Surgical Tech (Appleton & Lange) Part 9

Cholelithotripsy is the correct answer because it involves the use of noninvasive high-energy shock waves to break down gallstones into smaller fragments. This procedure allows the fragments to pass through the common bile duct and be eliminated from the body. Choledochoscopy is a procedure to visualize the common bile duct using a small camera, choledochostomy is the creation of a surgical opening into the common bile duct, and choledochotomy is the surgical incision of the common bile duct.

Bariatric surgery is a type of surgery that is specifically designed to treat obesity. It involves various procedures such as gastric bypass and gastric sleeve, which aim to reduce the size of the stomach and limit the amount of food that can be consumed. This surgery helps individuals with severe obesity to lose weight and improve their overall health. Therefore, the correct answer is obesity.

Povidone-iodine is the antiseptic solution of choice for a skin prep because it has broad-spectrum antimicrobial activity against bacteria, viruses, and fungi. It is effective in reducing the number of microorganisms on the skin, making it suitable for preoperative skin preparation. Povidone-iodine is also non-irritating and non-sensitizing to the skin, making it a safe and well-tolerated option for skin disinfection.

Pitocin is a synthetic form of oxytocin, a hormone that stimulates contractions in the uterus. It is commonly used to induce labor in pregnant women who are past their due date or have medical conditions that require delivery. Pitocin is administered through an IV and helps to initiate and strengthen contractions, ultimately leading to the onset of labor. It is a commonly used method for inducing labor and has been found to be effective in many cases.

Counts are done before the beginning of the case, at the beginning of wound closure, and at skin closure to ensure that all surgical instruments, sponges, and other equipment are properly accounted for. This helps to prevent any items from being left inside the patient's body after surgery, which can lead to complications and harm the patient. By conducting counts at these specific times, healthcare professionals can ensure the safety and well-being of the patient throughout the surgical procedure.

The correct answer is Verres. During a laparoscopy, a Verres needle is used to instill gas into the abdominal cavity. This needle is specifically designed for this procedure and has a sharp, tapered tip that allows for precise insertion through the abdominal wall. The Verres needle is commonly used because it helps create a pneumoperitoneum, which is necessary for optimal visualization of the abdominal organs during laparoscopy.

The action of reaching behind sterile team members to retrieve instruments is not an acceptable sterile technique principle because it violates the principle of maintaining a sterile field. By reaching behind team members, the scrub person is introducing potential contamination to the sterile field and increasing the risk of infection for the patient. It is important to always maintain the integrity of the sterile field and avoid any actions that can compromise its sterility.

A pressure reading higher than 8-10 mm Hg during the instillation of CO2 for creation of pneumoperitoneum may indicate that the needle is buried in fatty tissue, buried in the omentum, or in a lumen of intestines. This is because these structures have higher resistance to gas flow compared to the peritoneal cavity, causing an increase in pressure. Therefore, if the pressure reading is higher than the expected range, it suggests that the needle is not properly positioned within the peritoneal cavity.

A penrose drain is a soft, flexible, and non-absorbable rubber tube that is commonly used in surgery to drain fluids. In herniorrhaphy, a surgical procedure to repair a hernia, the penrose drain may be used to retract the spermatic cord structure. The penrose drain helps to keep the cord out of the way during the procedure, allowing the surgeon to access and repair the hernia without causing damage to the cord. The other options listed, such as the army-navy retractor, Green retractor, and silk suture, do not have the same retraction capabilities as a penrose drain.

The Babcock forceps is commonly used in gynecological procedures to grasp and manipulate delicate structures like the fallopian tube. It has a curved, atraumatic design with a fenestrated tip that allows for a secure grip without causing tissue damage. The Babcock forceps are particularly useful in procedures such as tubal ligation or ectopic pregnancy surgery, where gentle handling of the fallopian tube is crucial.

