Surgical Tech (Appleton & Lange) Part 9

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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 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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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 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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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 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.

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.

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 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.

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.

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.

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.

In surgery of the thyroid, "scratch" marking is done. This likely refers to a technique used to mark the surgical site or identify specific areas of the thyroid gland. The marking may be done to guide the surgeon during the procedure and ensure accurate and precise surgical intervention. The term "scratch" may refer to a superficial marking made on the skin or surface of the thyroid gland using a surgical instrument. However, without further context or information, it is difficult to provide a more specific explanation.

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.

During a laparoscopic cholecystectomy, the surgeon generally stands at the left side of the patient. This positioning allows the surgeon to have a clear view of the surgical site and access to the necessary instruments. It also provides a comfortable and ergonomic working position for the surgeon, as they can easily manipulate the laparoscopic instruments with their dominant hand. Additionally, standing at the left side allows the surgeon to work alongside the surgical team and communicate effectively with the first assistant.

During a laparoscopic procedure, it is important to maintain a certain level of pressure in the abdomen to create a working space for the surgeon. However, excessive pressure can lead to complications such as bradycardia (slow heart rate), changes in blood pressure, and potential gas emboli (air bubbles in the blood vessels). Therefore, the maximum pressure allowed to prevent these complications is 15 mm Hg. This pressure provides adequate working space while minimizing the risk of adverse events.

The Shirodkar procedure is a surgical technique used to prevent cervical dilatation and the release of uterine contents. It involves placing a non-absorbable suture around the cervix to reinforce and strengthen it, thus preventing it from opening and allowing the contents of the uterus to be expelled. This procedure is commonly used in cases where there is a risk of premature labor or cervical incompetence.

Hysteroscopy is the correct answer because it involves the endoscopic investigation of the uterus and tubes. This procedure allows the doctor to visually examine the inside of the uterus using a thin, lighted tube called a hysteroscope. It can help diagnose and treat various conditions such as abnormal bleeding, fibroids, polyps, and infertility issues. A hysteroscopy can provide valuable information about the structure and health of the uterus and tubes, making it a suitable choice for this scenario.

Soiled sponges are never touched with bare hands in order to maintain a sterile environment during surgical procedures. Touching the soiled sponges with bare hands can introduce bacteria or other contaminants into the surgical site, increasing the risk of infection for the patient. Therefore, it is important for healthcare professionals to use proper techniques and tools, such as gloves or instruments, to handle and dispose of soiled sponges safely.

Cervical carcinoma in situ refers to abnormal cells that are confined to the surface layer of the cervix and have not invaded deeper tissues. This classification implies that the cancer is noninvasive and has not spread to other areas of the body. It is important to identify cervical carcinoma in situ early as it has the potential to progress into invasive cervical cancer if left untreated.

An enterocele differs diagnostically from a rectocele by its contents and its position in the perineum. An enterocele is a herniation of the small intestine into the Pouch of Douglas, which is a space between the rectum and the back wall of the uterus in females. On the other hand, a rectocele is a herniation of the rectum into the posterior vaginal wall. Therefore, the correct answer is Pouch of Douglas.

The scrub person can pass off specimens on all items listed except for the sponge. This is because the sponge is typically used to absorb fluids and clean the surgical site during the procedure, making it unsuitable for carrying specimens. The towel, basin, and paper can all be used to safely transport specimens without compromising their sterility.

The incision that would require cutting through Scarpa's fascia is the inguinal incision. Scarpa's fascia is a layer of connective tissue located in the lower abdomen, and it is present in the inguinal region. When performing an inguinal incision, surgeons would need to cut through Scarpa's fascia to access the underlying structures in that area. The other options, subcostal, Phannenstiel, and McBurney, do not involve cutting through Scarpa's fascia.

The scrub person is responsible for defogging the video camera. This is because the scrub person is typically in close proximity to the camera during surgical procedures and has the ability to quickly clean the lens if it becomes foggy. The circulator is responsible for managing the overall flow of the surgical procedure, the surgeon focuses on performing the surgery, and the camera operator is responsible for operating the camera but may not be in close proximity to the camera at all times. Therefore, the scrub person is the most likely person to be responsible for defogging the video camera.

Sterility can be achieved through various procedures, including laparoscopy, minilaparotomy, and posterior colpotomy. However, culdoscopy is not a procedure that is typically used to achieve sterility. Culdoscopy is a diagnostic procedure that involves the insertion of a scope through the posterior vaginal wall into the cul-de-sac, and it is not typically used as a sterilization procedure.

An advanced inflammation of the bowel could be conservatively treated with a temporary colostomy. This procedure involves creating an opening in the abdomen called a stoma, through which a portion of the colon is brought to the surface. This allows waste to bypass the inflamed or damaged section of the bowel, giving it time to heal. The colostomy is temporary because once the inflammation subsides, the stoma can be closed and normal bowel function can be restored.

