures
bone healing
nonunion ; screws
___________ wires or K-wires or pins are sterilized, sharpened, smooth stainless steel pins.
They come in different sizes and are used to ____________________ (
___________ fixation) or to provide an anchor for ___________.
The pins are often driven into the bone through the _______ (___________ fixation) using a ________ or _________ . They also form part of the ___________ apparatus.
Kirschner
hold bone ;pin
skeletal traction. ; skin
percutaneous pin ; power or hand drill
Ilizarov apparatus.
An intramedullary rod, also known as an intramedullary nail (IM nail) or inter-locking nail or __________ nail , is a __________ forced into the __________ of a bone.
IM nails have long been used to treat fractures of _______ bones of the body.
Küntscher nail ; metal rod
medullary cavity ; long bones
IM nails resulted in earlier return to activity for the soldiers, sometimes even within a span of a few weeks, since they _______________________, rather than entirely _______________
share the load with the bone
supporting the bone
Open Reduction Internal Fixation (ORIF)
Open reduction refers to _____________________, as is necessary for some fractures.
Internal fixation refers to fixation of _____________________, _____________________, and other devices to enable or facilitate healing.
open surgery to set bones,
screws and/or plates
intramedullary rods
Closed Reduction Internal Fixation (CRIF) is reduction without any ___________ , followed by __________.
It appears to be an acceptable alternative in unstable distressed _____________ fractures of the _________ in children, but if fracture displacement after closed reduction exceeds ________, open reduction and internal fixation is recommended.
open surgery
internal fixation
lateral condylar ; humerus
2 mm
5Rs of fracture management
Resuscitate
Radiology
Reduce
Retain
Rehabilitate
Atresia is __________ due to a _________
Failure of canalization
Vascular accident
Most common type of TOF is???
Type C
Distal fistula
Proximal atresia
CHARGE syndrome is a disorder that affects many areas of the body.
CHARGE:
List all
coloboma, heart defects, atresia choanae , growth retardation, genital abnormalities, and ear abnormalities.
The ‘double bubble’ sign in prenatal diagnosis is most often associated with __________________
duodenal atresia
omphalocele defect
This sac consists of
an inner layer of ________
middle layer of _____________
outer layer of ___________.
peritoneum; Wharton’s jelly
amnion
Gastroschisis is a birth defect where a _______ in the _______________ beside the _________ allows the baby’s ________ to extend outside of the baby’s body.
hole; abdominal (belly) wall
belly button
intestines
What Is a PSARP?
A _____________________ (PSARP), sometimes called a ________ surgery, is a procedure that repairs _________________, or defects of the ______ and/or ______.
posterior sagital anorectoplasty
pull-through
anorectal malformations
rectum; anus
When there is unilateral undescended tetes, the percentage for fertility is _______
For bilateral, it’s _______
60-66%
33%
Placenta Previa
When the ______________________________.
placenta covers the opening in the mother’s cervix
Placenta praevia risk factors include a ___________, age older than _____ and a history of previous surgeries, such as a ____________ or ____________ removal.
previous delivery
35
caesarean section (C-section)
uterine fibroid
Placenta Previa
The main symptom is _______________ (with or without?) pain during the _______-half of pregnancy.
bright red vaginal bleeding
Without
second
5 tails of Lockwood
Perineum
Root of the penis
Femoral triangle
Superficial inguinal pouch
Scrotal
____________ is the absence of both testes at birth
_____________ is the presence of only one testis
_____________ is a very rare anomaly, which is defined by the presence of more than two testicles
Anorchia
Monorchia
Polyorchidism
Types of testes?
Ectopic
Undescended
Retractile
Ascending
Congenital
Acquired
Laparotomy Is a part of emergency treatment
T/F
T
A __________( _____________) is the most definitive initial treatment of a pneumothorax.
chest tube (or intercostal drain)
Immediate management of open pneumothorax is to __________ with a __________ sterile occlusive dressing that is closed securely with tape on __________. Thus, the dressing prevents ______________________________ during inspiration but allows _________________ during expiration.
cover the wound
rectangular ; only 3 sides.
atmospheric air from entering the chest wall
any intrapleural air out during expiration.
Most moderate sized and all massive hemothoraxes should be treated with _________________ .
tube thoracostomy
Flail chest is a traumatic disorder that happens when ______________ located ___________ are ________ in _______________
three or more ribs
next to each other
fractured
two or more places.
________________ to achieve chest cavity stabilization is the standard treatment for patients with both flail chest and lung damage.
This treatment has a demonstrated ability to reduce mortality rates, but the possibility of developing ___________ increases the longer it is in place.
Mechanical ventilation
neumonia
The definitive treatment for cardiac tamponade is _____________________________.
removal of the accumulated pericardial fluid
Definitive treatment of airway obstruction
An ___________ or ________________ may be inserted into the airway. This can help get oxygen through swollen airways. A _____________ or ___________ are surgical openings made in the airway to bypass an obstruction.
endotracheal; nasotracheal tube
tracheostomy and cricothyrotomy
X-rays you do in an emergency situation
Mention3
Chest X-ray
Pelvic X-ray
Cross table lateral of the Cervical spine
Adjuncts of primary survey
Mention 6
Vital signs
Pulse oximeter and CO2
ECG
Urine output
Urinary/gastric catheters
Arterial blood gases
Adjuncts to Primary Survey
Diagnostic Tools
●_____________
● _______________
Focused abdominal sonography in trauma(FAST)
Diagnostic peritoneal lavage
When do I start the secondary survey?
After
●_________ is completed
● ABCDEs are ___________
● ____________ are returning to normal
Primary survey
reassessed
Vital functions
13 Pathological lead pouts of Intussusception
Meckel’s diverticulum
Polyps
Intestinal duplication
Lymphoma
Hemangioma
Lymphosarcoma
Enteric cysts
Henoch-schloein purpura
Cystic fibrosis
Benign intestinal neoplasm
Ectopic gastric mucosa
Ectopic pancreatic mucosa
Ascariasis
Clinical presentation of Intussusception
•sudden onset of _____________ and _________ of the _______
•___________
•stool is initially _______ then _________
Intermittent Inconsolable cries; indrawing; legs
Vomiting
Mucoid; bloody
Abdominal USS in Intussusception
Color duplex to detect ???
Viability
Non -operative management
Hydrostatic reduction can be done in intussusception using _____,______,________
Saline
Barium
Gastrograffin
Contraindications to Non-operative reduction of intussusception
Absolute:
Signs of _____________, suspected ____________
Relative : ________ bleeding, symptoms > _________
Peritonitis; perforation
Rectal; 24-48hrs