An anterior and posterior repair would accomplish the repair of cystocele and rectocele. A cystocele occurs when the bladder protrudes into the vagina, and a rectocele occurs when the rectum protrudes into the vagina. An anterior and posterior repair involves surgically repairing and strengthening the tissues and muscles in the front (anterior) and back (posterior) walls of the vagina to correct these conditions. This procedure helps to restore the normal anatomy and function of the pelvic floor, alleviating symptoms such as urinary incontinence and difficulty with bowel movements.

Gastrointestinal decompression during a general surgical procedure can be achieved by using a Levine tube or a Miller-Abbot tube. Both of these tubes are specifically designed for decompression purposes in the gastrointestinal tract. The Levine tube is a nasogastric tube that is inserted through the nose and into the stomach, allowing for the removal of gastric contents and decompression. The Miller-Abbot tube, on the other hand, is a longer tube that is inserted through the nose or mouth and into the small intestine, providing decompression of both the stomach and small intestine. Therefore, options A and B are both correct as they represent effective methods for gastrointestinal decompression during surgery.

The proper method of removing the gallbladder specimen after complete dissection and irrigation of the operative site in a laparoscopic cholecystectomy is to utilize an endobag, pull the gallbladder through the largest port, and decompress the gallbladder by suctioning bile before removal. This ensures that the specimen is contained and prevents spillage of bile or stones into the abdominal cavity, reducing the risk of infection or other complications.

Intraoperative cholangiograms are imaging procedures performed during surgery to visualize the bile ducts. They can be done using either open abdominal or laparoscopic procedures. A contrast medium is injected directly into the common bile duct to enhance visibility. The correct answer, "cholangiocath," refers to a catheter specifically designed for this purpose, allowing the contrast medium to be injected accurately into the bile duct.

An end-to-end anastomosis (EEA) is a device that can potentially eliminate the need for an abdominoperineal resection because it allows for a low anterior anastomosis to be performed. This means that the device can connect two sections of the intestine together, allowing for the restoration of normal bowel function without the need for removing the rectum and anus. By avoiding the need for a more invasive surgery like abdominoperineal resection, the EEA device can potentially lead to a faster recovery and better quality of life for the patient.

Oxytocic is the correct answer because it is a drug that is administered to aid in the expulsion of the placenta. Oxytocic drugs stimulate contractions of the uterus, which helps in the delivery of the placenta after childbirth. These drugs are commonly used to prevent postpartum hemorrhage and ensure the complete expulsion of the placenta from the uterus. Anticholinergic, antihistamine, and hypoxic drugs are not typically used for this purpose.

Grossly soiled instruments should be wiped off with a sponge moistened with water or soaked in a basin of sterile distilled water. This helps to remove debris and prevent it from drying and becoming more difficult to clean. Using a sponge moistened with water or soaking in sterile distilled water helps to maintain a clean and sterile environment for the instruments.

Pelviscopy differs from laparoscopy in the utilization of a larger trocar and a 30 degree angled scope. Laparoscopy typically uses a smaller trocar and a straight scope. The larger trocar and angled scope used in pelviscopy allow for better visualization and access to the pelvic area. The utilization of auxiliary ports for ancillary instrumentation is a common feature in both pelviscopy and laparoscopy, so it is not a distinguishing factor between the two procedures. Therefore, the correct answer is A & C.

A temporary colostomy is a procedure where a surgically created opening, called a stoma, is made in the abdominal wall to divert the flow of stool from the colon. This allows the colon to rest and heal. The procedure is reversible, meaning that the stoma can be closed and normal bowel function can be restored. This is different from a permanent colostomy, where the stoma is permanent and the colon is not reconnected. Temporary colostomy is commonly performed in cases of bowel obstruction, diverticulitis, or to allow healing after certain surgeries.

