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An example of an indication for liver transplantation would be

Primary hepatic cancer

An indirect inguinal hernia can result from the failure of the ___________________ to regress.

Processus vaginalis

Which hormone is responsible for promoting growth of the lobular structure of the breast?

Progesterone

which term refers to a movement that decreases the angle of a joint

flexion

The pharmacologic agent used to delineate lymph nodes is which one of the following?

Lymphazurin

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

Deaver retractors will replace Richardson retractors with the heavier patient.

What proportion of women presenting with a palpable breast mass are diagnosed with cysts?

15%

Which of the following hormones from the anterior pituitary control secretion of breast milk?

Prolactin

Epinephrine is combined with local anesthetics to:

Prolong the effects of local anesthesia.

Which blood vessels SUPPLY the liver with blood?

Hepatic artery and hepatic portal vein

What is the name given to the anatomical landmark where the common bile duct meets the pancreatic duct?

Hepatopancreatic ampulla of Vater

What kind of anesthetic block is used for a vitrectomy procedure?

retrobulbar

What balance of hormones favors growth of the mammary glands during pregnancy?

High progesterone:estrogen ratio

A congenital condition in which parasympathetic innervation is missing from a section of the colon, impairing motility is referee to as:

Hirschsprung's disease

in a(n) hernia tissue protruding from the hernia may be swollen and squeezed

strangulated

To place one or more clamps at a right angle to a tube or vessel is: Select one: a. to cross-clamp b. to double-clamp c. resection d. anastomosis

a. to cross-clamp

with in vitro fertilization the embryos are transferred first to the upper uterine fundus, then fertilized with the freshsemen and allowed to implant a-true b- false

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 replaced richardson retractors in the heavier patient

An inguinal (oblique) incision is made for surgical procedures of the _____________? Select one: a. liver b. spermatic cord c. spleen d. appendix

b. spermatic cord

During a loop colostomy, the assistant retracts the abdominal wall with a: Select one: a. Kelly retractor b. right angle retractor c. Deaver retractor d. Richardson retractor

b. right angle retractor

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

subcostal

RUQ refers to what part of the abdominal section? Select one: a. right lower quality b. right upper quadrant c. right upper quality d. right lower quadrant

b. right upper quadrant

In a _____________ hernia, tissue protruding from the hernia may be swollen and squeezed. Select one: a. Spigelian b. strangulated c. incisional d. direct inguinal

b. strangulated

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

hepatocytes; bile

telescoping of the intestines occurring mainly in children and resulting in ischemia and necrosis of the bowel is

intussusception

Which structure of the eye is colored and its muscles constrict or relax to control the amount of light entering the pupil?

iris

The breast spans vertically between which costal cartilages?

2nd and 6th

What volume of colostrum is typically produced following birth?

40ml/day

The organs and organ systems that are including in general surgery are the following EXCEPT:

A.spleen B.pancrease C.femur D.breast c.femur

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

Strangulated hernia

A trephine is used in which ophthalmologic procedure?

keratoplasty

Which part of the rectum relaxes to accommodate feces?

Ampulla

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

Access, visualization, good lighting, clamps

What is the initial pathological change in alcoholic liver disease?

Accumulation of fat in hepatocytes with hepatomegaly

To place two clamps over a section of tissue to prevent bleeding when the tissue is severed is: Select one: a. to cross-clamp b. to double-clamp c. anastomosis d. resection

b. to double-clamp

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

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 are very vascular

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

What is the clinical significance of 'vascular segments' of the spleen?

Allows for subtotal splenectomy

Which of the following individuals is likely to develop acute gastritis?

An individual with an allergy to shellfish

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

A procedure in which two hollow organs are joined surgically is:

Anastomosis

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

What is the recommended first-line management for simple lactational mastitis?

Antibiotics and continue breastfeeding

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 (left thoracoabdominal incision; right posterior lateral thoracotomy and midline abdominal incision; or three-incision [three-hole] approach with cervical, right thoracotomy, and midline laparotomy incisions) may e used per surgeon preference or tumor location.

The majority of superficial lymphatic vessels accompanying the cephalic vein go on to enter which set of lymph nodes?

Apical axillary lymph nodes

What does the pathophysiology of chronic gastritis include?

Atrophy of the gastric mucosa with decreased secretions

Which of the following breast masses infer an increased risk of developing breast cancer?

Atypical ductal hyperplasia

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

What causes massive inflammation and necrosis in acute pancreatitis?

Autodigestion of tissue by pancreatic enzymes

Which of the following nodes receives the majority of breast tissue lymph?

Axillary nodes

What type of instrument is used to grasp the loop of transverse colon?

Babcock

What does the term periodontitis refer to?

Bacterial damage to the teeth and surrounding alveolar bone

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

Which of the following is contained in pancreatic exocrine secretions?

Bicarbonate ion

Yellow or greenish stained vomitus usually indicates the presence of:

Bile

What does the term melena mean?

Blood in a dark-colored stool

what does the term melena mean?

Blood in a dark-colored stool

Which of these is not a common symptom of pancreatitis?

Blood in stools

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?

Both procedures require only an abdominal skin incision(s) as the rectal segment is removed and anastomosed intraluminally.

Which of the following best describes steatorrhea?

Bulky, fatty, foul-smelling stools

From which artery does the splenic artery arise?

Celiac trunk

Which structure is NOT considered part of the portal triad?

Central vein

Carly Shelmire is a 5-year-old girl with ah 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.

Which of these is not a condition that arises at a porto-systemic shunt as a result of portal hypertension?

Caput Medusae

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.

Complete the sentence: The esophagus opens out into the _____________ of the stomach.

Cardia

Which of the following would a perforated gastric ulcer likely cause?

Chemical peritonitis

How does iron deficiency anemia frequently develop with ulcerative colitis?

Chronic blood loss in stools

What indicates the presence of third-stage alcohol hepatitis?

Decrease production of blood clotting factors

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 descries Ann's procedure?

Colonoscopy with endoscopic ultrasound (EUS)

Which of the following is NOT a difference between colostrum and mature breast milk?

Colostrum contains fewer immunoglobulins

What causes hypovolemic shock to develop with intestinal obstruction?

Continued vomiting and fluid shift into the intestine

What does the term gluconeogenesis refer to?

Conversion of excess glucose into glycogen for storage

What does the defecation reflex require?

Coordination through the sacral spinal cord

what does the defecation reflux require?

