Operating Room Theory Test

The __________ is a raised mound of tissue that protects the symphysis pubis.

mons pubis

____________ patients are extremely careful of their AV access sites and need to take precautions to prevent injury at the site.

Hemodialysis

The ________ cavity lies posterior to (behind) the peritoneal cavity.

retroperitoneal

Incision shown in picture

subcostal

The functional units of the liver are the lobules. The functional cells of the liver are the ______________ and they manufacture _______________.

hepatocytes; bile

Which action best reflects the movement of urine from the renal pelvis to the bladder?

Slight distention of the renal pelvis initiates a wave of peristaltic contractions

Identify the structures in this image.

1.right lobe of liver 2.right hepatic duct 3.cystic duct 4.common bile duct 5.gallbladder 6.duodenum 7.main pancreatic duct 8.tail of pancreas 9.stomach 10.left lobe of liver

A kidney transplant entails transplantation of a living-related or cadaveric donor kidney into the recipient's iliac fossa. It is performed in an effort to restore renal function and maintain life in a patient who has end-stage renal disease. Select the statement that best reflects the ideal living-related donor candidate.

An identical twin or sibling or parent, ABO and HLA compatibility, good health

In a(n) _____________ hernia, tissue protruding from the hernia may be swollen and squeezed.

Strangulated

Have two main tissue layers, an outer cortex and the inner medulla

kidney

Renal calculus

kidney

Fibrocystic changes in the breast describe many different breast changes. These changes affect almost all women at some time in their lives. Nipple discharge is more commonly associated with benign lesions than with cancer; however, discharge is usually significant only if it is spontaneous, persistent, and:

All of the options are significant.

TAH

Abdominal procedure

Tubal ligation

Abdominal procedure

During a splenectomy, what four major requirements must be met to stop bleeding?

Access, visualization, good lighting, clamps

Although each potential kidney transplant recipient is judged individually as a candidate, which condition from the list below would most likely eliminate a patient as a candidate for kidney transplant?

Active cancer

The mesh-plug open hernia repair technique is indicated for which type(s) of hernias?

All of the options are correct

Open common bile duct (CBD) exploration may be indicated in some cases where:

All of the options are correct.

The liver, pancreas, and spleen share many similarities. Select the statement about these organs that is true.

All three are solid organs and very vascular.

A breast biopsy, performed after the patient has received a local anesthetic, will require adjunct sedation and monitoring equipment. What relevant considerations should the surgical team member note during the preoperative assessment?

Allergies

Breast screening guidelines are developed and published by the American Cancer Society (ACS) for asymptomatic women of various age and risk groups. Select the statement that best reflects the ACS guidelines for women at high risk for breast cancer.

An individualized screening plan

Edward Lewis is scheduled for a transthoracic esophagectomy with lymph node dissection for cancer of the esophagus. Which incisional approach is indicated for this procedure?

Any of the three above incisions may be used per surgeon preference or tumor location.

A McBurney incision is used for surgical procedures of the ____________.

Appendix

The ________ glands lie on both sides of the vestibule and secrete mucus during sexual intercourse.

Bartholin

An example of perineal glands that secrete mucus is:

Bartholin's glands.

Select the diagnosis/procedure option that pairs the correct surgical diagnosis with the surgical/endoscopic procedure for diseases of the esophagus:

Barrett's dysplasia of the distal esophagus/endoscopic mucosal resection (EMR)

Of the open hernia procedures listed below, which classic hernia procedure is considered, by some surgeons, to not be anatomically correct because the superior transversalis fascia is sutured to the inguinal ligament instead of to the inferior portion of the transversalis fascia or the Cooper ligament?

Bassini repair

What procedure is being performed in this image?

Billroth II

Carly Shelmire is a 5-year-old girl with a history of weight loss and stomach upset and pain after eating; she is also small for her age. Her pediatrician suspects celiac disease. Carly has arrived at the pediatric endoscopy unit for a procedure that is less invasive and will also have the benefit of spending the next few hours in the mall across from the hospital with her mom until the procedure is over. What is Carly's scheduled procedure?

Capsule endoscopy

Exposure of intra-abdominal anatomy is crucial to safe surgery and employs varied instruments, applications of highly technical energy sources, patient manipulations, light, and imaging. What is unique to the laparoscopic approach that promotes exposure?