When the scrubperson is draping a nonsterile table, they must cuff the drape over their gloved hands. This is important because it helps to maintain the sterility of the gloves and prevents contamination of the sterile field. Cuffing the drape over the gloved hands creates a barrier between the nonsterile table and the sterile gloves, ensuring that the gloves do not come into direct contact with the table surface. This helps to minimize the risk of introducing pathogens or other contaminants into the sterile field during the surgical procedure.

During a hysterectomy, the special technique employed is to discard the instruments used on the cervix and vagina. This is done to ensure that any potential contamination or infection is eliminated. By discarding these instruments, the risk of post-operative complications is reduced, and the patient's recovery is improved.

The main purpose of skin prep is to remove dirt, oil, and microbes, and to reduce the microbial count. This is important because dirt, oil, and microbes can harbor bacteria and other pathogens, increasing the risk of infection. By removing these substances and reducing the microbial count, the risk of infection during a medical procedure or surgery is minimized. Sterilizing the patient's skin or removing all bacteria from the skin is not necessary or practical, as the skin naturally harbors bacteria and complete sterilization is not possible.

When handling uterine curettings, it is important to keep the endometrial and endocervical curettings separate. This is because they are different types of tissue and may require different testing or analysis in the lab. By keeping them separate, it ensures that each type of tissue can be properly examined and diagnosed, if necessary. Placing them in the same container could lead to confusion or inaccurate results.

After uterus removal in a hysterectomy, it is necessary to isolate the cervical and vaginal instruments from the instrument set in a discard basin. This is done to prevent any contamination or infection from the removed uterus. The cervix is then cauterized to stop any bleeding and new instruments are used for the cervical closure. Finally, the cervical instruments are returned to the basket for further use if needed.

During thyroid surgery, the parathyroid glands are identified and preserved. These small glands are located near or attached to the thyroid gland and play a crucial role in regulating calcium levels in the body. Preserving the parathyroid glands is important to prevent complications such as hypoparathyroidism, which can lead to low calcium levels. The other options mentioned in the question, including the hyoid bone, thyroglossal duct, and thyroid bone, are not structures that are typically identified or preserved during thyroid surgery.

Hulka forceps are commonly used in gynecologic surgery. These forceps are designed to grasp and manipulate delicate tissues during procedures such as hysterectomy, tubal ligation, or other gynecologic surgeries. They are specifically designed to minimize tissue trauma and ensure precise handling of structures within the pelvis. Therefore, the correct answer is gynecologic surgery.

When covering a Mayo stand, the scrubperson should use a wide cuff. This is because a wide cuff provides better coverage and protection for the Mayo stand, ensuring that it remains sterile during the procedure. A wide cuff helps to prevent any contamination from reaching the sterile field and maintains the integrity of the sterile environment. Using a wide cuff also allows for easier and more secure placement of the cover on the Mayo stand, reducing the risk of it slipping or coming off during the procedure.

During normal labor, an episiotomy is performed to make an incision in the perineum (the area between the vagina and anus) in order to widen the vaginal opening and facilitate delivery. This procedure is done to minimize trauma to the mother and prevent excessive tearing of the tissues during childbirth. It is a common surgical intervention that can help prevent complications and promote a safer delivery for both the mother and the baby.

The technique employed for cervical biopsy is to take multiple punches at specific locations on the cervix, namely at 3, 6, 9, and 12 o'clock positions. This approach ensures that samples are collected from different areas of the cervix, increasing the chances of detecting abnormalities and providing a more comprehensive evaluation of the tissue. By taking multiple punches, the pathologist can analyze various regions of the cervix, leading to a more accurate diagnosis.

Culdocentesis is the correct answer because it refers to the surgical procedure of needle aspiration of the cul-de-sac. This procedure involves the insertion of a needle into the cul-de-sac, the space between the uterus and rectum in females, to obtain fluid or tissue samples for diagnostic purposes. Colpocleisis, culdotomy, and colpotomy are not related to this specific procedure and therefore are not the correct answers.

