Podcast
Questions and Answers
Which of the following studies is a radiologic procedure in which contrast media is injected through a cystoscope?
Which of the following studies is a radiologic procedure in which contrast media is injected through a cystoscope?
Which component of the rigid endoscopic system for cystoscopy is blunt ended and minimizes mucosal trauma during insertion?
Which component of the rigid endoscopic system for cystoscopy is blunt ended and minimizes mucosal trauma during insertion?
Flank, Gibson, inguinal, and scrotal are examples of what?
Flank, Gibson, inguinal, and scrotal are examples of what?
Operative approaches
Cryptorchidism is more commonly known as?
Cryptorchidism is more commonly known as?
Signup and view all the answers
Which incisional approach is used for access to the lower ureter and may be used for donor kidney implantation?
Which incisional approach is used for access to the lower ureter and may be used for donor kidney implantation?
Signup and view all the answers
In which surgical approach would the latissimus dorsi, internal and external oblique muscles be transected for access to the operative site?
In which surgical approach would the latissimus dorsi, internal and external oblique muscles be transected for access to the operative site?
Signup and view all the answers
Suprarenal glands are more commonly known as?
Suprarenal glands are more commonly known as?
Signup and view all the answers
Which of the following structures encloses the kidneys and suprarenal glands?
Which of the following structures encloses the kidneys and suprarenal glands?
Signup and view all the answers
What does the adrenal medulla secrete?
What does the adrenal medulla secrete?
Signup and view all the answers
At approximately what age or period would a patient MOST likely be diagnosed with a Wilms' tumor?
At approximately what age or period would a patient MOST likely be diagnosed with a Wilms' tumor?
Signup and view all the answers
Radical nephrectomy is usually performed with the patient in which position?
Radical nephrectomy is usually performed with the patient in which position?
Signup and view all the answers
Which structure is ligated and transected first in a radical nephrectomy or laparoscopic simple nephrectomy, following isolation of the vessels and ureters?
Which structure is ligated and transected first in a radical nephrectomy or laparoscopic simple nephrectomy, following isolation of the vessels and ureters?
Signup and view all the answers
The left kidney is larger and slightly higher than the right.
The left kidney is larger and slightly higher than the right.
Signup and view all the answers
Where is the hilum of the kidney located?
Where is the hilum of the kidney located?
Signup and view all the answers
Which part of the kidney becomes the proximal ureter?
Which part of the kidney becomes the proximal ureter?
Signup and view all the answers
What is the name of the basic structure composed of renal corpuscles and tubules and numbers over a million?
What is the name of the basic structure composed of renal corpuscles and tubules and numbers over a million?
Signup and view all the answers
Liver cirrhosis has a direct correlation to each of the following EXCEPT: liver cirrhosis.
Liver cirrhosis has a direct correlation to each of the following EXCEPT: liver cirrhosis.
Signup and view all the answers
Simple nephrectomy is routinely performed in which position?
Simple nephrectomy is routinely performed in which position?
Signup and view all the answers
What measure is taken to reduce the metabolic needs and prevents tubular necrosis of a kidney removed for transplant?
What measure is taken to reduce the metabolic needs and prevents tubular necrosis of a kidney removed for transplant?
Signup and view all the answers
How many suture ligatures or free ties should the surgical technologist have prepped for ligation of the renal artery and vein prior to transection and removal?
How many suture ligatures or free ties should the surgical technologist have prepped for ligation of the renal artery and vein prior to transection and removal?
Signup and view all the answers
What is the morcellator used for in a laparoscopic simple nephrectomy?
What is the morcellator used for in a laparoscopic simple nephrectomy?
Signup and view all the answers
Which of the following items would likely be needed if the pleural cavity is unintentionally entered during nephrectomy?
Which of the following items would likely be needed if the pleural cavity is unintentionally entered during nephrectomy?
Signup and view all the answers
Which of the following is NOT a form of polycystic kidney disease?
Which of the following is NOT a form of polycystic kidney disease?
Signup and view all the answers
Dialysis and kidney transplant are the only two treatments for which of the following?
Dialysis and kidney transplant are the only two treatments for which of the following?
Signup and view all the answers
When is a patient classified as being end-stage renal failure?
When is a patient classified as being end-stage renal failure?
Signup and view all the answers
Just before the surgeon clamps the renal vessels of the donor's kidney, what does the anesthesia provider put in the IV?
Just before the surgeon clamps the renal vessels of the donor's kidney, what does the anesthesia provider put in the IV?
