general surgery
large intestine order including the flexures
cecum, ascending colon, hepatic flexure, transverse colon, splenic flexure, descending colon, sigmoid, rectum
small intestine structure
duodenum, jejunum, ileum
Eviceration
Protrusion of an internal organ through a wound or surgical incision
Trendelenburg position
The body is laid flat on the back (supine position) with the feet higher than the head
friable
a descriptive term for tissue that means fragile and easily torn. eg spleen and liver
Cirrhosis
a disease of the liver in which the tissue hardens and the venous drainage becomes blocked. - caused by chronic alcoholism
carcinoma
a malignant tumor that occurs in epithelial tissue
Nissen fundoplication
a surgical technique used to suture the fundus of the stomach around the esophagus to prevent gastric reflux
exploratory laparotomy
abdominal operation for the purpose of examining the abdominal organs and tissues for signs of disease or other abnormalities
bile enters duodenum through
ampulla of vater
stoma
an opening created in the abdominal wall by an ostomy
what is the distal portion of the stomach
antrum
During laparotomy and laparoscopy, patients are
at a high risk for hypothermia.
morbid obesity
body mass index (BMI) of 40 or greater, which is generally 100 or more pounds over ideal body weight
modified radical mastectomy
the surgical removal of the entire breast and all of the axillary lymph nodes under the adjacent arm
the terminal end of the cecum has a slender tube called
vermiform appendix
the inner surface of the small intestine has a fingerlike projection called
villi
Incisional hernia
-The postoperative herniation of tissue into the tissue layers around an abdominal incision. -This may occur in the immediate postoperative period or later, after the incision has healed.
Abdominal peritoneum
-The serous membrane lining the walls of the abdominal cavity. -The retroperitoneum is the posterior aspect. In surgical discussions, abdominal usually refers to the anterior aspect.
Roux-en-Y gastric bypass
-bypass most of the stomach, -leaving small pouch to receive food -a part of the jejunum is reattached to the pouch to make food exit -the remaining jejunum limb is attached to the upper jejunum to allow gastric secretion to enter the intestines
large vessels are secured with what tie
0 or 2.0 tie / stick tie
esophagus in adult
10inches (25cm)
The ileum is how long?
13.5ft (4m)
the colon measures about
5ft (1.5m)
Duodenum is how long?
8-10 inches(20cm to 25cm)
Jejunum is how long?
9ft (2.7cm)
hook wire
A device used to pinpoint the exact location of a nonpalpable mass detected during a mammogram; also referred to as a hook needle. A fine wire is inserted into the mass during the examination, and the tissue around the needle is removed for pathological examination and definitive diagnosis.
skin flap
A flap that is created by incising the skin and cutting it away from the underlying tissue to which it is attached. The flap can be increased in size or "raised" as it is enlarged by dissection.
nasogastric tube
A flexible plastic tube running from the nose, through the esophagus, and into the stomach. It is used to either drain the stomach or to deliver medications and/or nutrients.
Billroth II procedure
A gastrojejunostomy, or surgical anastomosis, of the stomach and the jejunum.
strangulated hernia
A hernia in which abdominal tissue has become trapped between the layers of an abdominal wall defect. The strangulated tissue usually becomes swollen as a result of venous congestion. Lack of blood supply can lead to tissue necrosis.
direct inguinal hernia
A hernia that results from weakness in the inguinal floor.
Exploratomy laparotomy
A laparotomy is performed to exmaine the abdominal cavity when less invasive measures fail to confirm a diagnosis.
Bowel technique
A method of preventing cross-contamination between the bowel contents and the abdominal cavity.
sentinel lymph node biopsy
A procedure in which one or more lymph nodes are removed to determine whether a tumor has metastasized
laparotomy
A procedure in which the abdominal cavity is surgically opened. The techniques used for laparotomy are used for all open surgical procedures of the abdomen.
subcutaneous mastectomy
A procedure in which the breast is removed, but the skin, nipple, and areola are left intact; -also called a lumpectomy.
hernia
A protrusion of tissue under the skin through a weakened area of the body wall.
Technetium-99
A radioactive substance used to identify sentinel lymph nodes.
linea alba
A strip of avascular tissue that follows the midline and extends from the pubis to the xiphoid process.
gastrostomy
A surgical opening through the stomach wall connecting to the outside of the body or another hollow anatomical structure.
anastomosis
A surgical procedure in which two hollow structures are joined.
Stoma appliance
A two- or three-piece medical device used to collect drainage from a stoma. The appliance is attached to the patient's skin and completely covers the stoma. This allows free drainage into a collection device or bag.
Ventral hernia
A weakness in the abdominal wall, usually resulting in protrusion of abdominal viscera against the peritoneum and abdominal fascia.
fistula
An abnormal tract or passage leading from one organ to another or from an organ to the skin; usually caused by infection.