Cervical conization is a surgical procedure that involves the removal of a cone-shaped piece of tissue from the cervix. This procedure is typically performed using a scalpel, cautery (a device that uses heat to cut or coagulate tissue), or a laser. However, a sclerosing solution is not used during cervical conization. Sclerosing solutions are typically used to treat varicose veins by causing them to collapse and stick together. Therefore, the correct answer is sclerosing solution.

If a sterile field becomes moistened during a case, the correct action to take is to add extra drapes to the area. This is done to maintain the sterility of the field and prevent any contamination that may occur due to moisture. By adding extra drapes, the wet sections are covered and isolated, ensuring that the rest of the field remains sterile. This helps to minimize the risk of infection and maintain a safe surgical environment.

Fogarty biliary catheters are specifically designed to facilitate stone removal. These catheters have an inflatable balloon at the tip that can be inflated to capture and remove stones from the bile duct or gallbladder. By inflating the balloon and gently pulling back, the stones can be safely extracted from the biliary system. This procedure is commonly used in cases where there are gallstones or other obstructions that need to be removed to restore proper bile flow.

Laparoscopic hernia repair is a minimally invasive surgical procedure used to repair hernias. TAPP (Transabdominal Preperitoneal), IPOM (Intraperitoneal Onlay Mesh), and LEP (Laparoscopic Extraperitoneal) are all designated options of laparoscopic hernia repair. However, ERCP (Endoscopic Retrograde Cholangiopancreatography) is not a designated option for hernia repair. ERCP is a diagnostic procedure used to examine the bile ducts and pancreatic ducts, not for hernia repair.

During surgery, towel clips may be removed and discarded as long as the area is covered with sterile linen. This is important to maintain a sterile environment in the operating room. The circulator, who is responsible for managing the surgical environment, may remove the towel clips if necessary, but it is important to ensure that the area is covered with sterile linen to prevent contamination.

A Kock pouch is a selected alternative to a conventional ileostomy that does not allow spontaneous stool exiting from the stoma. Instead, it requires daily catheterization of the stoma to evacuate the contents. This means that the Kock pouch is a reservoir created from the small intestine that collects stool, and it needs to be manually emptied using a catheter. This option provides a way for individuals to have more control over their bowel movements and avoid the need for an external ostomy bag.

Litter's hernia is the correct answer because it refers to an inguinal hernia that contains a Meckel's diverticulum. This type of hernia is named after a German surgeon named Carl Litter, who first described this specific type of hernia. The presence of a Meckel's diverticulum in the hernia can cause complications and requires surgical intervention.

Culdocentesis is a procedure used to confirm the diagnosis of ectopic pregnancy. It involves inserting a needle into the space behind the vagina and in front of the rectum to collect fluid. If there is blood in the fluid, it suggests that there may be a ruptured ectopic pregnancy. Culdocentesis is a minimally invasive procedure that can provide important diagnostic information without the need for more invasive surgeries like laparotomy. Therefore, culdocentesis is the most appropriate choice among the given options for confirming the diagnosis of ectopic pregnancy.

Extrauterine pregnancies, also known as ectopic pregnancies, occur when a fertilized egg implants and grows outside of the uterus. The most common locations for ectopic pregnancies are the abdominal cavity and the fallopian tube. The abdominal cavity provides space for the developing embryo to grow, while the fallopian tube is a common site for implantation due to its proximity to the uterus and its ability to provide a suitable environment for early embryo development. Therefore, the correct answer is "abdominal cavity and tube".

The correct answer is follicle. The most commonly identified ovarian cyst is the follicle. Follicle cysts occur when the follicle, which normally releases an egg during ovulation, does not break open and release the egg. Instead, the follicle continues to grow, forming a cyst. These cysts are usually harmless and often resolve on their own without treatment. They are commonly seen in women of reproductive age and are typically small in size.

Section curettage is a gynecologic procedure that involves scraping or suctioning the lining of the uterus. This procedure is commonly used for diagnostic purposes or to remove abnormal tissue, such as in cases of abnormal uterine bleeding or miscarriage. Various sizes of sterile cannulas are necessary for section curettage in order to accommodate different patient needs and ensure a safe and effective procedure. Cannulas are used to access the uterus and remove tissue, and having various sizes available allows the healthcare provider to select the most appropriate cannula for each individual patient.

A vesicourethral abdominal suspension is a surgical procedure used to treat urinary incontinence in women. The Marshall-Marchetti procedure is a specific type of vesicourethral abdominal suspension that involves attaching the bladder and urethra to the abdominal wall to provide support and prevent urine leakage. This procedure is named after the two surgeons who developed it, Dr. Marshall and Dr. Marchetti.

