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174 Cards in this Set
- Front
- Back
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When and where would a purse-string suture be used during a cholecystotomy
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placed in fundus to tighten and hold in place catheter...3.0 chromic suture would be used
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What is a Randall instrument used for
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Randall stone forceps - to remove gallstones
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What is the surgical name for pancreatoduodenectomy
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Whipple procedure
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Know about doing a cholangiogram
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shows presence and location of gallstones/obstructions. Contract medium is introduced into CBD and then an x-ray or fluoroscope is used.
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What is cholecystoduodenostomy
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opening to connect the GB and duodenum
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What instrument is used for blunt dissection of the
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kitners or peanuts -- use on sponge stick
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What forms the ampula of Vater
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point where pancreatic duct and duodenum communicates; location shared with common bile duct- bile enters duodenum through ampula of vater
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Be able to describe the hepatobiliary duct system
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Formed in liver -- stored in gall bladder -- released when food enters stomach via sphincter of oddi
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What is important to know about the cystic duct and cystic artery during a cholecystectomy
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They will need to be located and ligated -- clamped during surgery
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What is a cholecystostomy used for during a cholecystectomy
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To drain the gallbladder -- sucks all the fluid out
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What is the purpose of carbon dioxide during a cholecystectomy
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used to insufflate the peritoneum
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What is a Kocher incision
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subcostal -- Right subcostal will expose the GB --- Left subcostal used to remove spleen (not in trauma)
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Know the equipment needed to do an endoscopic cholecystectomy
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Tower -- screen, camera, light source, insufflator, suction, irrigation, #3 handle with #10 blade, trocars, #7 handle with #11 Blade, hoooks, endoclipappliers, blunt grasping forceps, hemostats, metz scissors, pickups, hassan and trocars and 3.0 Vicryl Sutures
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Know about the intraabdominal pressure used during an endoscopic cholecystectomy
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No more than 15 mmHg
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Know ligation material used during an endo chole
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silk ties or staples
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Define Choledocholithiasis
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Stones in the common bile duct
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What is the purpose of bile in the digestive system
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aids in food digestion -- bile emulsifies fat and bile salts
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What are Jorgensen and use during cholecystectomy
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Jorgensen - gallbladder scissors -- remove gallbladder from liver bed
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What is the purpose of the sphincter of Oddi
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Controls release of bile and pancreatic enzymes
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Know about postoperative complications of a cholecystectomy
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Internal hemmorrhage, renal failure, delayed wound healing, infection, obstruction
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What is the purpose of carbon dioxide during a cholecystectomy
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used to insufflate the peritoneum
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What is a Kocher incision
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subcostal -- Right subcostal will expose the GB --- Left subcostal used to remove spleen (not in trauma)
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Know the equipment needed to do an endoscopic cholecystectomy
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Tower -- screen, camera, light source, insufflator, suction, irrigation, #3 handle with #10 blade, trocars, #7 handle with #11 Blade, hoooks, endoclipappliers, blunt grasping forceps, hemostats, metz scissors, pickups, hassan and trocars and 3.0 Vicryl Sutures
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Know about the intraabdominal pressure used during an endoscopic cholecystectomy
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No more than 15 mmHg
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Know ligation material used during an endo chole
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silk ties or staples
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Define Choledocholithiasis
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Stones in the common bile duct
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What is the purpose of bile in the digestive system
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aids in food digestion -- bile emulsifies fat and bile salts
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What are Jorgensen and use during cholecystectomy
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Jorgensen - gallbladder scissors -- remove gallbladder from liver bed
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What is the purpose of the sphincter of Oddi
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Controls release of bile and pancreatic enzymes
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Know about postoperative complications of a cholecystectomy
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Internal hemmorrhage, renal failure, delayed wound healing, infection, obstruction
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What is the purpose of a T-Tube drain
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placed in CBD to help drain bile
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What procedure is performed for cancer of the head of the pancreas
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Whipple procedure
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What does the falciform separate
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Lobes of liver
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Define Hepatomegaly
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enlarged liver
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What are Bakes and what is the purpose
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Bakes Gallbladder dilator
dilation |
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What is a Tru-cut needle used for
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biopsy --- liver biopsy and other biopsies
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Know about the different abdominal incisions
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Study incisions
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What is the function of the abdominal fascia
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Support structure
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What operative procedure uses a Pfannenstiel incision
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C-section or abdominal hysterectomy
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Know reasons for surgical intervention
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prophylactic, diagnostic, curative and palliative
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What structures is located in the right iliac region sometimes requiring emergency surgery
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Appendix
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What considerations must go into the type of incision during surgery
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Quick entry
Visual Bloodless |
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Define Atresia
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Congenital absence or closure of a normal body opening or tubular structure -- narrowing
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What type of drain is a Jackson-Pratt drain
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Suction -- closed drainage system
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What procedure requires insertion of a foley catheter to maintain hemostasis
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TURP
