R - CHAPTER 5.docx.pdf

Chapter 5 SURGERY DIRECTIONS: Each of the questions or incomplete statements below is followed by four suggested answers or completions. Select the one that is best in each case. 521. Visual field defects in a left homonymou...

Chapter 5 SURGERY DIRECTIONS: Each of the questions or incomplete statements below is followed by four suggested answers or completions. Select the one that is best in each case. 521. Visual field defects in a left homonymous hemianopsia are a. Complete blindness in left eye b. Lateral one-half of left eye and lateral one-half of right eye c. Lateral one-half of left eye and medial one-half of right eye d. Anterior one-fourth of the lateral one-half of the left eye and anterior one-fourth of the medial one-half Rationale: C. since it is left homonymous hemianopsia, the visual defect will be lateral one-half of the eye and medial one half of the right eye. 522. The following is a list of symptoms that may indicate or arise in diseases of the ear. Which one will the physical therapist chiefly be concerned with? a. Deafness b. Tinnitus c. Vertigo d. Nausea and vomiting Rationale: PT may be concerned and may address the virtigo. 523. Thrombosis is a potential threat postoperatively for certain types of surgery. Patients should ambulate within what period of time to help prevent this? a. 3-6 days b. 5-7 days c. 14-21 days d. 7-14 days Rationale: To help prevent thrombosis from developing, a patient should be up ambulating within 1-2 weeks. 524. Physical signs of internal hemorrhage postoperatively include a. Feeble pulse b. Increased blood pressure c. Decreased respirations d. Warm clammy skin Rationale: The pulse will become weaker, the blood pressure will decrease, respirations increase, and the skin will be cold and clammy. 525. If an organ is removed, which suffix would be used (and attached to the organ removed) to describe the operation? a. Ectomy b. Otomy c. Ostomy d. Oscopy Rationale: “Ectomy” is the removal of the organ. 526. If, during an operation, the formation of an artificial opening was performed, which suffix would be used (along with the structure) to describe the operation? a. Ectomy b. Otomy c. Ostomy  d. Oscopy Rationale: new opening in an organ 527. The mediastinum includes a. The lungs, heart, and pericardium b. All structures within the pleural cavity c. The heart and pericardium only d. All structures between the lungs and outside the pleural cavity Rationale: Answer is self-explanatory; the others deal with periosteum. 528. Loss of the knee jerk indicates compression of which nerve root? a. T12 b. L1 c. L4 d. S3 Rationale: The musculature of the knee is innervated by the L4 nn root, thus the knee reflex. 529. A common postoperative complication following surgical procedure in which the semicircular canals have been involved is a. Asthenia b. Anoxemia c. Orthopnea d. Vertigo Rationale: Vertigo is the result of involvement of semicircular canals of the ear. 530. A surgical procedure carried out when the entire colon is excised is called a. Colostomy b. Colectomy c. Gastrostomy d. Cholecystectomy Rationale: Colonectomy is removal of the colon. 531. Anterior rhizotomy is a surgical procedure used a. On the nasal turbinates b. To correct a spina bifida occulta c. To correct a mass flexor reflex d. On the nasal sinuses Rationale: Rhizotomy is a surgical procedure to permanently relieve pain and reflexes that can cause the pain. 532. The most common form of congenital heart disease associated with cyanosis is a. Pulmonary stenosis b. Tetralogy of Fallot c. Coarctation of the aorta d. Aortic aneurysm Rationale: Location of tetralogy of Fallot in the heart associates it with cyanosis. 533. Embolism is LESS likely to occur from a. Thrombophlebitis b. Phlebothrombosis c. Deep thrombophlebitis d. Deep phlebothrombosis Rationale: Emboli arises more frequently from a blood clot due to infection.  534. When a positive Homan's sign is elicited, it is indicative of a. Thrombophlebitis b. Deep thrombus in the leg c. Superficial thrombus d. Embolism Rationale: A sign that is used to signify a deep thrombus versus a superficial thrombus. 