The term "Papanicolaou" refers to the Papanicolaou test, commonly known as a Pap smear. This test involves the collection of cells from the cervix, which are then examined under a microscope for any abnormalities or signs of cervical cancer. Therefore, the correct answer, "cytologic study of cervical smear," accurately describes the purpose of the Papanicolaou test.

In a cesarean birth, a bandage scissor is used to open the uterus. This type of scissor is specifically designed for cutting through bandages and other soft materials. It has a blunt tip and curved blades, which makes it safer to use in delicate procedures like a cesarean birth. The bandage scissor allows the surgeon to make a clean and precise incision in the uterus, ensuring the safety of both the mother and the baby.

Conization of the cervix is a surgical procedure that involves removing a cone-shaped piece of tissue from the cervix. This procedure is commonly performed to diagnose or treat cervical abnormalities. The options listed are different instruments or techniques that can be used to perform conization. The Thomas uterine curette is not typically used for this procedure, as it is primarily used for scraping the lining of the uterus during a dilation and curettage (D&C) procedure. Therefore, the Thomas uterine curette is the exception in this case.

Intraoperative chromotubation is a procedure used during surgery to assess the patency of the fallopian tubes. It involves injecting a colored dye into the tubes and observing its flow. Surgical cannulae are used to introduce the dye into the tubes. The question asks for the cannula that cannot be used for this purpose. The answer is "Hulka" because Hulka cannulae are specifically designed for tubal sterilization procedures and are not suitable for chromotubation.

The Allis instrument is commonly used in surgeries to grasp and hold tissues, such as the anterior cervix of the uterus, during dissection. It has sharp teeth that provide a secure grip, allowing the surgeon to manipulate and control the tissue effectively. The Heaney, Phaneuff, and Kelly instruments have different functions and are not specifically designed for grasping the cervix during a hysterectomy.

The correct answer is "A and C". This means that both "laparoscopic assisted vaginal hysterectomy (LAVH)" and "pelviscopic assisted vaginal hysterectomy (PAVH)" are alternative terms for the surgical procedure that is an alternative to abdominal hysterectomy utilizing an endoscope.

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The correct answer is Lahey because it is the only option that is not a type of instrument used in a vaginal procedure. Jacobs, Staude, and Skene are all types of instruments used in various vaginal procedures, while Lahey is not associated with any specific vaginal procedure instrument.

The correct answer is "all laundry should be discarded into impervious bags". This is because the aseptic principle of "confine and contain" focuses on preventing the spread of infection by confining and containing potentially contaminated materials. Discarding laundry into impervious bags does not align with this principle, as it does not confine and contain the laundry but rather allows it to be disposed of without proper containment.

The aim of stress incontinence operations is to improve the performance of a dislodged or dysfunctional vesical neck, restore normal urethral length, and tighten and restore the anterior urethral vesical angle. However, it does not involve repairing a congenital defect.

Laparoscopic tubal occlusion can be achieved through various methods such as using a silastic band, bipolar coagulation, or a spring clip. However, chemical ablation is not a method used for laparoscopic tubal occlusion. Chemical ablation refers to the destruction or removal of tissue using chemical agents, which is not typically used for tubal occlusion.

During a thyroidectomy, once the skin flaps are completed, the muscles that are incised in the midline of the neck are the strap muscles. The strap muscles, also known as the infrahyoid muscles, include the sternohyoid, omohyoid, and thyrohyoid muscles. These muscles are incised to gain access to the thyroid gland and allow for its removal. The sternocleidomastoid muscle is not incised in the midline of the neck during a thyroidectomy. The sternothyroid and sternoclavicular muscles are also not incised in this procedure.

In a laparoscopic cholecystectomy, the camera operator is responsible for controlling the camera that provides a visual feed of the surgical site. They need to have a clear view of the surgeon's actions and the area being operated on. By standing to the right of the first assistant, the camera operator can have a direct line of sight to the surgical field and easily capture the necessary footage. Additionally, this position allows for effective communication and coordination between the camera operator, surgeon, and other members of the surgical team.

A vesicovaginal fistula is a condition where there is an abnormal connection between the bladder and the vagina, leading to the leakage of urine into the vagina. This can occur due to various reasons such as childbirth complications, pelvic surgery, or radiation therapy. Symptoms may include urinary incontinence, recurrent urinary tract infections, and vaginal discharge. Treatment usually involves surgical repair of the fistula to restore normal urinary function.

The correct answer is radical vulvectomy and lymphadenectomy. This procedure involves the surgical removal of the vulva and the lymph nodes in the surrounding area, including the abdomen, perineum, and groin. It is typically performed for the treatment of vulvar cancer or advanced stage vulvar intraepithelial neoplasia. The goal of this procedure is to remove the cancerous tissue and any nearby lymph nodes that may be affected by the disease. Pelvic exenteration is a more extensive procedure that involves the removal of multiple organs in the pelvis, while the Manchester procedure is a specific type of surgery for uterine prolapse. The Wertheim procedure is a surgical technique used for the treatment of cervical cancer.

