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174 Cards in this Set

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