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Study sets matching "surgery 2"

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Study sets matching "surgery 2"

57 terms
Surgery 2
What is gas exchange?
What do the lungs need for gas exchang…
What is pulmonary performance?
What does general anesthesia do to pul…
O2 in, CO2 out
blood flow and air
perfusion and breathing
depresses it
What is gas exchange?
O2 in, CO2 out
What do the lungs need for gas exchang…
blood flow and air
40 terms
Ortho Surgery (Surgery Exam2)
PRE-Op
Pre-Op: CONDITIONS Table
Pre Op: ANTIBIOTICS
POST Op: DVT prophylaxis
Past Medical History... Past Surgical History... Review of Syste…
Give w/in 1 hr prior to OR!... NO:... evidence of continuing dos…
Risk Factors... Intraoperative devices ... (SCDs-sequential comp…
PRE-Op
Past Medical History... Past Surgical History... Review of Syste…
Pre-Op: CONDITIONS Table
44 terms
Trauma Surgery (Surgery Exam 2)
Objectives
Intro to Trauma
History of Trauma Care
Modern Trauma Care
1. Describe the components of the primary survey "ABC"s... 2. Id…
7th leading cause of death globally; leading cause of... death…
Edwin Smith Papyrus is an Egyptian medical text from... 1600 B.…
Trauma care advanced over last century, mostly... through manag…
Objectives
1. Describe the components of the primary survey "ABC"s... 2. Id…
Intro to Trauma
7th leading cause of death globally; leading cause of... death…
1,439 terms
surgery 2
Internal urethral sphincter:
External urethral sphincter:
GU pain
Renal pain
Detrusor muscle thickening. Smooth muscle under involuntary c…
Where the urethra passes through the pelvic floor. Skeletal m…
may be quite severe usually associated with obstruction or in…
caused by acute distention of the renal capsule ... back and can…
Internal urethral sphincter:
Detrusor muscle thickening. Smooth muscle under involuntary c…
External urethral sphincter:
Where the urethra passes through the pelvic floor. Skeletal m…
82 terms
Surgery 2
postoperative care
systems, ABC's
Airway​... Breathing​... Circulation​
Head-to-toe assessment
Where the focus is on the patient and required assessments on…
On Return to the Unit, a "__________" approach​... must be taken…
ABC's
done​ on immediate return​ of the patient from ​... the PACU/OR
postoperative care
Where the focus is on the patient and required assessments on…
systems, ABC's
On Return to the Unit, a "__________" approach​... must be taken…
269 terms
Surgery 2
Physiologic changes that occur as a me…
Significant correlation between preope…
Enteral nutrition
Parenteral nutrition
-hypermetabolism with increased energy expenditure... -glucose m…
longer length of hospital stay
Providing nutrition through the GI tract when the patient can…
IV nutrition (PPN and TPN)
Physiologic changes that occur as a me…
-hypermetabolism with increased energy expenditure... -glucose m…
Significant correlation between preope…
longer length of hospital stay
79 terms
surgery 2
types of wounds
Clean wound
Clean wound published rate of infection
Clean contaminated wound
-Clean... -Clean- contaminated... -Conaminated... -Infected (dirty)
-surgical insision that are created under aseptic conditions…
0-3.5%
-surgical incisions that are minimally contaminated but easy…
types of wounds
-Clean... -Clean- contaminated... -Conaminated... -Infected (dirty)
Clean wound
-surgical insision that are created under aseptic conditions…
77 terms
Surgery 2
ADCVAANDIML
Condition
Can someone get ancef with a penicilli…
What needs to be on the consent form
Admit to (attending, service, floor)... Dx (reason for admission…
Good: Vital signs are stable and within normal limits. Patien…
no if it is anaphalaxis
Need to explain diagnosis, procedure planned, risks and benef…
ADCVAANDIML
Admit to (attending, service, floor)... Dx (reason for admission…
Condition
Good: Vital signs are stable and within normal limits. Patien…
115 terms
Plastic Surgery Osler Day 2 - Hand Surgery
Cleland's location vs Grayson's
Main wrist extender?
Intersection syndrome?
Drummer's palsy
Dorsal
ECRB>ECRL
Compartment 1 crossing over Compartment 2
EPL rubs against Lister's tubercle and can rupture
Cleland's location vs Grayson's
Dorsal
Main wrist extender?
