Duke PA Gastrointestinal Surgery
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| show | acute abdomen
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| show | epigastrum
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| show | periumbilical region
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| pain from structures arising from the hindgut (left colon, sigmoid colon, rectum) localizes to the | show 🗑
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| show | GI Tract obstruction
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| steady, well localized pain usually occurs after | show 🗑
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| show | appendicitis
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| commonly occurs in women between the ages of 40-60 who are overweight and have a previous history of pregnancy | show 🗑
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| patients will have right upper quadrant pain that is accentuated on inspiration, and is accompanied by nausea and vomiting | show 🗑
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| show | acute cholecystitis
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| McBurney point | show 🗑
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| show | cholecystitis
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| show | appendicitis
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| the normal anatomic position of the appendix | show 🗑
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| results in an increased risk of perforation due to delayed diagnosis | show 🗑
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| show | right upper quadrant
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| show | 7
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| show | adolescents and young adults
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| show | appendicitis
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| ____ is seen in approximately 70% of appendicitis cases | show 🗑
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| the appendiceal lumen can be obstructed by | show 🗑
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| the number of ___ in the vermiform appendix peaks between the ages of 10-30 | show 🗑
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| show | diverticula, and duplications
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| after obstruction of the appendiceal lumen ___ continue | show 🗑
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| show | bacterial overgrowth and increased intraluminal pressure
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| ___ which ultimately leads to ulceration, necrosis, gangrene, and perforation | show 🗑
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| ____ alone should make the diagnosis of acute appendicitis in most patients | show 🗑
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| after 1-12 hours of diffuse mild to moderate pain, appendicitis pain will usually | show 🗑
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| Vomiting and diarrhea may be present in acute appendicitis but ___ | show 🗑
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| if vomiting precedes abdominal pain or if anorexia is not present ____ | show 🗑
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| show | fever
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| show | 38 degrees
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| show | usually normal with slight tachycardia due to pain, fever, or dehydration
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| show | lie motionless
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| show | restless
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| show | Rovsing's sign
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| show | rebound examination
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| show | false positive
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| show | psoas
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| this sign is best demonstrated by extension of the hip or flexion against resistance | show 🗑
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| ___ is produced by stretching this muscle with passive internal rotation of the thigh, with the hips in a flexed position | show 🗑
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| both the obturator and psoas signs are | show 🗑
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| a ___ exam is also important in evaluating any patient with abdominal pain | show 🗑
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| show | within the pelvis
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| show | gross blood
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| administer prophylactic antibiotics | show 🗑
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| show | the junction of the three tenia
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| show | appendiceal artery
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| show | a thourough search for other pathology is important
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| consider ___ of the wound for advanced and perforated appendicitis | show 🗑
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| show | exploratory laparotomy, and appendectomy
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| laparotomy can be accomplished through a ____ incision | show 🗑
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| show | McBurney incision
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| a right-lower-quadrant transverse ___ incision is preferred by many for appendicitis | show 🗑
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| show | lower midline laparotomy
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| show | intraabdominal drains
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| if a case of perforated appendicitis with generalized peritonitis is encountered, the wound should be considered grossly contaminated and | show 🗑
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| show | Chron's Disease
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| as a diagnostic procedure ____ is by far the most accurate, but it is invasive | show 🗑
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| laparoscopic appendectomy is especially useful | show 🗑
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| laparoscopic appendectomy is especially useful | show 🗑
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| laparoscopic appendectomy is especially useful | show 🗑
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| laparoscopic appendectomy is especially useful | show 🗑
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| show | should be of short duration
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| show | 24-48
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| ___ complications are by far the most frequently seen problem after appendectomy | show 🗑
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| once a wound infection is diagnosed the primary treatment is | show 🗑
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| if cellulitis is present in an infected wound | show 🗑
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| show | necrotizing fasciitis
