General Surgery Exam Review Flashcards - Chapter 14

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Questions and Answers

What do the bubbles in contrast media look like in a cholangiogram?

Stones

What is a thyroid tenaculum?

Layhey clamp

What is male breast enlargement called?

Gynecomastia

What abdominal organ is a Whipple procedure done on?

<p>Pancreas</p> Signup and view all the answers

Tetney is a complication for which procedure?

<p>Thyroidectomy</p> Signup and view all the answers

What life-threatening disease can result from thyrotoxicosis?

<p>Graves disease</p> Signup and view all the answers

Which anatomical structure is the largest mass of lymphatic tissue?

<p>Spleen</p> Signup and view all the answers

Mahoney dilators are used in the?

<p>Esophagus</p> Signup and view all the answers

What are the three regions of the pancreas?

<p>Head, body, and tail</p> Signup and view all the answers

What is the Triangle of Calot and during what surgery is it dissected?

<p>Cholecystectomy</p> Signup and view all the answers

What is it called when insufflation of CO2 goes into the abdominal cavity?

<p>Pneumoperitoneum</p> Signup and view all the answers

Where is the gallbladder located in relation to the liver?

<p>Inferior surface of the liver's right lobe</p> Signup and view all the answers

What is the open appendectomy incision called?

<p>McBurney's incision</p> Signup and view all the answers

What incision would the Linea Alba be opened to the peritoneum?

<p>Median vertical</p> Signup and view all the answers

When suturing the appendiceal stump, what is the suture technique called?

<p>Purse-string technique</p> Signup and view all the answers

What is the most frequent hernia in females?

<p>Femoral</p> Signup and view all the answers

What is the term for a procedure going into the abdomen?

<p>Laparotomy</p> Signup and view all the answers

If preserving the long thoracic and thoracodorsal nerves during surgery, what is the procedure called?

<p>Modified radical mastectomy</p> Signup and view all the answers

Where are the parathyroid glands located in relation to the thyroid?

<p>Inferior, superior, dorsal</p> Signup and view all the answers

What do the parathyroid glands regulate?

<p>Blood calcium concentration</p> Signup and view all the answers

What does 'cephalad to caudad' refer to?

<p>Head to tail</p> Signup and view all the answers

What is a handheld retractor used during a thyroidectomy?

<p>Green retractor</p> Signup and view all the answers

What type of hernia protrudes through the transverse versus fascia?

<p>Direct hernia</p> Signup and view all the answers

What is the type of hernia where both direct and indirect are present?

<p>Pantaloon</p> Signup and view all the answers

What type of hernia results from failure of the deep internal ring to close during fetal development and protrudes into the scrotum?

<p>Indirect hernia</p> Signup and view all the answers

What is the name of a gastric mass of indigestible vegetable fiber and hair that can require surgical intervention?

<p>Bezoar</p> Signup and view all the answers

What do 'end to end,' 'side to side,' and 'end to side' represent?

<p>Anastomosis</p> Signup and view all the answers

What does 'lap appy' refer to?

<p>Appendectomy</p> Signup and view all the answers

What can be used to dissect the appendix?

<p>Stapler, endoloop, intracorporeal suturing instrument</p> Signup and view all the answers

Which hernia repair can a Penrose drain be used for?

<p>Inguinal hernia</p> Signup and view all the answers

Which statement is correct regarding polyps and diverticulum in the colon?

<p>Polyps protrude inward; diverticulum protrudes outward</p> Signup and view all the answers

What is the most common permanent colostomy?

<p>Sigmoid colon</p> Signup and view all the answers

An intestinal stoma is created below the costal margin, above the beltline, and lateral to which muscle?

<p>Rectus abdominus</p> Signup and view all the answers

What position is used for anal rectal procedures?

<p>Jackknife (kraske)</p> Signup and view all the answers

The hepatic and splenic flexures are located proximal and distal to what part of the large intestine?

<p>Transverse colon</p> Signup and view all the answers

What does bowel technique refer to?

<p>Steps to prevent postoperative infections (SSI)</p> Signup and view all the answers

What viewing instrument is used for hemorrhoids?