McBurney incision
An incision in which the oblique right muscle is manually split to allow removal of the appendix.
Billroth I
Anastomosis of the remaining portion of the stomach to the duodenum. - also called gastroduodenostomy
segmental resection
Anatomical resection of the liver in which segments divided by specific blood vessels and biliary ducts are removed.
pancreatic duct is also called
Duct of Wirsung
Esophagoduodenoscopy
Endoscope is used to look at the esophagus, stomach, and duodenum
the liver is encapsulated by a thick fibrous sheath called
Glisson capsule
incarcerated hernia
Herniated tissue that is trapped in an abdominal wall defect. Incarcerated tissue requires emergency surgery to prevent ischemia and tissue necrosis.
dialators for esophagus are
Maloney, salary and ballon type
hemorrhoidectomy
excision of hemorrhoids, the swollen or distended veins in the rectal region
the liver is separated into two lobe by
falciform ligament
when anastomosing the mucosa and submucosa, what suture is used
fine absorbable 3.0 or 4.0 suture on a taper needle
babcock are used to
grasp intestinal tissue.
the vascular supply of the liver is derived from
hepatic artery and hepatic portal vien
the tail of the pancreas lies near the
hilus of the spleen
the liver is drained by the hepatic vien which connects to
inferior vena cava
endoscopy
insertion of a flexible tube into a natural opening in the body
ostomy
is a procedure in which a portion of the intestines is divide and the open end is secured to the skin, draining bowel and urine content outside the body
anastomosis
is a surgical connection between two hollow, or tubular, structures
End-to-end anastomosis
is the joining of two ends of bowel where they terminate
insulin and glucagon are produced by
islet of lengerhans
What is in retroperitoneal cavity?
kidneys, adrenal glands and ureters
during the resection of the jejunum and ileum what should be clamped and divided
mesentery
what supplied blood to the lower section of the small intestine
mesentery
what attaches the greater and lesser curvature of the stomach and covers the intestinal fold, providing warmth and protection to the viscera
omentum
whenever a portion of the stomach is removed the _____ is separated
omentum
-ostomy (suffix)
opening between two hallow organs
viscera
organs or tissue of the abdominal cavity
sigmoid colon lies in what cavity
pelvic cavity
Side-to-side anastomosis
performed by aligning two linear parts of the bowel - linear stapler is required
food travels down esophagus by
peristalsis (contractions)
Subhepatic space lies between
peritoneal covering on the liver and right kidney
the esophagus extends from
pharynx to stomach
synthetic mesh is made of synthetic material like
prolene, dacron and mersilence
what kind of suturing is used for appendectomy
purse string suture
the abdomen is divided into four major sections called
quadrants
Hesselbach's triangle borders
rectus abdominus, inguinal ligament, inferior epigastric vessels direct hernia through triangle
ileostomy
refers to the opening between the ileum and the outside abdominal wall for drainage
hemicolectomy
removal of a section of diseased colon and restoring continuity to the intestines.
lobectomy
removal of one or more anatomical section of the lung or liver
the pelvic cavity contains ?
reproductive organs, genitourinary(bladder) and lower GI systems(rectum)
Indirect inguinal hernia
result in protrusion of the abdominal viscera into the inguinal canal from the deep inguinal ring. -in female it can protrude to the labia -in male it can extend through the superficial ting within the spermatic cord and into the scrotum.
Nine regions of the abdomen
right hypochondriac, epigastric, left hypochondriac, right lumbar, umbilical, left lumbar, right iliac, hypogastric, left iliac
the anterior surface of the liver which is in contact with the diaphragm is referred to as
right or left subphrenic sopace
sutures used on hernia repair
silk and polyester, prolene
when anastomosing the Serosa layer of GI tract, what suture is used
silk or synthetic material on a taper needle
Sutures used for the peritoneum
size 0 absorbable synthetic on a curved needle running suture
sutures for fascia
size 0 and 2-0 synthetic braided suture such as polyester in a cutting or taper needle may be used.
Layers of the abdominal wall
skin-subcutaneous(fatty tissue)-fascia- muscle- peritoneum-
the sphinter located at the distal end of the common bile duct that open into the duodenum
sphincter of oddi
mastectomy
surgical removal of a breast except the lymph node - also called simple mastectomy
appendectomy
surgical removal of the appendix
sutures for skin
synthetic absorbable like monocrly
suture for subcutaneous fat
synthetic absorbable suture like dexon 3.0 on a taper need
sutures for muscle
synthetic absorbable sutures size 2.0 or 3.0 interrupted sutures
Reverse Trendelenburg
the body is laid flat on the back with the head higher than the feet
because hypothermia is a risk during a laparotomy and a laparoscopic procedure, _________ is therefore a high priority for the patient safety during all abdominal procedure
thermoregulation
reduce
to manipulate herniated tissue back into its normal anatomical position