Carbon dioxide pneumoperitoneum

Ann Contreras has consulted a noted colorectal surgeon after experiencing episodes of rectal bleeding over the last 2 weeks. She had a screening colonoscopy 5 years ago with several adenomatous polyps and mild diverticular disease. She presents to the endoscopy suite after a successful bowel prep and NPO since midnight. The GI endoscopist is confident that she will find tumor growth in the rectum and decides to employ further diagnostic applications to determine potential for metastasis. Which of the following endoscopic procedures best describes Ann's procedure?

Colonoscopy with endoscopic ultrasound (EUS)

Select the congenital anomaly that best reflects indications for fetal surgery.

Congenital diaphragmatic hernia

When the cord precedes the fetal head

Cord prolapsed

During a laparoscopic cholecystectomy, which two structures are occluded?

Cystic duct and cystic artery

Margie Donaldson's examination has revealed a family history of endometrial cancer. She has never been pregnant and has been taking hormone replacement therapy for 4 years. Her physician has scheduled her for a surgical procedure to obtain visual and pathologic information and provide treatment as indicated. Margie was sure that she would have to have a D (dilatation and curettage). Margie's surgery, on the operative schedule, would most probably be written as:

DC with endometrial biopsies, frozen section, possible LAVH.

Two patients are scheduled to have a gastrojejunostomy for obstruction. How will perioperative planning differ for a patient weighing 280 lb as compared to that for a 150-lb patient?

Deaver retractors will replace Richardson retractors with the heavier patient.

While direct and indirect hernias both protrude into the inguinal canal and represent tears in the transversalis fascia, which one of the two occurs within the Hesselbach triangle?

Direct inguinal hernia

In the past, radical procedures, which involved removal of the affected breast and all axillary and thoracic lymph nodes, were used to treat breast cancer. These procedures did not significantly lower mortality. What factor(s) may have contributed to mortality after these procedures?

Distant metastases may have already occurred without adjacent lymph node involvement at the time of its palpable detection.

Breast cancer is usually staged to measure the extent of the disease and to design a specific treatment plan, using the TNM (T = tumor; N = node; M = metastasis) classification system. Apply the description of a stage 0 carcinoma in situ to the appropriate disease description listed below.

Ductal carcinoma in situ (DCIS) has abnormal cells lining the ductal system and is often invasive.

Kidney transplantation is performed for acute and chronic ________.

ESRD

Sharon Close has been diagnosed with severe gastroesophageal reflux disease (GERD) without the dysplastic changes of Barrett's esophagus. Her GERD is unresponsive to proton pump inhibitors and histamine blockers. She also has a history of endometriosis with multiple surgeries for ablation of endometrial implants on her small bowel and adhesiolysis. Her surgeon is hesitant to pursue an open or a laparoscopic Nissen surgical approach. What procedure might her surgeon consider in lieu of a Nissen?

Endoluminal plication of the lower esophageal segment

Specific positioning considerations for bariatric patients require particular attention to protecting these patients from inherent risks related to their size and weight. Of considerable concern is the risk of injury to staff. Protective measures to protect both patient and staff include those below. Which measure reflects the most safety protection for both patient and staff?

Ensure that the OR bed can accommodate the patient's weight and girth.

Femoral hernias occur more frequently in which group of individuals?

Females

Review the list below and select the answer that reflects the correct match between the procedure and the disease.

Esophagogastroduodenoscopy (EGD) for gastric ulcer disease

_______ is absorption of fluid into the vascular system, leading to increased blood pressure and possible death related to fluid overload.

Extravasation

From the list below, select the statement that is true about fallopian tube cancer.

Fallopian tube cancer is very rare, with an incidence of less than 1%.

In transurethral resection of the prostate gland (TURP), the surgeon passes a resectoscope into the bladder through the urethra and resects successive pieces of tissue from around the bladder neck and the lobes of the prostate gland, leaving the capsule intact. TURP is traditionally indicated for patients with benign obstructive disease of the prostate. A TURP would be indicated for a patient with malignant prostatic disease under which of the following conditions?

For symptom relief of obstruction before initiating other treatments

The recipient liver OR is arranged for a major laparotomy and vascular procedure with customized instruments, supplies, and sutures according to the transplant surgeon's preference. In addition to the general patient care accessories, equipment, and supplies needed for any large surgery, also included are intraoperative laboratory testing and an autotransfusion system. Describe the boundaries of the surgical skin prep for the patient about to receive a liver transplant.

From the neck to midthigh; bedline to bedline

________ stones (calculi) are formed by the precipitation of specific salts from filtrate that becomes supersaturated.

kidney

The liver is essential in the metabolism of carbohydrates, proteins, and fats, generating nutrient stores of which substance that supplies energy sources to the brain and body?

