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Surgery Random Study Guide 2
Terms in this set (72)
What are the pre and post splint checks?
Temperature of skin
What is the first and most important principle of wound care?
Copious irrigation and adequate debridement
To minimize scars, wound closures should run parallel to which connective tissue bundles?
What type of forceps should be used on skin?
What type of forceps should be used on delicate internal tissue?
How long do you leave sutures in on the face?
How long do you leave sutures in on the trunk?
What is an advantage of monofilament suture?
Causes less trauma and inflammation as it passes through tissue
What is an advantage of braided suture?
Has less tendency to kink or curl and requires fewer knots to be held in place
List four types of absorbable sutures?
What are the most common nonabsorbable sutures?
What are advantages of using a braided synthetic over silk?
Synthetics are less reactive than silk
What size suture do you use on the abdomen?
What is the name of the site of suture attachment on a surgical needle?
What needle do you use on the skin?
What needle do you use on soft tissue and fascia?
How far from the wound edge should an interrupted 4-5mm stitch be placed?
Should wound edges be inverted or everted?
When should a jejunal tube be placed instead of a gastric tube?
When concerns for aspiration are present or in the setting of gastric ileus
What are three indicatoins for performing a tracheostomy?
Prolonged mechanical ventilation
Upper airway obstruction
Neurologic deficits preventing clearing of secretions and increasing risk of aspiration
Where do you perform a needle thoracostomy?
2nd intercostal space at the midclavicular line
Where should one place a chest tube?
Anterior axillary line
Incision above the 6th rib
Enter above the 5th rib
How often should a peripheral IV be changed?
Every 3-4 days or sooner if patient experiences pain
How long should a tourniquet be left on?
No more than 3 minutes
When do you use a nontunneled central venous catheter?
Short term therapy <7 days
What two maintenances are required for implanted ports?
1. Flushing every 4 weeks with heparin
2. Huber needle change every 7 days
What is the first line of cellular defense?
What organism is associated with dog bites?
What organism is associated with cat bites?
What is a clean wound?
Appendectomy/ Breast biopsy
What is a clean-contaminated wound?
Elective colon resection
What is a contaminated wound?
Stab wound with colon perf
What is a dirty wound?
Perforated diverticulitis with abscess?
When should perioperative antibiotics be given?
One hour prior to skin incision
Which antibiotic should be given perioperatively if not anaerobes suspected?
Ancef (1st generation cephalosporin)
What is the most common cause of diarrhea post-operatively?
What is the treatment for C. diff?
Which knife is considered the general purpose blade and is used to incise the skin?
What are mayo scissors used for?
What are metzenbaum scissors used for?
All purpose ddissection scissors
Which clamp is considered the general all purpose clamp?
What is the most commonly used suction?
What are standard pre-op fluids?
D51/2NS + 20mEq/L KCl
Incidence of appendicitis is highest in which population?
What is the gold standard of diagnosis for appendicitis?
What is the treatment for ruptured appendix?
Percutaneous drainage and antibiotics
Appendectomy 4 weeks later
What is the procedure of choice for gallbladder disease?
Name the most significant complication following cholecystectomy
Common bile duct injury
An abdominal hernia is a protrustion of viscera through a defect in which abdominal layer?
What are the borders of hesselbach's triangle?
Inferior epigastric muscles
Describe the formation of an indirect hernia?
Abdominal viscera passes through the internal ring within a patent processus vaginalis
What type of imaging is useful in diagnosing a hernia in obese patients?
What is the standard of care for inguinal hernia repair
What is the standard of care for femoral hernia repair?
Coopers pectineal ligament repair
What is the recurrence for hernia after open repair?
Less than 5%
Name two physical exam findings in scrotal hernia
Bowel sounds on auscultation of scrotum
The sympathetic nervous system in the colon?
The sympathetic nervous system in the colon?
Intestinal motility and secretions
A true diverticula contains how many layers of the colon wall?
What is the most common type of diverticula?
Pseudodiverticula (Type 1)
-Submucosa through circular muscle only
Erosion of the blood vessels
How do you diagnose diverticulitis?
What is a colovesical fistula?
Communication between the colon and bladder
Most common symptom of colovesical fistula?
What is the most common cause of hematochezia?
Upper GI Bleed
What two findings are characteristic of Crohn's disease?
Non-caseating granulomas in submucosa
Transmural inflammation of the colon
Define ulcerative colitis
Superficial inflammatory process involving submucosa of colon
What histologic finding is characteristic of ulcerative colitis?
Operative management for ulcerative colitis?
Removal of the entire colonic mucosa is curative
When should oral antibiotics be given in bowel surgery?
30 minutes prior to incision
What is the treatment for symptomatic internal hemorrhoids?
Rubber band ligation
What is the treatment for symptomatic external hemorrhoids?
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