<p>Anoscope</p> Signup and view all the answers

What type of suture needle is used for the liver?

<p>Blunt</p> Signup and view all the answers

What incision is used for an open cholecystectomy?

<p>Right subcostal incision</p> Signup and view all the answers

What retractor is used for an open cholecystectomy to elevate the liver?

<p>Sweetheart/Harrington retractor</p> Signup and view all the answers

Why do we inject saline through the cholangiogram catheter before the contrast media?

<p>To make sure it is patent (patency)</p> Signup and view all the answers

What is the endocrine secreting gland of the pancreas that makes up only 1 percent of the organ?

<p>Islets of Langerhans</p> Signup and view all the answers

If a T-tube or wound drain is left after a laparoscopic cholecystectomy, where would it come out of?

<p>(Out of one of the 1mm) right port</p> Signup and view all the answers

What is pancreaticoduodenectomy more commonly known as?

<p>Whipple</p> Signup and view all the answers

Where is the needle localization performed?

<p>Breast</p> Signup and view all the answers

What is the first node in the axillary chain?

<p>Sentinel node</p> Signup and view all the answers

What is it called when removing the entire breast without any lymph nodes?

<p>Simple mastectomy</p> Signup and view all the answers

What is the irrigation fluid commonly used for breast biopsy or mastectomy surgeries?

<p>Sterile water</p> Signup and view all the answers

If a mastectomy is scheduled following a breast biopsy and frozen sections indicate carcinoma, what do we do?

<p>Reprep, redrape, regown, new gloves, and new instruments</p> Signup and view all the answers

What do bifurcated drains and fluffy pressure dressings help to prevent after a mastectomy?

<p>Hematomas and seromas</p> Signup and view all the answers

Can we hold a camera during a minimally invasive surgery?

<p>True (A)</p> Signup and view all the answers

A laparoscopic procedure can be converted to an open procedure?

<p>True (A)</p> Signup and view all the answers

Should skin preps be performed vigorously on breast procedures?

<p>False (B)</p> Signup and view all the answers

Does the Hassan technique require a Verres needle?

<p>False (B)</p> Signup and view all the answers

What is the function of the mesentery?

<ol> <li>Provides the vascular supply to the intestine; 2. Holds the intestine in place</li> </ol> Signup and view all the answers

What are the functions of the omentum?

<ol> <li>Stores adipose tissue; 2. Shock absorber, protects underlying organs; 3. Lubricates the surface of the abdominal viscera</li> </ol> Signup and view all the answers

What are the functions of the small intestine?

<p>Digestion and absorption of nutrients</p> Signup and view all the answers

What are the functions of the large intestine?

<ol> <li>Absorption of water and electrolytes; 2. Converts food material into fecal waste; 3. Produces vitamin K</li> </ol> Signup and view all the answers

What is the movement of food through the intestine with muscles called?

<p>Peristalsis</p> Signup and view all the answers

What are the two layers of the peritoneum?

<p>Visceral and parietal</p> Signup and view all the answers

What are the organs of the alimentary canal?

<p>Mouth, pharynx, esophagus, stomach, small intestine, large intestine, rectum, and anus</p> Signup and view all the answers

What is the function of the pharynx?

<p>Passageway for food and liquid</p> Signup and view all the answers

What is the primary function of the mouth?

<p>Mastication, secretion of saliva</p> Signup and view all the answers

What is the function of the esophagus?

<p>Passes food to stomach</p> Signup and view all the answers

What does the stomach secrete for digestion?

<p>HCl acid and mucus</p> Signup and view all the answers

What is the role of the small intestine?

<p>Digest chime and nutrient absorption</p> Signup and view all the answers

What are the components of the large intestine?

<p>Ascending, transverse, descending, sigmoid cecum and appendix</p> Signup and view all the answers

What is the rectum's function?

<p>Storage place for fecal matter</p> Signup and view all the answers

What is the function of the anus?

<p>Expels solid waste and controls its expulsion</p> Signup and view all the answers

Flashcards

Cholangiogram Appearance: Bubbles

Bubbles in contrast media during a cholangiogram, mimicking the appearance of stones.

