Quiz 7
A vacuum beanbag positioning device and an Axillary role are commonly used in the prone position Answers: True False
False (lateral)
A Dexon suture is the best choice in vascular procedures for suturing in grafts. Answers: True False
False (prolene)
A Surgeons knot consists of two half-hitches in the same direction followed by the third half-hitch made in the same direction of the first two Answers: True False
False (third made in opposite direction)
PT (Prothrombin Time) = Answers: 11-12.5 sec. 60-70 sec. 70-180 sec 30-40 sec.
11-12.5 sec.
Hemoglobin (HGB) Normal Adult Range female Answers: 37 - 47% 12 - 16 g/dl 40 - 54% 14 - 18 g/dl
12 - 16 g/dl
Sodium (Na) serum - Normal level Adult = Answers: 135 to 145 mEq/L 3.5 to 5 mEq/L 8.5 to 10 mg/dL 90 to 165 mEq/L
135 to 145 mEq/L
Natural active immunity- temporary immunity from receiving a injection of immune serum taken from another individual or animal which has produced antibodies against a specific pathogen. Example- tetanus and rabies Answers: True False
False (artificial passive immunity)
Coumadin acts as an anticoagulant by inhibiting vitamin C Answers: True False
False (inhibits vitamin K)
In Spinal anesthesia the local anesthetic is injected into the subarachnoid space Answers: True False
True
is an active collagen available in powder form. It is applied directly to a bleeding surface, followed by placing firm pressure using a dry sponge. Answers: Thrombin Avitene Surgicel Gelfoam
Avitene
The wound enters into the respiratory, alimentary, genital, or urinary tract under controlled conditions without unusual contamination; an example of this is a nonperforated appendectomy or a vaginal procedure Answers: Clean Contaminated Dirty Clean contaminated
Clean contaminated
Facultative bacteria live in anaerobe conditions Answers: True False
False ( in either aerobe or anaerobe)
"the thing speaks for itself" Answers: Doctrine of Res Ipsa Loquitur Primum Non Nocere Doctrine of Foreseeability Doctrine of detrimental reliance
Doctrine of Res Ipsa Loquitur
cells contain a true nucleus bound by a nuclear membrane and membrane-bound organelles; the nucleus divides by mitosis Answers: Prokaryotic Algae Eukaryotic mitosis
Eukaryotic
Hypokalemia over than 8 may be associated with vomiting, severe perspiration, diarrhea or loop diuretics such as lasix and may result in cardiac arrhythmias Answers: True False
False
a technique used in gastrointestinal surgeries. It can be applied as either an interrupted or continuous suture that repairs the collagenous submucosal layer without disturbing the lumen, Answers: Horizontal mattress Vertical mattress Connell Lembert
Lembert
An excessive formation of mass of granulation tissue Answers: Purulent Proud flesh Cicatrix Keloid
Proud flesh
The force the suture can withstand before breaking Answers: Lembert Connell Tensile strength capillary action
Tensile strength
1 OR 2% Lidocaine has a duration of 1.5-2 hours Answers: True False
True
A microorganism that is able to cause a disease is called a pathogen. Pathogenicity is the ability of an organism to produce a disease. Virulence is the intensity of the pathology produced by the pathogen Answers: True False
True
A prion is an infectious agent that induces abnormal folding of normal cellular prion proteins in the brain. The various transmissible spongiform encephalopathies caused by prions lead to brain damage and death. Creutzfeldt-Jakob disease (CJD) or mad cow disease is the most well known. Answers: True False
True
A square knot is composed of two half-hitches, made in the opposite direction of each other Answers: True False
True
Bipolar Current does not require a ground pad, the current flows between the tips of the forceps (one tip is the active electrode and the opposite tip is inactive), a foot pedal is used to activate the current. The Bipolar is used on delicate procedures such as neurosurgery where exact accuracy to a very specific area is required. Current only flows to tissue grasped by the forceps. Answers: True False
True
Blood, Urea, Nitrogen (BUN) Adult7-25 mg/dl is a measurement of renal function and liver function Answers: True False
True
Epidermis layer is further divided into five, separate layers. In order from most superficial to deepest, they are the: Stratum Corneum Stratum Lucidum Stratum Granulosum Stratum Spinosum Stratum Basale Answers: True False
True
Ethilon® a monofilament suture has Around 20%-25% of tensile strength remaining at 1 year - losses Tensile Strength over time Answers: True False
True
HCO3 Calculated value of the amount of bicarbonate in the bloodstream normal range 22 to 26 mEq/L Answers: True False
True
Halsted's principles include: gentle handling of tissues, meticulous hemostasis, strict aseptic technique, sharp dissection of tissue, using the minimal amount of smaller gauge non-irritating suture material during wound closure, never leave a dead space during wound closure and avoid tension during wound closure. Answers: True False
True
Hypermagnesemia may be associated with: medications such as lithium, hyperthyroidism, acidosis, viral hepatitis or tumor metastases. An individual may experience Bradycardia, respiratory depression, nausea or muscle paralysis. Hypomagnesaemia is most often associated with GI or Urinary loss. The individual may experience confusion, psychosis, vomiting, arrhythmias, tremors, vertigo or seizures. Answers: True False
True