Coordination through the sacral spinal cord

A _____ breast biopsy is taken when a biopsy needle is inserted into the mass and tissue is retrieved for histologic examination.

Core biopsy

The bare area of the liver is bounded by which hepatic ligament?

Coronary

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

Cross- clamp

Which vessel is the main arterial supply to the gallbladder?

Cystic artery

In peptic ulcer disease, which of the following does NOT decrease the resistance if the mucosal barrier?

Decrease vagal stimulation

malnutrition may develop in children with celiac disease because of:

Damage to the intestinal villi

Choose the significant change in arterial blood gases expected with prolonged severe vomiting:

Decreased bicarbonate ion, decreased PCO2, serum pH 7.35

What indicates the presence of third-stage alcohol hepatitis?

Decreased production of blood clotting factors

What is the primary cause of increased bleeding tendencies associated with cirrhosis?

Deficit of vitamin K and prothrombin

What is the definition of dysphagia?

Difficulty in swallowing

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

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

Direct inguinal hernia on the right

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

Direct inguinal hernia.

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.

During a colon resection, the ----- is often removed

Distal ilium

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.

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

Division

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

Double- clamp

Which of the types of invasive breast cancer listed below has the highest incidence of occurrence?

Ductal carcinoma

which is a functional of the liver? a- forms blod elements b- secrets insulin c- synthesizes cholecteron d- store white blood cells

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

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 and 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 the 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

What type of breast biopsy involves removing the entire mass for pathologic study?

Excisional biopsy

The inferior epigastric artery forms the lateral border of inguinal triangle. From which artery does it arise?

External iliac

Which ligament attaches the liver to the anterior abdominal wall?

Falciform ligament

Overhead OR spotlights should be placed on highest setting to provide necessary illumination during intraocular procedures.

False

a gastrostomy is a procedure involving the passage of a flexible fiberoptic gastroscope to inspect the mucosal walls of the stomach.

False

A hernia arising from a weakness in the transversalis fascia below the inguinal ligament is a(n):

Femoral hernia

For what reason may a subcutaneous mastectomy be performed?

For patients with chronic mastitis

What does the term gluconeogenesis refer to?

Formation of glucose from protein and fat

How does chemical peritonitis and shock frequently result from acute pancreatitis?

Inflammation and increased vascular permeability of the peritoneum affect fluid balance.

. 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

which procedure is performed to treat gastroesophageal reflux?

Fundoplication

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

Which of the following processes is likely to occur in the body immediately after a meal?

Glycogenesis

What is the likely effect of long-term exposure to a hepatotoxin?

Gradual irreversible damage to the liver and cirrhosis

The gastrosplenic and splenorenal ligaments are part of which structure?

Greater omentum

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

What is the most common type of hepatitis transmitted by blood transfusion?

HCV

What is frequently the first manifestation of stress ulcers?

Hematemesis

In lymphangitis, which group of axillary lymph nodes tends to be affected first?

Humeral

Deep lymphatic vessels of the upper limb terminate in which lymph nodes?

Humeral axillary lymph nodes

How does fat necrosis appear on ultrasound?

Hyperechoic mass

Which of the following frequently occurs 2 to 3 hours after meals in post-gastrectomy patients?

Hyporglycemia

Which of the following represents the replacement device for the cataract lens in the eye?

IOL

During the course of a hepatitis B infection, the onset of jaundice occurs in the:

Icteric stage

What is the cause of inflammatory bowel disease?

Idiopathic

Which of the following is the primary site for absorption of nutrients?

Ileum

Why does mild hyperbilirubinemia occur in newborns?

Immature liver cannot process bilirubin quickly enough

Where are Kupffer cells found?

In the hepatic sinusoids

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

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

Incisional hernia

Which factors contribute to ascites in patients with cirrhosis?

Increased aldosterone and deficit of albumin

What is the primary cause of esophageal varices?

Increased hydrostatic pressure in the veins

Which of the following is NOT an action of the vagus nerve on the stomach?

Increased pyloric sphincter tone

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

Indirect inguinal hernia

Identify a major reason making it difficult to prevent the spread of hepatitis B.

Infection is often asymptomatic.

How does pelvic inflammatory disease frequently lead to bacterial peritonitis?

Infection spreads through the fallopian tubes directly into the peritoneal cavity.

Which structure would be least likely to be damaged in a stab wound to a male rectum?

Inferior mesenteric artery

What are the typical changes occurring with Crohn's disease?

Inflamed areas of the wall of the ileum alternating with thick fibrotic or normal areas

What causes the characteristic rigid abdomen found in the patient with peritonitis?

Inflamed peritoneum, resulting in reflex abdominal muscle spasm

An __________ (oblique) incision is made for surgical procedures of the spermatic cord.

Inguinal

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

Inguinal canal, femoral rings, umbilicus

Which of the following is NOT a part of the roof of the inguinal canal?

Inguinal ligament

Select the triad of the boundaries of the Hesselbach triangle.

Inguinal ligament, rectus abdominis muscle, deep epigastric vessels

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

Inssusception

What vessel provides arterial supply to the medial aspect of the breast?

Internal thoracic artery

How does localized peritonitis develop from acute appendicitis before rupture?

Intestinal bacteria escape through the necrotic appendiceal wall.

Telescoping of the intestines occurring mainly in children and resulting in ischemia and necrosis of the bowel is:

Intussusception:

Which statement about the McBurney incision is most correct?

It is an oblique inguinal incision in the right lower quadrant

Which of the facts listed below is true regarding the sentinel node?

It is located in the same site in every patient.

Which of the following applies to hepatitis A infection?

It is transmitted by the fecal-oral route.

Which of the following genetic disorders is most associated with gynecomastia?

Klinefelter's syndrome

A patient presenting with gynecomastia secondary to testicular failure would present with which of the following blood panels?

LH high and testosterone low

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

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

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 incisions?

Laparoscopic port incisions.

What type of incision will be used for a vagotomy?

Laparotomy

A surgical intern is performing (with assistance!) a left hemicolectomy. How can she differentiate large bowel from small bowel?

Large bowel is marked by small pouches of peritoneum filled with fat

Which of the following is not a risk factor for invasive ductal carcinoma?

Late menarche

The superficial vessels travelling with the basilic vein terminate in which nodes?

Lateral axillary

What would be the likely outcome from chemical peritonitis related to a perforated gallbladder?

Leakage of intestinal bacteria into blood and the peritoneal cavity

LLQ

Left Lower Quadrant

LLQ refers to what part of the abdominal section

Left Lower Quadrant

LUQ

Left Upper Quadrant

Which of the following is NOT an attachment of the greater omentum?