Glycogen

The mammary glands are affected by physiologic changes throughout a woman's life span. Select the option that best reflects the life cycle events that impact the anatomy and physiology of the breasts.

Growth and development, menstruation, and pregnancy and lactation

_____________ focuses on the treatment and prevention of diseases affecting the female reproductive system.

Gynecology

TURP syndrome is a state of severe hyponatremia, caused by systemic absorption of irrigating fluid during the procedure. Select the sign/symptom that the anesthesia provider would report in a patient experiencing TURP syndrome.

Hypertension

The ________ are the primary organs for filtration of the blood.

kidneys

Hernia-entrapped viscera, typically loops of small intestine, will result in intestinal obstruction with resulting pain, vomiting, and distention. What is the appropriate descriptive diagnosis of this condition?

Incarcerated hernia

Select the most common hernia that occurs in both males and females and name the side on which it would most likely occur.

Indirect inguinal hernia on the right

Identify the triad of anatomic sites of abdominal wall weakness with a potential for hernias.

Inguinal canal, femoral rings, umbilicus

Select the triad of the boundaries of the Hesselbach triangle.

Inguinal ligament, rectus abdominis muscle, deep epigastric vessels

Which statement about the McBurney incision is most correct?

It is an oblique inguinal incision in the right lower quadrant.

A(n) ________ may be used to outline structures of the urinary system, including any stones larger than 2 mm.

KUB

_______________ instruments are specialized for reproductive structures.

Laparoscopic

Ramona Guerne has been admitted through the emergency department for severe abdominal pain, distended abdomen, and fever. The surgery service has been consulted and has scheduled her for exploratory surgery. Ramona has undergone two abdominal surgeries in the past for "female problems" and states that she has a tendency to form keloids. A small bowel obstruction is suspected. Postoperative ileus is a common complication of open abdominal surgery. Select the procedure that is least likely to promote postoperative ileus formation in this patient.

Laparoscopic lysis of adhesions with release of bowel torsion

Triangulation is a term used to describe the method used to provide instrument access to the anatomy during abdominal surgery. It is uniquely associated with which surgical incision?

Laparoscopic port incisions

______________ is a fibrous, benign tumor of the uterus that usually arises from the myometrium.

Leiomyoma

________ is a nearly sterile fecal waste that accumulates while the fetus is in the uterus.

Meconium

In total abdominal hysterectomy, the surgeon uses _____ scissors and long tissue forceps to separate the bladder and the uterus.

Metzenbaum

An umbilical cord wrapped one or more times around the baby's neck

Nuchal cord

Many breast cancer patients subscribe to various complementary and integrative therapies to provide relief from anxiety, depression, pain, and chemotherapy and radiation therapy related complications and side effects. Quality of life issues become important in providing comfort and life balance. In addition to their oncology physicians and other health care providers, patients may also receive therapeutic assistance for their cancer care from which of the following?

Nutritionists and dietitians

________ relates to the process of pregnancy and birth (parturition).

Obstetrics

What classification of drugs are GYN/obstetric-related medications that require monitoring of blood pressure, assessment for continued bleeding, and monitoring of fundal response to the drug?

Oxytocics

Select the statement that most correctly matches a risk factor for adhesions with an appropriate preventive strategy.

Patients with endometriosis may be best served with a laparoscopic approach.

The spermatic cord is retracted with a small _________________.

Penrose drain

Ova travel through the fallopian tubes toward the uterus by which type of action?

Peristalsis

Select the option that pairs the correct surgical diagnosis with the surgical/endoscopic procedure for diseases of the abdomen.

Peritoneal cancer/hyperthermic intraperitoneal chemotherapy and adhesions/lysis of adhesions

What composes the lining of a herniated abdominal sac?

Peritoneum

The general risks associated with gastrointestinal surgery parallel those risks associated with most abdominal procedures. Select a complication that is the most typical risk associated with surgery of the large bowel.

Peritonitis

Michael Mason has suffered from subsacral pain and swelling for 2 weeks and finally was referred to a colorectal surgeon for care. He is currently in the ambulatory surgical center OR bed positioned in the jackknife position. The perioperative nurse has gently but firmly taped his buttocks laterally to the rails of the OR bed to promote exposure to the surgical site. What procedure is Michael prepared to undergo, based on his symptoms and the surgical preparation?