ECRB>ECRL
54 terms
surgery 2
clean wounds
clean contaminated wounds
contaminated wounds
dirty wounds
category 1
category 2
category 3
category 4
clean wounds
category 1
clean contaminated wounds
category 2
119 terms
Surgery 2
Lobular CA
Mucinous/Colloid breast ca
BIRADS I-II (negative and benign findi…
BIRADS III (probably benign)
Breast CA Characterized by intracytoplasmic mucin with indian…
Extra cellular pools of mucin (vs lobular ca)
Birads score needing routine follow-up at 1 year
Birads score with very high probability of benign findings. S…
Lobular CA
Breast CA Characterized by intracytoplasmic mucin with indian…
Mucinous/Colloid breast ca
Extra cellular pools of mucin (vs lobular ca)
23 terms
2 - Surgery
Preoop for any patient with h/o cardia…
how long before a surgery must a smoke…
SIRS criteria
Rx for gastric perforation
- EKG... - stress testing to evaluate for ischemic coronary lesi…
6-8 weeks
at lease 2 ... - Body temperature < 36 C or >38 C... - HR >90 BPM…
1. NPO... 2. NG tube to suction gastric juices... 3. IV NS + broad…
Preoop for any patient with h/o cardia…
- EKG... - stress testing to evaluate for ischemic coronary lesi…
how long before a surgery must a smoke…
6-8 weeks
250 terms
surgery 2
how to identify patients requiring sur…
determining operative risk
the organ systems requiring eval and o…
the major predictor of cardiac risk
pt has a problem that can be treated with surgery ... pt must be…
identify all organ systems that are dysfunctioning ... ensure th…
cardiac... pulm... renal... hepatic... hemostatic... nutritional-immune
history of previous mi
how to identify patients requiring sur…
pt has a problem that can be treated with surgery ... pt must be…
determining operative risk
identify all organ systems that are dysfunctioning ... ensure th…
76 terms
Surgery Exam 2: Vascular Surgery
The right and left coronary arteries b…
Three branches of the aortic arch
Three branches of the abdominal aorta
The inferior mesenteric artery supplie…
Ascending aorta
Brachiocephalic trunk... Left common carotid... Left subclavian
Celiac trunk... SMA... IMA
:
The right and left coronary arteries b…
Ascending aorta
Three branches of the aortic arch
Brachiocephalic trunk... Left common carotid... Left subclavian
218 terms
Surgery 2
amnesia, analgesia, unconsciousness, m…
I
II
III
what are the components of anesthesia?
everything is visible classifies an airway as Mallampati clas…
uvula is fully visible, fauces visible classifies an airway a…
soft palate and base of uvula are visible classifies an airwa…
amnesia, analgesia, unconsciousness, m…
what are the components of anesthesia?
I
everything is visible classifies an airway as Mallampati clas…
212 terms
Surgery2
Difference between neck veins in cardi…
T/F: PCWP is low in cardiogenic shock
Purpose of incentive spirometry post-op
3 sx of retroperitoneal abscess
cardiogenic: elevated JVP... hypovolemic: flat
FALSE... in all other types of shock PCWP is low. In cardiogenic…
Decrease risk of post-op pneumonia
- fever... - chills... - deep abdominal pain
Difference between neck veins in cardi…
cardiogenic: elevated JVP... hypovolemic: flat
T/F: PCWP is low in cardiogenic shock
FALSE... in all other types of shock PCWP is low. In cardiogenic…
21 terms
Surgery 2
Tamponade dx:
Cardiogenic shock- what not to give?
Tx for subdural hematoma to lower ICP:
diffuse axonal injury=
Clx or... FAST US (not x ray)... give fluid and blood
additional fluid and blood
mannitol/furosemide, hyperventilate
blurring of gray-white interface on CT to show hemorrhage. be…
Tamponade dx:
Clx or... FAST US (not x ray)... give fluid and blood
Cardiogenic shock- what not to give?