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What is an epigastric hernia
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hietal hernia
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What type of hernia occurs in the Hesselback's triangle
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Direct Hernia
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What is an umbilical hernia
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Weakening of the abdominal wall around or under the umbilicus - oomphalocele
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Know sutures used during an inguinal hernia repair
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0 Ethibond
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What is the transversalis fascia function
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Support structure
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What is the purpose of a penrose during an inguinal hernia repair
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Retract spermatic cord
Always use wet |
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What procedures might result in male sterilization
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inguinal hernia repair
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Another name for a ventral hernia
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Incisional hernia
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Wht procedure requires a lower oblique incisionn
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inguinal hernia
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Define gynecomastia
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abnormal enlargement of male breast tissue
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What are the supernumerary structures
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extra nipple, extra axillary tissue,
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What causes most breast abcesses
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Staph aureus
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Know blood supply to the breast
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mammary arteries and also axillary arteries
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What is a fibroidadenoma of the breast
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benign breast tumors -- firm discrete and nontender
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Know average age breast cancer is diagnosed
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rare before 30 but increases each decade thereafter
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What is a sarcoma of the breast
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Malignant tumor of the connective tissue metastisizes through the blood to the lungs and bone
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What is a mammogram
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x-ray to locate breast tumors in early stage
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Know about breast examinations
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make sure to check breast 7 days after periods. BSE = stand in shower tissue should be soft with no bumps and no excretions from nipple
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What is a Senns instrument and when used
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it is a retractor
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Know grasping instrument used to grasp breast mass during breast biopsy
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Allis or tenaculum
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What part of the breast is affected by Pagets disease
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Nipple (orangy discharge)
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Localization for breast biopsy first takes place where
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X-ray
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What might cause a pneumothorax
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if clamp penetrate intercostal it could damage pleura. If that happens you may need to place a chest tube.
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What is used to check the tumor's response to hormonal therapy
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Estrogen, progesterone receptors
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When is money a consideration in breast surgery
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Implants -- reconstruction
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What instrument can be used to get instruments off the back table post incisions
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Sponge sticks
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When would a skin graft be used
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reconstruction due to possible radiation causing damage
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Define lumen
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inside a hollow structure
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Where is bile secreted
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CBD into duodenum
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What is the functions of the gallbladder
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stores bile until needede
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What type of jaundice requires operative intervention
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Surgical jaundice - obstruction
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What happens to liver enzymes in the presence of jaundice
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elevated
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What causes gallstones
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abnormal composition of bile, reduced flow of bile, cholesterol, obesity, inflammation of gall bladder
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Where is the foramen of Winslow located
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sulcus or the fossa of the liver gallbladder bed
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Know about the blood supply to the liver
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hepatic artery and veins
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When would you use absorbable sutures on the liver
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Lacerations
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Be able to identify suture - largest and most strong
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0 chromic and big blunt needle
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Where are the spermatic cord, vein and artery located
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in the spermatic cord
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What is the classification of heparin
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procuced by the liver, anticoagulant
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Where is a Hasson cannula used
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belly button -- umbilicus
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Know care of endoscopic equipment
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never twist or roll up tightly
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Know landmarks used during endoscopic inginal herniorrphaphy
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zyphoid process -- bony prominences
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What is the purpose of polypropylene mesh during hernia repair
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reinforcement and strength
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With what procedure is abdominal distention a common complication
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Paritonitis -- used retention suture
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What is comprises the biliary system
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Liver, Gallbladder, Ducts and Pancreas
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What is the largest internal organ
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Liver
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Where is the liver located
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Right Hypochondrium and epigastric regions under diaphram
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What ducts are included in the ductal system of the biliary system
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cystic duct, common bile duct, common hepatic duct, rt and lt hepatic duct and pancreatic duct
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What are the cells of the liver called
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hepatocytes
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What are the functions of hepatocytes
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produce bile, liver and mast cells manufacture and are associated with heparin production and plasma proteins, fat and protein metabolism, heat production, conversion of sugar into glycogen
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What is givn to babies to help if they have trouble in clotting
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Vitamin K
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Never cut, tie off or clip what?