Pilonidal cystectomy

The PSA test is a serum lab test for prostate-specific antigen. If the test value is elevated, the patient is at risk for carcinoma of the prostate; a PSA value greater than 10 ng/ml is highly suggestive of prostatic carcinoma. Tissue from a transrectal prostate biopsy provides the cellular information to confirm the diagnosis. The American Urological Association (AUA) prostate cancer staging tool essentially provides what important information about the tissue specimen?

Prostate cancer stages of severity

What type of stitch will be placed around the base of the appendix?

Purse string

An orthotopic neobladder is surgically created as a bladder substitute after a cystectomy, prostatectomy, or hysterectomy is performed for bladder cancer. Bladder substitution relies on meticulous dissection with preservation of the urinary sphincter and neurovascular bundles, as well as a watertight urethral anastomosis. Also termed the "Le Bag continent diversion," what segments of the bowel and/or small intestine are used in this technique to create the neobladder?

Right colon and ileum

As the surgeon prepared to clamp and transect the bowel during a small bowel resection for tumor, the scrub person transferred instruments from the Mayo stand to the back table and prepared the sterile field for bowel isolation technique. The rationale for this application involves

Risk for Infection

Identify the marginal boundaries of the breasts.

Second to sixth rib horizontally, lateral edge of sternum to anterior axillary line

The hysteroscope is inserted into the uterus with the _________ in place.

Sheath

Sally Hargraves is a 72-year-old patient with multicentric carcinoma in situ (CIS) of the vulva, without evidence of leukoplakia and pruritus. She has a history of prior papillomavirus infection. Select the most appropriate surgical option.

Simple vulvectomy

A rare hernia occurring between the transverse abdominis and rectus muscles is a(n) __________.

Spigelian hernia

A subcostal incision is used for surgical procedures of the _____________.

Spleen

Sarah Pergines, an 82-year-old woman, was referred to the breast surgery service by her gerontologist because of a large inflammatory mass in her left breast. Sarah stated that the lump has existed for several years and she believed it was just part of old age. The surgeon examined Sarah and found tumor nodules growing into the skin of the breast, with breast swelling and redness. Diagnostic imaging results described a tumor that had grown into the chest wall and may have spread to axillary lymph nodes and to other lymph nodes behind the breastbone and below the collarbone. Based on this description, what is Sarah Pergines' probable cancer stage?

Stage IIIc

Talia Mendelson, a 27-year-old patient who had a lumpectomy for early-onset breast cancer, arrived at the ambulatory surgery center for infusion port insertion. She is scheduled to begin adjuvant chemotherapy next week. The catheter component of Talia's port system is inserted into what structure(s)?

Subclavian or jugular vein

_______________ includes removal of the uterus and cervix

TAH

Charles Wilkins had a laparoscopic hernia repair with good results and an uneventful recovery. Weeks later, as he reviewed his hospital bill, he noted that he had been charged for a very expensive preperitoneal distention balloon, polypropylene mesh, an endomechanical stapler, and three endosurgical trocars. What hernia repair technique was probably performed on Charles?

TEP repair

____________ is an instrument or other device that puts pressure on tissue, usually to stop bleeding.

Tamponade

Which two similar hernia repair approaches reestablish the integrity of the transversalis fascia and simultaneously reestablish and strengthen the posterior inguinal floor by sewing the transversalis fascia to the Poupart ligament?

The McVay and the Cooper ligament repair

The transabdominal preperitoneal patch (TAPP) hernia repair and the totally extraperitoneal patch (TEP) repair differ in the manner in which access is gained to the preperitoneal space. Which of the two provides access to the preperitoneal space without entering the peritoneum?

The TEP technique

Select the statement that best reflects the functional components of the gastrointestinal (GI) tract.

The alimentary canal extends from the mouth to the anus.

Select the statement that best describes fine needle aspiration of a suspicious breast mass.

The aspirate fluid is cytologically examined.

The goal of breast cancer surgery is removal of the mass with a margin of normal tissue and a good cosmetic result. The choice of procedure depends on the size and site of the mass, the characteristics of the cells, the stage of the disease, and the patient's choice. Select the statement that best reflects the difference between minimally invasive excisional breast biopsy with stereotactic image-guided location and removal of tissue.

The excisional biopsy is performed under direct visualization, while the stereotactic approach is image-guided.

