General Surgery Module Review

In thyroid surgery, which structures are identified and preserved?

Parathyroid glands

Provide patients with a choice in primary care to restore that patients health

This is NOT a primary purpose of general surgery

Severe complications such as________can result if all parathyroid glands are removed

Tetany

Thyroid and parathyroid glands produce hormones that affect: growth, metabolism, and weight but not___

Immune system

Which is the most common treatment for a tumor in a breast between 2 and 5cm in diameter and no distant metastasis

Total mastectomy

What condition will occur if there is a physiologic calcium imbalance

Tetany

The parathyroid glands regulate

Blood calcium concentration

When a surgeon removes the entire thyroid lobe to treat toxic diffuse goiter, what is the procedure called?

Thyroid lobectomy

The parathyroid glands are located _____to the thyroid gland

Posterior

Wound dressings for thyroid and parathyroid surgery vary. What would you NOT use for wound dressing

Insert drain, use cottonoids and a 4x4, secured by an ace bandage

A metaboloic imbalance resulting from a hyperactive thyroid is known as

Graves disease

Parathyroidectomy

One or more parathyroid glands are removed to treat malignancy

How do you NOT handle cancerous breast tissue

Use formalin on specimens sent for estrogen binding studies

Place the patient in the _______position with neck hyperextended for thyroid or parathroid surgeries

Modified dorsal recumbent

There are_______ parathyroid glands

4

A metabolic imbalance resulting in lethargy and weight gain from a hypoactive thyroid is known as

Cretinism

What is the longest section of the digestive tract

Intestines

Which section of the colon passes across the upper abdomen, below the liver and stomach, and above the small intestine, to the spleen in the upper left abdomen

Transverse

Which procedure involves the insertion of an inert prosthesis for the purpose of enlarging the breast

Augmentation

If the patient has a positive breast Bx and the surgeon proceeds to do a radical mastectomy, what do you do with the drapes

The person is re-prepped and new instruments and drapes are used

Which is not a breast tissue:
Supra-areolar
Intra-areolar
inframmary
radial

Intra-areolar

Until proven otherwise, all breast masses are considered

Malignant

The axillary area contains an average of how many lymph nodes

fifty-three

The bilateral organs lying in the superficial fascia of the pectoral area are called____

mammary glands

There are 12-20 lobes contained in the tissue of each breast, each lobe is subdivided into ______ that contain the secreting cells and alveoli, drained by single____

Grape-like clusters, lactiferous duct

Abnormal enlargement of the male breast is called

gynecomastia

The major difference between a radical mastectomy and a modified radical mastectomy is the _________ may also be removed during a radical mastectomy

Pectoral muscles

Which is the pear-shaped sac that stores the bile that assists in the digestive breakdown of foods

Gallbladder

Which breast Bx uses a Silverman to extract cells from the lump

Needle Bx

The removal of the distal portion of the stomach with establishment of anastomosis between the stomach and jejunum is more commonly known as a______

Billroth II

Liver tissue is extremely _____so ____ substances are often used during surgery

Friable, hemostatic

Removing affected structures is not a primary purpose in what surgery

Hernia

The principle hazard encountered intraoperaltively during a splenectomy is

hemorrhage

Hemangioma refers to____

Mass of blood vessels in a benign tumor

The________is composed of exocrine and endocrine glandular tissue that secretes digestive enzymes

Pancreas

Which organ varies in size and its vascular tissue supports the immune system and monitors and stores blood cells

Spleen

What is the largest organ in the body

liver

The procedure used to remove the gallbladder using either open surgery or laparoscope is a

cholecystectomy

A right hemicolectomy involves the removal of the

ascending colon

a splenectomy is performed for all of the following except:
tumors
ruptures
hypersplenism
trisegmentectomy

Trisegmentectomy

Surgery performed for lowe sigmoid or rectal malignancies is an

Abdominoperineal resection

Common herniation include all the following except:
pelvic
hiatal
epigastric
umbilical

pelvic

When is bowel technique necessary

When the intestinal tract is entered during a surgical procedure

Resection means

Significant excision of an organ or structure

Partial or complete removal of the colon is

Colectomy

The severe restriction of the bowel that eventually necroses is

strangulation

Externalization through the abdominal wall of the proximal end of the transected ileum; performed in conjunctin with a total colectomy

Ileostomy

A small or outward growth projecting into the intestinal tract is a

polyp

The following are examples of intestinal pathology except:
diverticulitis
volvulus
obstructions
neoplasm

neoplasm

An appendectomy is performed via a

McBurney incision

Rectal forceps ____used during a gastrointestinal surgery

Not

When the surgeon enters the gastrointestinal tract, the surgical technologist should always