Signup and view all the answers
Which of the following is given IV after the donor kidney is removed to reverse the heparinization?
Which of the following is given IV after the donor kidney is removed to reverse the heparinization?
Signup and view all the answers
What might the donor kidney be placed into to reduce the possibility of injury during handling and transplantation?
What might the donor kidney be placed into to reduce the possibility of injury during handling and transplantation?
Signup and view all the answers
Into which anatomical area of the abdomen will a transplanted donor kidney be implanted?
Into which anatomical area of the abdomen will a transplanted donor kidney be implanted?
Signup and view all the answers
Which cutting instruments should the surgical technologist have ready for anastomosis of the renal vessels into the recipient?
Which cutting instruments should the surgical technologist have ready for anastomosis of the renal vessels into the recipient?
Signup and view all the answers
Which suture configuration is used to anastomose vessels in transplants?
Which suture configuration is used to anastomose vessels in transplants?
Signup and view all the answers
What is the medical term for the procedure of connecting a donor ureter to a recipient bladder?
What is the medical term for the procedure of connecting a donor ureter to a recipient bladder?
Signup and view all the answers
Cystoscopy and ureteroscopy procedures are performed in which position?
Cystoscopy and ureteroscopy procedures are performed in which position?
Signup and view all the answers
Which of the following is used to ensure patency of the ureters or allow for drainage of urine from the kidneys?
Which of the following is used to ensure patency of the ureters or allow for drainage of urine from the kidneys?
Signup and view all the answers
Where in the genitourinary system do calculi originate?
Where in the genitourinary system do calculi originate?
Signup and view all the answers
What device is used through the ureteroscope to capture an intact calculus or fragments if fractured by laser?
What device is used through the ureteroscope to capture an intact calculus or fragments if fractured by laser?
Signup and view all the answers
What procedure is performed to remove a calculus lodged in the area of the hilum?
What procedure is performed to remove a calculus lodged in the area of the hilum?
Signup and view all the answers
In what position is the patient placed for proximal pyelolithotomy?
In what position is the patient placed for proximal pyelolithotomy?
Signup and view all the answers
What anatomical structure is the bladder attached to in males?
What anatomical structure is the bladder attached to in males?
Signup and view all the answers
Which of the following is responsible for emptying of the bladder and closure of the bladder orifice?
Which of the following is responsible for emptying of the bladder and closure of the bladder orifice?
Signup and view all the answers
The vesical arteries that supply the bladder arise from the?
The vesical arteries that supply the bladder arise from the?
Signup and view all the answers
Which irrigation or distention fluid would be contraindicated during cystoscopy for fulguration of bladder tumor?
Which irrigation or distention fluid would be contraindicated during cystoscopy for fulguration of bladder tumor?
Signup and view all the answers
How is the anesthetic jelly that is inserted into the male urethra prior to cystoscopy kept from leaking out?
How is the anesthetic jelly that is inserted into the male urethra prior to cystoscopy kept from leaking out?
Signup and view all the answers
What is a unique feature of the OR table in a cystoscopy suite?
What is a unique feature of the OR table in a cystoscopy suite?
Signup and view all the answers
An elevated serum PSA exam might prompt the additional investigation of a(n):
An elevated serum PSA exam might prompt the additional investigation of a(n):
Signup and view all the answers
Which of the following procedures could be done in either a male or female patient?
Which of the following procedures could be done in either a male or female patient?
Signup and view all the answers
Which of the following is a glass or plastic evacuator used to remove tissue and debris during TURP?
Which of the following is a glass or plastic evacuator used to remove tissue and debris during TURP?
Signup and view all the answers
Omnipaque, Renografin, and Isovue are used in cystoscopy as:
Omnipaque, Renografin, and Isovue are used in cystoscopy as:
Signup and view all the answers
Which instrument is used in TURP or TURBT and includes the sheath, obturator, working element, and ESU loops?
Which instrument is used in TURP or TURBT and includes the sheath, obturator, working element, and ESU loops?
Signup and view all the answers
Which distention fluid is nonelectrolytic and will lyse malignant tumor cells because of cellular uptake?
Which distention fluid is nonelectrolytic and will lyse malignant tumor cells because of cellular uptake?
Signup and view all the answers
What type of light is used for illumination in endoscopic equipment?
What type of light is used for illumination in endoscopic equipment?
Signup and view all the answers
What is the medical term for excision of the urinary bladder?
What is the medical term for excision of the urinary bladder?
Signup and view all the answers
What is the more common name for ureteroileocutaneous diversion?