535. Patients with secondary varicosities have had a prior episode of a. Deep arterial thrombosis b. Deep venous thrombosis c. Superficial arterial thrombosis d. Superficial venous thrombosis Rationale: Deep Venous Thrombosis is a possible result from weakened and enlarged veins. 536. The most dreaded complication of deep venous thrombosis is a. Fat embolism b. Pulmonary embolism c. Arterial embolism d. Fracture embolism Rationale: B. An embolus breaking loose and dislodging in the lungs 537. A piece of living tissue which is detached and transplanted to another site in the same patient is called a. Autograft b. Isograft c. Hemograft d. Heterograft Rationale: Definition of autograft 538. A full thickness skin graft is used to a. Bolster fascial defects b. Correct skin defects of limited size c. Fill out large defects d. Repair scalp Rationale: A full skin graft can be used only on defects with a limited size. It will not fill in large areas as well as numerous small grafts will. 539. a cause of congenital heart disease is a. systolic murmurs b. tetralogy of Fallot c. cardiac impulse d. diastolic murmurs Rationale: B. Because of location, it is most susceptible to congenital heart disease. Many times it is associated with cyanosis. 540. pulmonary stenosis involves a. left ventricular hypertrophy b. left atrial hypertrophy c. right ventricle narrowing of opening d. right arterial narrowing of opening Rationale: Pulmonary stenosis is a result of blood entrance into the narrow opening of the right ventricle. DIRECTIONS: Each group of questions below consists of a list of lettered headings followed by a list of numbered words. Phrases, or statements. For each numbered word, phrase, or statement, select the one lettered heading that most closely associated with it. Each lettered heading may be selected once, more than once, or not at all. Questions 541-545  A. Wallerian degeneration B. Neurilemmoma C. Von Recklinghausen's syndrome D. Neurofibroma E. Neuroma 541. a discrete, encapsulated, benign tumor Answer: B. Neurilemmoma Rationale: benign tumor that can arise from any nerve in the body 542. An outgrowth of Schwann cells and axons Answer: E. Neuroma Rationale: It defines what a neuroma is. 543. Motor paralysis and loss of sensation result Answer: A. Wallerian Degeneration Rationale: Degeneration is wasting away, causing paralysis 544. A benign, nonencapsulated tumor Answer: D. Neurofibroma Rationale: Description of a neurofibroma. 545. Associated with a hereditary disorder Answer: C. Von Recklinghausen's syndrome Rationale: It is a syndrome associated with a hereditary disease. Questions 546-550 A. Myomectomy B. Oophorectomy C. Cystectomy D. Vagotomy E. Salpingestomy 546. An operation for removal of the urinary bladder Answer: C. Cystectomy Rationale: Cystectomy is a removal of the bladder. 547. An operation commonly used to treat duodenal ulcer Answer: D. Vagotomy Rationale: vagotomy is used to treat duodenal ulcers 548. An operation commonly performed to remove benign growths from the uterus Answer: A. Myomectomy Rationale: Myomectomy is the surgical of benign growths in the uterus 549. An operation performed for the removal of a fallopian tube Answer: E. Salpingestomy, Rationale: Salpingestomy is a surgical removal of the fallopian tubes. 550. A surgical procedure of removing the ovaries Answer: B. Oophorectomy Rationale: Oophorectomy is a surgical removal of the ovaries. Questions 551-555 A. Coarctation of the aorta B. Hirscsprung's disease C. Patent ductus arteriosus D. Tetralogy of Fallot  E. Craniosynostosis 551. Retention of fetal vessel joining pulmonary artery to aorta Answer: C. Patent ductus arteriosus Rationale: C. Patent ductus arteriosus it is retention of the fetal vessel joining the pulmonary artery to the aorta 552. Interventricular septal defect Answer: D. Tetralogy of Fallot Rationale: D. Tetralogy of Fallot is an interventricular septal defect. 553. Narrowing of descending aorta Answer: A. Coarctation of the aorta Rationale: A. Coarctation of the aorta 554. Premature closure of skull sutures. Answer: E. Craniosynostosis Rationale: E. Craniosynostosis is the premature closure of skull sutures. 