ABSA Sutures and Wound Repair General Surgery PDF

Who discovered that the body absorbs sutures made from animal tissues? -AnswerPhilip Syng Physick Which suture material is NOT absorbed but remains as a living tissue in the body? -Answer-Fascia lata Space caused by separation of wound edges which have not been closely approximated by sutures is c...

Who discovered that the body absorbs sutures made from animal tissues? -AnswerPhilip Syng Physick Which suture material is NOT absorbed but remains as a living tissue in the body? -Answer-Fascia lata Space caused by separation of wound edges which have not been closely approximated by sutures is called -Answer-Dead Space An interrupted suture, which is placed through tissue from one side of the wound to the other and then back through tissue again is called -Answer-Matress Suture material which, during healing process, becomes encapsulated by fibrous tissue is called -Answer-Non absorbable suture In the presence of infection, the absorption rate of surgical gut is: -AnswerIncreased Which suture can be used in presence of infection? -Answer-Polypropylene Suture in which short lateral stitches are taken beneath -Answer-Subcuticular Healing process in which a wound is purposely left open and allowed to heal from bottom upward is called -Answer-Secondary intention Surgical gut is made from the -Answer-Submucosa layer of sheep\'s intestines Which is most inert in tissue -Answer-Wire Stay suture does not pass through -Subq -Rectus muscle -Mesentery -Fascia -Answer-Mesentery Spitting open or gaping of wound is called -Answer-Dehiscence Which of the following is used to stop bleeding and oozing on surfaced of severed BONES -Answer-Mixture of waxes (chiefly beeswax) Protrusion of bowel through separated edges of abdominal wound closure is Answer-Evisceration Silk is not recommended for use in gallbladder kidney or bladder because Answer-It may become nucleus for stone formation Most braided or twisted non absorbable sutures should not be used in presence of active infection because -Answer-The sutures become breeding place for infection Halsted Technique consists mainly of -Answer-Interrupted silk sutures Another name for a stick tie or transfixation suture is -Answer-Suture ligature Bumpers or guards are used on tension sutures to -Answer-Prevent heavy suture from cutting into skin Tissue trauma will be kept to minimum by using -Answer-Sutured swaged to a needle Amount of weight or pull necessary to break suture or ligature material is called Answer-Tensile strength Which would have ea weakening effect on suture? Soaking in saline Testing tensile strength Straightening it -Answer-ALL OF THE ABOVE Which of following synthetic non absorb suture material is least reactive in tissue? Polypropylene Polyester fiber Nylon teflon impregnanted polyester -Answer-Polypropylene What type of suture would be used when closing the anus for perineal stage of an and perineal resection -Answer-Purse string suture Ampulla of water is dilated for -Answer-Common duct stones Select procedure that require isolation of instruments from rest of operative field: 1. Open intest anastomosis 2. Common duct exploration 3. Exteriorization of coostomy 4. esophagomyotomy -Answer-1,2,3, Open anastomosis Common duct expo ext of colostomy A longitudinal ulcer in anal canal is \_\_\_\_ and \_\_\_\_\_ is a tubular tract that has its skin opening beside anus -Answer-Fissure in ano Fistula in ano Protrusion of viscera through and incision following surgery is -AnswerEvisceration All of the following require immediate surgery except: Complete SBO Cecal volvulus Bile peritonitis Massive rectal prolapse -Answer-Massive rectal prolapse Cessation of peristalsis -Answer-Paralytic ileus An abd incision made parallel and about four cm lateral to midline is a -AnswerParamedium rectus Which concerning hernias is NOT true? Incarcerated hernia the intestinal flow is obstructed Strangulated hernia causes acute intestinal obstruction Direct hernia leaves the abdomen through inguinal ring Femoral hernia appears below pouparts ligament -Answer-Direct hernia leaves the abdomen through inguinal ring Subtotal gastric