An abdominal perineal resection, or APR, for a patient at high risk for colon cancer without anal/rectal involvement (e.g., familial adenopolyposis [FAP]) can be accomplished through an open laparotomy or laparoscopic-assisted ileoanal pull-through approach, per surgeon preference and appropriate patient selection. Which of these statements about approaches for APR is correct?

The laparoscopic-assisted approach only has an abdominal skin incision(s).

What technologic characteristic of robotic surgery provides a superior indication for robotic-assisted laparoscopic cholecystectomy?

The magnified three-dimensional picture may reduce bile duct injuries during dissection.

Patients having genitourinary surgery are at risk for impaired urinary elimination. Select the statement that best reflects a desired outcome for an adult patient.

The patient will regain his or her normal pattern of urinary elimination.

Select the statement about the prostate that best reflects its location, size, and weight

The prostate sits below the base of the bladder, is 4 cm at the base, and weighs 20 to 30 g

Jan Stuyvesant, a surgical technologist, was the scrub person during a robotic-assisted laparoscopic cholecystectomy. She locked the robotic endoscissor into the adaptor on the robotic arm and positioned the tip end into the trocar port in order for the surgeon to dissect the cystic duct and artery, while the surgical assistant placed the clips on the cystic duct and artery. As she reached across the sterile field to insert the cholangiocatheter through the port, the anesthesia provider accidentally made contact with the distal end of the catheter as he stood up to reach the monitor controls. The contaminated end of the catheter touched the endoscopic clip applier, the endoscissor connector that the surgeon was using, the glove of the assistant, and Jan's gown sleeve. The surgeon ordered everyone to change their gown and gloves and covered the port area with a sterile towel. What was the rationale for the surgeon to continue to dissect and not change his attire?

The surgeon was not in contact with the sterile field because he worked from the robotic console.

Joanne Grizwald, a 24-year-old woman with type 1 diabetes who is in end-stage kidney failure, is scheduled for a combined kidney-pancreas transplant. She is relatively healthy and at normal weight for her height in spite of her disease process. Her bleeding time and coagulation parameters are within normal limits. The circulating nurse has set up the autotransfusion system, verified Joanne's blood type, and crossmatched blood availability. The scrub person, while organizing the sterile back table, identified several instruments that she will not need. She organizes those instruments on the most distant part of the back table. What instruments is the scrub person unlikely to need during this procedure?

The transplant procedure is an open approach and laparoscopic instruments (the insulated electrosurgical-adapted scissors, graspers, and the endoscopic suction tips) are not needed.

Resectoscope myomectomy

Transcervial procedure

Hysteroscopy

Transcervical procedure

LEEP

Transcervical procedure

_____________ pelvic procedures require vaginal speculums and long instruments, including uterine clamps and heavy dissecting scissors.

Transvaginal

Anastomosed to the ilium when creating an ileal conduit

Ureter

A wide variety of ureteral and urethral drains, stents, and other catheters are designed and used for specific urologic procedures. A commonly used catheter is described by its tip. What catheter type is described as open-ended tip, whistle tip, cone tip, and olive tip?

Ureteral catheter

_______ uses a rigid or flexible scope, which is inserted through the urethra and advanced into the renal pelvis and ureter.

Ureteroscopy

The cervix is the lower neck of the ______________.

Uterus

Removal of cystic Bartholin gland

Vaginal procedure

Repair of cystocele

Vaginal procedure

Repair of vesicovaginal fistula

Vaginal procedure

Ductal ectasia is a benign breast disorder that is difficult to distinguish from cancer, primarily because it presents with:

a hard and irregular mass, nipple discharge, and enlarged axillary nodes

The removal or destruction of tissue is called ___________.

ablation

The ________ glands are paired organs that lie on the medial side of the upper kidney.

adrenal

A procedure in which two hollow organs are joined surgically is __________.

anastomosis

Composed of four tissue layers: the outer serosa, the muscular layer, the submucosa, and the inner mucosa

bladder

Contains a region called the trigone

bladder

Distended with fluid to enhance visualization during cystoscopic procedures

bladder

Continuous irrigation may be used to locate microscopic _________.

bleeders

The surgical team gently abducted Matilda's arms into position on padded armboards at less than 90 degrees with palms facing up. Extra padding was placed under her elbows and an armboard strap was secured over her forearm. The armboards were locked into place to prevent inadvertent abduction. This important maneuver is designed as a risk reduction strategy to prevent:

brachial plexus injury.

