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Chapter 23--Part 1 (Fuller) Flashcards

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1
Q

The category of general surgery encompasses procedures of the _____ and non-cosmetic procedures of the _____.

A

abdomen

breast

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2
Q

The organs and organ systems involved in general surgery are:

A
  1. abdominal wall
  2. gastrointestinal system
  3. biliary system (gallbladder)
  4. spleen
  5. pancreas
  6. hepatic system
  7. breast
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3
Q

The body is divided into semiclosed compartments called _____.

A

cavities

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4
Q

The abdominal cavity contains the _____.

A

abdominal viscera

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5
Q

The pelvic cavity contains structures of the _____.

A

reproductive, genitourinary, and lower gastrointestinal systems

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6
Q

The retroperitoneal cavity contains the _____

A

kidneys, adrenal glands, and ureters

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7
Q

The abdomen is divided into four quadrants, they are:

A
  1. right upper quadrant (RUQ)
  2. left upper quadrant (LUQ)
  3. right lower quadrant (RLQ)
  4. left lower quadrant (LLQ)
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8
Q

The abdomen is divided into nine regions, they are:

A
  1. left and right hypochondriac regions (rib area)
  2. left and right lumbar regions (flank area)
  3. left and right iliac regions (inguinal area)
  4. epigastric region: upper abdomen (literally “above the stomach”)
  5. umbilical region (area near umbilicus)
  6. hypogastric region: lower abdomen (“below the stomach”)
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9
Q

The abdominal wall is composed of distinct tissue layer, which support the viscera; these layers comprise the following:

A
  1. skin
  2. subcutaneous fatty tissue
  3. fascia
  4. muscle
  5. peritoneum
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10
Q

The _____ layer lies directly under the skin.

A

subcutaneous

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11
Q

The subcutaneous layer is composed of _____, which varies in thickness from _____ inch to more than _____ inches.

A

lobulated adipose (fat)
1/4 (0.63 cm)
8 (20 cm)

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12
Q

The _____ is a strong serous membrane that lines the abdominal cavity.

A

abdominal peritoneum (also called the parietal peritoneum)

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13
Q

The _____ protects the viscera in the _____ and secretes serous fluid, which lubricates the viscera.

A

peritoneum

abdomen

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14
Q

The _____ is an extension of the peritoneum that attaches to the posterior abdominal wall and fans out to cover the small intestine.

A

mesentery

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15
Q

The _____ is the area bounded by the rectus abdominis muscle, the inguinal ligament, and the inferior epigastric vessels.

A

Hesselbach triangle

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16
Q

The Hesselbach triangle is associated with an _____.

A

inguinal hernia

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17
Q

The Hesselbach triangle is larger in the _____ than in the _____.

A

male

female

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18
Q

The spermatic cord in the male follows the inguinal canal and contains the following structures:

A
  1. spermatic fascia
  2. cremaster muscle
  3. genitofemoral nerve
  4. ductus deferens
  5. lymph vessels
  6. testicular vein and artery
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19
Q

The most common pathology of the abdominal wall is a _____.

A

hernia

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20
Q

A _____ set is used for procedures involving the abdominal wall.

A

laparotomy

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21
Q

_____ and _____ are commonly used to repair defects in the fascia.

A

braided synthetic sutures

surgical mesh

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22
Q

Most surgeons use a _____ although _____ may also be used.

A

tapered needle

surgical staples

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23
Q

Surgical mesh is used for _____.

A

hernia repairs

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24
Q

Biosynthetic mesh is made of _____ similar to suture. (examples are _____, _____, and _____)