resection with gastrojejunostomy anterior to transverse colon is a Answer-Billroth II Saccular dilation leading from lumen of bowel is -Answer-Diverticulum Surgical procedure for head of pancreas is -Answer-Whipple Vagotomy is performed with partial gastrectomy for peptic ulcer disease to Answer-Decrease secretion of hydrochloric acid Esophageal varices occur when an increase in \_\_\_\_ obstructions forces \_\_\_\_ blood to seek a new avenue of return to the \_\_\_\_ -Answer-PORTAL VEIN VENOUS RIGHT ATRIUM A Roux en Y procedure for common duct repair is -AnswerCholedocojujenostomy Surgical bypass procedure for portal HTN is a shunt between \_\_\_\_ and \_\_\_\_ or between \_\_\_\_ and \_\_\_\_\_ -Answer-Portal vein and IVC or Splenic vein and left renal vein All of the following cause intestinal obstruction except: Intussusception Volvulus of cecum Colitis Superior mesenteric embolus -Answer-Colitis Which statement concerning thyroid is not true? Blood supply is from ext carotid Gland affects rate at which all tissue metabolize Glandular segment is essential to life Thyroid crisis can occur in patient with hyperthyroidism -Answer-Glandular segment is essential to life Which statement concerning SBO is not true? May lead to metabolic acidosis Causes distention of proximal intestine May lead to metabolic alkalosis Causes distention of Distal intestine -Answer-Causes distention of DISTAL intestine in which of the following is a loop colostomy done? Abdominperineal resection Bowel decompression Total colectomy Hemicolectomy -Answer-Bowel decompression Which of the following must be sutured to close an upper paramedic incision?: 1. Ant rectus sheath 2. Rectus abd muscle 3. Post rectus sheath 4. Peritoneum -Answer-1,3,4 Ant rectus \_\_ Post Rectus\-- Peritoneum Benign intestinal tumor is a \_\_\_\_\_ while \_\_\_\_\_ is malignant -Answer-Fibromata, lymphosarcoma Which concerning splenectomy is not true Major veins and arteries to be ligated are in hilum of spleen Sub capsular hematoma or splenic rupture require emergency surgery Thrombocytosis usually occurs following surgery Surgery causes increases in antibody production -Answer-Surgery causes increases in antibody production Which does not require emergency surgery Fecal impaction Sigmoid colon volvulus Paralytic ileus All -Answer-All of the above Four major sources of blood supply to stomach: -Answer-Right and left gastroepiploic Right and left gastric Anastomosis between small intestine and colon is a -Answer-Ileocolostomy Surgical removal of endocrine gland affects the -Answer-Body metabolism Structure that must be identified in parotidectomy -Answer-Cranial Nerve VII (7 facial) Which may be performed for breast and/or prostatic malignancy 1. prostatectomy 2. mastectomy 3. adrenalectomy 4. hypophysectomy 5. oophorectomy 6. orchiectomy -Answer-ALL OF THE ABOVE Salivary glands consiste of 1. sublingual 2. Submax 3. parotid 4. stepsons 5. Brunner\'s -Answer-1,2,3 Sublingual Submaxillary Parotid Which statements about endocrine glands is/are false? Release their secretions into blood stream Essential for growth and development Ductless None of the above -Answer-NONE of the above, they are all true Acromegaly is te result of hyper function of the -Answer-pituitary Statement concerning a post hypophysectomy patient is true? Replacement adrenal steroid therapy is required Diabetes insidious may occur Cessation of menstruation and infertility occurs All of the above -Answer-ALL of the above Secreting cells of mammary glands -Answer-Alveoli Whipple for carcinoma of pancreas includes removal of \_\_\_ pancreas, entire \_\_\_\_, portion of \_\_\_ and distal segment of \_\_\_\_ -Answer-HEAD of pancreas entire DUODENUM portion of STOMACH distal segment of COMMON BILE DUCT Low levels of adrenocortical hormone in the blood or urine is indicative of \_\_\_\_\_ dz -Answer-Addisons Radical mastectomy for cancer involves removal of portion of the \_\_\_\_ muscles Answer-Pectorals major and minor Bleeding from the tonsillar bed is controlled with \_\_\_ rather than \_\_\_ which might damage the \_\_\_\_ -Answer-PRESSURE rather than SUTURE LIGATURE which may damage EXTERNAL