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| show | abscess
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| drainage and antibiotics are the treatments for | show 🗑
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| show | right paracolic gutter, pelvis, or intraloop position
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| show | CT-guided catheter drainage
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| show | pylephlebitis
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| show | pylephlebitis
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| is often seen in the elderly, immunocompromised, or in advanced sepsis, and is often a preterminal finding | show 🗑
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| show | 2000
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| the most common nonobstetric emergency in pregnant women | show 🗑
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| show | left shift
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| show | negligible
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| show | 1.5
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| a cleft in the anterior abdominal wall that is bound anteriorly by the external oblique aponeurosis and posteriorly by the transversalis fascia | show 🗑
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| show | the inguinal canal
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| show | external oblique aponeurosis at the external inguinal ring
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| ____ hernias come through the internal inguinal ring and enter the inguinal canal | show 🗑
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| show | the scrotum
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| show | indirect inguinal hernias
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| ____ hernias come through the posterior wall of the inguinal canal and are a defect in the transversalis fascia | show 🗑
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| show | the scrotum
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| the main etiologic factor in direct inguinal hernias is | show 🗑
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| risk factors for direct inguinal hernias | show 🗑
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| ____ hernias are more common in women | show 🗑
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| show | incarceration and strangulation
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| show | truss
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| show | acutely incarcerated hernia
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| the ___ approach is best for recurrent hernias (open or laparoscopic) | show 🗑
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| show | 5-10
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| the recurrence rate for indirect inguinal hernias is __% | show 🗑
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| show | only when a suture repair would be under undue tension
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| Ventral, incisional hernias frequently occur because of | show 🗑
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| show | cooper's ligament, the iliopubic tract, and or the inguinal ligament inferiorly, and the conjoined tendon or internal oblique aponeurosis superiorly
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| show | various plug techniques
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| a large peice of material is fixed with only a few sutures | show 🗑
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| the anterior boundry of the inguinal canal | show 🗑
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| show | transversalis fascia and transversus abdominis aponeurosis
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| the inferior boundry of the inguinal canal | show 🗑
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| show | internal oblique and transversus abdominis muscle and aponeuroses
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| show | direct inguinal hernias
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| show | indirect inguinal hernias
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| show | Bassini repair
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| show | McVay (Cooper's ligament repair)
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| the transversus abdominus aponeurosis, and the internal oblique aponeurosis | show 🗑
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| show | iliopubic tract and inguinal ligament
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| show | Cooper's ligament
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| medial boundry of the femoral canal | show 🗑
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| lateral boundry of the femoral canal | show 🗑
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| show | 1-2
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| the only acceptable approach to the treatment of femoral hernias is | show 🗑
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| show | 2
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| umbilical hernias are usually | show 🗑
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| ____ umbilical defects should be repaired | show 🗑
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| recurrence of umbilical hernia is | show 🗑
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| umbilical hernias have ___ complications | show 🗑
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| show | exhales
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| show | an onlay of polypropylene mesh should be performed
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| inflammation of the gallbladder | show 🗑
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| show | obstruction of the cystic duct by a stone
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| acute cholecystitis is distinguished from an attack of biliary colic by | show 🗑
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| show | bacterial pathogens
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| if cholecystitis is left untreated ___ may develop (most often seen in diabetic patients) | show 🗑
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| show | severe gangrenous cholecystitis
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| patients suspected of having acute cholecystitis should | show 🗑
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| show | myocardial ischemia, pancreatitis, cholangitis
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| show | cholecystectomy
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| show | 72 hours to 1 week
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| if the patient is diagnosed with choecystitis 4-5 days after onset of symptoms | show 🗑
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| show | Extracorporeal shock wave lithotripsy for gallstones
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| show | portal hypertension, cirrhosis, previous RUQ surgery
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| show | laparoscopic cholecystectomy