Lesser curvature of the stomach

How does the spleen connect to the pancreas?

Ligaments that join the tail of the pancreas

During a total mastectomy, what must the surgical technologist have readily available?

Ligating clips (same as hemostat clip you pick up with a clip applier)

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

Liver

A midline incision is used for surgical procedures of the_____

Liver

In which structure is oxygenated blood (arterial) mixed with unoxygenated blood (venous) so as to support the functions of the structure?

Liver

to which site does colon cancer usually first metastasize?

Liver

Which of the following is not considered a benign breast condition?

Lobular carcinoma

What incision is mainly used for a pancreaticoduodenectomy procedure?

Long right paramedian

Which of the following is a major cause of primary hepatocellular cancer?

Long-term exposure to certain chemicals

A __________ abdominal incision is made for surgical procedures of the uterus?

Lower Transverse

What pain is typical of diverticulitis?

Lower left quadrant

The abdomen is divided into nine regions; the organ located in the flank area is in the:

Lumbar

A 58 year old woman is confirmed to have invasive ductal carcinoma on tissue biopsy pathology. In consultation with her physicians, she makes it clear that she is opposed to getting radiation therapy, for fear of side effects. What is the most appropriate treatment option for this patient?

Mastectomy of affected breast

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

McBurney

A study was conducted that compared laparoscopic and open-mesh methods of inguinal hernia repair and also compared TEP and TAPP techniques for cost and patient outcome effectiveness. Some of the factors measured included patient's return to prior activities, persisting pain and numbness, infection, length of operation time, and complications. The researchers discovered several compelling findings and many differences between the two approaches.

Mesh infection rate was low with both techniques. There was no apparent difference in the rate of hernia recurrence

What type of cellular adaptation is seen in Barretts Esophagus?

Metaplasia

What is the embryonic precusor to the appendix?

Midgut

A _________ incision is used for surgical procedures of the liver.

Midline

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

Mobilization

Which part of the gallbladder is the most common location of gallstone impaction?

Neck- Hartmans pouch

Why is amputation frequently a necessity in diabetics?

Necrosis and gangrene in the feet and legs

What does congenital esophageal atresia cause?

No fluid or food entering the stomach

What type of epithelium is found in the rectum below the pectinate line?

Non-keratinized squamous lines the epithelium below the pectinate line as it is derived from ectoderm

Which part of the colon is enveloped by visceral peritoneum?

None of the above

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

what incision is most commonly used for an open inguinal hernia?

Oblique inguinal

What usually initiates acute appendicitis?

Obstruction of the lumen of the appendix

Small, hidden amounts of blood in stool are referred to as:

Occult blood

What would be the result of chronic bleeding from gastric carcinoma?

Occult blood in the stool and anemia

prolonged or severe stress predisposes to peptic ulcer disease because:

Of reduced blood flow to the gastric wall and mucous glands

Which of the following statements about pancreaticoduodenectomy is true?

Pancreaticoduodenectomy 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 lower half of the common bile duct.

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

Paralytic ileus: (Paralysis of the ileum)

What type of incision is used for surgical procedures of the pancreas?

Paramedian

Which of the following cells in the gastric mucosa produce intrinsic factor and hydrochloric acid?

Parietal cells

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.

Which nodes primarily receives lymph from the anterior thoracic wall?

Pectoral

The spermatic cord is retracted with a small _________________.

Penrose drain

The spermatic cord is retracted with small______

Penrose drain

The spermatic cord is retracted with a small _________________.

Penrose drain.

Select the option that pairs the correct surgical diagnosis with 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

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.

Where do the testes originate from?

Posterior abdominal wall

In a direct inguinal hernia the peritoneal sac enters the inguinal canal through which anatomical area?

Posterior wall

Which of the following is the most frequent location of peptic ulcers?

Proximal duodenum

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

Purse string suture

what type of procedure may be performed in patients with an obstructing pyloric ulcer?

Pyloroplasty

all of the following are supplies needed for a GI Surgery EXCEPT

Raney clips

What is a common cause of gastroenteritis due to Salmonella?

Raw or undercooked poultry or eggs

How may a fistula form with Crohn's disease?

Recurrent inflammation, necrosis, and fibrosis, forming a connection between intestinal loops

which is a main function of the stomach?

Release of gastric and somatostatin

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

Resection

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

Resection

RUQ

Right Upper Quadrant

Where in the abdomen is the liver predominantly located?

Right hypochondrium

RLQ

Right lower quadrant

RLQ refers to what part of the abdominal section

Right lower quadrant

In females, which of the following structures travel through the inguinal canal?

Round ligament

Identify the marginal boundaries of the breasts

Second to sixth rib and horizontally from the lateral edge of sternum to anterior axillary line

Which is a function of the pancreas?

Secretes glucagon

Which is a function of the liver?

Secretes insulin

When highly acidic chyme enters the duodenum, which hormone stimulates the release of pancreatic secretions that contains very high bicarbonate ion content?

Secretin

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

Sentinel lymph node biopsy

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

Sentinel lymph node biopsy

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

Sentinel lymph node biopsy

What is the major effect when a gallstone obstructs the cystic duct?

Severe colicky pain in upper right quadrant

Which of the following is a typical indicator of an intestinal obstruction caused by paralytic ileus?

Severe steady abdominal pain

Which of the following arteries is most associated with supplying the greater curvature of the stomach?

Short gastric arteries

when a portion of the proximal stomach and the paraesophageal junction move above the diaphragm, this is called a:

Sliding Hernia

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

Spigelian

A rare hernia occurring between the transverse abdominis and rectus muscles is a

Spigelian hernia

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

Spigelian hernia

Which organ does NOT lie in contact with the liver?

Spleen

During a ____________, the four major requirements to stop bleeding are access, visualization, good lighting, and clamps.

Splenectomy

The body of the pancreas receives blood supply from the pancreatic branches of which artery?

Splenic

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

Spread of metastasis

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

Which of the following structures lies anteriorly to the spleen?

Stomach

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

Which group of nodes typically has the most nodes?

Subscapular

Which procedure is most commonly performed to resect a benign pancreatic tumor?

Subtotal distal pancreatectomy

What procedure involves creating a right paramedic or upper midline abdominal incision?

Subtotal gastrectomy

Superficial lymphatic vessels in the upper limb lie close to which other structures?

Superficial veins

In cases of splenomegaly, which border of the spleen can be palpated?