additional fluid and blood
49 terms
surgery 2
reduce hip anteriorly, put dislocated…
displace infant's femoral head
dz with recurrent fx & blue sclere
cong hip dysplasia tx
ortolani
barlow
osteogenic imperfecta
pavlik harness
reduce hip anteriorly, put dislocated…
ortolani
displace infant's femoral head
barlow
33 terms
Surgery 2
Medially: Rectus abdominis Inferiorly:…
Procesus vaginalis
Tunica vaginalis
Protruding Pikes Dont Contribute To A…
Hesselbach's triangle boundaries
Peritoneal diverticulum formed in the fetus; passes through l…
Lower expanded part of procesus vaginalis;normally closed off…
Spermatic cord contents
Medially: Rectus abdominis Inferiorly:…
Hesselbach's triangle boundaries
Procesus vaginalis
Peritoneal diverticulum formed in the fetus; passes through l…
209 terms
Surgery 2
FOOSH
High riding humeral head on MRI
bone formation at a specific site
no osteoblast activity and should cons…
fall on out-stretched hand
rotator cuff tear
hot scan
cold scan
FOOSH
fall on out-stretched hand
High riding humeral head on MRI
rotator cuff tear
197 terms
Surgery 2
upper GI bleed terminates in ______
green aspirate on NG tube indicates __…
Red aspirate on NG tube indicates ____…
_____ used to test the presence of blo…
duodenum ligament of trite
not upper GI
upper
gastrooccult
upper GI bleed terminates in ______
duodenum ligament of trite
green aspirate on NG tube indicates __…
not upper GI
74 terms
Surgery 2
Causes of death in trauma on the scene…
Cause of death within 1-4 hrs of traum…
Cause of death within weeks of trauma…
Trauma triad of death
Spinal cord injury... Brain injury... Brainstem injury... Aorta lacera…
Epidural hematoma... Subdural hematoma ... Hemopneumothorax... Abdomin…
Sepsis... MOF
Hypothermia, coagulopathy, metabolic acidosis
Causes of death in trauma on the scene…
Spinal cord injury... Brain injury... Brainstem injury... Aorta lacera…
Cause of death within 1-4 hrs of traum…
Epidural hematoma... Subdural hematoma ... Hemopneumothorax... Abdomin…
768 terms
Surgery 2
What is anaesthesia?
We cannot select the patients going in…
Define asepsis
What is considered a clean surgical pr…
The elimination of sensation (touch, pain)
Can organise the surgical list to the degree of infection pre…
absence of micro-organisms which cause disease
There is no break in sterile technique/ asepsis.... A surgical w…
What is anaesthesia?
The elimination of sensation (touch, pain)
We cannot select the patients going in…
Can organise the surgical list to the degree of infection pre…
648 terms
Surgery #2
when to take hemothorax to the OR?
"white out lung"
pulmonary contusion...does it go to OR?
inward movment of ribcage with inspira…
-greater than 1.5 L with initial chest tube... or... -greater tha…
pulmonary contusion
no... -just manage symptoms and make sure they are coughing and…
flail chest... --> 3 or more consecutive ribs fractured in a row
when to take hemothorax to the OR?
-greater than 1.5 L with initial chest tube... or... -greater tha…
"white out lung"
pulmonary contusion
140 terms
Surgery 2
What are Langer Lines?
Why are transverse incisions preferred…
What nerve innervates the umbilicus?
What are the advantages of an Upper mi…
Correspond to the direction in which the skin will split when…
Transverse heal with a more narrow scar
10th intercostal nerve
1. Allows access to esophagus, hiatus, stomach and duodenum,…
What are Langer Lines?
Correspond to the direction in which the skin will split when…
Why are transverse incisions preferred…
Transverse heal with a more narrow scar
116 terms
Surgery 2
What are the steps in wound closure?
Quick clot
Lidocaine doses
Marcaine (Bupivacaine) doses
1. Hemostasis... 2. Local numbing block... 3. Cleanse area (normal…
Factors X and XI of clotting cascade to obtain hemostasis
5 mg/kg... with epi 7mg/kg
2.5 mg/kg... with epi 3-3.5 mg/kg
What are the steps in wound closure?