A ________ attaches to the head of the scope and accepts accessory tools.

bridge

Miranda Cox returned to her gynecologist's office for a second Pap smear when her routine exam showed dysplastic cells in her cervical cytology test. Miranda has a family history of cervical cancer and had laser ablation within the last 2 years for vulvar condylomata. She can expect her gynecologist to perform another Pap smear and:

colposcopy with endocervical biopsy

Stones caused by the precipitation of minerals, such as calcium, and other substances from the urine or kidney filtrate are ________________.

calculi

The ________ is a highly vascular organ that contains sensitive erectile tissue.

clitoris

What is being created in this image?

colostomy

Ryan has an indirect hernia that is characterized by a small neck, thin walls, and close attachment to the cord structures. Marc has a hernia with a short, wide neck, and a thick-walled sac. Based on this description, Ryan has a(n) ____________ hernia and Marc has a(n) __________ hernia.

congenital; acquired

This condition more likely with breech presentation

cord prolapsed

Identify the procedure in this image.

cystocele repair

Matilda Gunderson, a 55-year-old woman with uterine cancer, is scheduled for an open panhysterectomy. She is positioned in low lithotomy with her legs symmetrically arranged in padded cradle stirrups. After the incision is made and primary dissection accomplished, she will be positioned in Trendelenburg position to facilitate exposure of the lower pelvis and displacement of the small bowel from the operative area. Matilda is at risk for compromise and injury related to prolonged Trendelenburg tilt, which promotes:

decreased pulmonary compliance and functional residual capacity.

Protrusion of abdominal or inguinal tissue directly through the transversalis fascia is a(n) __________.

direct inguinal hernia

A procedure in which one section of tissue is cut away from another is __________.

division

In adult circumcision, a ________ incision is made in the skin and carried circumferentially.

dorsal

The head of the pancreas is fixed to the:

duodenum.

Marla Moriarity, a 32-year-old recently unemployed and uninsured college professor, is diagnosed with an early ectopic pregnancy. Her obstetrician has given her the option of surgical or medical therapy. She is well-informed about the details of each medical and surgical option, but her primary concern about her condition is that her decision will be based upon her strong cultural belief system that will not sanction the destruction of the fetus. Marla's treatment decision will most likely be:

emergency laparotomy for a ruptured ectopic pregnancy

The ________ is/are small projection(s) that extend from the end of the tube.

fimbriae

The adrenal glands lie retroperitoneally beneath the diaphragm, capping the medial aspects of the superior pole of each kidney. The adrenal medulla secretes ______________ while the adrenal cortex secretes ____________ and ____________.

epinephrine; steroids and hormones

A patient whose neck has been slashed and has a severed lower trachea may also have injury to the:

esophagus.

The anterolateral abdominal wall consists of an arrangement of muscles, fascial layers, and muscular aponeuroses lined interiorly by peritoneum and exteriorly by skin. The key landmark of the _____________ designates the roof of the inguinal canal and the key landmark of the __________ designates the floor of the inguinal canal.

external oblique aponeurosis; transversalis aponeurosis and fascia

A hernia arising from a weakness in the transverse fascia below the inguinal ligament is a(n) __________.

femoral hernia

The organs and organ systems that are included in general surgery are the following EXCEPT __________.

femur

Surgical blockage prevents implantation (pregnancy) and development of a ________.

fetus

An example of a potential risk associated with pneumoperitoneum would be:

gas embolus into an exposed blood vessel during the procedure.

The _____________ is composed of a vast system of microscopic tubules that communicate directly with the capillaries to filter the blood.

glomerulus

Most ______________ procedures are performed with the patient in the supine or lithotomy position.

gynecological

An example of a common postoperative complication related to inguinal hernia surgery is:

hernia recurrence.

High-intensity focused ultrasound (HIFU) is a noninvasive technique used in the treatment of prostate cancer. HIFU is a targeted therapy that is highly focused into a small area without causing collateral tissue damage. Aside from primary therapy, HIFU can be used as salvage therapy, primarily after radiation. HIFU can be performed as an outpatient procedure, often with an epidural anesthetic. The HIFU-directed energy modality is best described as:

high-temperature nonionizing thermal energy.

