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Questions and Answers
What is the primary purpose of endometrial ablation?
What is the primary purpose of endometrial ablation?
- To burn away the endometrium and reduce menstrual flow (correct)
- To remove the uterus completely
- To increase menstrual flow
- To diagnose ovarian cancer
Which of the following instruments is commonly used to measure the depth of the uterus during a D&C procedure?
Which of the following instruments is commonly used to measure the depth of the uterus during a D&C procedure?
- Tenaculum
- Uterine sound (correct)
- Hegar dilator
- Endoscope
What is the common medium used for cautery in endometrial ablation?
What is the common medium used for cautery in endometrial ablation?
- Saturated saline solution
- Normal saline
- Bicarbonate solution
- Non-electrolytic ionic medium (correct)
During a hysteroscopy, which angle of hysteroscope is specifically mentioned for visualization?
During a hysteroscopy, which angle of hysteroscope is specifically mentioned for visualization?
For what purpose is a tenaculum utilized during a D&C procedure?
For what purpose is a tenaculum utilized during a D&C procedure?
Which of the following conditions may necessitate performing a dilation and curettage (D&C) procedure?
Which of the following conditions may necessitate performing a dilation and curettage (D&C) procedure?
Which surgical approach is associated with a Heaney needle driver?
Which surgical approach is associated with a Heaney needle driver?
What type of laser is common for treating conditions related to pelvic endometriosis?
What type of laser is common for treating conditions related to pelvic endometriosis?
In which position is a patient typically placed for gynecological procedures involving the pelvis?
In which position is a patient typically placed for gynecological procedures involving the pelvis?
What is the main goal of performing a hysteroscopy?
What is the main goal of performing a hysteroscopy?
Which ligaments are considered crucial surgical landmarks during gynecological procedures?
Which ligaments are considered crucial surgical landmarks during gynecological procedures?
What is the primary function of the fallopian tubes in gynecological anatomy?
What is the primary function of the fallopian tubes in gynecological anatomy?
Which arteries provide the main blood supply to the uterus?
Which arteries provide the main blood supply to the uterus?
Which layer of the uterus is primarily affected when fibroids develop?
Which layer of the uterus is primarily affected when fibroids develop?
What is the role of pelvic lymph nodes in gynecological anatomy?
What is the role of pelvic lymph nodes in gynecological anatomy?
In terms of gynecological surgeries, what distinguishes minimally invasive procedures from open procedures?
In terms of gynecological surgeries, what distinguishes minimally invasive procedures from open procedures?
Which anatomical structure is directly attached to the vagina and is essential for reproductive functions?
Which anatomical structure is directly attached to the vagina and is essential for reproductive functions?
What is the primary clinical consideration for obstetrical patients undergoing gynecological surgery?
What is the primary clinical consideration for obstetrical patients undergoing gynecological surgery?
What are the main purposes of performing gynecological surgeries?
What are the main purposes of performing gynecological surgeries?
Which statement best describes the function of the uterine ligaments?
Which statement best describes the function of the uterine ligaments?
What is a common complication that presents with bradycardia and hypotension during a procedure?
What is a common complication that presents with bradycardia and hypotension during a procedure?
In which position should a patient be placed for a vaginal hysterectomy?
In which position should a patient be placed for a vaginal hysterectomy?
Which type of hysterectomy involves the complete removal of the uterus through the abdominal wall?
Which type of hysterectomy involves the complete removal of the uterus through the abdominal wall?
What surgical procedure repairs a Cystocele?
What surgical procedure repairs a Cystocele?
What material is commonly used for suturing during a vaginal cystocele repair?
What material is commonly used for suturing during a vaginal cystocele repair?
Which instrument is specifically utilized to provide visualization during a laparoscopic hysterectomy?
Which instrument is specifically utilized to provide visualization during a laparoscopic hysterectomy?
What technique is employed to occlude the fallopian tubes during laparoscopic procedures?
What technique is employed to occlude the fallopian tubes during laparoscopic procedures?
What is the purpose of a Valtchev uterine mobilizer in laparoscopic procedures?
What is the purpose of a Valtchev uterine mobilizer in laparoscopic procedures?
Which procedure specifically addresses pelvic organ prolapse through surgical repair of vaginal walls?
Which procedure specifically addresses pelvic organ prolapse through surgical repair of vaginal walls?
During vaginal hysterectomy, what is the approach for incision around the cervix?
During vaginal hysterectomy, what is the approach for incision around the cervix?
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Study Notes
Gynecological Surgeries Overview
- Gynecological surgeries serve diagnostic, therapeutic, and reproductive purposes.
- Patient-centered care is essential, requiring sensitivity to individual needs.
Anatomy
- Key structures include the uterus, cervix, ovaries, and fallopian tubes, vital for various gynecological procedures.
- Blood supply primarily comes from the Internal Iliac Artery, with additional contributions from the ovarian, vaginal, and superior rectal arteries.
- Pelvic autonomic nerves stem from the superior hypogastric plexus, influencing visceral sensations.
- Lymphatics are associated with major vessels and include pelvic lymph nodes and iliac/pre-aortic nodes.
Uterine Structure
- The uterus consists of the serous layer, myometrium (often housing fibroids), and endometrium (the lining).
- Uterine ligaments function as surgical landmarks and support the organ; important ligaments include broad, cardinal, uterosacral, and round.
Adnexa
- Adnexa incorporate the fallopian tubes and ovaries; fertilization occurs in the fallopian tubes, with eggs transported to the uterus.
Perioperative Nursing Considerations
- Comprehensive patient history and pain tolerance assessment are essential.
- Proper surgical positioning, especially lithotomy, and accurate surgical counts are critical.
Surgical Instrumentation
- Dilation and Curettage (D&C) involves a weighted speculum, tenaculum to grasp the cervix, Hegar dilators, and curettes for tissue sampling.
- Additional laparoscopic instruments include hysteroscopes for visualization, specialized forceps, and a basic surgical instrument setup.
Surgical Procedures
- Dilation and Curettage: Commonly performed alongside other gynecological procedures like hysteroscopy and cone biopsy.
- Hysteroscopy: Diagnostic tool for uterine disorders; requires D&C setup and specific instruments for uterine visualization.
- Endometrial Ablation: Targets menorrhagia by ablating the endometrium to decrease menstrual flow.
Hysterectomy Types
- Types include vaginal, Laparoscopic Assisted Vaginal Hysterectomy (LAVH), and abdominal (partial/subtotal, total, radical).
- Vaginal hysterectomy is suitable for smaller uteri and cases of uterine prolapse.
Cystocele and Rectocele Procedures
- Surgical repairs involve the anterior or posterior vaginal wall; often performed during vaginal hysterectomy.
- Cystocele repair addresses bladder protrusion while rectocele repair deals with rectal wall protrusion into the vagina.
Laparoscopic Assisted Vaginal Hysterectomy (LAVH)
- Uterus is removed using an endoscope for visualization, allowing for effective biopsies and larger uterus removal.
- Bipolar cautery and ligasure devices may be employed for coagulation during the procedure.
Laparoscopy Applications
- Used for diagnostic evaluations in pelvic pain and infertility, as well as therapeutic procedures including tubal ligation and ovarian cystectomy.
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