Hysteroscopy is a procedure that allows a doctor to examine the inside of the uterus. It is commonly used to identify and remove various conditions such as lost IUDs, intrauterine adhesions, and submucosal fibroids. However, fallopian adhesions are not typically identified or removed during a hysteroscopy. Fallopian adhesions refer to scar tissue that forms in the fallopian tubes, which are not directly accessible through a hysteroscopy. Therefore, fallopian adhesions would not be included in the list of conditions that can be addressed through this procedure.

A Stamey endoscopic procedure is performed to suspend the vesicle neck. This procedure involves the use of sutures to lift and support the bladder neck, which helps to treat urinary incontinence. By suspending the vesicle neck, the procedure helps to improve the function of the bladder and prevent urine leakage. This procedure is commonly used in cases where there is a weakness or laxity in the muscles and tissues that support the bladder neck.

An enterocele refers to a herniation of the cul-de-sac of the Pouch of Douglas. The Pouch of Douglas is a space located between the rectum and the back wall of the uterus in females. In an enterocele, the small intestine protrudes into this space, causing a bulge or herniation. This condition can lead to symptoms such as pelvic pain, discomfort, and difficulty with bowel movements. Treatment options may include lifestyle changes, pelvic floor exercises, or surgery, depending on the severity of the enterocele.

Pelvic exenteration is the preferred procedure for recurrent or persistent carcinoma of the cervix after radiation therapy has been completed. This procedure involves the removal of the pelvic organs, including the uterus, cervix, ovaries, and nearby lymph nodes. It is a radical surgery that aims to remove all the cancerous tissues in the pelvis. This procedure is chosen because it offers the best chance of complete removal of the cancer and can be curative in some cases. Other options like Wertheim's procedure, abdominal perineal resection, and low-anterior resection may be considered in certain situations, but pelvic exenteration is the preferred choice.

In a cesarean section, when closing the uterus after making an incision, the edges of the uterine incision are clamped with Pennington forceps. Pennington forceps are commonly used in gynecological surgeries for grasping and holding tissues firmly. They have a curved shape with serrated jaws that provide a secure grip, making them suitable for clamping the edges of the uterine incision during closure. Allis, Kocher, and Babcock forceps are also commonly used in surgical procedures, but they are not specifically designed for clamping the edges of a uterine incision.

Trachelorrhaphy is the correct answer because it refers to the surgical reconstruction of the cervical canal. This procedure is typically performed to repair a tear or defect in the cervix, which can occur due to childbirth or other causes. Cervicectomy, vulvectomy, and circlage are not appropriate terms for the reconstruction of the cervical canal. Cervicectomy refers to the removal of the cervix, vulvectomy refers to the removal of the vulva, and circlage refers to the placement of a stitch around the cervix to prevent premature labor.

A palliative invasive procedure done to prevent malnutrition or starvation is known as gastrostomy. This procedure involves creating an opening in the stomach through the abdominal wall to provide a direct access for feeding. It is commonly used in patients who are unable to eat or swallow properly due to various medical conditions, such as cancer, neurological disorders, or severe injuries. By inserting a feeding tube through the gastrostomy, essential nutrients and fluids can be delivered directly to the stomach, ensuring adequate nutrition and preventing malnutrition.

Laparoscopic tubal occlusion is a method of sterilization that involves blocking or sealing the fallopian tubes to prevent fertilization. This can be achieved through various techniques such as bipolar coagulation, the use of Silastic bands, and the spring loop method. However, the Surgitie ligating loop is not typically used for tubal occlusion. Therefore, it is the exception among the given methods.

Schauta is the name given to a radical vaginal hysterectomy. This procedure involves the removal of the uterus, cervix, and upper part of the vagina through the vaginal route. It is commonly used for the treatment of gynecological cancers, particularly cervical cancer. The Schauta technique allows for a less invasive approach compared to other methods, such as the Wertheim's procedure, which involves a more extensive removal of surrounding tissues. The LaFort procedure, on the other hand, is a different surgical technique used for the treatment of pelvic organ prolapse. Exenteration refers to the removal of all pelvic organs, including the uterus, cervix, vagina, bladder, and rectum, and is not specifically associated with a radical vaginal hysterectomy.

Colpocleisis is a surgical procedure that involves obliterating the vagina by denuding and approximating the anterior and posterior walls. This procedure is typically performed in older women who no longer desire sexual activity and may be experiencing pelvic organ prolapse or urinary incontinence. It is a relatively simple and effective procedure that can improve quality of life for these women. Vaginoplasty, colpoperinorrhaphy, and colporrhaphy are all different surgical procedures that involve repairing or reconstructing the vagina, but they do not provide obliteration like colpocleisis does.