1. Hemostasis... 2. Local numbing block... 3. Cleanse area (normal…
Quick clot
Factors X and XI of clotting cascade to obtain hemostasis
Surgery 2
Anesthesiologist
Anesthesiologist Goal
ASA Physical Classification Goal
ASA Physical Status Classification
Consultant & Primary Care Provider
Ensure Pt Safety & Comfort throughout surgery
Assess Pt preoperatively to predict operative risk
1: Healthy... 2: Mild systemic but no functional limitation... 3: S…
Anesthesiologist
Consultant & Primary Care Provider
Anesthesiologist Goal
Ensure Pt Safety & Comfort throughout surgery
271 terms
Surgery 2
describe the peritoneum
what are the retroperitoneal organs?
function of peritoneum
how does peritoneal fluid move from ab…
anteriorly it reflects onto the posterior surface of the abdo…
ureters, kidneys, aorta
secretes fluid that passes via diaphragmatic lymph channels t…
during inspiration, pressure decreases in thorax allowing a p…
describe the peritoneum
anteriorly it reflects onto the posterior surface of the abdo…
what are the retroperitoneal organs?
ureters, kidneys, aorta
33 terms
surgery 2
Short term fasting 시 최대한 혈중 포도당 유지를 위해…
포도당 생성을 위해 근육에서 제공하는 아미노산 2가지
장기간금식 시 amino acid를 이용해 gluconeogenesi…
Wound healing의8 phase
Insulin 수치 저하는 단백질 분해와 glycogen 분해, 말초조직에서 케톤체 이용률 증가, 포도당 신합성
glutamine, alanine
신장 (kidney)
stop bleeding, chemotaxis, epithelial migration, proliferatio…
Short term fasting 시 최대한 혈중 포도당 유지를 위해…
Insulin 수치 저하는 단백질 분해와 glycogen 분해, 말초조직에서 케톤체 이용률 증가, 포도당 신합성
포도당 생성을 위해 근육에서 제공하는 아미노산 2가지
glutamine, alanine
11 terms
Surgery 2
Hepatocellular presentation
Hepatocellular w/u
Only curative option for hepatocellula…
HIDA scan
-Often asymptomatic early.... -Advanced disease presents with ab…
Liver functions/serologies... -Alfa feto protein (AFP)- Elevated…
liver transplant
Hepatobiliary Iminodiacetic Acid Scan = radionuclide scanning…
Hepatocellular presentation
-Often asymptomatic early.... -Advanced disease presents with ab…
Hepatocellular w/u
Liver functions/serologies... -Alfa feto protein (AFP)- Elevated…
157 terms
Surgery 2
Where do upper GI bleeds occur?
What is the most significant cause of…
What is the differential for upper GI…
What are upper GI Sxs?
Proximal to the ligament of Treitz= suspensory muscle of the…
Peptic ulcer disease (duodenal and gastric bleeds)
-Duodenal/Gastric ulcers... -Acute gastritis... -Esophageal varices…
-Hematochezia... -Coffee Ground Emesis... -Melena
Where do upper GI bleeds occur?
Proximal to the ligament of Treitz= suspensory muscle of the…
What is the most significant cause of…
Peptic ulcer disease (duodenal and gastric bleeds)
60 terms
Cardiac Disease Surgery (Surgery Exam 2)
Outline
Heart Disease Stats
Cardiac Embryology: ... Growth & Rotation
Cardiac Embryology: ... 3D Rotation (Grow…
I. Congenital Heart Disease... A. Objectives... B. Relevance... C. Bas…
Congenital heart disease... • #1 congenital malformation... • 1% of…
Outline
I. Congenital Heart Disease... A. Objectives... B. Relevance... C. Bas…
Heart Disease Stats
Congenital heart disease... • #1 congenital malformation... • 1% of…
255 terms
Surgery 2
What is the approach for a gastrotomy?
What do you use to cut into the stomach?
Where do you cut in the stomach for a…
How do you close for a gastrotomy?
ventral midline
metzenbaum scissors
equidistant between greater and lesser curvatures
submucosa - cushing... seromuscular - lembert
What is the approach for a gastrotomy?
ventral midline
What do you use to cut into the stomach?
metzenbaum scissors
100 terms
Surgery 2
What are the ABCDEs?
When is it appropriate to intubate?
What type of intubation is done based…
What is the most important part of the…
Airway:... - assess patency... - chin lift/jaw thrust... Breathing:... -…
decreased LOC... mechanically compromised airway... ventilatory pro…
< 8 yo, laryngeal injury ... Tracheostomy... > 8 yo, no laryngeal…
Neck - MAINTAIN midline immobilization during exam
What are the ABCDEs?