A bulb syringe is used when the fetal head is delivered during a cesarean. This is because the bulb syringe is used to suction out any mucus or fluids from the baby's nose and mouth to ensure that the airway is clear and the baby can breathe properly. Using the bulb syringe at this point helps to prevent any potential respiratory difficulties for the newborn.

A gastroplasty is a surgical procedure that is performed to reduce the size of the stomach. This can be done through various techniques such as gastric banding or sleeve gastrectomy. By reducing the size of the stomach, the amount of food that can be consumed is limited, leading to weight loss. This procedure is often performed in individuals who are severely obese and have not been successful with other weight loss methods.

The correct answer is peanut because a peanut is commonly used as a surgical instrument during blunt dissection of the gallbladder from the sulcus of the liver. It is small, smooth, and can be easily maneuvered to separate tissues without causing excessive damage or bleeding. The other options, such as Metzenbaum scissors, Kelly forceps, and tampons, are not typically used for this specific procedure.

In laparoscopy, tubal patency is checked by injecting methylene blue into the cervical canal. Methylene blue is a dye that is commonly used to assess tubal patency during laparoscopic procedures. It is injected into the cervical canal and if the dye flows freely through the fallopian tubes and spills out into the abdominal cavity, it indicates that the tubes are open and patent. This test helps to evaluate the function and patency of the fallopian tubes, which is important in diagnosing infertility or other reproductive issues.

The question asks for the drain that is not considered an active postoperative drain attached to an external force. The sump, chest, and Hemovac drains are all examples of active postoperative drains that are connected to an external force to facilitate drainage. However, a Penrose drain is a passive drain that relies on gravity for drainage and does not require an external force. Therefore, the correct answer is Penrose.

Hysteroscopy is a procedure that allows visualization of the internal contour of the uterus. It involves inserting a thin, lighted tube called a hysteroscope through the vagina and cervix into the uterus. This procedure is commonly used to diagnose and treat various uterine conditions such as abnormal bleeding, fibroids, polyps, and infertility. It provides a direct view of the uterine cavity, allowing the doctor to identify any abnormalities and perform necessary interventions if needed.

When both direct and indirect hernias occur in the same inguinal area, the defect is termed "pantaloon." This term is used to describe a specific type of hernia where there is a combination of both direct and indirect hernias. The name "pantaloon" is derived from the appearance of the hernia, which resembles a pair of pants or trousers with two separate compartments. In this case, the hernia bulges out in both the medial and lateral aspects of the inguinal area, resulting in a pantaloon-shaped defect.

A myomectomy is a surgical procedure performed on young women who have benign uterine tumors and want to preserve their fertility. During a myomectomy, the surgeon removes the fibroids while leaving the uterus intact. This allows the woman to still have the potential to conceive and carry a pregnancy to term. It is a suitable option for women who have uterine fibroids but do not want to undergo a complete removal of the uterus (hysterectomy) or other more extensive procedures like the Wertheim or LeFort procedures.

Before the removal of a thyroglossal cyst, the bone that is transected with bone-cutting forceps is the hyoid bone. The hyoid bone is a U-shaped bone located in the neck, just above the thyroid cartilage. It serves as an attachment point for various muscles involved in swallowing and speech. Transecting the hyoid bone allows for easier removal of the thyroglossal cyst, which is a congenital abnormality in the midline of the neck.

A Foley catheter is placed into the presurgical hysterectomy patient to avoid injury to the bladder. During surgery, there is a risk of accidental damage to the bladder, and inserting a catheter helps to prevent this by draining urine from the bladder and keeping it empty. This reduces the risk of bladder trauma during the surgical procedure.

A choledochoscope is a medical instrument that is used to directly visualize the common bile duct. It is inserted into the duct through a small incision or through an endoscope. The choledochoscope has a light source and a camera that allows the healthcare professional to see the inside of the duct and identify any abnormalities or blockages. This procedure is commonly used to diagnose and treat conditions such as gallstones, tumors, or strictures in the common bile duct.

