Genitourinary Surgical Procedures Quiz

Questions and Answers

Which of the following studies is a radiologic procedure in which contrast media is injected through a cystoscope?

CT scan

Retrograde urogram (correct)

MRI

Ultrasound

Which component of the rigid endoscopic system for cystoscopy is blunt ended and minimizes mucosal trauma during insertion?

Cystoscope

Sheath

Obturator (correct)

Trocar

Flank, Gibson, inguinal, and scrotal are examples of what?

Operative approaches

Cryptorchidism is more commonly known as?

Undescended testicles 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?

Gibson 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?

Subcostal flank Signup and view all the answers

Suprarenal glands are more commonly known as?

Adrenal Signup and view all the answers

Which of the following structures encloses the kidneys and suprarenal glands?

Gerota's fascia Signup and view all the answers

What does the adrenal medulla secrete?

Catecholamines Signup and view all the answers

At approximately what age or period would a patient MOST likely be diagnosed with a Wilms' tumor?

Between ages 3 and 8 years Signup and view all the answers

Radical nephrectomy is usually performed with the patient in which position?

Supine 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?

Renal artery Signup and view all the answers

The left kidney is larger and slightly higher than the right.

True Signup and view all the answers

Where is the hilum of the kidney located?

Medial midsection Signup and view all the answers

Which part of the kidney becomes the proximal ureter?

Renal pelvis 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?

Nephron Signup and view all the answers

Liver cirrhosis has a direct correlation to each of the following EXCEPT: liver cirrhosis.

True Signup and view all the answers

Simple nephrectomy is routinely performed in which position?

Lateral 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?

Cooling with Collins solution or ice slush 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?

Three Signup and view all the answers

What is the morcellator used for in a laparoscopic simple nephrectomy?

Chopping the kidney and ureter into small pieces for suctioning Signup and view all the answers

Which of the following items would likely be needed if the pleural cavity is unintentionally entered during nephrectomy?

Chest tube with drainage system Signup and view all the answers

Which of the following is NOT a form of polycystic kidney disease?

Traumatic Signup and view all the answers

Dialysis and kidney transplant are the only two treatments for which of the following?

End-stage renal disease Signup and view all the answers

When is a patient classified as being end-stage renal failure?

When both kidneys are functioning at or below 10% of normal 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?

Heparin and mannitol Signup and view all the answers

Which of the following is given IV after the donor kidney is removed to reverse the heparinization?

Protamine sulfate Signup and view all the answers

What might the donor kidney be placed into to reduce the possibility of injury during handling and transplantation?

Woven stockinette Signup and view all the answers

Into which anatomical area of the abdomen will a transplanted donor kidney be implanted?

Right lower quadrant Signup and view all the answers

Which cutting instruments should the surgical technologist have ready for anastomosis of the renal vessels into the recipient?

#11 blade and 45° angle Potts scissors Signup and view all the answers

Which suture configuration is used to anastomose vessels in transplants?

Fine, non-absorbable, double-armed Signup and view all the answers

What is the medical term for the procedure of connecting a donor ureter to a recipient bladder?

Ureteroneocystostomy Signup and view all the answers

Cystoscopy and ureteroscopy procedures are performed in which position?

Low-lithotomy 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?

Double-J or pigtail stent Signup and view all the answers

Where in the genitourinary system do calculi originate?

Kidney Signup and view all the answers

What device is used through the ureteroscope to capture an intact calculus or fragments if fractured by laser?

Basket stone forceps Signup and view all the answers

What procedure is performed to remove a calculus lodged in the area of the hilum?

Pyelolithotomy Signup and view all the answers

In what position is the patient placed for proximal pyelolithotomy?

Lateral Signup and view all the answers

What anatomical structure is the bladder attached to in males?

Prostate Signup and view all the answers

Which of the following is responsible for emptying of the bladder and closure of the bladder orifice?

Detrusor muscle Signup and view all the answers

The vesical arteries that supply the bladder arise from the?

Internal iliac artery Signup and view all the answers

Which irrigation or distention fluid would be contraindicated during cystoscopy for fulguration of bladder tumor?