CAROTID Which is the master gland of endocrine system -Answer-Pituitary Pancreas secretes hormones: \_\_\_ and \_\_\_ which are involved in \_\_\_\_ metabolism Answer-Glucagon Insulin Carbohydrate Adrenocorticotropin (ACTH) , FSH and LH are secreted by -Answer-Pituitary only not adrenals, not ovaries and not testes Hormone estrogen is secreted by -Answer-Adrenal cortex and ovaries Not by pituitary and not by adrenal medulla Which gland is vital to body\'s immunity mechanism? -Answer-Thymus Test of thyroid function is \_\_\_\_ which measures \_\_ -Answer-BMR which measures CONSUMPTION AT REST Which about surgery of breast is/are false? -Answer-Augmentation mammoplasty is done for gynecomastia Excessive accumulation of uric acid in blood with disposition of acid crystal in tissue causes -Answer-Gout Care must be taken not to damage which structures during thyroidectomy -AnswerParathyroids Trachea Recurrent laryngeal nerve The \_\_\_ hormones secreted by the \_\_\_\_ hormones regulate the metabolism of calcium and ph0sphate -Answer-Parathyroid Parathyroid Which about thyroid is true Tracheal compression can occur from post op edema Gland is essential to life Non toxic glandular goiter produces excess thyroid hormon All of the above -Answer-Tracheal compression can occur from post op edema Three main vessels which are ligated in thyroidectomy are -Answer-Superior middle and inferior thyroid veins Complete removal of \_\_\_\_\_ glands results in severe tetany -Answer-Parathyroid Choledocotomy is a/an: -Answer-iNcision into common bile duct Characteristic symptom of perforated peptic ulcer -Answer-Shock Separation of congenital hypertrophied sphincter which prevents tempting of the stomach in an infant is -Answer-Pyloromyotomy Surgical correction of hiatal hernia -Answer-Diaphragm crura is tightened Hemorrhage occurring during operation on biliary tree is usually result form injury to -Answer-Cystic artery Which dx does not require operation\" Intussusception Strangulated hernia Meckles Paralytic ileus -Answer-Paralytic ileus Which concerning the spleen is false Fibrous attachment to diaphragm kidney and stomach Hilum contained major veins and arteries Splenic artery is a branch of the celiac axis Splenic vein drains into IVC -Answer-Splenic vein drains into IVC This is FALSE longitudinal ulcer in anal canal is -Answer-Fissure in ano Which postop complication of total gastrectomy: 1. Dumping syndrome 2. Anemia 3. Vitamin B 12 deficiency 4. Diarrhea -Answer-ALL OF THE ABOVE The \_\_\_ is attached to the\_\_\_\_\_\> Omentum, stomach Mesentery, diaphragm Omentum, diaphragm Mesentery, stomach -Answer-OMENTUM, STOMACH Partial gastrectomy followed by gastroduodenal anastomosis is a -Answer-Billroth I Which anastomoses are completed with Whipple operation?: 1. pancreatojejunostomy 2. Duodenojejunostomy 3. Choledocojejunostomy 4. Gastrojejuonstomy -Answer-1,3, 4 Pancreatojejunostomy choledocojejunostomy Gastrojejunostomy In upper quadrant oblique incision (subcostal) which muscle is retracted / transversely divided? -Answer-Rectus Care must be taken during ligation of the vena cava for pulmonary embolism to prevent injury to\" -Answer-Lumbar veins Right ureter Removal of fibroses palmar aponeurosis is done for -Answer-Dupuytren\'s contracture Removal of fibrinous deposit or restrictive membrane on the pleural lining that interferes with pulmonary ventilation is a -Answer-Cardiac poudrage Post op GI bleeding can cause\_\_\_\_\_ shock while \_\_\_\_\_ shock is result of failure of arterial pressure -Answer-HYPOVOLEMIC NEUROGENIC Carcinoma of fun may be confirmed by -Answer-Scalene node biopsy Mediastinoscopy Bronchoscopy Not by esophagoscopy Place these digestive system structures in correct sequence Pylori sphincter Fundus Diaphragm jejunum Esophagus cardiac sphincter duodenum ampulla of vater -Answer-Esophagus Diaphragm Cardiac sphincter Fundus Pyloric sphincter Duodenum Ampulla of vater Jejunum Ileum Which is not hemostatic agent -Answer-Oxytocin Bone wax, oxidized cellulose, styptics and thrombin are Acute cholecystitis is usually associated with -Answer-Gall stone Cystic duct obstruction Bacterial infection