Superior

Which portion of the duodenum is partially intraperitoneal?

Superior

What widens the angle of the duodenojejunal junction to allow passage of intestinal contents?

Suspensory muscle of the duodenum

Two techniques currently used for laparoscopic approach to a direct inguinal hernia are:

TAPP (transabdominal peritoneal) TEP (total extra peritoneal)

Which is the only part of the pancreas that is intraperitoneal?

Tail

which two similar hernia repairs 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 mouth to the anus.

The bare area of the liver is bounded by which hepatic ligament?

The anterior and posterior folds of the coronary ligament demarcate the bare area of the ligament

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.

Which of the following is NOT a characteristic feature of the jejunum (when compared to the ileum)?

The ileum has more arterial arcades, with shorter vasa recta.

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

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.

Which of the following occurs with hepatitis B?

The liver is inflamed and enlarged.

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.

During this procedure, a gamma ray detecting probe is used to determine which lymph nodes are affected: Select one: a. excisional biopsy b. sentinel lymph node biopsy c. none of the above d. wire localization

b. sentinel lymph node biopsy

Which of the following is the terminal branch of the gastroduodenal artery?

The right gastro-omental artery is the terminal branch of the gastroduodenal artery, which arises from the common hepatic artery

What part of the mesoderm is the visceral peritoneum derived from?

The splanchnic mesoderm gives rise to the visceral peritoneum.

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.

What is the mammary tissue that extends laterally on the pectoralis major toward the axilla called?

The tail of Spence

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.

Why does herpes simplex infection tend to recur?

The virus persists in latent form in sensory nerve ganglia.

Which of the following statements applies to bile salts?

They emulsify lipids and lipid-soluble vitamins.

How do many oral hypoglycemic drugs act?

To stimulate the pancreas to produce more insulin

what procedure removes the entire stomach to eliminate malignant lesions?

Total gastrectomy

Alfred Eichelberger has a liver abscess secondary to a diverticular abscess. He underwent a percutaneous drainage that was unsuccessful. He is now scheduled for surgical drainage of the abscess. What approach is the surgeon likely to use to drain Alfred's abscess?

Transperitoneal

Which part of the colon is enveloped by visceral peritoneum?

Transverse and sigmoid colon

Which structure subdivides the greater sac of the peritoneal cavity?

Transverse colon

Which of the following breaks protein down into peptides?

Tripsyn

Cataracts are categorized as a general condition of aging rather than a disease process.

True

Donor corneas must be screened for HIV, HBV, and CJD prior to transplant.

True

The surgical technologist must develop the ability to transfer very small, delicate instruments into the surgeon's hand in a functional manner so that he or she does not have to look away from the microscope.

True

instruments need to be separated for an abdominoperineal resection

True

sterile water is used during laparotomy procedures because of its isotonic properties

True

Which of the following breaks protein down into peptides?

Trypsin

Which of the following applies to carcinoma of the breast?

Tumor cells may demonstrate estrogen receptors on the membrane.

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

Umbilical

In which quadrant of the abdomen does the spleen lie?

Upper left quadrant

RLQ refers to what part of the abdominal section? Select one: a. right lower quadrant b. right upper quadrant c. right lower quality d. right upper quality

a. right lower quadrant

A lower transverse abdominal incision is made for surgical procedure of the______

Uterus

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

Uterus

Which of the following stimulates increased peristalsis and secretions in the digestive tract?

Vagus nerve

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.

David Linscomb has a diagnosis of cholelithiasis and is scheduled for a cholecystectomy with an intraoperative cholangiogram. What data can be gained from the cholangiogram?

Visualization of the gallbladder to determine the number and size of stones

Twisting of the bowel on itself is:

Volvulus

What is a common sign of acute gastritis?

Vomiting and anorexia

a cyst located on an ovary is usually removed to prevent futher damage or transformation into sympotomatic condition a-true b-false

air and gas are nos used during a hysteroscope for uterine insufflation atrue b false

bacterial are transmilted only though insect bites a-true b-false

colitis is one reason hemicolectomy or total colectomy may be performed a-true b-false

instrument need to be separated for an abdominoperineal resection a-tue b-false

intrauterine thermal ballon ablation is contraindicated for women wishin to have future pregnancies a-true b-false

once the abdominal cavity is entered, all free 4x4 sponges should be removed from the field? a-true b- false

people with a compromised immune system are at risk for contracting tuberculosis a-true b-false

prior to starting a gynecologic surgery via the abdomen, urethal catheters may be inserted do that the ureters rs may be identified a true b false

resident flora aid in the synthesis of vitamins and folic acid while in the large intestine but may cause an infection if relocated to a surgical incision a-true b-false

stomach acid provides what line of defence a-first b-second c-third d- fouth

use of fetal monitor is recomended in surgical procedure after 16 wees gestation a-true b-false

what incision is most commonly used for an open inguinal hernia? a- oblique ingunal b- thoracoabdominal c- pfannestiel d- paramdian

what organ contains a vault is divided into four fornices a-vagina b- uterus c- clitoris' d-perineum

which describe signs and symptoms of localized infection? a- inflammation, red, painful swelling b-generalized edema lyphedema c- hemtoma with clear exudate d scaly rash with skin nudles

which is a consideration in the plan od care an obese patient during bariatic procedure? a- antiembolic stockings b- disposable blood pressure cuff c- limited warm blankets d-nutritional supplements

which is a part of the female external genitalia that make up the uvula a-labia majora b-fallopian tubes c- cervix d-bilaterial ovaries

which is a type of antibiotic whose mechanism inhibits the cell systhesis? a- vancomycin b sulfanomide' c-tetracucline d- quinolene

which is main objetives in the maintenance of general anesthesia? a- ensure analgeisia is constatn b- maintain consistent hypovolemia c- ensure correct sutures lines d-ensure the patient can her the surgeon begin the procedure

which is one exaple of an infection to antibiotic therapy a- MRSA b- helicobacter pylori c- tetracycle d- rhinitis

which term decribe method of anesthesia production a- balanced b- moderate c- complete d- provisional

who has higer risk of exposure to potentially harmful microorganis? a- scrub person b-circulating nurse c- central processing tech d- flouroscopy techniciam

wich is type of hernia? a- inguinal b- thoracic c- pelvic d- external

wich technique is used to decreases the patient's intraoperative awareness? a- use of the BIS monitor b- common use of muscle relaxants and narcotics c- use of hypothermia machine d- adqueate tissue perfison

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.