The renal artery and vein enter and exit the kidney on the medial side of the organ through a concave area known as the:

hilum

A ___________ is a benign, fluid-filled sac that develops in the anterior testis

hydrocele

During _________ a fiberoptic hysteroscope is inserted through the cervix and into the uterus.

hysteroscopy

The Whipple procedure is the removal of the head of the pancreas, the entire duodenum, a portion of the jejunum, the distal third of the stomach, and the ____________ as a surgical treatment for____________.

lower half of the common bile duct; pancreatic cancer

While the pancreas' function is carbohydrate metabolism with the production of insulin and digestive enzymes, the spleen's function is primarily ___________ with the production of _______________.

immunologic; leukocytes

Protrusion of abdominal tissue through one or more abdominal layers is a(n) __________.

incisional hernia

Contributing factors to hernia formation include age, gender, previous surgery, obesity, nutritional status, and pulmonary and cardiac disease. The formation of the hernia at a site of weakness is due to any number of conditions that cause:

increased pressure within the abdomen.

A hernia in which abdominal viscera slides into the inguinal canal from the deep inguinal ring is a(n) __________.

indirected hernia

A urethral or ureteral catheter that is left in place is a(n) ________ catheter.

indwelling

Telescoping of the intestines, occurring mainly in children and resulting in ischemia and necrosis of the bowel is __________.

intussusception

Jeannie Donahue is admitted for the fourth time for treatment and management of her pseudomyxoma peritonei, or peritoneal cancer. She is scheduled for open laparotomy for inspection with lymph node surveillance and frozen sections and peritoneal washings for cytologic examination. Her surgical oncologist has recommended a treatment that may slow the growth of the tumor seedings and prolong her life: intraoperative intraperitoneal hyperthermic chemotherapy. Jeannie's perioperative nurse prepares the OR and instructs the new scrub person on chemotherapy safety precautions. For this procedure, it is imperative that the staff:

know how to use the chemo spill kit and where it is stored.

What procedure is being shown in this image?

laparaoscopic excision of an ectopic pregnancy

LAVH is the removal of the uterus by a combined ________ and vaginal approach.

laparoscopic

Which procedure is indicated by this trocar placement?

laparoscopic cholecystectomy

Women of high socioeconomic status and higher education also have a high incidence of breast cancer, most likely due to:

later age at first birth.

The abdomen is divided into nine regions; the organs located in the rib area is in the __________.

left and right hypochondriac regions

The abdomen is divided into nine regions; the organ located in the inguinal area is in the __________.

left and right iliac regions

LLQ refers to what part of the abdominal section?

left lower quadrant

A(n) _________ is a benign, smooth muscle tumor of the uterus.

leiomyoma

In robotic-assisted prostatectomy, the patient is prepped and draped for an abdominal laparoscopic procedure in the ________ position.

lithotomy

A midline incision is used for surgical procedures of the ___________.

liver

The spermatic cord in the male follows the inguinal canal and contains the following structures, EXCEPT __________.

lymph nodes

Excessive bleeding during menses is ____________.

menorrhagia

The freeing up of tissue from its attachments before anastomosis or resection is __________.

mobilization

What procedure is shown in this image?

modified radical mastectomy

Patients are ________ for postoperative swelling and possible hemorrhage.

monitored

During urologic surgery, large quantities of irrigating fluids are infused intraoperatively. Which of the following is appropriate?

monitoring and recording the volume of IV and irrigating fluids instilled.

When catheterizing the female patient, the urethra must be located. The correct order of the external organs of the vulva listed anterior to posterior is:

mons pubis, labia majora, labia minora, clitoris, urethra, vaginal opening.

Morris Bettelman, an 86-year-old retired plumber, states that he has suffered from a groin hernia all of his adult life; he states, "as far back as I can remember." Sometimes he has to push the bulge back into his abdominal muscle and then he is fine until he has a coughing spell. This morning the bulge was large and tender when he woke up and he could not reduce it. As the pain increased, he felt weak and nauseous. His daughter took him to the emergency department. Morris was diagnosed with a strangulated incarcerated hernia and scheduled for emergency surgery. If the contents of Morris' hernia sac become compromised, with strangulation of the bowel, the probable label on his surgical specimen will be:

necrotic bowel.

Whenever electrosurgical instruments are used, the irrigation fluid must be ________

nonelectrolytic

The biliary system (also called the biliary tree) drains bile from the gallbladder to the ampulla of Vater. The primary function of the gallbladder is to:

store and concentrate bile.