What is the more common name for ureteroileocutaneous diversion?
Signup and view all the answers
What is the name of a continent urinary reservoir that may be performed following cystectomy?
What is the name of a continent urinary reservoir that may be performed following cystectomy?
Signup and view all the answers
What is the name of the connective tissue that forms the umbilical ligament and is used for traction in radical cystectomy?
What is the name of the connective tissue that forms the umbilical ligament and is used for traction in radical cystectomy?
Signup and view all the answers
In radical cystectomy with ileal conduit on a male patient, what tissue will be sent for frozen section to verify clear margins?
In radical cystectomy with ileal conduit on a male patient, what tissue will be sent for frozen section to verify clear margins?
Signup and view all the answers
What is done with the edge of the ilium that is brought out through the abdominal wall for stoma creation?
What is done with the edge of the ilium that is brought out through the abdominal wall for stoma creation?
Signup and view all the answers
Marshall-Marchetti-Krantz (MMK) is a traditional version of which general type of procedure?
Marshall-Marchetti-Krantz (MMK) is a traditional version of which general type of procedure?
Signup and view all the answers
Vesicourtheral suspension and pubovaginal slings are performed to mainly treat moderate to severe:
Vesicourtheral suspension and pubovaginal slings are performed to mainly treat moderate to severe:
Signup and view all the answers
What is one of the main objectives of procedures for female stress incontinence?
What is one of the main objectives of procedures for female stress incontinence?
Signup and view all the answers
Which of the following is NOT a type of pubovaginal or suburethral sling?
Which of the following is NOT a type of pubovaginal or suburethral sling?
Signup and view all the answers
What structure of male anatomy is divided into three sections: prostatic, membranous, and spongy?
What structure of male anatomy is divided into three sections: prostatic, membranous, and spongy?
Signup and view all the answers
Approximately how many lobules comprise the average prostate gland?
Approximately how many lobules comprise the average prostate gland?
Signup and view all the answers
What is the common diagnosis of a patient undergoing transurethral resection of the prostate?
What is the common diagnosis of a patient undergoing transurethral resection of the prostate?
Signup and view all the answers
Which of the following are male urethral dilators or sounds?
Which of the following are male urethral dilators or sounds?
Signup and view all the answers
Baumrucker, Iglesias, Stern-McCarthy, and Nesbit are types of:
Baumrucker, Iglesias, Stern-McCarthy, and Nesbit are types of:
Signup and view all the answers
Which signal should alert the surgical team that prostate capsule perforation is imminent and may conclude the procedure?
Which signal should alert the surgical team that prostate capsule perforation is imminent and may conclude the procedure?
Signup and view all the answers
What is used to resect the prostate gland tissue through the resectoscope?
What is used to resect the prostate gland tissue through the resectoscope?
Signup and view all the answers
Which type of catheter is placed postoperatively following TURP?
Which type of catheter is placed postoperatively following TURP?
Signup and view all the answers
Which self-retaining retractor is used for open suprapubic prostatectomy?
Which self-retaining retractor is used for open suprapubic prostatectomy?
Signup and view all the answers
Bonanno, Malecot, and Pezzer are types of:
Bonanno, Malecot, and Pezzer are types of:
Signup and view all the answers
What does specialized tissue within the seminiferous tubules produce?
What does specialized tissue within the seminiferous tubules produce?
Signup and view all the answers
What is the term for an abnormal accumulation of serous fluid around the testis contained within the tunica vaginalis?
What is the term for an abnormal accumulation of serous fluid around the testis contained within the tunica vaginalis?
Signup and view all the answers
Which procedure is performed for testicular cancer, trauma, or necrosis secondary to torsion?
Which procedure is performed for testicular cancer, trauma, or necrosis secondary to torsion?
Signup and view all the answers
What is the medical term for the free fold of skin that covers the glans penis?
What is the medical term for the free fold of skin that covers the glans penis?
Signup and view all the answers
Which of the following is the term for the inability to retract the foreskin of the penis?
Which of the following is the term for the inability to retract the foreskin of the penis?
Signup and view all the answers
Diabetes, vascular disorder, nerve damage, and trauma are all possible causes of:
Diabetes, vascular disorder, nerve damage, and trauma are all possible causes of:
Signup and view all the answers
What is the MOST serious post-op complication of penile implant surgery?
What is the MOST serious post-op complication of penile implant surgery?
Signup and view all the answers
Which dilating instrument is used to dilate the corpora for placement of penile prosthesis?