Following gastric resection, the onset of nausea, cramps, and dizziness immediately after meals indicates:

a large volume of chyme has entered the intestines, causing distention.

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

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

a)division b)to clamp and divide c)mobilization d) to cross-clamp c)mobilization

The spermatic cord is retracted with a small _________________. Select one: a. Penrose drain b. JP drain c. arm tourniquet d. ortho drain

a. Penrose drain

During a splenectomy, what four major requirements must be met to stop bleeding? Select one: a. access, visualization, good lighting, clamps b. access, visualization, good lighting, retractors c. access, visualization, temperature, clamps d. access, visualization, time, clamps

a. access, visualization, good lighting, clamps

A procedure in which two hollow organs are joined surgically is: Select one: a. anastomosis b. to cross-clamp c. resection d. to double-clamp

a. anastomosis

During an intraoperative cholangiography, all of the following supplies will be used, EXCEPT: Select one: a. injectable water b. contrast medium c. stopcock d. 30 and 50 cc syringe

a. injectable water

Telescoping of the intestines occurring mainly in children and resulting in ischemia and necrosis of the bowel is: Select one: a. intussusception b. volvulus c. paralytic ileus d. strangulation

a. intussusception

The abdomen is divided into nine regions; the organs located in the inguinal area is in the: Select one: a. left and right iliac regions b. left and right lumbar regions c. left and right hypochondriac regions d. umbilical region

a. left and right iliac regions

During a total mastectomy, what must the surgical technologist have readily available? Select one: a. ligating clips b. scissors c. kockers d. retractors

a. ligating clips

The abdomen is divided into nine regions; the organ located in the umbilicus area is in the: Select one: a. umbilical region b. left and right iliac regions c. left and right lumbar regions d. left and right hypochondriac regions

a. umbilical region

Twisting of the bowel on itself is: Select one: a. volvulus b. paralytic ileus c. strangulation d. intussusception

a. volvulus

an_______ amputation is performed at the lower third of the thing above-knee

above-knee

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

access, visualization, good lighting, clamps

Surgical treatment for breast cancer can include:

all of the above.

the mesh plug open hernia repair technique is indicated for which type of hernia

all of the options are correct

a procedure in which two hollow organs are joined surgically is

anastomosis

What is the portion of the eye between the cornea and the iris in which aqueous fluid flows and nourishes tissues?

anterior chamber

A McBurney incision is used for surgical procedures of the

appendix

A McBurney incision is used for the surgical procedure of the______

appendix

a mcburney incision is used for surgical procedure of the

appendix

Pancreatic cancer may be diagnosed early if obstruction of bile or pancreatic secretions develops when the tumor is located:

at the head of the pancreas.

What does the pathophysiology of chronic gastritis include?

atrophy of the gastric mucosa with decreased secretions

Phrenicocolic ligament

attaches left colic flexure to the diaphragm

a _____ breast biopsy is taken when a biopsy needle is inserted into the mass and tissue is retrived for histologic examination a- fine needle aspiration b- core biopsy v- stereotic breast biopsy d- excisional

a gastrostomy procedure is a procedure involving the passage og a flexible fiber optic gastroscope to inspect the mucosal walls of the stomach a-true b- false

alow anterior colon recestion requires the creation of permanent colostomy a-true b-false

bacteria have membrane-bound organelles with nucleus a-true b-false

clear colored peritonea fluid is a positive finding when a culdocentesis is performed a-true b-false

in the case of hand surgery it is important to amputate a severely damaged thumb even if salvaging the thumb is a possibility a-true b-false

pelvic endoscopic cases are not considered sterile procedures a-true b-false

sterile water may be used during abdominal procedure to moisten laparatomy packs a-true b- false

sterile water us used during laparotomy procedures because of its isotonic properties a-true b-false

what form of hepatitis is major health care- associated problem transmitted by blood, saliva,semen and other body fluids a-hepatitis A b- hepatitis b c-hepatitis c d-hepatiti d

what open procedure involves creating mcburney incision? a- femoral hernia repair b- appendectomy c- left upper lobe resection d- modified mastectomy

what procedure removes the enteri stomach to eliminate malignant lession a- subtotal gastrectomy b- total gastrectomy c- total vagotomy d-total pyloroplasty

whcich is a transmission route of virusese a- vector contact b- insect bites c- skin to skin contact d- intact skin

when caring for pregnant patient in the OR enviroment it is essential to keep the temperature below 60F to prevent premature contractions a-true b-false

when positionin a pregnan patient in the oR in supine position alwayys placed wedge or small roll under the left side a-true b-false

which is an example of active immunity againts the prevention of disease? a- a preformed immuglobulin b- a vaccine or booster shot c- vitamin supplemnts d- vitamin supplements

which is an exple of helmithic disease? a- parasites b-bloodborne flukes'= c-influenza d- latrogenic creutfeldt-jakob

which is functional of the pancreas a- digests carbohydrates b- secretes glucagon c-stores blood elements d- forms cholesterol

which is the most comon site for pancreatic tumor a- fundus of pancreas b- head of pancreas c- islets of langerhans d acini

which of the following is common fungal infection transmission route? a- urine b-coughin c-fecal material d- spermatic fluid

which type of stoma is created in the opening of the cecum throug the lower right side of the abdomen? a- ileostomy b- cecostomy c- colostomy d- gastrostomy

wich conditions may be indicative of systematic infection a- tem= 37.5c, heart rate -76 b-tem- 38.5 c, respiratory rate= 26 to 30 c white blood cell count= 5000, heart rate=90 d temp= 36.5c, respiratory rate=18

wich is a desired result of balance anesthesia? a- hypotension b- amnesia c- hypovolemia d- neuromiscular blockede