Seldom diagnosed before labor

nuchal cord

Usually occurs with an active baby in the early months of pregnancy

nuchal cord

Approximately 400,000 people die annually as a result of __________.

obesity

The kidneys are highly vascular organs. Approximately how much of the entire circulating blood volume do the kidneys process at any one time?

one fifth

What procedure is being shown in this image?

open appendectomy

Insertion of penile implant

open procedure

Kidney transplant

open procedure

Suprapubic prostatectomy

open procedure

Matthew Ryan, a 9-year-old boy, is admitted to the emergency department for a sledding accident, when he lost control of his sled and crashed into a tree. He is pale and in pain; his abdomen is tender and firm to palpation. The CT scan suggests rupture of the spleen with internal bleeding. Matthew's scheduled surgery will most probably be a(n):

open total splenectomy.

This occurs most often as a postoperative complication or a result of pelvic or back injury and peritonitis __________.

paralytic ileus

The anatomical area between the posterior vestibule and the anus is the ____________.

perineum

The ________ is a thick organ that adheres to the uterus on the maternal side.

placenta

Usually identified on routine ultrasound in the prenatal period

placenta previa

When the placenta implants completely or partially over the cervical os

placenta previa

Can be caused by abdominal trauma, abnormalities of the uterus, a short umbilical cord, and hypertension

placental abruption

Fetal demise results if the entire placenta separates from the uterus

placental abruption

Identify the pathology in this image

placental abruption

Premature separation of the placenta from the uterine wall

placental abruption

An example of an indication for liver transplantation would be:

primary hepatic cancer.

The ________ gland surrounds the urethra and secretes an alkaline fluid that contributes to seminal fluid.

prostate

A _________ hysterectomy is performed to treat pelvic malignancy.

radical

All of the following are supplies needed for a GI surgery, EXCEPT __________

raney clips

Backward (opposite of its normal direction) flow of a body fluid is _______

reflux

A procedure in which a section of an organ is cut apart or removed is __________.

resection

The _________ is constructed with an outer sheath that allows fluid outflow and an inner sheath for continuous irrigation.

resectoscope

RLQ refers to what part of the abdominal section?

right lower quadrant

The _____________ is a layered tissue sac that encases the testicles.

scrotum

During this procedure, a gamma ray detecting probe is used to determine which lymph nodes are affected.

sentinel lymph node biopsy

An inguinal (oblique) incision is made for surgical procedures of the _____________.

spermatic cord

When setting up for a gastrectomy, the scrub person will ensure that appropriate instruments are available to clamp and ligate the:

splenic vessels.

The internal thoracic lymph nodes, which drain the inner half of the breast, can also be a channel for the:

spread of metastasis.

A(n) ________ prosthesis is placed into the scrotal sac after orchiectomy

testicular

During a laparoscopic colectomy, the scrub person carefully placed the endoscopic electrosurgery instruments on the Mayo stand after inspecting the integrity of the insulation along the shaft. This practice is designed to meet the expectation for the following outcome: The patient will be free from:

thermal burns and adhesions, and impaired tissue integrity.

To place one or more clamps at a right angle to a tube or vessel is __________.

to cross-clamp

To place two clamps over a section of tissue to prevent bleeding when the tissue is severed is __________.

to double-clamp

Twisting of an organ or a structure on itself is ________.

torsion

Cystoscopy

transurethral procedure

TURP

transurethral procedure

Ureteral stent placement

transurethral procedure

Uses continuous irrigation

transurethral procedure

An abdominal wall defect occurring in the linea alba at the umbilical ring is a(n) __________.

umbilical hernia

The abdomen is divided into nine regions; the organ located in the umbilicus area is in the __________.

umbilical region

All of the following are distinct tissue layers that support the viscera, EXCEPT __________.

umbilicus

Moves urine along by peristalsis

ureter

Communicates with the lower bladder for excretion of urine from the body

urethra

Meatotomy

urethra

The ________ communicates with the lower bladder to enable excretion of urine from the body.

urethra

A lower transverse abdominal incision is made for surgical procedures of the __________.

uterus

The donor liver OR is prepared for an open laparotomy procedure with basic laparotomy and vascular instruments and accessories. A second sterile instrument table is set up to receive and prepare the procured liver. Select the additional instruments and accessories needed on the donor organ preparation table.

vascular instruments, silk sutures and ties, sterile ice, flushing solution, and slush machine.

The term ___________ refers collectively to all the structures located within the labia minora.

vestibule

Twisting of the bowel on itself is __________.

volvulus

The structures that together make up the external genitalia are called the _________.

vulva

Depending on their location, hernias are classified as direct inguinal, indirect inguinal, femoral, umbilical, incisional, or epigastric. Hernias in any of these groups are either reducible or nonreducible. The characteristic "reducible" hernia can best be described as a hernia:

with visceral contents that can be returned to the abdomen.