Balancing a video camera in endoscopy requires the scrub person to focus the camera on a white sponge, a white wall, or a glove wrapper. The color white is chosen because it provides a neutral background that helps in adjusting the camera's settings and ensuring accurate visualization during the procedure. Any of the mentioned options can be used interchangeably as long as they provide a white surface for the camera to focus on.

In a thyroidectomy, a loop retractor is used to retract the sternocleidomastoid muscle. This muscle is located in the neck and plays a crucial role in head and neck movements. By retracting the sternocleidomastoid muscle, surgeons gain better access to the thyroid gland, allowing for a safer and more efficient procedure. The platysma muscle, cervical fascia, and thyroid veins are not directly involved in the retraction process during a thyroidectomy.

Oxytocics are given in a cesarean after the baby's shoulders are delivered to contract the uterus. Oxytocics are medications that stimulate uterine contractions, helping the uterus to contract and prevent excessive bleeding. By contracting the uterus, oxytocics help in the expulsion of the placenta and reduce the risk of postpartum hemorrhage. Therefore, administering oxytocics after the baby's shoulders are delivered is essential to ensure proper uterine contraction and prevent complications.

An incarcerated hernia refers to a situation where the abdominal contents are trapped within the hernia sac and cannot be easily reduced or pushed back into the abdominal cavity. This can lead to complications if the blood supply to the trapped tissues is compromised. It is different from a sliding hernia, where a portion of an organ, usually the stomach, slides into the hernia sac. A spigelean hernia occurs when part of the intestine protrudes through the spigelian fascia, a layer of tissue in the abdominal wall. A strangulated hernia is a type of incarcerated hernia where the blood supply to the trapped tissues is completely cut off, resulting in tissue death and potentially life-threatening complications.

Pelviscopy is the correct answer because it refers to the use of an endoscope to visually examine the pelvic and intraabdominal area. This minimally invasive procedure allows for a detailed examination of the reproductive organs, including the uterus, ovaries, and fallopian tubes. It is commonly used for diagnostic purposes, such as evaluating infertility, pelvic pain, and abnormal bleeding. Culdocentesis is the aspiration of fluid from the cul-de-sac, hysteroscopy involves examining the inside of the uterus, and salpingogram is an X-ray procedure to evaluate the fallopian tubes.

Closed-wound drainage is the correct answer for the question. Closed-wound drainage is a method used to drain fluid from a surgical incision. It involves placing a drainage tube or system within the wound, allowing the fluid to exit the body and collect in a reservoir. This helps prevent the buildup of fluid, reduces the risk of infection, and promotes healing. The other options, such as Penrose, sump, and cigarette drain, are not typically used for drainage following a mastectomy.

A three-chip endoscopy camera procedure produces the truest color. This is because a three-chip camera uses three separate sensors to capture red, green, and blue light, which are then combined to create a more accurate representation of colors. In contrast, one-chip and two-chip cameras may not capture colors as accurately due to the limitations of their sensor systems. A four-chip camera, although having more sensors, may not necessarily provide truer colors as the additional sensor may not significantly enhance color accuracy. Therefore, a three-chip endoscopy camera procedure is considered to produce the truest color.

A Humi cannula is used in gynecologic surgery. This type of cannula is specifically designed for use in gynecological procedures, such as laparoscopy or hysteroscopy. It is used to create a pathway for the insertion of surgical instruments and to maintain a clear field of vision during the procedure. The cannula allows the surgeon to introduce and remove instruments, as well as to insufflate gas or fluid into the surgical area as needed. Therefore, gynecologic surgery is the correct answer for the use of a Humi cannula.

A purse-string suture would be placed into the wall of a large ovarian cyst before aspiration of its contents and final removal. This type of suture is commonly used to create a circular closure by pulling the edges of the tissue together like a drawstring, which helps to prevent leakage or spillage of the cyst contents during the aspiration procedure.