Thyroid Tenaculum (Layhey Clamp)

A specialized surgical clamp used in thyroid surgeries, also known as a Layhey clamp.

Gynecomastia

Male breast enlargement, a condition affecting men.

Whipple Procedure (Pancreaticoduodenectomy)

A complex surgical procedure involving removal and reconstruction of the head of the pancreas, duodenum, and part of the stomach.

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Tetany Complication (Thyroidectomy)

A potential complication of thyroidectomy surgeries, which involves spasms in the vocal cords.

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Thyroidtoxicosis (Graves' Disease)

A life-threatening condition characterized by excessive thyroid hormone production, often caused by Graves' disease.

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Spleen (Largest Lymphatic Tissue)

The largest lymphatic organ, vital in filtering blood and storing immune cells.

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Mahoney Dilators (Esophagus)

Instruments used for dilating (widening) the esophagus, often during procedures like esophageal stricture dilation.

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Regions of the Pancreas: Head, Body, Tail

The different sections of the pancreas, crucial for understanding surgical procedures involving this organ.

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Triangle of Calot (Cholecystectomy)

A triangular space near the gallbladder critical for accurate dissection during cholecystectomy.

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Insufflation of CO2 (Pneumoperitoneum)

The introduction of CO2 into the abdominal cavity, creating a space for laparoscopic surgeries.

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Gallbladder Location (Inferior Right Lobe)

The location of the gallbladder, nestled on the liver's surface.

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McBurney's Incision (Appendectomy)

A common surgical incision used for open appendectomy, made near the appendix at McBurney's point.

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Linea Alba Incision (Median Vertical)

A vertical incision in the midline of the abdomen, used to access the peritoneum and other internal organs.

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Appendiceal Stump Suture Technique (Purse-string)

A suture technique used to close the appendiceal stump after appendectomy, securely tying off the appendix.

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Common Female Hernia (Femoral)

Femoral hernias are more common in females, caused by a weakening in the femoral canal.

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Laparotomy (Abdominal Entry)

The general procedure of surgically opening the abdomen, often used in various abdominal surgeries.

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Modified Radical Mastectomy (Nerve Preservation)

A type of breast cancer surgery that aims to remove the breast while preserving nerves crucial for shoulder movement.

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Parathyroid Glands Location (Thyroid)

The locations of the parathyroid glands, small glands that regulate blood calcium levels.

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Parathyroid Function (Calcium Regulation)

The primary function of the parathyroid glands, regulating the calcium levels in the blood.

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Cephalad to Caudad (Head to Tail)

A directional term indicating movement from the head towards the tail of the body.

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Green Retractor (Thyroidectomy)

A handheld retractor used to hold tissues apart during thyroid surgeries.

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Direct Hernia (Transverse Fascia)

A type of inguinal hernia that occurs directly through the transverse fascia, a weak spot in the abdominal wall.

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Pantaloon Hernia (Combined)

A specific type of inguinal hernia where both direct and indirect hernias are present.

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Indirect Hernia (Deep Internal Ring)

An inguinal hernia occurring due to incomplete closure of the deep internal ring during fetal development, allowing tissue to enter the inguinal canal.

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Gastric Mass: Bezoar

A solid mass in the stomach, usually composed of indigestible materials, sometimes requiring surgical removal.

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Anastomosis Types (End-to-End, Side-to-Side, End-to-Side)

Different ways of connecting or reconnecting the ends of tissues, commonly performed during surgeries.

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Lap Appy (Appendectomy)

Slang term for appendectomy, a procedure used to remove the appendix.

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Methods for Appendix Dissection (Stapler, Endoloop, Suturing)

Methods used to cut and remove the appendix during laparoscopic appendectomy.

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Penrose Drain (Inguinal Hernia Repair)

A surgical drain used in inguinal hernia repairs, preventing fluid from accumulating in the surgical site.

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Colon Exam Findings: Polyps vs. Diverticula

Distinctive features of the colon seen on an exam: polyps grow inward, while diverticula bulge outwards.