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Common Bile Duct
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Islets of Langerhans found in the pancreas are made up of what
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Alpha Cells for glucagon and
Beta cells for Insulin |
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The Pancreas is divided into what three parts
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head, body and tail
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What part of the pancreas can you NOT live without
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The tail
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The pancreas is the only organ that is what
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An Endocrine gland and also an excocrine gland
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Jaundice in babies usually is caused from excess of what
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bilirubin
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The two types of jaundice are what and give example of each
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surgical - obstruction
medical - hepatitis |
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What does LFT stand for
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Liver Function Test
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Mammory glads are similar to what
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large sebaceous (sweat) glands
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The breast has a normal globular contour fascial support known as Cooper's ligament which is what kind of ligament
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Suspensory ligament
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An elongation of mammary tissue normally extends laterally on the pectoralis major toward the axilla is called what?
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Tail of Spence
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12-20 glandular lobes make up the breast that are separated by connective tissue. In each lobe there are smaller lobules which are composed of connective tissue that contain what?
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Alveoli or Acini which are milk producing cells
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What resembles grapelike clusters in the breast
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lactiferous ducts
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What is the pigmented area that surrounds the nipple
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areola
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What do you want to do with the nerves of the breast during surgery
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Identify them and not severe them.
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A lump is considere benign or malignant until diagnosis?
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malignant
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What does BX mean
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Biopsy
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What does I&D Mean
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Incision and Drainage
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In a urinalysis what is the normal ph range
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PH range is from 0-14
Normal is slightly acide 6-6.5 |
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What is not normally found in the urine and if so what does it indicate
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sugar--
indicates diabetes |
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What does specific gravity mean and what is the normal values
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the kidneys ability to concentrate urine and normal is 1.003 to 1.035
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What is the specific function of WBC
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Fight infection by phagocytosis and to produce or distribute antibodies in the immune response
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High protein diet causes what in the urine
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excessive acid in urine which can lead to coma or death
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What is comprises the biliary system
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Liver, Gallbladder, Ducts and Pancreas
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What is the largest internal organ
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Liver
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Where is the liver located
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Right Hypochondrium and epigastric regions under diaphram
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What ducts are included in the ductal system of the biliary system
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cystic duct, common bile duct, common hepatic duct, rt and lt hepatic duct and pancreatic duct
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What are the cells of the liver called
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hepatocytes
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What are the functions of hepatocytes
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produce bile, liver and mast cells manufacture and are associated with heparin production and plasma proteins, fat and protein metabolism, heat production, conversion of sugar into glycogen
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What is givn to babies to help if they have trouble in clotting
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Vitamin K
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Never cut, tie off or clip what?
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Common Bile Duct
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Islets of Langerhans found in the pancreas are made up of what
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Alpha Cells for glucagon and
Beta cells for Insulin |
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The Pancreas is divided into what three parts
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head, body and tail
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Abdominal peritoneum
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serous membrane lining the walls of the abdomen
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epigastric
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region of the abdomen above the umbilicus following the upper edge of the stomach
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fascia
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a fibrous band or membrane lying deep into the skin and supporting muscles
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hypogastric
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below the level of the stomach
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linea alba
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a tendinous median line on the anterior abdominal wall; separates the rectus muscle
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McBurney incision
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an oblique right muscle-splitting incision. This is used for removal of the appendix
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Muscle splitting incision
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incision that separates muscle tissues along the length of their fibers. the muscle is not cut. This results in little or no bleeding and prevents the moderate to severe postoperative pain associated with muscle cutting.