555. Absent autonomic nerve cells in wall of distal colon. Answer: B. Hirschsprung's disease Rationale: Hirschsprung's disease is the absence of autonomic nerve cells in the wall of the distal colon. Questions 556-560 A. Carpal tunnel syndrome B. Dupuytren's contracture C. Tinel's sign D. Dysarthria E. Colporrhaphy 556. Fibrous metaplasia of the superficiai palmar fascia Answer: B. Dupuytren's contracture Rationale: Dupuytren’s contracture is a fibrous metaplasia of the superficial palmar fascia. 557. Symptom of cerebellar disease Answer: D. Dysarthria Rationale: Dysarthria is a symptom of cerebellar disease 558. Answer: A. Carpal tunnel syndrome Rationale: The decompression of the transverse metacarpal ligaments the surgical procedure to alleviate the carpal tunnel syndrome. (Liechty, Synopsis of Surgery, 4th ed. p.505) 559. Gynecological surgical procedure Answer: E. Colporrhaphy Rationale: Colporrhaphy is a gynaecological surgical procedure. 560. Distal paresthesia by percussing site of tumor Answer: C. Tinel’s sign Rationale:Tinel’s sign is used to determine distal paresthesia by percussing the site of the tumor. Questions 561-565 A. Posterior Rhizotomy B. Cervical myelopathy C. Baker's cyst D. Chondromalacia E. Boutonniere deformity 561. Enlargement of the semimembranous bursa Answer: C. Baker’s Cyst Rationale: C. Baker’s cyst is the enlargement of the semimembranous bursa. 562. Degeneration of the articular surface of the patella Answer: D. Chondromalacia Rationale: D. Chondromalacia is the degeneration of the articular surface of the patella. 563. A surgical procedure to relieve intractable pain Answer: A. Rhizotomy Rationale: A. Rhizotomy is a surgical procedure to relieve intractable pain. 564. Erosion of extensor tendon at proximal phalanx Answer: E. Boutonniere deformity Rationale: E. A boutonniere deformity is the erosion of the extensor tendon at the proximal phalanx. 565. Presenting signs of a progressive, spastic paraparesis with variable sensory loss Answer: B. Cervical myelopathy Rationale: B. Cervical myelopathy is a progressive disease with variable sensory loss. Questions 566-570 A. Spinal cord neoplasm B. Malignant tumor involving vertebral column C. Compression of fourth lumbar nerve root D. Compression of first sacral nerve root E. Compression of fifth cervical nerve root 566. Loss of knee jerk Answer: C. Compression of fourth lumbar nerve root Rationale: C. Loss of knee jerk due to compression of L4 nerve root. 567. Onset of symptoms of spinal cord compression is rapid Answer: B. Malignant tumor involving vertebral column Rationale: B. Malignant tumor can cause symptoms of rapid compression of the spinal cord 568. Onset of symptoms of spinal cord compression is usually gradually Answer: A. Spinal cord neoplasm Rationale: Spinal cord neoplasm causes symptoms of gradual spinal cord compression. 569. Rigidity of neck muscles Answer: E. Compression of fifth cervical nerve root Rationale: Compression of C5 nerve root causes rigidity of neck muscles. 570. Loss of ankle jerk Answer: D. Compression of first sacral nerve root Rationale: Compression of S1 nerve root causes the loss of the ankle jerk. Questions 571-575 A. Vertical incision B. Left oblique incision C. Paramedian incision D. Transverse incision E. Curve or zigzag incision 571. Surgical approach for splenectomy Answer: B. Left oblique incision Rationale: Left oblique incision is used for a splenectomy. 572. Main muscular pull for abdominal surgery Answer: D. Transverse incision Rationale: a transverse incision is the main muscular pull for abdominal surgery. 573. Surgical approach for gynecological disorders  Answer: C. Paramedian incision Rationale: A paramedian incision is used for the surgical incision for gynaecological disorders. 574. Incision is across flexor surface of joint Answer: E. Curve or Zigzag incision Rationale: A curve or zigzag incision is across the flexor surface of a joint 575. Surgical approach used on the sternum region Answer: A. Vertical incision Rationale: A. The vertical incision is used in the sternum region