In a CT scan several radiation beams and electronic radiation detectors rotate around the patient while the patient moves through the machine measuring the amount of radiation absorbed by the body. A computer processes the information and creates two dimensional cross sectional images Answers: True False
True
In the Supine position if the feet extend beyond the bed an extension must be added. Prolonged plantar flexion can cause foot drop, so a padded footboard can be placed against the bottom of the foot. Answers: True False
True
In the lithotomy position; If the lateral side of the knee is allowed to rest against the metal stirrup, pressure on the peroneal nerve may occur. Answers: True False
True
In the presence of Possible infection an interrupted closure is the best option Answers: True False
True
Laser is an acronym for "light amplification by the stimulated emission of radiation". A laser controls how the atoms raised to a higher energy level release photons. In a laser the medium contained in the resonating chamber (laser head) is subjected to a high energy source such as electricity or light which causes the atoms in the medium to move to a higher energy level and then return to a lower level releasing photons. Answers: True False
True
Local anesthetics are divided into amide and ester classes. Amide includes the commonly used lidocaine and bupivacaine (Marcaine) Answers: True False
True
Mechanical hemostasis uses instruments, tourniquets, and dressings to clamp or occlude blood vessels until the clotting mechanism forms a clot. Mechanical hemostasis can be accomplished by Placing bone wax over cut bone edges Answers: True False
True
Most Frequently Damaged Nerve Of Lower Extremity!!! Common Peroneal/Fibular Nerve caused by Compression of lateral aspect of knee against stirrup and patient in the Lateral position. Answers: True False
True
Naloxone (Narcan) is an opiate antagonist that reverses the effects of opiates. Answers: True False
True
Negligence is the act of omission or commission of an act that a reasonable and prudent individual would not do under the same circumstances. In medical negligence the patient must establish a basic case by establishing the FOUR D's: Duty -owed to the patient-established physician-client relationship. Derelict -breach of standard care Direct Cause-causation- damage or injuries that resulted from the physician's breach of duty were directly related to that breach and that no intervening acts could have caused the damages. Damage - to the patient. Actual-damages that compensate for injuries sustained such as medical care and loss of wages ect...). Exemplary or punitive damage awards the patient for pain, suffering, and mental anguish. Answers: True False
True
On the fracture table excessive pressure from the post can cause injury to the genitalia and pudendal nerve. Injury to the pudendal and perineal nerves can cause fecal incontinence and loss of perineal and penile sensation. Answers: True False
True
Partial prothrombin time (PTT) is Often preformed to determine if heparin (blood thinning) therapy is effective and or detection of a clotting disorder. Activated partial thromboplastin time (APTT) more sensitive than PTT Answers: True False
True
Pezzer or Malecot catheters are Self-retaining catheters used to drain the bladder for suprapublic bladder drainage; the catheter drains by gravity and is connected to a drainage container Answers: True False
True
Platelets are small fragments of megakaryocyte cytoplasm found in the blood; essential for clotting. A platelet count between 40,000 and 100,000/mm3 normally represents thrombocytopenia and could cause bleeding during and after surgery Answers: True False
True
Polyglycolic acid ( Dexon®) A Braided suture Loses around 45% of tensile strength by 2 weeks; majority absorbed by the body by 1 month Answers: True False
True
Primary or first intention healing occurs in three phases: inflammatory, proliferation, and maturation Answers: True False
True
Respiratory Acidosis is an increased accumulation of carbon dioxide resulting in increased acidity of body fluids. < ph >HCO3 >pCo2 . Answers: True False
True
Serum Bilirubin: Adult normal values 0.3-1.0 mg/dl increased values are associated with liver disease, mononucleosis, drug abuse, low exposure to sunlight or hemolytic anemia. Answers: True False
True
Stent dressing are used when the wound is on an area of the body where a pressuring dressing cannot be placed, for example the head and neck. The long ends of sutures are tied over the dressing to keep it in place allowing evenly placed pressure over the wound Answers: True False
True
The Fowler position is a sitting position with the patient lying on their back with the buttocks over the middle bend in the operating bed and the knees padded over the lower break. The upper section of the OR bed is raised to as much as 90 degrees and the knees are flexed by slightly lowering the foot section of the bed Answers: True False
True
The Gram stain distinguishes between gram-positive and gram negative bacteria. The differences in the bacteria cell wall will cause gram-positive bacteria to stain purple and gram-negative bacteria to stain pink. Answers: True False
True