Saline 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?

A flexible penile clamp is applied to the head of the penis Signup and view all the answers

What is a unique feature of the OR table in a cystoscopy suite?

It has a mesh drain attachment Signup and view all the answers

An elevated serum PSA exam might prompt the additional investigation of a(n):

Prostate biopsy Signup and view all the answers

Which of the following procedures could be done in either a male or female patient?

Cystoscopy Signup and view all the answers

Which of the following is a glass or plastic evacuator used to remove tissue and debris during TURP?

Ellik Signup and view all the answers

Omnipaque, Renografin, and Isovue are used in cystoscopy as:

Contrast media Signup and view all the answers

Which instrument is used in TURP or TURBT and includes the sheath, obturator, working element, and ESU loops?

Resectoscope Signup and view all the answers

Which distention fluid is nonelectrolytic and will lyse malignant tumor cells because of cellular uptake?

Water Signup and view all the answers

What type of light is used for illumination in endoscopic equipment?

Fiber-optic Signup and view all the answers

What is the medical term for excision of the urinary bladder?

Cystectomy Signup and view all the answers

What is the more common name for ureteroileocutaneous diversion?

Ileal conduit Signup and view all the answers

What is the name of a continent urinary reservoir that may be performed following cystectomy?

Koch pouch 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?

Urachus 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?

Segments of bilateral ureters 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?

The edges are everted and affixed to the skin Signup and view all the answers

Marshall-Marchetti-Krantz (MMK) is a traditional version of which general type of procedure?

Suprapubic vesicourethral suspension Signup and view all the answers

Vesicourtheral suspension and pubovaginal slings are performed to mainly treat moderate to severe:

Stress incontinence Signup and view all the answers

What is one of the main objectives of procedures for female stress incontinence?

Restore the posterior urethrovesical angle Signup and view all the answers

Which of the following is NOT a type of pubovaginal or suburethral sling?

Radiopaque vaginal packing Signup and view all the answers

What structure of male anatomy is divided into three sections: prostatic, membranous, and spongy?

Urethra Signup and view all the answers

Approximately how many lobules comprise the average prostate gland?

50 Signup and view all the answers

What is the common diagnosis of a patient undergoing transurethral resection of the prostate?

Benign prostatic hypertrophy Signup and view all the answers

Which of the following are male urethral dilators or sounds?

Van Buren Signup and view all the answers

Baumrucker, Iglesias, Stern-McCarthy, and Nesbit are types of:

Urethral dilators Signup and view all the answers

Which signal should alert the surgical team that prostate capsule perforation is imminent and may conclude the procedure?

Leg jerking Signup and view all the answers

What is used to resect the prostate gland tissue through the resectoscope?

ESU loop electrode Signup and view all the answers

Which type of catheter is placed postoperatively following TURP?

3-way 22 Fr. Foley with 30 mL balloon Signup and view all the answers

Which self-retaining retractor is used for open suprapubic prostatectomy?

Judd-Mason Signup and view all the answers

Bonanno, Malecot, and Pezzer are types of:

Suprapubic catheters Signup and view all the answers

What does specialized tissue within the seminiferous tubules produce?

Sperm 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?

Hydrocele Signup and view all the answers

Which procedure is performed for testicular cancer, trauma, or necrosis secondary to torsion?

Orchiectomy Signup and view all the answers

What is the medical term for the free fold of skin that covers the glans penis?

Prepuce Signup and view all the answers

Which of the following is the term for the inability to retract the foreskin of the penis?

Phimosis Signup and view all the answers

Diabetes, vascular disorder, nerve damage, and trauma are all possible causes of:

Impotence Signup and view all the answers

What is the MOST serious post-op complication of penile implant surgery?

Surgical site infection Signup and view all the answers

Which dilating instrument is used to dilate the corpora for placement of penile prosthesis?

Hegar Signup and view all the answers

What procedure is performed for penile carcinoma resistant to chemotherapy or radiation?

Penectomy 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.

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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.