A

synthetic material
Prolene
Dacron
Mersilene

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25
Mesh is available in _____ or _____ which are fitted at the edge of the defect.
sheets or patches
26
A _____ usually is measured and cut during surgery, although precuts are available.
patch
27
Gastrointestinal surgery includes procedures of the _____.
lower esophagus, stomach, small intestine, large intestine, rectum, and anus
28
The _____ is a tubular structure that extends from the pharynx to the stomach.
esophagus
29
The stomach is located under the _____ in the left upper abdomen.
diaphragm
30
The three contiguous anatomical sections of the stomach are the _____, the _____, and the _____.
1. fundus (upper portion) 2. body (midsection) 3. antrum (distal or lower portion)
31
The _____ is approximately 8 to 10 inches long (20 to 25 cm)
duodenum
32
The duodenum receives _____.
chyme (liquefied food broken down by the stomach)
33
The _____ is approximately 9 feet (2.7 m) long.
jejunum
34
The jejunum and the ileum are suspended from the abdominal wall by a sheet of vascular tissue called the _____.
mesentery
35
During _____ of the jejunum or the ileum, the mesentery must be clamped and divided from the intestine.
resection
36
The _____ extends from the distal ileum to the rectum.
large intestine
37
The large intestine is divided into five distinct sections, they are:
1. the ascending colon 2. the transverse colon 3. the descending colon 4. the sigmoid colon 5. the rectum
38
The colon measures about _____.
5 feet (1.5 m)
39
The distal 4 to 5 inches (10 to 12.5 cm) of the intestine is the _____.
rectum
40
The rectum terminates in the _____.
anal canal
41
The presence of GI disease is confirmed primarily by _____, ______, and _____.
imaging studied, blood and metabolic studies, and physical examination
42
An _____ is often performed before open or laparoscopic surgery.
endoscopy
43
A _____ and _____ of the inner surface of the intestine and stomach are performed to rule out or confirm carcinoma and provide tissue for further tests.
biopsy | visual examination
44
During laparotomy and laparoscopy, patients are at high risk for _____.
hypothermia
45
Therefore _____ is a high priority for patient safety during all abdominal procedures.
thermoregulation
46
Compression _____ or a sequential compression device is used during all lengthy _____ procedures to prevent _____.
stockings laparotomy deep vein thrombosis (DVT)
47
The patient is placed in the _____ position for most laparoscopic and open surgery of the GI system.
supine
48
The _____ position may be used in procedures that require perineal access, such as abdominoperineal resection.
low lithotomy
49
The operating table must be able to accommodate up to _____.
800 pounds (360 kg)
50
A _____ is used for GI surgery.
basic laparotomy
51
During GI surgery, sharp dissection is made with _____scissors, an _____, _____, and _____.
Metzenbaum ESU ultrasound shears (Harmonic system) a high-frequency coagulator (LigaSure)
52
During GI surgery, _____ and _____ claps are used to grasp intestinal tissue.
Babcock and Allis
53
Resection of the bowel or stomach is performed with _____ clamps or with surgical _____ instruments.
atraumatic | stapling
54
When the bowel, omentum, and mesentery have been exposed, a _____ suction tip should be available.
Poole
55
Surgical stapling instruments frequently are used in _____ and _____.
resection | anastomosis
56
Special equipment that might be required during GI surgery are:
1. High-frequency (HF) vessel-sealing system (LigaSure) 2. Ultrasound scalpel 3. Vessel loops for large vessel dissection 4. Ultrasound probe 5. Bowel bag 6. Temporary ostomy bag
57
The GI system is a continuous "tube" attached to the _____ and _____ wall by a complex system of vascular membranes.
abdominal | pelvic
58
A procedure in which one section of tissue is cut away from another.
division (differs from resection, where a portion of the organ is removed)
59
To place one or more clamps at a right angle to a tube or vessel.
cross-clamp
60
To place two clamps over a section of tissue to prevent bleeding when the tissue is severed.
double-clamp (this prevents hemorrhage and the release of fluids from the intestine or stomach)
61
To both double-clamp and divide tissue.
clamp and divide
62
During _____ instruments and supplies used while the bowel is open are kept separate from all other sterile items.
bowel technique (also called isolation technique)
63
After closure of the bowel, all _____ instruments and supplies are removed from the field.
contaminated
64
Before the abdomen is closed, the surgical team _____.
dons fresh gloves
65
An _____ is an outpatient procedure, and the surgery is performed with the patient under sedation.
endoscopy
66
Preparation for endoscopy includes _____.
a period of fasting
67
Upper GI studies require limitations on _____.
oral intake
68
Lower GI endoscopy requires _____ and an _____
dietary restrictions | enema
69
GI endoscopy is performed for the following purposes:
1. establish or confirm a diagnosis 2. to perform selected surgical procedures 3. to allow postoperative inspection of the surgical site from within the lumen of the GI tract
70
Esophagoduodenoscopy (EGD), is a diagnostic endoscopy of the _____.
esophagus, stomach, and proximal duodenum
71
Goals of the EGD are:
1. direct diagnostic observation of the inside of the esophagus and duodenum, with biopsy 2. treatment of varices 3. sclerotherapy of esophageal varices 4. polyp removal 5. endoscopic gastronomy for insertion of a feeding tube 6. placement of a stent for an esophageal stricture
72
Colonoscopy is an endoscopy of the _____.
large intestine
73
A colonoscopy is used for diagnostic purposes and for minor surgery such as:
1. removal of polyps 2. biopsy or removal of lesions that do not require resection 3. coagulation of small bleeding diverticula 4. laser treatment of small tumors 5. routine screening for colon cancer
74
Sigmoidoscopy is performed to examine tissue and/or obtain biopsy specimen of the _____ and _____.
sigmoid colon | rectum
75
During a sigmoidoscopy, the patient is placed in the _____ or _____ position.
prone | lithotomy
76
A surgical procedure in which two hollow organs are joined.
anastomosis
77
A gastroduodenostomy, or surgical anastomosis, of the stomach and the duodenum.
Billroth I procedure
78
A gastroduodenostomy, or surgical anastomosis, of the stomach and the jejunum.
Billroth II procedure
79
A technique or process in which the stomach contents are continually drained into a collection device. Required after gastric surgery or disease.
decompression
80
To surgically free up an organ or other structure by dissecting its attachments to other tissue. Often includes dividing and ligating attached blood vessels.
mobilize
81
Flexible tube inserted through the nose and advanced into the stomach. Used to decompress the stomach or means to feed the patient.
Nasogastric (NG) tube
82
Surgical removal of an organ
resection
83
An opening created in a hallow organ and sutured to the skin to drain the organ's contents. May be temporary or permanent.
stoma
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