Surgical Procedures and Specimens Quiz

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Questions and Answers

What is the primary reason an appendix is generally removed?

Acute appendicitis (correct)

Chronic gastrointestinal issues

Routine examination during laparoscopic surgery

Preventative measure for colorectal cancer

In a cone biopsy procedure, what shape is the tissue that is removed from the cervix?

Circular

Cone-shaped (correct)

Rectangular

Cube-shaped

Which of the following correctly describes the dimensions of a specimen described in a sample dictation for an appendix?

6 cm in length × 1 cm in diameter

5 cm in length × 0.9 cm in diameter (correct)

5 cm in length × 2 cm in diameter

7 cm in length × 1.5 cm in diameter

What is one of the specifications that should be noted when processing an appendix?

Color of the external surface Signup and view all the answers

What unusual finding might be recorded during the processing of the appendix's mucosal surface?

Ulceration Signup and view all the answers

What does the term 'salpingo-oophorectomy' refer to?

Removal of fallopian tubes and ovaries Signup and view all the answers

Which procedure is most likely to involve the collection of multiple specimens from the cervix?

Cone biopsy Signup and view all the answers

When cutting sections of the appendix for processing, at what intervals should the remainder of the appendix be sectioned?

3 mm intervals Signup and view all the answers

What should be recorded regarding the appendix when examining its condition?

Thickness of the wall and diameter of the lumen Signup and view all the answers

Which type of sample submission is required if mucin accumulation is present in the lumen?

Submit the entire appendix and the resection margin in a separate cassette Signup and view all the answers

In what scenario would a total hysterectomy specimen be processed differently?

Based on whether the condition is benign or malignant Signup and view all the answers

What specific sections are required when submitting the appendix after an appendectomy for a normal gross appearance?

The entire specimen must be submitted Signup and view all the answers

What does 'RSS' denote in the context of submitting appendix specimens?

Representative section submitted Signup and view all the answers

What additional structures are involved in a radical hysterectomy for malignancy?

Parametrium and regional lymph nodes Signup and view all the answers

What should be done with specimens from total hysterectomies for benign conditions?

Submit the entire specimen for examination Signup and view all the answers

Which type of abnormality should be noted in the appendix lumen contents during examination?

Fibrous obliteration or parasites Signup and view all the answers

Study Notes

Grossing Simple Specimens

LEEP (Loop Electrosurgical Excision Procedure): Technique using a wire to remove abnormal cells from the cervix.
- Commonly results in multiple specimens, including anterior and posterior cervix.
Cone Biopsy of the Cervix: Surgical removal of a cone-shaped tissue section from the cervix, encompassing both upper and lower parts.
Resection: Surgical removal of all or part of an organ or body structure.
Segmental Resection (Segmentectomy): Partial removal of an organ or other body structure.
Salpingo-Oophorectomy: Removal of the fallopian tube (salpingectomy) and ovary (oophorectomy).

Appendix Processing

Reasons for Appendectomy: Acute appendicitis, incidental removal during other surgeries, or as part of a right colectomy.
Appendix Appearance:
- Dimensions: Length, diameter, and range of dimensions.
- Color: Tan/pink, gray/green.
- External Surface: Edema, fibrinous exudate, hyperemia (redness), purulence, perforations, hemorrhage (possible indication of endometriosis).
- Mesoappendix: Dimensions, color (e.g., tan/brown), edematous, fibrinous exudate, purulence, hemorrhagic areas.
Sections and Submission:
- Longitudinal Section: Of the tip, extending into a cassette, serosa may be inked for orientation.
- Transverse Sections: At 3mm intervals.
- Record: Wall thickness, lumen diameter (dilated, fibrosed, constricted), mucosa condition (glistening, ulcerated, hyperemic), lumen contents (fecalith, foreign body, purulence, blood, parasites, mucin, fibrous obliteration).
- Submit: One longitudinal section of the tip and two transverse sections (one near the resection margin and one near the tip), including any abnormalities.
- If Mucin Accumulation or Suspicious Tumor: Submit the entire appendix and the resection margin separately.
- Grossly Normal Appendix with Appendectomy for Appendicitis: Submit the entire specimen.

Cassettes for Appendix

Cassette 1: Longitudinal section of the tip and proximal margin, 2 fragments, representative section submitted (RSS).
Cassette 2: Cross-sections including the area of perforation, 4 fragments, representative section submitted (RSS).

Complex Specimen Grossing: Hysterectomy and Salpingo-Oophorectomy

Specimen Categories:
- Total hysterectomy for benign conditions (e.g., prolapse or fibroids).
- Total hysterectomy for malignant conditions (e.g., endometrial carcinoma).
- Radical hysterectomy for malignant conditions (e.g., cervical carcinoma) including vaginal cuff, parametrium, and regional lymph nodes.
Processing: The entire specimen is submitted. One level is examined for women.

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Description

Test your knowledge on various surgical procedures related to the cervix and appendix processing. This quiz covers techniques like LEEP, cone biopsy, and salpingo-oophorectomy, along with details about appendectomy and the characteristics of the appendix. Perfect for medical students or healthcare professionals looking to refresh their understanding of these topics.