Airway:... - assess patency... - chin lift/jaw thrust... Breathing:... -…
When is it appropriate to intubate?
decreased LOC... mechanically compromised airway... ventilatory pro…
44 terms
Surgery 2
DDx of breast mass
Breast cancer is higher in which race?
Highest death rates for breast cancer…
Risk factors for male breast CA
(from most to least common)... Fibrocystic condition... Fibroadenom…
White > Black > Hispanic/Asian/Nat Americans
Black (30% higher than white)
BRCA 2... Klinefelter's syndrome... Fam hx... Obesity
DDx of breast mass
(from most to least common)... Fibrocystic condition... Fibroadenom…
Breast cancer is higher in which race?
White > Black > Hispanic/Asian/Nat Americans
43 terms
Surgery 2
Which abdominal wall layer is sterile?
name of lines in which skin splits whe…
what type (vertical or transverse) cre…
SQ tissue is made up of which fascia l…
Peritoneum
Langer's lines
transverse
Campers (superficial) and Scarpas (deep)
Which abdominal wall layer is sterile?
Peritoneum
name of lines in which skin splits whe…
Langer's lines
82 terms
Surgery 2
GCS: eyes 1-4?
GCS: verbal 1-5?
GCS: motor 1-6?
knife wound to neck - next steps (2)?
1 - no opening... 2 - opens to pain... 3 - opens to speech... 4 - open…
1 - none... 2 - incomprehensible... 3 - inappropriate... 4 - confused…
1 - none... 2 - decerebrate (extensor)... 3 - decorticate (flexing)…
...
GCS: eyes 1-4?
1 - no opening... 2 - opens to pain... 3 - opens to speech... 4 - open…
GCS: verbal 1-5?
1 - none... 2 - incomprehensible... 3 - inappropriate... 4 - confused…
46 terms
Surgery 2
MCC of epididymitis in male < and > 35…
MC of surgery in children >2 y.o.
Toxic megacolon is more common with UC…
Tx of clostridial gas gangrene
<35: gonorrhoea/ chlamydia... >35: Gm- rods
Appendicitis
UC
surgical debridement and abx
MCC of epididymitis in male < and > 35…
<35: gonorrhoea/ chlamydia... >35: Gm- rods
MC of surgery in children >2 y.o.
Appendicitis
72 terms
SURGERY 2
determines velocity in blood vessels?
indications for surgical inervention i…
test of choice for carotid artery dz?
gold standard for dx lesions of aortic…
Doppler
tissue loss, rest pain, lifestyle liming claudicaiton
duplex scan
four vessel arteriography
determines velocity in blood vessels?
Doppler
indications for surgical inervention i…
tissue loss, rest pain, lifestyle liming claudicaiton
50 terms
Surgery 2
What are the antibiotics of choice for…
What is the colonoscopy screening reco…
What is the only indication for surger…
How are hemorrhoids diagnosed? How are…
Ciprofloxacin and metronidazole (or ampicillin-gentamicin plu…
At 8 years after diagnosis should do colonoscopy every year (…
Fistuolotomy for fistulas
- Internal: anoscopy; external: direct visualization... - Intern…
What are the antibiotics of choice for…
Ciprofloxacin and metronidazole (or ampicillin-gentamicin plu…
What is the colonoscopy screening reco…
At 8 years after diagnosis should do colonoscopy every year (…
1,148 terms
SURGERY #2
hypovolemia ... 1. signs... - correct acute…
hypervolemia... 1. signs... 2. causes... 3. tre…
hyponatremia... 1. hyperosmolar ... 2. normo…
hypernatremia ... 1. hypovolemic... 2. hyper…
1. tachycardia, hypotension, decreased urine output, loss of…
1. acute shortness of breath, tachycardia, peripheral edema,…
1. dilutional hypernatremia - ex. hyperglycemia, mannitol, os…
1. volume defecit, more free water than sodium ... 2. iatrogenic…
hypovolemia ... 1. signs... - correct acute…
1. tachycardia, hypotension, decreased urine output, loss of…
hypervolemia... 1. signs... 2. causes... 3. tre…
1. acute shortness of breath, tachycardia, peripheral edema,…
56 terms
Surgery 2
What are the steps of a lameness exami…
When is supporting limb lameness evide…
When is swinging limb lameness evident?
