In the bucket (Surgery) Flashcards
When does receptive relaxation occur in the body?
A) After a actin/myosin contraction
B) After the stomach empties all its food contents/gastric juices into the duodenum
C) During swallowing for easy propulsion of bolus
D) Before ventricular diastole
C – during swallowing the lower esophageal sphincter goes through receptive relaxation to allow easy propulsion of the esophageal contents into the stomach.
Where does the esophagus come through the diaphragm?
A) The hiatal opening
B) The orifice of trite
C) Callot’s opening
D) The cardiac orifice
D – the cardiac orifice is so named because of the proximity to the heart
What muscles does the anal canal pass between?
A) The Levator Ani muscles
B) Recto-urethralis muscle
C) Longitudinal Muscles
D) Pectineus
A – the anal canal passes between the two medial borders of the levator ani muscles
What are the layers of the small bowel in order from superficial to deep?
A) Serosa, Muscularis Externa, Sub-mucosa, mucosal
B) Serosa, muscularis externa, mucosal, sub-mucosal
C) Adventitia, muscularis externa, sub-mucosa, mucosal
D) Adventitia, muscularis externa, mucosal, sub-mucosal
A – serosa (layer consisting of simple squamous epithilieum, called mesothelium), muscularis externa (layer consisting of circular & longitudinal muscle layers), Sub-mucosa (consists of dense connective tissue & adipose tissue, along w/ all the blood vessesl, nerves & structures responsible for secreting digestive enzymes), Mucosal (made up of epithelium, lamina propria & muscularis mucosa; produces mucous that lubricates & protects the inner surface, secretes digestive enzymes, absorption of nutrients & protection barrier)
Where does the majority of mesentery attach on to in the abdominal cavity?
A) Diaphragm
B) Lateral abdominal wall
C) Anterior abdominal wall
D) Posterior abdominal wall
D – the majority of mesentery is dorsal & therefore, attaches to the posterior abdominal wall
Where does the greater omentum attach/cover?
A) From the stomach to the sigmoid colon
B) From the stomach to the transverse colon
C) From the hepatic flexure to the descending colon
D) From the cecum to the transverse colon
B – extends from the stomach to cover the transverse colon & the folds of the intestine. The lesser omentum extends between the transverse fissure of the liver & the lesse curvature of the stomach
What is/are the type(s) of movements seen in GI tract?
A) Rhythmic B) Tonic C) Propulsion D) Clonic E) Both A & B F) A, B & C, but not D
E – rhythmic contrations consist of intermittent contractions that are responsible for mixing & moving food. Tonic movements consist of a constant level of contracture during relaxation, such as at a sphincter. Propulsion is a means of creating force leading to movement, but is not a type of movement in itself.
Match the following cells with their associated function:
1) Interstitial cells of Cajal A) motility along the length of the gut
2) Myenteric (Auerbach) Plexus B) Slow Wave Generation
3) Submucosal (Meissner) Plexus C) local control of motility of the gut
1-B, 2-A, 3-C
What cranial nerves are associated with swallowing?
V, IX, X, XII (Side Note: CN X is largely parasympathetic, so remember parasympathetic system drives digestion, while the sympathetic system shuts down digestion)
Which of the following are cause for insertion of a PEG tube?
A) Stroke B) Advanced Dementia C) Esophageal cancer that is being treated with radiation D) For Post-surgical Drainage E) All of the above
E – All of the above. Both A & B, think of damage to the swallowing center in the medulla & lower pons. Damage here would not allow the pt to swallow on their own. C – anyone needing radiation to their face/neck need a PEG tube bc consuming food through a radiated area could be toxic. D – it can be used more then feedings! Putting suction on the end will help the drainage from surgical repair of a ulcer, for instance.
“One thing a PA needs to know about, no matter which field he/she goes into is compartment syndrome. What is compartment syndrome?”
Compartment syndrome is a limb- and life-threatening condition which occurs after an injury, when there is not a sufficient amount of blood to supply the muscles and nerves with oxygen and nutrients because of the raised pressure within the compartment such as the arm, leg or any enclosed space within the body and leads to nerve damage because of the lack of blood supply. The severity of compartment syndrome can be divided into acute, subacute, and chronic compartment syndrome.
How many compartments are there in the lower leg? Name them
4; Anterior, Lateral, Superficial Posterior, Deep Posterior
Two incisions are made in the lower leg. One on the lateral aspect, the other medial. The doctor then asks, which compartment(s) am I gaining access to with this lateral incision? The medial?
Via lateral: Lateral and Anterior ; Medial incision: Deep Posterior and Superficial Posterior
There are various types of compartment syndrome. Where, on the body, is compartment syndrome most common?
Lower extremity
What is the name of the technique/procedure done to relieve compartment syndrome?
Fasciotomy
