Questions and Answers
What is the primary function of the Ligament of Treitz in the gastrointestinal tract?
Which arteries are primarily responsible for supplying blood to the small intestine?
What step in the abdomen sequence involves securing the area before any cuts are made?
In which technique are bowel instruments isolated from clean instruments during surgery?
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What is the role of the GIA stapler in gastrointestinal surgery?
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What is one consequence of inadequate mesenteric repair after bowel removal?
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What two components make up the Nissen Fundoplication procedure?
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Which bariatric surgery procedure involves removing a significant portion of the stomach?
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What is the main purpose of a temporary colostomy?
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Which type of colostomy procedure is considered an urgent intervention?
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What surgical procedure involves scraping the uterine lining?
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What is the risk associated with exceeding a pressure of 16 mmHg during pneumoperitoneum?
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Which ligaments are involved in the support of the uterus?
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What is the primary purpose of Heparinized Solution in intraoperative procedures?
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What is the primary indication for performing a pelvic exenteration?
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Which type of graft is typically used to bypass the right coronary artery in CABG?
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In a total abdominal hysterectomy, which organs are removed?
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What indication would most likely lead to a Lung Volume Reduction Surgery?
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What is the purpose of the vault count during gynecological surgery?
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What is the role of the Implantable Cardioverter Defibrillator (ICD)?
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What anatomical feature is essential for single-lung ventilation?
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Which statement accurately describes the functions of Papavarine?
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Which surgical approach is associated with a Transhiatal Esophagectomy?
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During CABG, which graft technique is preferred due to its durability and long-term patency?
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What is the purpose of a pacemaker in cardiac treatment?
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What defines VATS in thoracic procedures?
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Which surgery allows the bladder conditions to be fixed while removing the prostate?
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What type of fluid is used during TURP procedures to manage high absorption into the bloodstream?
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Which type of cystoscopy is specifically indicated for men with obstructive symptoms?
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Which structure is removed during a nerve-sparing radical retropubic prostatectomy?
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What is the purpose of inserting a venous cannula during cardiopulmonary bypass?
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What kind of suture is typically used for valve repairs or replacements during cardiac surgery?
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During which procedure is the native kidney not removed unless cancerous?
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Which type of irrigation fluid is used during an observational cystoscopy?
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What is the main concern during a laparoscopic kidney transplant procedure?
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Which procedure involves creating a reservoir for urine using a piece of ileum?
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What is the primary indication for performing a TURP procedure?
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What is the function of the cardioplegia catheter in cardiac surgery?
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What indicates a possible bladder perforation during irrigation fluid overload?
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Study Notes
Gastrointestinal
- Ligament of Treitz: Connects the duodenum to the jejunum; important anatomical landmark.
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Blood supply:
- Celiac trunk branches into splenic, common hepatic, and left gastric arteries.
- Superior Mesenteric Artery: Supplies small intestine, ascending colon, and ⅔ of transverse colon.
- Inferior Mesenteric Artery: Supplies from the transverse colon down to the rectum.
- Surgical technique sequence: Clamp - clamp - cut - tie for bowel surgery.
- Bowel Isolation Techniques: Prevents cross-contamination and mechanical metastasis of malignant cells during surgery; involves irrigation before closure.
- Instrument handling: Bowel instruments separated from clean instruments, placed in a K-basin.
- Extra draping: Applied around the incision area for closure to maintain sterility.
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Staplers in surgery:
- GIA (Gastrointestinal Anastomosis): Cuts, staples, and divides simultaneously; suitable for side-to-side anastomosis; can join various lumen sizes.
- TA (Thoracoabdominal Stapler): Requires manual cutting after stapling.
- EEA (End to End Anastomosis): Performs end-to-end and end-to-side anastomosis; cuts in a circular fashion.
- Mesenteric Repair: Necessary when bowel is removed to prevent postoperative bowel entrapment and obstruction.
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Nissen Fundoplication:
- Involves plication (shortening stomach tissue) and crurrorhaphy (suture repair).
- Balance in suturing tension is critical: excessive tension leads to food obstruction; insufficient tension may allow GERD to persist.
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Bariatric surgeries:
- Roux-En-Y Gastric Bypass: Reduces stomach size, connecting to the jejunum; food bypasses the duodenum, promoting quicker satiety.
- Gastric Lap Band: Adjustable band restricting ingested food volume.
- Sleeve Gastrectomy: Removes 85% of the stomach for food restriction.