All of the following are supplies needed for a GI surgery, EXCEPT: Select one: a. bowel bag b. LF Correctx c. vessel loops d. HF

b. LF=low frequency

Two techniques currently used for laparoscopic approach to a direct inguinal hernia are: Select one: a. TAPP and TPE b. TAPP and TEP c. TPE and TAP d. TEP and TPPA

b. TAPP and TEP

During a laparoscopic cholecystectomy, which two structures are occluded? Select one: a. cystic artery and common bile duct b. cystic duct and cystic artery c. cystic duct and common bile duct d. common bile duct and artery

b. cystic duct and cystic artery

Protrusion of abdominal or inguinal tissue directly through the transversalis fascia is a(n): Select one: a. indirect hernia b. direct inguinal hernia c. strangulated hernia d. incisional hernia

b. direct inguinal hernia

A procedure in which one section of tissue is cut away from another is: Select one: a. mobilization b. division c. cross-clamp d. clamp and divide

b. division

A hernia in which abdominal viscera slides into the inguinal canal from the deep inguinal ring is a(n): Select one: a. strangulated hernia b. indirect hernia Correctx c. incisional hernia d. direct inguinal hernia

b. indirect hernia

A midline incision is used for surgical procedures of the ___________? Select one: a. uterus b. liver c. appendix d. sigmoid colon

b. liver

What type of stitch will be placed around the base of the appendix? Select one: a. none of the above b. purse string c. horizontal d. interrupted

b. purse string

A procedure in which a section of an organ is cut apart or removed is: Select one: a. to double-clamp b. resection c. anastomosis d. to cross-clamp

b. resection

Abdominal wall defect occurring in the linea alba at the umbilical ring is a(n): Select one: a. direct inguinal hernia b. umbilical hernia c. Spigelian hernia d. femoral hernia

b. umbilical hernia

Oral candidiasis is considered to:

be an opportunistic fungal infection of the mouth.

Yellow or greenish stained vomitus usually indicates the presence of:

bile.

Predisposing factors to cholelithiasis include excessive:

bilirubin or cholesterol concentration in the bile.

In patients with cirrhosis, serum ammonia may increase when:

bleeding occurs in the digestive tract

In patients with cirrhosis, serum ammonia may increase when:

bleeding occurs in the digestive tract.

Which of these is not a common symptom of pancreatitis?

blood in stools

what diagnostic text involves staining cervical squamous ephitheium with iodine-based lugo's solution? a- pap smear b- endocervica test c- schriller's tets d- LEEP

what is an obvious sing of gallstones or precense of neoplasm on or near to the gallbladder? a- hypertension b- conjutivitis c- jaundice d- obesity

what is the definition of bioflilm a- an implantable meshlike tissue that helps to prevent adhesion in the peritoneum b- a celas spray used on sterile intruments to keep infection rates low c- a collection of microorganism that deveops on the surface of implanted medical diviced d- a patient- specific pictures of organs or body tissie that define a disease process

what is the name of the procedure stricly followed to protect all personnel from contact with blood bodily fluid a- the golden rule b- universal precaution c-standard precaution d- HIPAA precautions

what term mean bleeding between mestrual period in premenopausal woman? a-menstration b- menorrhafgia c- menometrorrhagia d- menache

what type of breast biopsy involves removing the entire mass for pathologic study a- core biopsy b- incisional biopsy c- excesional biopsy d-stereotatic breast biopsy

what type of mastectomy involves wedge or quadrant of breast tissue being removed? a-radical b- simple c- segmental d- modified radical

what type of procedure is performed after diagnosis of misssed imcomplete spantenous abortion? a- pap smear b- hystroscopy c- dilation and evacution d- tubal ligation

whic is one of four phases of bacteria reprodiction stage? a- birth phase b- development phase c- lag phase d- wrking phase

which are two examples of diseases causes by exotoxin a- tuberculosis acute respiratoy infection b- influenxa, antrax c- dipheria leprose d otitis media, e coli

which is a dease caused by direct contact or exposure of neurologis tissue to a prion- a- kaposi's sarcoma b- tape worms c- creatzfeldt-jakob disease d-pneumocytis carinii

which is a reason peritoneal lavage is performed? a- to cool down the peritoneal contents b- to create a pneumoperitomeun c- to determine presence of active intraabdominal bleeding d- to decompress the bladder

which is common intrument needed for a common duct exploration a- richardson retractor b- cooley clamp c- malleable scoop d- mahoney dilator

which is main function of stomach a-digestion of proteins b- absorption of water c- release of gastrin and somatostatin d-excretion of chyme

which is method of administering a general anesthesia a-by mouth b- transderdermally c- inhalation d- via the bladder

which is not a sexually transmitted disease? a- gonorrhea b- herpes simplex c- shingles d- chamidia

which is the infectious process caused by exotoxins secrreted by types od ptaphylococus aureus? a- septic shock b- plague c- toxin shoc syndrome d- tuberculosis

which procedure is most commonly performed to resect a bening pancreatic tumor a- total pancreatectomy b- gastrojejutostomy c- subtotal distal pancreatectomy d- pancreaticoduodecnectomy

which procedure is performed to treat gastroesophageal reflux a- whipple procedure b- roux-en-Y c fundoaplication d- choledechoscopy

why would a broad-sprectrum antibiotic drug be given before surgical procedure a- to allow development of a super-resistant bacteria b- to cover any potential surgical contamination c- for procedure assosiated with high risk of infection d- to asses for any sensitivity or allergic reaction

wich is recomendation for caring for a surgical patient with TB? a-use reusable anesthesia equipment as often as possible b- operate on these patent as soon as possible to decrease thespread of the secretion c- use respiratory isolation precaution fo those patient with TB sputum culture d- keep these patient in isilation room positive with positivepressure ventiation

wich open procedure can also be performed as a minimal invasive laparoscopic procedure? a- liver wedge resection b- whipple c-cholecystectomy d- coloscopy

A rare hernia occurring between the transverse abdominis and rectus muscles is a(n): Select one: a. umbilical hernia b. femoral hernia c. Spigelian hernia d. direct inguinal hernia

c. Spigelian hernia

A McBurney's incision is used for surgical procedures of the ____________? Select one: a. pancreas b. spleen c. appendix d. uterus

c. appendix

During a colon resection, the ______________ is often removed. Select one: a. proximal colon b. distal colon c. distal ileum d. proximal ileum

c. distal ileum

A hernia arising from a weakness in the transversalis fascia below the inguinal ligament is a(n): Select one: a. umbilical hernia b. direct inguinal hernia c. femoral hernia d. Spigelian hernia

c. femoral hernia

Protrusion of abdominal tissue through one or more abdominal layers is a(n): Select one: a. Spigelian hernia b. strangulated hernia c. incisional hernia d. direct inguinal hernia

c. incisional hernia

The abdomen is divided into nine regions; the organs located in the rib area is in the: Select one: a. left and right lumbar regions b. left and right iliac regions c. left and right hypochondriac regions d. umbilical region

c. left and right hypochondriac regions

LUQ refers to what part of the abdominal section? Select one: a. left lower quality b. left upper quality c. left upper quadrant d. left lower quadrant

c. left upper quadrant

The freeing up of tissue from its attachments before anastomosis or resection is: Select one: a. to cross-clamp b. to clamp and divide c. mobilization d. division

c. mobilization

Approximately 400,000 people die annually as a result of: Select one: a. SSI b. wrong surgical site c. obesity d. HAI

c. obesity

This occurs most often as a postoperative complication or a result of pelvic or back injury and peritonitis: Select one: a. volvulus b. strangulation c. paralytic ileus d. intussusception

c. paralytic ileus

What is the name of the structure that is a small depression containing only cones and has the highest visual acuity?

central fovea

During a laparoscopic ___________, the cystic duct and cystic artery structures are occluded.

cholecystectomy

Obstruction of the biliary tract by gallstones is referred to as:

choledocholithiasis

Obstruction of the biliary tract by gallstones is referred to as:

choledocholithiasis.

