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Surgery 2 Lec 6
Nova Orlando
61
Health Care
Graduate
05/02/2011

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Cards

Term
special considerations in pediatric surgery
Definition
cardiac perfusion, fetal lung immaturity, cold stress, significantly increased risk of infection
Term
main cause of death in children from 1-15yo
Definition
trauma
Term
what is considered in children under 6yo due to poor venous access
Definition
intraosseous (tibial) access
Term
hypertrophy of the circular muscle of the pylorus, usually presents in caucasian males with projectile emesis
Definition
hypertrophic pyloric stenosis (HPS)
Term
palpable "olive tumor" in the epigastrum
Definition
hypertrophic pyloric stenosis
Term
treatment of hypertrophic pyloric stenosis
Definition
pyloromyotomy
Term
when is orchidoplexy performed for cryptorchidism?
Definition
about 6m of age if testes cannot be manipulated into a scrotal position
Term
this condition is fatal without surgery by age 2
Definition
biliary atresia
Term
treatment for neuroblastoma
Definition
surgery, chemo, and radiation
Term
malignant tumor of renal origin
Definition
Wilms' Tumor
Term
neurosurgery case that presents with new onset seizures
Definition
cavernous angioma (cavernous malformation)
Term
neurosurgery case that presents with intracerebral or subarachnoid hemorrhage
Definition
arteriovenous malformation (AVM) and fistula
Term
major cause of spontaneous intracerebral hemorrhage
Definition
chronic HTN
Term
by what point in time will most saccular aneurysms rehemorrhage?
Definition
24 hrs
Term
glioma
Definition
primary intercranial tumors that develop from glia
Term
types of extra-axial tumors (arise from outside the brain parenchyma)
Definition
meningiomas, schwannomas of cranial and spinal nerves, adenomas
Term
cause of secondary traumatic brain injury
Definition
decreased oxygen delivery to the brain
Term
essential components of the initial neuro exam in TBI
Definition
GCS, and pupillary size and reactivity
Term
saddle anesthesia, urinary retention, and significant motor weakness
Definition
cauda equina syndrome
Term
treatment of cauda equina syndrome
Definition
emergent laminectomy
Term
narrowing of the spinal canal with resultant neurologic deficits, present with neurogenic claudication
Definition
lumbar spinal stenosis
Term
treatment of surgical radiculopathy
Definition
surgical fusion
Term
compression of the entire cerivcal cord, either by a large herniated disk fragment or osteophytic bony spurs
Definition
cervical myelopathy
Term
treatment of cervical myelopathy
Definition
surgical decompression STAT, if untreated --> quadriparesis
Term
goal of plastic surgery
Definition
to restore form and function
Term
areas prone to problematic scars and keloids
Definition
ears, anterior chest, and shoulders
Term
know they types of wound closure, primary, secondary, and tertiary
Definition
primary = immediately closed
secondary = no closure
tertiary = delayed closure
Term
what type of sutures are less constrictive?
Definition
interrupted
Term
sutures left in too long result in _____, taken out too early result in _____.
Definition
too late = tram tracking
too early = wound dihesence
Term
when are facial sutures removed? areas of active motion?
Definition
face = 5 days
active motion = 14 days
Term
removal of devitalized and contaminated tissues while preserving crtical structures such as nerves, blood vessels, tendons, and bone
Definition
debridement and irrigation
Term
what is the mainstay of wound infection control?
Definition
irrigation
Term
nerve responsible for thumb adduction
Definition
median nerve
Term
nerve responsible for little finger flexion
Definition
ulnar nerve
Term
this injury results in mallet finger, avulsions are most likely to occur at the DIP joint from a jamming injury
Definition
extensor tendon rupture
Term
MC carpal bone fx
Definition
scaphoid fx
Term
complication of untreated scaphoid fx
Definition
avascular necrosis
Term
area of tenderness associated with a scaphoid fx?
Definition
snuffbox
Term
which has more bacterial isolates, animal or human bites?
Definition
human
Term
positive Finkelstein's test
Definition
De Quervain's Tenosynovitis
Term
treatment of de Quarvain's
Definition
local steroid injection, immobilization, local heat, NSAIDs, surgical decompression as a last resort
Term
pt can flex digit but attempts to extend the digit result in it suddenly snapping back.
Definition
Trigger thumb/fingers
Term
positive Tinel's and Phalen's test
Definition
carpal tunnel
Term
tx for Dupuytren's contracture
Definition
surgical excision = regional palmar and digital fasciectomy
Term
tx of vulva dysplasia
Definition
primarily wide radical excision
Term
dx and staging of cervical cancer is made using
Definition
LEEP (loop electrosurgical excision procedure)
Term
definitive dx of a pelvic mass requires
Definition
visual insepction and histologic diagnosis
Term
best indicator of traumatic injury to the urinary system
Definition
hematuria
Term
indications for renal exploration (transabdominal)
Definition
persistent renal bleeding, expanding or pulsatile perirenal hematoma and aterial injury
Term
indication for nephrectomy
Definition
unstable pt who has a normal contralateral kidney
Term
treatment for testicular torsion
Definition
immediate surgical exploration
Term
treatment of priapism
Definition
arterial emoblization, or open surgical arterial ligation
Term
non-malignant enlargement of the prostate causing obstruction of urinary outflow
Definition
BPH
Term
how do you dx BPH?
Definition
UA, serum PSA, serum creatinine, uroflowmetry and postvoid residual
Term
treatment of BPH
Definition
TURP = preferred, open prostatectomy, TUNA
Term
collection of fluid within the tunica
Definition
hydrocele, surgical correction is only required when pt is symptomatic from the size
Term
painless fluid filled sac above and posterior to the testicle
Definition
spermatocele
Term
bag of worms on exam
Definition
varicocele
Term
Mc site of varicocele
Definition
left side
Term
often curative procedure for renal cell carcinoma
Definition
radical nephrectomy
Term
what is rencal cancer NOT responsive to?
Definition
radiation and chemotherapy
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