The Reverse Trendelenburg position has the patient supine with the entire bed tilted with head up and feet down. This position causes the abdominal viscera to move downward toward the pelvic cavity increasing exposure of the organs in the upper abdominal cavity. It may be used for surgery on the gallbladder, biliary tract, liver, stomach, or lower esophagus, such as laparoscopic Nissen fundoplication, procedures on the head, and to expose the neck for a thyroidectomy. Reverse Trendelenberg and Foot Board Caution: 1. Excessive plantar flexion of the feet for extended periods of timea. Anterior tibial nerve injury (Stretching) b. Results in foot drop--Common Fibular and Anterior Tibial Nerve Injury 2. Reverse trendelenberg position decreases venous return to the heart Answers: True False
True
The first part of a urinalysis is direct visual observation. Normal, fresh urine is pale to dark yellow or amber in color and clear. Normal urine volume is 750 to 2000 ml/24hr. Answers: True False
True
The knot preferred in surgery is a square knot, also called a reef knot. Answers: True False
True
The light beam of a Carbon Dioxide (CO2) laser is invisible and is delivered through an articulating arm. In order to see the beam usually a helium-neon laser beam is added to produce visible red aiming beam. The CO2 laser uses carbon dioxide, nitrogen, and helium gases Answers: True False
True
The main component of a bacteria cell wall is peptidoglycan. The main function of the wall is to maintain the bacteria cells shape. Surrounding most bacteria cells is the glycocalyx. This structure is also called the capsule. The capsule helps keep the cell from drying out and aids in protection from phagocytosis Answers: True False
True
The most common nosocomial infection is a urinary tract infection caused by Escherichia coli, Kelbsiella and other bacteria Answers: True False
True
The three basic mechanisms of hemostasis are 1. Vasoconstriction, 2. Platelet plug formation, 3. Clotting of blood. Answers: True False
True
The thyroid gland, a butterfly-shaped mass of glandular tissue in the base of the neck, performs the vital function of controlling the body's metabolism through its hormones triiodothyronine (T3) and thyroxine (T4). Both T3 and T4 are produced in response to TSH from the pituitary gland and boost the metabolic rate of many diverse cells throughout the body. Calcitonin, another important thyroid hormone, helps to regulate the body's calcium levels by reducing the amount of calcium ion in the blood. Answers: True False
True
To apply cricoids pressure (Sellick's maneuver) locates the thyroid prominence on the front of the neck in the midline. With your fingers on the thyroid prominence move your fingers down staying in the midline until your fingers drop into the cricothyroid notch. Place your index finger and thumb on each side of the cricoid cartilage and press directly backwards. The amount of pressure required seems to vary depending on the source; however an average suggested force between 30 and 40 Newtons (6.6 to 8.8 pounds) seems to be the average suggested pressure. Answers: True False
True
To tie under tension, reverse the direction of a surgeon's knot to hold down the first throw. After bringing down the first throw in a square knot (two half hitches in the same direction), reverse the direction of pull to lock down the first throw while you make the second throw. Answers: True False
True
Troponin T less than 0.2 mcg/L and Troponin I less than 0.03 mcg/L. Cardiac specific muscle proteins rise when cardiac muscle is damaged. Answers: True False
True
When the clotting factors are activated they go through a series of steps referred to as a clotting cascade (the third mechanism). During the cascade---Thrombin (derived from prothrombin) converts fibrinogen to fibrin. Thrombin is a key factor in the clotting process. At first the mesh formed by fibrin is loose. Factor XIII causes the fibrin strands to form crosslinks creating a dense aggregation of fibers. This meshwork of fibers traps erythrocytes and platelets to form a clot. Answers: True False
True
While holding a clamp on a vessel always show the surgeon the tip of the instrument so the surgeon can ensue the free tie or strand of suture is correctly placed. Always hold the instrument steady without pulling upwards in order to keep from pulling the instrument off the vessel being tied or tearing the vessel. Answers: True False
True
Wound Vac: The application of negative pressure in vacuum-assisted closure removes edema fluid from the wound through suction. This results in increased blood flow to the wound (by causing the blood vessels to dilate) and greater cell proliferation. Another important benefit of fluid removal is the reduction in bacterial colonization of the wound, which decreases the risk of wound infections. Through these effects, vacuum-assisted closure enhances the formation of granulation tissue, an important factor in wound healing and closure. Answers: True False
True
pH is the negative logarithm of the hydrogen ion concentration in blood Answers: True False
True
the goals when closing a wound are to evert and approximate the edges of the wound. To "approximate, not strangulate" tissue, begin each stitch with the hand properly holding the needle holder in full pronation and then slowly supinate the hand, placing the needle through the tissue. Answers: True False
True
A type of wound healing in which wound edges are not approximated (closed), the wound is left to heal from the inner layer to the outside surface (heals from bottom up) by formation of granulation tissue and contraction Answers: primary first intention second intention third intention
second intention