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Permanent Colostomy Site (Sigmoid Colon)

The most frequent location for a colostomy, where a portion of the colon is brought through the abdominal wall.

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Intestinal Stoma Creation (Location Guidelines)

The optimal placement for an intestinal stoma, ensuring proper functioning and comfort.

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Anal/Rectal Procedure Position (Jackknife/Kraske)

A specific position used for anal procedures, where the patient lies face down with the hips bent.

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Flexures of the Large Intestine (Hepatic/Splenic)

The bends or curves in the large intestine, important landmarks during surgery.

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Bowel Technique (Preventing SSI)

Strict protocols followed in surgery to prevent infections at the surgical site, crucial for patient safety.

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Anoscope (Viewing Hemorrhoids)

A special instrument used for visual examination of the anus and rectum, often employed in the diagnosis and treatment of hemorrhoids.

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Suture Needle for Liver Surgery (Blunt)

Blunt needles are preferred for liver surgeries to minimize damage to the delicate liver tissue.

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Open Cholecystectomy Incision (Right Subcostal)

A common incision used for open cholecystectomy, made along the right side of the ribcage.

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Liver Elevation - Sweetheart Retractor (Cholecystectomy)

A specialized retractor used during cholecystectomy to lift the liver and provide better surgical access.

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Cholangiogram Catheter Patency Check (Saline)

A saline solution is injected into the cholangiogram catheter before contrast to check for blockages and ensure proper function.

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Pancreatic Endocrine Gland (Islets of Langerhans)

Specialized cell clusters in the pancreas, responsible for producing and releasing hormones.

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T-Tube/Wound Drain Position (Lap Chole)

The exit point for the T-tube/wound drain after a laparoscopic cholecystectomy.

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Pancreaticoduodenectomy Terminology (Whipple)

Another name for the Whipple procedure, reflecting its complexity and wide scope.

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Needle Localization (Breast Procedures)

A procedure used to pinpoint the location of a tumor or other lesion in the breast, often guiding biopsies or tumor removal.

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Sentinel Node (Axillary Lymph Chain)

The first lymph node in the axillary chain, often used to assess cancer spread.

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Simple Mastectomy (Breast Removal)

A surgical procedure for breast cancer, involving the removal of the entire breast without lymph node dissection.

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Irrigation for Breast Procedures (Sterile Water)

Sterile water is crucial for irrigating the breast during surgical procedures, removing debris and keeping the area clean.

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Mastectomy Protocol with Frozen Section Results (Reprep, Redrape, Regown, New Instruments)

Additional steps required in a mastectomy procedure if a cancer diagnosis is confirmed from a frozen section, ensuring proper removal of the tumor.

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Post-Mastectomy Management (Drains, Pressure Dressings)

Important post-mastectomy management practices, reducing the risk of complications like fluid buildup.

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Camera Use in Minimally Invasive Surgery (Holding Camera)

It's acceptable for surgeons to directly hold the camera during minimally invasive procedures, offering better control and visualization.

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Laparoscopic to Open Procedure Conversion (Surgical Conditions)

The possibility of converting from a laparoscopic procedure to an open procedure during surgery, depending on the situation.

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Breast Procedures Skin Prep (Gentle)

Gentle skin preparation is vital for breast surgeries, avoiding harsh treatment that could damage the skin.

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Hassan Technique (No Verres Needle)

The Hassan technique for laparoscopic cholecystectomy does not require the use of a Verres needle, potentially simplifying the procedure.

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Mesentery Function (Blood Supply & Stabilization)

The mesentery's key functions include supplying blood to the intestines and maintaining its position in the abdomen.

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Omentum Roles (Adipose, Protection, Lubrication)

The omentum's multiple roles include fat storage, protecting organs, and lubricating abdominal surfaces.

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Small Intestine Functions (Digestion & Absorption)

The small intestine's primary functions are digestion and absorption of nutrients, crucial for the body's energy and growth.

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Large Intestine Functions (Water Absorption, Feces, Vitamin K)

Key functions of the large intestine: water and electrolyte absorption, fecal formation, and vitamin K production.