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

What structure is avascular, external, and its function is to refract light rays?

cornea

To plce one or more clamps at a right angle to a tube or vessel si to

cross-clamp

During a laparoscopic cholecystectomy, which two structures are occluded?

cystic duct and cystic artery

for what reason may a subcutaneous mastectomy be perfomed a-shorter, less painful procedure b-removal fo the overlying skin and nipple c- remval of noninvasive tumor present under the breast d- for patints with chronic mastitis

the_____ is the largest lympatic organ in the body' a-pancreas b- liver c- appendix d-spleen

what incision is mainly used for pancreaticoduodenectomy procedure> a- longitudinal midline b- subcostal c- minimal acces d- long right paramedian

what positon a patient should patient be in when receiving spinal anesthesia? a- supine b- prone c- lithotomy d- lateral

what procedure allows visualization of rectal lumens via plexible scope? a- colonoscopy b- gastroscopy c- bronchoscopy d- sigmoidcoscopy

what procedure involves creating a right paramedic or upper midline abdominal incision? a- lung resection b- cholecystectomy c appendectomy d- subtotal gastrectomy

what term decribe the herniation of the restum into the vagina a- enterocele b- hydrocele c- cystocele d- retrocele

what two hormones helps prepare the uterus for implation of the fertilized egg? a- tertosterone and estrogen b- insulin and estrogen c- progestin and testosterone d- progesterone and estrogen

what type of procedure may be performed in patient with an obstructing pyloric ulcer? a- vagoplasty b- mammoplasty c- vagotomy d- pyloroplasty

what type of procedure uses a T-tube to drain the common bile ducts? a- choledochoscopy b- cholithotrispsy c- choledochduodenostomy d-choledochostomy

what type of test is done to test fallopian tube patency' a- tubal curettage b- tubal ligation c- tubal biopsy d- tubal insufflation

which is a common microorganism in the operating room that is found on skin, hair,and the upper respiratory track a- hepatitis virus b- pseduomona c- eschorichia coli d- staphylococci

which is amethod of administering inhalation gases and vapors? a nasal cannula b intravenously c inramuscular injection d laryngeal mask

which is an action od epinephrine? a- vasodilator b- hypotension c- sympathetic nerve bloker d- prolongs anesthesia

which is an action that occurs during the viral infection stages? a-dormancy phase b- death of host cell c- exponentical growth d- inflamatory response production

which piece of emergency equipment should be aviable at the all times and ready for use? a-electrosurgery unit b- transesophageal transducer c- argon beam coagulator d- endotracheal tubes

which technique of tuban ligation is the most reliable way to ensure the tubes are ligated> a- fallope ring b filshie clip c- cautery d- pomeroy technique

why would a surgeon choose to irrigate a mastectomy wound with sterile water rather than sterile normal saline? a- sterile water is less expenssine than normal saline b- normal saline shrinks the cancerous cells c- saline is irritating to the skin d- sterile water may be used to crenate the cancerous cells

wich is method used to prevent '' rewarming shock'' a- quickly indiced vasodilation b- hypervolemia c- immediate blood transfusion d- adquate oxygenation

What type of instrument is used to grasp the loop of transverse colon? Select one: a. Kelly b. Pennington c. Allis d. Babcock

d. Babcock

The organs and organ systems that are included in general surgery are the following EXCEPT: Select one: a. breast b. spleen c. pancreas d. femur

d. femur

What type of incision will be used for a vagotomy? Select one: a. McBurney's b. transverse c. midline d. laparotomy

d. laparotomy

The abdomen is divided into nine regions; the organ located in the flank area is in the: Select one: a. left and right iliac regions b. umbilical region c. left and right hypochondriac regions d. left and right lumbar regions

d. left and right lumbar regions

LLQ refers to what part of the abdominal section? Select one: a. left upper quadrant b. left upper quality c. left lower quality d. left lower quadrant

d. left lower quadrant

A range of procedures are available for surgical management of a breast tumor. All of the following are available, EXCEPT: Select one: a. fine needle insertion b. sentinel node detection c. needle aspiration biopsy d. lumpectomy

d. lumpectomy

The spermatic cord in the male follows the inguinal canal and contains the following structures, EXCEPT: Select one: a. spermatic fascia b. cremaster muscle c. lymph vessels d. lymph nodes

d. lymph nodes

A paramedian incision is used for surgical procedures of the _____________? Select one: a. uterus b. appendix c. spleen d. pancreas

d. pancreas

A subcostal incision is used for surgical procedures of the _____________? Select one: a. pancreas b. appendix c. uterus d. spleen

d. spleen

All of the following are distinct tissue layers that support the viscera, EXCEPT: Select one: a. skin b. fascia c. subcutaneous d. umbilicus

d. umbilicus

A lower transverse abdominal incision is made for surgical procedures of the __________? Select one: a. pancreas b. appendix c. spleen d. uterus

d. uterus

The presence of food in the intestine stimulates intestinal activity but inhibits gastric activity through the:

enterogastric reflex.

The presence of food in the intestine stimulates intestinal activity but inhibits gastric activity through the:

defecation reflex.

Adjuvant chemotherapy and radiation may be used in cases of breast cancer in order to:

destroy any micrometastases.

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

direct inguinal hernia

protrusion of abdominal or inguinal tissue directly through the transversalis fascia is a

direct inguinal hernia

protrusion of abdominal or inguinal tissue directly through the transversals facia is a(n)

direct inguinal hernia

a procedure in which one section of tissue is cut away from another is

division

The head of the pancreas is fixed to the:

duodenum

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

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

esophagus

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

esophagus

Which procedure done on an eye with internal malfunction or loss of contents and no possible recovery of sight provides better mobility and cosmetic result with a prosthetic eye?

evisceration

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

What is the term for the six muscles that provide movement of the eye?

extrinsic

femoral hernias occur more frequently in which group of individuals

females

a hernia arising from a weakness in the transverse fascia below the inguinal ligament is a

femoral hernia

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

femur

What does the term gluconeogenesis refer to?

formation of glucose from protein and fat

The visceral peritoneum:

forms the outer covering of the stomach.