What is primary lameness?
1. History... 2. Inspection at rest... 3. Palpation of musc-skel sy…
During stance phase
During the swing phase-caused by upper limb or axial skeleton
A lameness present before any tests are performed.
What are the steps of a lameness exami…
1. History... 2. Inspection at rest... 3. Palpation of musc-skel sy…
When is supporting limb lameness evide…
During stance phase
24 terms
Surgery2
Herceptin ( Transtusumab )
Hasteled
Patey
Scanlon
Convert Her2 to best prognosis
Radical mastectomy
P. Minor is cut to dissect the level 3 nodes
P. Minor is retracted to dissect the level 3 nodes
Herceptin ( Transtusumab )
Convert Her2 to best prognosis
Hasteled
Radical mastectomy
114 terms
Surgery/surgery assistant exam 2
Surgery assistant preoperative respons…
Surgery assistant intraoperative respo…
Surgery assistant postoperative respon…
Assess clipping and surgical scrub
patient prep and positioning
instrumentation... instrument handling
wound and patient care
Sufficient hair removal Aseptic preparation
Surgery assistant preoperative respons…
patient prep and positioning
Surgery assistant intraoperative respo…
instrumentation... instrument handling
71 terms
surgery tools 2
.STANDARD OPERATING SCISSORS BLUNT/BLUNT
.blunt sharp
sharp sharp
knowles bandage scissors
.STANDARD OPERATING SCISSORS BLUNT/BLUNT
.blunt sharp
83 terms
Neurosurgery (Surgery Exam 2)
Brain Anatomy Divisions
Cerebrum:... FRONTAL
Cerebrum:... PARIETAL
Cerebrum:... TEMPORAL
Cerebrum... - Frontal, Parietal, Temporal, Occipital... Cerebellu…
Higher INTELLECTUAL functions!... -CONSCIOUSNESS... -responses to O…
Visual & TOUCH SENSATIONS! ... -coordinates SENSORY control of b…
L: ... HEARING! ... -UNDERSTANDING... -memory of what is seen or heard…
Brain Anatomy Divisions
Cerebrum... - Frontal, Parietal, Temporal, Occipital... Cerebellu…
Cerebrum:... FRONTAL
Higher INTELLECTUAL functions!... -CONSCIOUSNESS... -responses to O…
70 terms
Surgery Cardio 2
1 workup and management of a pt with a…
2 risk factors for peripheral vascular…
3 common nerves injured during carotid…
strap muscles
Start by discussing with patients their risk factors and en…
(Remember that SOME studies show that *diabetes is NOT a risk…
Cranial nerve IX (glossopharyngeal) - injury may result in…
TOSS... thyrohyoid... omohyoid... sternohyoid... sternothyroid... thyrohyo…
1 workup and management of a pt with a…
Start by discussing with patients their risk factors and en…
2 risk factors for peripheral vascular…
(Remember that SOME studies show that *diabetes is NOT a risk…
76 terms
Surgery Exam 2: Vascular Surgery
The right and left coronary arteries b…
Three branches of the aortic arch
Three branches of the abdominal aorta
The inferior mesenteric artery supplie…
Ascending aorta
Brachiocephalic trunk... Left common carotid... Left subclavian
Celiac trunk... SMA... IMA
:
The right and left coronary arteries b…
Ascending aorta
Three branches of the aortic arch
Brachiocephalic trunk... Left common carotid... Left subclavian
93 terms
2.5 Chest Surgery
where do lymphatics drain to?
what imaging is effective for screenin…
what imaging is critical for staging c…
what imaging with evaluation of superi…
cephalad toward the hilum
x ray
CT
MRI
where do lymphatics drain to?
cephalad toward the hilum
what imaging is effective for screenin…
x ray
29 terms
LA Surgery 2-7
Sole abscess location
Possible etiologies of sole abscesses
Signs of foot abscesses
Diagnosing a foot abscess
Between sensitive and insensitive laminae
Sole bruises- inflammation allows bacteria access to tissues…
Severe lameness... Heat in hoof... Increased digital pulse... Pain rea…
Based on signs... Sometimes nerve blocks needed or useful... Radiog…
Sole abscess location
Between sensitive and insensitive laminae
Possible etiologies of sole abscesses
Sole bruises- inflammation allows bacteria access to tissues…
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