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Peristalsis (Intestinal Movement)

The rhythmic muscle contractions that propel food through the digestive tract, essential for digestion.

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Two Layers of Peritoneum (Visceral & Parietal)

The two layers of peritoneum, lining the abdominal cavity and covering abdominal organs.

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Alimentary Canal Organs (Mouth to Anus)

The digestive tract, including various organs that process food, from the mouth to the anus.

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Pharynx Function (Food Pathway, UPPP)

The pharynx's role as a pathway for food and drinks, also involved in surgeries like UPPP (uvulopalatopharyngoplasty).

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Mouth Functions (Mastication & Saliva)

The mouth's vital functions: chewing food (mastication) and secreting saliva.

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Esophagus Role (Transporting Food, Esophagectomy)

The esophagus' role in carrying food to the stomach, related to esophageal surgeries like esophagectomy.

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Stomach Functions (Acid Secretion, Mucus, Gastrectomy)

The stomach's crucial functions: acid secretion for digestion, mucus production for protection, and association with gastrectomy.

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Small Intestine Anatomy (Duodenum, Jejunum, Ileum)

Components of the small intestine: duodenum, jejunum, and ileum, vital for digestion and absorption.

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Large Intestine Structure (Ascending, Transverse, Descending, Sigmoid, Cecum, Appendix)

Structure of the large intestine: ascending, transverse, descending, sigmoid colon, cecum, and appendix, critical for water absorption and waste conversion.

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Rectum Function (Fecal Storage, Hemorrhoidectomy)

The rectum's function as a storage site for feces, linked to procedures like hemorrhoidectomy.

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Anus Functionality (Waste Expulsion, Anal Fissure)

The anus' role in controlling waste expulsion, relevant to surgeries for anal fissures and other issues.