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Colostomy/Ileostomy:
- Temporary colostomies: Indicated for bowel rest or healing; Hartmann's procedure used in emergencies.
- Permanent colostomy: Rosebud colostomy may be performed for cancer.
- Abdominoperineal Resection: Removes lower sigmoid, rectum, and anus; necessitates dual surgical teams and specific positioning.
Gynaecology
- Uterine Ligaments: Include cardinal, uterosacral, round, and broad ligaments.
- Dilation and Curettage (D & C): Procedure involving cervix dilation to scrape uterine lining, typically for heavy bleeding or post-miscarriage clean-up.
- Vault Count: Conducted during cervical entry/removal; includes initial and closing counts.
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Pneumoperitoneum:
- Closed pneumoperitoneum achieved with Verres needle.
- Volume: 2.5-4 L; maintain pressure below 16 mmHg to avoid gas embolism.
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Hysterectomy types:
- Total Abdominal: Removal of the entire uterus and cervix.
- Partial/Subtotal: Removal of the uterus only.
- Radical: Extensive removal including surrounding organs and lymph nodes.
- Bilateral Salpingo-Oophorectomy (BSO): Removal of both fallopian tubes and ovaries.
- Endometrial Ablation: Utilizes non-electrolytic ionic media for menorrhagia treatment; considerations for fluid intake/output due to potential complications.
- Ovarian Cancer: Often asymptomatic until late-stage; prevalent in women aged 50-60 years.
- Pelvic Exenteration: Comprehensive removal of pelvic organs due to persistent carcinoma, typically post-radiation therapy.
Urology (Genitourinary)
- Counting Procedures: Differentiated methods for laparoscopic and open surgeries to maintain sterility.
- Cystoscopy: Diagnostic tool for visual examination; utilizes flexible scopes for men and rigid scopes for women.
- TURP (Transurethral Resection of Prostate): Treats enlarged prostates without removing capsule; monitors for fluid overload and potential bladder perforations.
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Irrigation Fluids:
- Normal Saline: Used for observational cystoscopies.
- Sterile Water: Employed with monopolar cautery in specific conditions.
- Kidney Transplant: Typically left kidney used due to longer vein; requires careful donor selection; recipient's native kidney usually retained unless cancerous.
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Prostatectomy Types:
- Suprapubic: Transvesical removal approach, mainly for obstruction.
- Retropubic: Allows excellent exposure and closure of the prostate's capsule; nerve-sparing technique preserves erectile function.
- Ileal Conduit: Created post-radical cystectomy; urine is diverted through a stoma using a segment of ileum.
Cardiovascular
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Heart Anatomy:
- Chambers: right atrium, right ventricle, left atrium, left ventricle.
- Valves: tricuspid, pulmonary, mitral, aortic.
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Blood Circulation:
- Deoxygenated blood flows from vena cavae to lungs; oxygenated blood returns to the body via the aorta.
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Nursing Interventions:
- Review cardiac catheterization for coronary artery status and potential bypass requirements.
- Monitor anesthesia closely during induction; apply CPBM when necessary.
- CPBM (Cardiopulmonary Bypass Machine): Facilitates temporary heart and lung bypass during surgery, allowing for cardiac manipulation.
- CABG (Coronary Artery Bypass Graft): Addresses severe coronary artery disease; uses various grafts, often from internal mammary arteries, for longevity.
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Pacemaker and ICD:
- Pacemaker adjusts abnormal heart rhythms.
- ICD monitors activity and delivers shocks for critical dysrhythmias.
Thoracic
- Thoracic Anatomy: Includes pleural cavity components and respiratory structures such as the trachea and bronchi.
- VATS (Video-Assisted Thoracoscopic Surgery): Minimally invasive approach with specific counting protocols.
- Double Lumen ETT: Enables single-lung ventilation, crucial for lobectomies.
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Lung Procedures:
- Wedge resection removes localized lesions.
- Lung lobectomy entails complete lobe removal, requiring precise mobilization techniques.
- Lung Volume Reduction Surgery: Targets hyperinflated lung tissue in COPD patients; uses stapling for vascular management.
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Esophagectomy Techniques:
- Approaches include transhiatal and transthoracic, utilizing dual or tri-incisional strategies for complex cases.
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Description
Test your knowledge on the key structures and functions of the gastrointestinal system. This quiz covers important aspects such as the Ligament of Treitz, blood supply from the celiac trunk, and mesenteric arteries. Additionally, it includes techniques for bowel isolation and procedural steps in surgeries.