Which dilating instrument is used to dilate the corpora for placement of penile prosthesis?
Signup and view all the answers
What procedure is performed for penile carcinoma resistant to chemotherapy or radiation?
What procedure is performed for penile carcinoma resistant to chemotherapy or radiation?
Signup and view all the answers
Study Notes
Genitourinary Surgical Procedures
- Retrograde urogram involves injecting contrast media through a cystoscope for imaging of the urinary system.
- Obturator is a blunt-ended component used in cystoscopy to minimize mucosal trauma during insertion.
- Approaches such as flank, Gibson, inguinal, and scrotal are utilized for accessing the genitourinary system.
- Cryptorchidism refers to undescended testicles, a condition requiring surgical intervention.
- Gibson incision provides access to the lower ureter, often used for donor kidney implantation.
- Subcostal flank surgery involves transsecting latissimus dorsi and abdominal oblique muscles for access.
- Suprarenal glands are also known as adrenal glands, vital for hormone production.
- Gerota's fascia encloses the kidneys and adrenal glands, supporting their structural integrity.
Kidney Anatomy and Function
- The adrenal medulla secretes catecholamines, essential for stress response.
- Wilms' tumor is most frequently diagnosed in children aged 3 to 8 years.
- Radical nephrectomy is performed with the patient in a supine position.
- The renal artery is the first structure ligated and transected during a nephrectomy.
- The left kidney is typically larger and positioned higher than the right kidney.
- The hilum of the kidney is located at the medial midsection, serving as an entry/exit point for vessels.
- The renal pelvis is the part of the kidney that connects to the proximal ureter.
- A nephron is the fundamental unit of the kidney, consisting of renal corpuscles and tubules.
Surgical Treatments and Techniques
- Simple nephrectomy is commonly performed in the lateral position.
- Cooling with Collins solution or ice slush is crucial for reducing metabolic demands of a harvested kidney.
- Three suture ligatures should be prepared for ligation during renal artery and vein transection.
- A morcellator is used in laparoscopic nephrectomy to chop kidney tissue into small pieces for suction.
- If the pleural cavity is accessed unintentionally during nephrectomy, a chest tube is required.
- Not all forms of polycystic kidney disease are classified; traumatic is an exception.
- End-stage renal disease requires dialysis or kidney transplant when renal function is critically low (below 10% of normal).
Anesthesia and Postoperative Care
- Heparin and mannitol are given IV before clamping donor renal vessels to maintain renal viability.
- Protamine sulfate is administered postoperatively to reverse heparinization after kidney removal.
- Donor kidneys are often placed in a woven stockinette for protection during transplant handling.
- Transplanted kidneys are typically implanted in the right lower quadrant of the abdomen.
Cystoscopy and Ureteroscopy
- A #11 blade and 45° angle Potts scissors are essential instruments for renal vessel anastomosis.
- Fine, non-absorbable, double-armed sutures are commonly used for vessel anastomoses in transplants.
- Ureteroneocystostomy connects a donor ureter to the recipient bladder.
- Cystoscopy and ureteroscopy are performed with the patient in a low-lithotomy position.
- Double-J or pigtail stents are utilized to ensure ureter patency or to facilitate urinary drainage.
Complications and Techniques
- A basket stone forceps is employed to capture intact calculi or fragments during ureteroscopy.
- Pyelolithotomy is a procedure to remove kidney stones lodged near the hilum.
- Surgical staff must be vigilant for leg jerking, which may indicate impending prostate capsule perforation during resection.
- Ellik evacuators remove debris during TURP procedures.
- 3-way 22 Fr. Foley catheters are used postoperatively after TURP to facilitate urine drainage.
Urological Pathologies and Treatments
- Benign prostatic hypertrophy is commonly diagnosed in patients undergoing prostatic surgery.
- Hegar dilators are used to facilitate penile prosthesis placement.
- Postoperative complications of penile surgery may include surgical site infections.
- Penectomy is performed for unresectable penile carcinoma resistant to treatment.
- Conditions like phimosis and hydrocele are common issues requiring surgical intervention within the male reproductive system.
These notes provide a concise overview of key aspects related to genitourinary surgery, focusing on anatomical structures, surgical procedures, and relevant medical conditions.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Description
Test your knowledge on various genitourinary surgical procedures and kidney anatomy. This quiz covers topics such as retrograde urograms, surgical approaches, and key anatomical structures like the adrenal glands. Perfect for medical students and professionals looking to refresh their understanding of these essential concepts.