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Study Notes

General Surgery Exam Review

  • Cholangiogram Appearance: Bubbles in contrast media resemble stones.
  • Thyroid Tenaculum: Also known as Layhey clamp, utilized in thyroid surgeries.
  • Male Breast Enlargement: Condition known as gynecomastia.
  • Whipple Procedure: Surgical procedure performed on the pancreas.
  • Tetney Complication: Associated with thyroidectomy surgeries.
  • Thyroidtoxicosis Disease: Graves disease is life-threatening and linked to thyroid issues.
  • Lymphatic Tissue: The largest mass of lymphatic tissue in the body is the spleen.
  • Mahoney Dilators: Used specifically in procedures involving the esophagus.
  • Regions of the Pancreas: Divided into three parts: head, body, tail.
  • Triangle of Calot: Critical area dissected during a cholecystectomy.
  • Insufflation of CO2: Leads to pneumoperitoneum, a key term in abdominal surgeries.
  • Gallbladder Location: Positioned on the inferior surface of the liver's right lobe.
  • Appendectomy Incision: McBurney's incision is standard for open appendectomy.
  • Linea Alba Incision: Median vertical incision opens to the peritoneum.
  • Appendiceal Stump Suture Technique: Employs the purse-string technique for closure.
  • Common Female Hernia: Femoral hernias are frequent in females.
  • Abdominal Entry Procedure: Laparotomy refers to entering the abdomen through surgical incision.
  • Modified Radical Mastectomy: Designed to preserve long thoracic and thoracodorsal nerves.
  • Parathyroid Glands Location: Inferior, superior, and dorsal to the thyroid gland.
  • Parathyroid Function: Regulates blood calcium concentration.
  • Cephalad to Caudad: Directional term referring from head to tail.
  • Green Retractor: A handheld instrument used during thyroidectomy.
  • Direct Hernia Type: Occurs through the transverse versus fascia.
  • Pantaloon Hernia: Characterized by the presence of both direct and indirect hernias.
  • Indirect Hernia: Results from failure of the deep internal ring to close during fetal development.
  • Gastric Mass Requirement: A bezoar, consisting of indigestible fibers or hair, may need surgical intervention.
  • Anastomosis Types: Includes end-to-end, side-to-side, and end-to-side connections.
  • Lap Appy: Informal term for appendectomy.
  • Methods for Appendix Dissection: Tools include stapler, endoloop, and intracorporeal suturing instruments.
  • Inguinal Hernia Repair: Can involve the use of a Penrose drain for drainage.
  • Colon Exam Findings: Polyps protrude inward while diverticula protrude outward.
  • Permanent Colostomy Site: Most common colostomy is located at the sigmoid colon.
  • Intestinal Stoma Creation: Positioned below the costal margin, above the beltline, and lateral to the rectus abdominus.
  • Anal Rectal Procedure Position: The jackknife (kraske) position is utilized for anal procedures.
  • Flexures of the Large Intestine: Hepatic and splenic flexures are located proximal and distal to the transverse colon.
  • Bowel Technique: Refers to protocols aimed at preventing surgical site infections (SSI).
  • Viewing Instrument for Hemorrhoids: An anoscope is used for viewing.
  • Suture Needle for Liver Surgery: Blunt needles are used due to the liver's delicate structure.
  • Open Cholecystectomy Incision: Usually performed with a right subcostal incision.
  • Liver Elevation during Cholecystectomy: A sweetheart/Harrington retractor is utilized.
  • Cholangiogram Catheter Patency Check: Saline is injected prior to contrast media to ensure patent status.
  • Pancreatic Endocrine Gland: Islets of Langerhans comprise 1% of the pancreas and function in hormone secretion.
  • T-Tube/Wound Drain Position Post-Lap Chole: Exits from one of the right ports.
  • Pancreaticoduodenectomy Terminology: Commonly referred to as the Whipple procedure.
  • Needle Localization Site: Conducted in the breast for identifying lesions.
  • Sentinel Node: The first node in the axillary lymph node chain.
  • Simple Mastectomy Definition: Involves removal of the entire breast without lymph node excision.
  • Irrigation for Breast Procedures: Sterile water is used for irrigation prior to and during surgeries.
  • Mastectomy Protocol with Frozen Section Results: Requires reprep, redrape, regown, and use of new instruments if carcinoma is confirmed.
  • Post-Mastectomy Management: Bifurcated drains and fluffy pressure dressings prevent hematomas and seromas.
  • Camera Use in Minimally Invasive Surgery: It is permissible to hold a camera during such procedures.
  • Laparoscopic to Open Procedure Conversion: Possible depending on surgical conditions.
  • Breast Procedures Skin Prep: Should be gentle; vigorous preps are not recommended.
  • Hassan Technique Requirement: Does not necessitate a Verres needle.
  • Mesentery Function: Vascular supply to the intestine and stabilization of intestinal position.
  • Omentum Roles: Adipose storage, organ protection, and lubrication of abdominal surfaces.
  • Small Intestine Functions: Main site for nutrient digestion and absorption.
  • Large Intestine Functions: Absorbs water/electrolytes, transforms food into fecal waste, and produces vitamin K.
  • Peristalsis: Refers to muscle movement facilitating food transit through the intestine.
  • Two Layers of Peritoneum: Visceral layer covers organs while parietal lines the abdominal cavity.
  • Alimentary Canal Organs: Includes mouth, pharynx, esophagus, stomach, small intestine, large intestine, rectum, and anus.
  • Pharynx Function: Acts as a passageway for food and liquids, involved in surgeries like UPPP.
  • Mouth Functions: Responsible for mastication and saliva secretion.
  • Esophagus Role: Transports food to the stomach, relevant in esophagectomy.
  • Stomach Functions: Secretes hydrochloric acid and mucus for digestion; associated with gastrectomy.
  • Small Intestine Anatomy: Comprises duodenum, jejunum, and ileum; involved in digestion and absorption.
  • Large Intestine Structure: Includes ascending, transverse, descending, sigmoid colon, cecum, and appendix; critical for water absorption and fecal conversion.
  • Rectum Function: Serves as a storage site for fecal makeup, linked to procedures like hemorrhoidectomy.
  • Anus Functionality: Controls expulsion of solid waste, related to surgical procedures for anal fissures.

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