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 auto-transfusion system. Describe the boundaries of the surgical skin prep for the patient about to receive a liver transplant.

from neck to midthigh; bedline to bedline

Although many factors may precipitate pancreatitis, the two major causes are:

gallstones and alcohol abuse.

An example of a potential risk associated with pneumoperitoneum would be

gas embolus into an exposed blood vessel during the procedure

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

gas embolus into an exposed blood vessel during the procedure.

A type of diabetes that may develop during pregnancy and disappear after delivery is called:

gestational diabetes.

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 spleen has a number of important functions, which include:

hematopoiesis, destruction of old erythrocytes, blood reservoir.

Bilirubin is a product of

hemolysis of red blood cells (RBCs) and breakdown of hemoglobin

The functional units of the liver are the lobules. The functional cells of the liver are the _______ and they manufacture ____________

hepatocytes; bile

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

hernia recurrence.

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

hypochondriac (ORGANS are in that umbilical region)

Severe vomiting can lead to metabolic acidosis because of increased:

hypovolemia and lactic acid production.

Dehydration limits compensation available for an acid-base imbalance resulting from prolonged vomiting and diarrhea because:

hypovolemia limits renal function.

During the course of a hepatitis B infection, the onset of jaundice occurs in the:

icteric stage.

The abdomen is divided into nine regions; the organs located in the inguinal area is in the:

iliac

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

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

protrusion of abdominal tissue through one or more abdominal layers is an

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.

The pathophysiology of peptic ulcer disease may involve any of the following EXCEPT:

increased stimulation of mucus-producing glands.

A hernia in which abdominal viscera slides into the inguinal canal from the deep inguinal ring is an

indirect hernia.

which is a type of hernia?

inguinal

indentify 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

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.

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.

A group of United Kingdom (UK) researchers undertook an analysis of several research studies comparing the outcomes of laparoscopic versus open incisional hernia repair of patients who had prior laparotomies. They examined surgical time, duration of hospital stay, perioperative complications, postoperative surgical site pain, and recurrence rates in 183 patients whose incisional hernias were repaired by the open approach and 183 repaired by the laparoscopic approach. Based on the results of this study, an appropriate risk reduction strategy for patients with incisional hernias would be to repair incisional hernias:

laparoscopically.

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 region

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 the

left and right iliac 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 midline incision is used for surgical procedures of the

liver

a midline incision is used for the surgical procedure of the

liver

With acute appendicitis, localized pain and tenderness in the lower right quadrant results from:

local inflammation of the parietal peritoneum.

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

the whipple procedure is the removal of the head of teh 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.

What pain is typical of diverticulitis?

lower left quadrant

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

lymph nodes

The early stage of vomiting causes:

metabolic alkalosis.

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

mobilization

the freeing up of tissue from its attachments before anastomosis or resection is

mobilization

Into which structures do the lacrimal ducts drain tears?

nasal cavity

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.

Tetracaine drops are used in ophthalmologic procedures to:

numb the surface of the eye and surrounding structures

Approximately 400,000 people die annually as a result of

obesity

Approximately 400,000 people die annually as a result of:

obesity

what incision of most commonly used for an open inguinal hernia?

oblique inguinal

Small, hidden amounts of blood in stool are referred to as:

occult blood.

Prolonged or severe stress predisposes to peptic ulcer disease because:

of reduced blood flow to the gastric wall and mucous glands.

What is the condition of the lens that is treated by cataract extraction?

opacified

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 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

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

the spermatic cord is retracted with a small

penrose drain

what composes the lining of a herniated abdominal sac

peritoneum

in a _________ hernia, tissue protruding from the hernia may be swollen and squeezed

strangulated

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

purse string

which type of stitch will be placed around the base of the appendix

purse string

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

resection

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

resection

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

as the surgeon prepared to clamp and transect the bowel during a small bowel resection for tumor, the scrub clears the mayo stand to the back table and prepared the sterile field for bowel isolation technique. the rationale for this approach is

risk for infection

When highly acidic chyme enters the duodenum, which hormone stimulates the release of pancreatic secretions that contains very high bicarbonate ion content?

secretin

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

sentinel lymph node biopsy

A factor that may precipitate encephalopathy with cirrhosis is the elevated:

serum ammonia.

A subcostal incision is used for surgical procedures of the

spleen

The _____ is the largest lymphatic organ in the body.

spleen

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

splenic vessels

when setting up for a gastrectomy the scrub person will ensure that appropriate instruments are available to clamp

splenic vessels

Injectable saline, contrast medium, and ____________ are supplies needed for an intraoperative cholangiography.

stopcock

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

What procedure involves creating a right paramedic or upper midline incision

subtotal gastrectomy

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.

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

the patient has undergone prior biliary surgery, a positive cholangiogram shows a CBD obstruction during an open cholecystectomy,laparoscopy technology is not available.

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

the patient has undergone prior biliary surgery, a positive cholangiogram shows a CBD obstruction during an open cholecystectomy, and laparoscopy technology is not available (all of the above)

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 on for more clamps at a right angle to a tube or vessel is____

to cross-clmap

which is a reason peritoneal lavage is performed?

to determine presence of active intraabdominal bleeding

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

to double-clamp

Stools that are more liquid and contain mucus and frank blood are typical of:

ulcerative colitis

Stools that are more liquid and contain mucus and frank blood are typical of:

ulcerative colitis.

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

umbilical hernia

An abdominal wall defect occurring in the linea alba at the umbilical ring is an

umbilical hernia

an abdominal wall defect occurring in the lines alba at the umbilical ring is a(n)

umbilical hernia

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

all of the following are distinct tissue layers that support the viscera, except

umbilicus

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

uterus

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

What is the name of the gelatin-like fluid that fills the posterior cavity of the eye?

vitreous humor

Twisting of the bowel on itself is

volvulus

A patient with acquired pyloric stenosis would likely:

vomit undigested food from previous meals.

What is a common sign of acute gastritis?

vomiting and anorexia

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

with visceral content that can be returned to the abdomen

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:

exammmmm222

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