Have suction ready for immediate use

The removal of a cyst filled with pus, hair, or tissue debris from the sacrococcygeal area is called a

Pilonidal cystectomy

A scan utilizing nuclear imaging to view parts of the biliary system is called a

Hepatic intraductal assay

ESWL is used to

Shatter gallbladder stones

What Dx procedure assists in distinguishing between cystic and solid tumor lesions

Ultrasonography

What priamry part of the anatomy is responsible for mixing and partial digestion of materials

Stomach

The primary F(x) of the ________is to reabsorb water and electrolytes

Large intestine

Instruments used on the end of the GI tract when an anastomosis wil be performed are

Always non-crushing

A____is a surgically created opening from some portion of the colon to the exterior through the abdominal wall

Colostomy

Meckel's diverticulum is found in the

Ileum

When a segment of intestine is removed, the segment must first be mobilized by removing it from its mesentsary. Essential instruments for this mobilization include

Metzenbaum scissors, kelly clamp, suture ties

This procedure requires the removal of this organ attached to the distal ileum, establishing bowel continuity

Meckel's diverticulectomy

When doing skin prep on someone with a stoma, the stoma is always

done last or separately

Supporting tissue layers for the stomach include

Mucosa, submucosa, muscularis, serosa

A cholecystectomy _________ require special bowel technique

Does not

Surgical technique used in GI surgeries involving the surgical union of two hollow structures in known as

Anastomosis

The imperforation or closure of a normal tubular opening of the body is known as

Atresia

Small blind pouches that form the lining and wall of a canal or organ, especially the colon, are called

Diverticula

An ileostomy is the

formation of a permanent or temporary opening into the ileum

The invagination of proximal intestine into the lumen of distal intestine is called

Intussusception

The surgical procedure commonly performed in conjunction with total colectomy is a

ileostomy

Which type of hernia occurs in Hesselbachs triangle

Direct

Is McBurney incision transverse

No

The_____incision is an alternative to the midline incision, but is less likely to____

Paramedian, herniate

What midline incision is used for subumbilical access

Lower

Which herniorrhaphy procedure uses tightly wound mesh that is pushed through the internal ring of th ebody, then expanded in the fascia to prevent reocurrence

umbrella plug

an_____hernia occurs in the middle of the abdomen between the xiphoid process and the umbilicus

Epigastric

the ____ incision is used to expose pilonidal cysts

rectal

This curved, transverse incision follows the symphasis pubis and is used to access the pelvis

Pfannenstiel

A _________ herni is one which the sac contents become ischemic and will eventually necrose

Strangulated

The term that describes the protrussion of tissue or structure through a defect in the supporting structures that normally contain it is

Herniation

With the ______ hernia, a portion of the stomach protrudes through the opening for the esophagus into to diaphragm

Hiatal

Which type of hernia is a result of a congenital weakness in the internal ring and is most common in men

Indirect

With this congenital condition, intra-abdominal contents are pushed through the abdominal wall around the umbilicus

Omphalocele

The ______ drain is used to retract spermatic cord structures in a male inguinal herniorrhaphy

Penrose

This hernia is often aggravated by obesity or excessive coughing and can be either sliding or paraesophageal

Incisional

The______hernia is more prevalent in women than in men

Femoral

Surgeons generally wait until infants with umbilical hernias reach age

2

What hernia protrudes into the inguinal canal but not into the spermatic cord and rarely into the scrotum

Direct

Which of the following is not a type of drain:
penrose
urinary catheter
chest
culture

Culture

Which instrument is not a biliary specialty instrument:
Allis forceps
bakes dilator
scoop, cystic duct, mayo
gallduct probe

Allis forceps

A rectal speculum may be used for which general surgery

GI

A__________Bx involves the injection of radioisotope into the breast mass, spreading to breast lymph nodes prior to surgery

Sentinel node

What is a factor that affects the prognosis of a person with cancer

Type of caner
location of cancer
stage of cancer

Which is incorrect:
Abdominal hernias are the most common surgeries in the U.S.
Hernias occur over 25 times more frequently among men than women
Hernias self heal over time
Hernias often occur with a weakness in the tissue

Hernias self heal over time

Most general surgeries are performed under _______ anesthesia

General and regional

General surgical procedures are classified Class I: Clean or Class II: Clean-contaminated because the aerodigestive or biliary tract are entered under controlled conditions and without unusual contamination. Sometimes classified as Class III: Contaminated

True

Hernias typically occur in which area

Hiatal

Another region hernias typically occur is

Epigastric