Empyema Which is serious post op problems following parathyroidectomy -Answer-Tetany Gout Renal stones Weakness of the fascial margin of the internal ring is a \_\_\_\_\_ a weakness of fascial floor of inguinal canal is \_\_\_\_ -Answer-DIRECT hernia INDIRECT hernia Portacval shunt is indicated for: -Answer-Esophageal varices Backpressure on portal vein Leunnec\'s cirrhosis Not indicated for portal HTN Vagotomy for peptic ulcer often is accompanied by pylorplasty because -AnswerVagotomy may cause gastric atony In 2 layer bowel anastomosis, the inner \_\_\_\_\_ layer is closed with \_\_\_ sutures and the outer \_\_\_\_\_ layer with \_\_\_\_ sutures -Answer-Inner MUCOSAL layer with absorbable Outer SEROSAL layer with non absorbable Combine in antrectomy or gastroenterostomy, \_\_\_\_ is the most common op procedure for peptic ulcer: -Answer-Vagotomy Pancreas functions as an \_\_\_ gland , secreting insulin and \_\_\_ directly into the \_\_\_\_ -Answer-ENDOcrine gland, secreting insulin and GLUCAGON, directly into BLOOD SERUM As a consequence of ligating the inferior mesenteric artery and vein, it is necessary to remove the entire \_\_\_\_\_ colon and anastomose the \_\_\_\_ colon to the \_\_\_\_ colon -Answer-LEFT colon and anastomose the TRANSVERSE colon to the Sigmoid colon The operative procedure for carcinoma of the head of the pancreas or ampulla of water is a -Answer-Whipple Which structures are amenable to stapling:j Bronchus Galea Bowel Split thickness graft Ankle bones -Answer-ALL of the above SBO leads to electrolyte imbalances. First to \_\_\_\_ from loss of \_\_\_\_-, then to \_\_\_\_\_ due to loss of \_\_\_\_ -Answer-First, ALKALOSIS from loss of HYDROCHLORIC ACID Then ACIDOSIS from loss of WATER AND SODIUM In gastric bypass for morbid obesity, stapling the \_\_\_\_ portion of the stomach provided a small \_\_\_\_Outlet -Answer-PROXIMAL GASTROJUJENOSTOMY Which can cause intestinal obstruction: Volvulus Hernia Mesenteric infarction paralytic ileus intussusception -Answer-ALL Causes of peritonitis include which of the following: Ruptured spleen Puerperal infection gangrenous obstruction of bowel acute pancreatitis ulcerative colitis -Answer-ALL OF THE ABOVE Dumping syndrome occurs after gastric resection because of the -Answer-rapid entry of food into jejunum After completion of anastomosis in colon resection procedures, the mesentery is carefully reapprximated to -Answer-Prevent internal hernia with bowel entrapment Which statement concerning parenteral hyperalimentation therapy following GI surgery is false? Catheter is inserted into a large diameter vein with high blood flow too rapid flow of suction causes hyperglycemia Constant monitoring is necessary Basic solution consists of hypotonic glucose and amino acids. -Answer-Basic solution consists of hypotonic glucose and amino acids. Purpose of vagotomy is treating patients with peptic ulcers is to -Answer-Decrease gastric acid hypersecretion \_\_\_\_\_\_ is a life threatening obstruction in which the intestinal lumen is obstructed both proximally and distally, leading to bowel necrosis , perforation and peritonitis -Answer-Volvulus Many post op patients are in state of \_\_\_\_\_ due to \_\_\_\_ depletion, a condition that retards wound healing -Answer-negative nitrogen balance protein The \_\_\_\_ is most common site for cancer of large intestine -Answer-Rectosigmoid To provide necessary calories in the nutritionally deficient post op patient, parenteral hyperalimentation is preferred over routine IV therapy because Answer-IV fluid volume could surpass boys fluid tolerance The preoperative bowel prep for intestinal surgery may include administration of neomycin whih -Answer-Reduced aerobic and anaerobic resident bacteria in bowel When a loop of jejune is anastomosed end to side with the esophagus in a total gastrectomy, a \_\_\_\_ is necessary to \_\_\_\_\_ -Answer-Jejnuojejunosotomy, to prevent regurgitation esophagitis For a perforated diverticulum of the colon, affected bowel segment is resected followed by a/an: -Answer-Two stage operation Which urinary diversion procedure are used when bladder no longer serves as the urine reservoir?