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paramedian
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an incision of the vertical abdominal wall lateral to the midline
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pfannenstiel
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a transverse incision of the lower abdomen below the umbilicus and just above the pubis in a natural fold or crease
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subcostal
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literally "under the rib" describes an incision or area of the abdominal wall that folllows the slope of the tenth costal cartilage
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subcutaneous tissue
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the superficial fascia layer that covers the abdominal wall. fatty tissue that attaches to this tissue can range from thin to very thick
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transverse incision
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an incision that follows a line perpendicular to the midline of the body
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strangulated hernia
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herniated tissue that is strangulated and has a compromised or absent blood supply
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incisional hernia
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occurs along a previous surgery line caused by infection, obesity, excess tension
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direct inguinal hernia
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an acquired weakness in the inguinal floor that leads to protrusion of the abdominal contents
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indirect inguinal hernia
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a hernia that protrudes across the membranous sac of the spermatic cord. Usually present at birth
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mesh
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soft pliable material used to fix hernias
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TEP approach to fix a hernia
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a laparoscopic hernia repair approached from the extraperitoneal space.
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An indirect hernia in a male
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the hernia extends along the length of the membrane covering the spermatic cord and can emerge through the superficial righ
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Incarcerated Hernia
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A hernia that the tissue has become entrapped in the defect
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What is the procedure used to fix a hiatel hernia
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Nissen Fundoplication
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The liver is encapsulated in a thick fibrous sheath called what
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Glisson's capsule
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What is a disease of the liver in which the tissue becomes hardened sometimes caused from alcoholism
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cirrhosis
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Friable
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term used to describe tissue that is fragile
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subphrenic
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term used to describe below the liver
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Cholelithiasis
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Condition in which calculi or bilestones are present in the bile in the gallbladder
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Choledochojejunostomy
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A surgical anastomosis of the common bile duct and the jejunostomy
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cholecystectomy
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surgical removal of the gallbladder
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pancreatojejunostomy
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a surgical anastomosis of the pancreas and the jejunum
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parenchyma
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tissue that makes up an organ for example the liver parenchyma is the body of the liver itself
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trisegementectomy
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In hepatic surgery the removal of the right lobe of the liver and a portion of the left
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wedge resection
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the surgical removal of a small, sometimes pie-shaped portion of the liver
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metastatic
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condition in which cancer spreads from a primary site to other areas of the body
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The pancreatic duct or the central duct of the pancreas is known as what
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"Duct of Wirsung"
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Cholecystitis
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Inflammation of the gallbladder
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choledochoduodenostomy
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a procedure that establishes a new connection between the common bile duct and the duodenum
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Total mastectomy
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also called a simple mastectomy procedure removes the breast including the skin and nipple. Lymph-node dissection is not performed
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staging
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a method used to determine the severity of cancer
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tylectomy
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procedure of localized removal of a lesion; synonymous with lumpectomy
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lumpectomy
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the wide excision of a malignant mass of breast tissue. Also known as segmental biopsy or tylectomy
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Modified radical mastectomy
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removal of the entire breast, nipple and aerolar region. the lymph nodes are also removed. This is the most common procedure for malignant breast tumor
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pedicle flap
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a section of tissue that is partially removed from one area of the body and transferred to a nearby location
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excisional biopsy
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removal of a tissue for pathological examination
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hook-wire
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a device used to pinpoint the exact location of a nonpalpable mass detected during a mammogram. A fine needle is inserted into the mass during the examination and the tissue around the needle is removed for pathological exam
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subcutaneous mastectomy
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procedure that removes the breast while leaving the skin, nipple and aerola intact
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