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| after laparoscopic cholecystectomy, N/V and increasing abdominal pain are often early warning signs of | show 🗑
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| show | painless jaundice
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| show | minimal pain and be able to eat
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| what are the 4 F's of gall stones | show 🗑
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| cholelithiasis | show 🗑
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| show | gallstones in the common bile duct
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| show | 15
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| inflammation of the common bile duct | show 🗑
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| cholecystectomy is performed for | show 🗑
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| show | laparoscopic cholecystectomy
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| show | laparoscopic cholecystectomy
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| complications of laparoscopic cholecystectomy | show 🗑
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| what do you want to see on the critical view for cholecystectomy | show 🗑
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| common bile duct injury is ___ with lap approach | show 🗑
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| ___ hernias go through Hasselbach's triangle | show 🗑
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| It is defined by the following structures:Rectus abdominis muscle (medially), Inferior epigastric vessels (superior and laterally). Inguinal ligament, sometimes referred to as Poupart's ligament (inferiorly) | show 🗑
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| which is a recurrent hernia by definition | show 🗑
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| male:female ratio of inguinal hernia __:1 | show 🗑
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| show | femoral hernia
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| elements of both direct and indirect hernia | show 🗑
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| show | Computed tomography (CT) scan
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| inability to reduce hernia contents | show 🗑
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| compromise of intestinal vascular supply secondary to incarceration | show 🗑
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| no mesh hernia repair | show 🗑
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| most common hernia repair using mesh | show 🗑
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| the only time you want to do a laparoscopic hernia repair | show 🗑
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| Laparoscopic hernia repair has not been shown ___ than open repair | show 🗑
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| show | absorption (water, electrolytes/carbohydrates), storage, propulsion, digestion
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| show | Bacteroides fragilis
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| show | E. coli, Klebsiella
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| show | diverticula
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| true diverticula (13%) | show 🗑
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| pseudodiverticula (87%) | show 🗑
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| presence of multiple diverticula, present in majority of people >70 years, >90% in sigmoid, usually asymptomatic, common cause of massive lower GI bleed from right-sided location | show 🗑
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| inflammation or microperforation of diverticula, fever, LLQ pain, palpable mass, may produce abscess/colonic obstruction, does not usually cause bleeding | show 🗑
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| show | peritonitis, obstruction, intractable disease, recurrence, presence of fistula
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| Non-operative management for diverticulitis | show 🗑
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| communication between colon and bladder | show 🗑
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| torsion of redundant sigmoid colon on itself | show 🗑
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| classical clinical picture of ____: elderly patients with a history of chronic constipation | show 🗑
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| show | hematochezia
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| show | upper GI bleed
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| most common cause of lower GI bleed hematochezia | show 🗑
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| show | tachycardia, hypotension, orthostatic hypotension
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| show | Crohn’s Disease
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| show | Crohn's disease
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| show | Crohn's disease
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| most common area affected by Crohn's disease | show 🗑
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| show | surgeons
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| mainstay of medical treatment for Chron's disease | show 🗑
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| indications for surgery in Crohn's | show 🗑
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| Surgery cannot cure __ | show 🗑
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| Goal of surgery for Crohn's disease | show 🗑
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| show | ulcerative colitis
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| show | ulcerative colitis
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| Surgery can cure __ | show 🗑
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| show | 3rd
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| colorectal cancer risk factors | show 🗑
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| colorectal cancer screening recommendations include and annual DRE and FOBT starting at age | show 🗑
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| show | 10
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| show | Colorectal cancer
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| four types of colon polyps | show 🗑
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| staging for colorectal cancer involves | show 🗑
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| show | hemorrhoids
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| Predisposed by age, gravity, shear forces, increased abdominal pressure | show 🗑
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| show | External hemorrhoids
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| above dentate line & covered by columnar epithelium, may prolapse, bleed, and/or thrombose | show 🗑
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| internal hemorrhoidal disease without significant external disease or other benign anorectal disease, can be | show 🗑
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| show | Surgical hemorrhoidectomy
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