Test Review - Sutures and Wound Repair in General Surgery, Exams of Nursing

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American Board of Surgical Assistants TEST REVIEW - Sutures and Wound Repair/ General Surgery with Answers Who discovered that the body absorbs sutures made from animal tissues? - ✔P️hilip Syng Physick Which suture material is NOT absorbed but remains as a living tissue in the body? - ✔F️ascia lata Space caused by separation of wound edges which have not been closely approximated by sutures is called - ✔D️ead Space An interrupted suture, which is placed through tissue from one side of the wound to the other and then back through tissue again is called - ✔M️atress Suture material which, during healing process, becomes encapsulated by fibrous tissue is called - ✔N️on absorbable suture In the presence of infection, the absorption rate of surgical gut is: - ✔I️ncreased Which suture can be used in presence of infection? - ✔P️olypropylene Suture in which short lateral stitches are taken beneath - ✔S️ubcuticular Healing process in which a wound is purposely left open and allowed to heal from bottom upward is called - ✔S️econdary intention Surgical gut is made from the - ✔S️ubmucosa layer of sheep's intestines Which is most inert in tissue - ✔W️ire Stay suture does not pass through -Subq -Rectus muscle -Mesentery -Fascia - ✔M️esentery Spitting open or gaping of wound is called - ✔D️ehiscence Which of the following is used to stop bleeding and oozing on surfaced of severed BONES - ✔M️ixture of waxes (chiefly beeswax) Protrusion of bowel through separated edges of abdominal wound closure is - ✔E️visceration Silk is not recommended for use in gallbladder kidney or bladder because - ✔I️t may become nucleus for stone formation Most braided or twisted non absorbable sutures should not be used in presence of active infection because - ✔T️he sutures become breeding place for infection Halsted Technique consists mainly of - ✔I️nterrupted silk sutures Another name for a stick tie or transfixation suture is - ✔S️uture ligature Bumpers or guards are used on tension sutures to - ✔P️revent heavy suture from cutting into skin Tissue trauma will be kept to minimum by using - ✔S️utured swaged to a needle Amount of weight or pull necessary to break suture or ligature material is called - ✔T️ensile strength Which would have ea weakening effect on suture? Soaking in saline Testing tensile strength Straightening it - ✔A️LL OF THE ABOVE Which of following synthetic non absorb suture material is least reactive in tissue? Polypropylene Polyester fiber Nylon teflon impregnanted polyester - ✔P️olypropylene Which of the following must be sutured to close an upper paramedic incision?: 1. Ant rectus sheath 2. Rectus abd muscle 3. Post rectus sheath 4. Peritoneum - ✔1️,3,4 Ant rectus __ Post Rectus-- Peritoneum Benign intestinal tumor is a _____ while _____ is malignant - ✔F️ibromata, lymphosarcoma Which concerning splenectomy is not true Major veins and arteries to be ligated are in hilum of spleen Sub capsular hematoma or splenic rupture require emergency surgery Thrombocytosis usually occurs following surgery Surgery causes increases in antibody production - ✔S️urgery causes increases in antibody production Which does not require emergency surgery Fecal impaction Sigmoid colon volvulus Paralytic ileus All - ✔A️ll of the above Four major sources of blood supply to stomach: - ✔R️ight and left gastroepiploic Right and left gastric Anastomosis between small intestine and colon is a - ✔I️leocolostomy Surgical removal of endocrine gland affects the - ✔B️ody metabolism Structure that must be identified in parotidectomy - ✔C️ranial Nerve VII (7 -facial) Which may be performed for breast and/or prostatic malignancy 1. prostatectomy 2. mastectomy 3. adrenalectomy 4. hypophysectomy 5. oophorectomy 6. orchiectomy - ✔A️LL OF THE ABOVE Salivary glands consiste of 1. sublingual 2. Submax 3. parotid 4. stepsons 5. Brunner's - ✔1️,2,3 Sublingual Submaxillary Parotid Which statements about endocrine glands is/are false? Release their secretions into blood stream Essential for growth and development Ductless None of the above - ✔N️ONE of the above, they are all true Acromegaly is te result of hyper function of the - ✔p️ituitary Statement concerning a post hypophysectomy patient is true? Replacement adrenal steroid therapy is required Diabetes insidious may occur Cessation of menstruation and infertility occurs All of the above - ✔A️LL of the above Secreting cells of mammary glands - ✔A️lveoli Whipple for carcinoma of pancreas includes removal of ___ pancreas, entire ____, portion of ___ and distal segment of ____ - ✔H️EAD of pancreas entire DUODENUM portion of STOMACH distal segment of COMMON BILE DUCT Low levels of adrenocortical hormone in the blood or urine is indicative of _____ dz - ✔A️ddisons Radical mastectomy for cancer involves removal of portion of the ____ muscles - ✔P️ectorals major and minor Bleeding from the tonsillar bed is controlled with ___ rather than ___ which might damage the ____ - ✔P️RESSURE rather than SUTURE LIGATURE which may damage EXTERNAL CAROTID Which is the master gland of endocrine system - ✔P️ituitary Pancreas secretes hormones: ___ and ___ which are involved in ____ metabolism - ✔G️lucagon Insulin Carbohydrate Adrenocorticotropin (ACTH) , FSH and LH are secreted by - ✔P️ituitary only not adrenals, not ovaries and not testes Hormone estrogen is secreted by - ✔ Adrenal cortex and ovaries Not by pituitary and not by adrenal medulla Which gland is vital to body's immunity mechanism? - ✔T️hymus Test of thyroid function is ____ which measures __ - ✔B️MR which measures CONSUMPTION AT REST Which about surgery of breast is/are false? - ✔A️ugmentation mammoplasty is done for gynecomastia Excessive accumulation of uric acid in blood with disposition of acid crystal in tissue causes - ✔G️out Care must be taken not to damage which structures during thyroidectomy - ✔P️arathyroids Trachea Recurrent laryngeal nerve The ___ hormones secreted by the ____ hormones regulate the metabolism of calcium and ph0sphate - ✔P️arathyroid Parathyroid Which about thyroid is true Tracheal compression can occur from post op edema Gland is essential to life Non toxic glandular goiter produces excess thyroid hormon All of the above - Place these digestive system structures in correct sequence Pylori sphincter Fundus Diaphragm jejunum Esophagus cardiac sphincter duodenum ampulla of vater - ✔E️sophagus Diaphragm Cardiac sphincter Fundus Pyloric sphincter Duodenum Ampulla of vater Jejunum Ileum Which is not hemostatic agent - ✔O️xytocin Bone wax, oxidized cellulose, styptics and thrombin are Acute cholecystitis is usually associated with - ✔G️all stone Cystic duct obstruction Bacterial infection Empyema Which is serious post op problems following parathyroidectomy - ✔T️etany Gout Renal stones Weakness of the fascial margin of the internal ring is a _____ a weakness of fascial floor of inguinal canal is ____ - ✔D️IRECT hernia INDIRECT hernia Portacval shunt is indicated for: - ✔E️sophageal varices Backpressure on portal vein Leunnec's cirrhosis Not indicated for portal HTN Vagotomy for peptic ulcer often is accompanied by pylorplasty because - ✔V️agotomy may cause gastric atony In 2 layer bowel anastomosis, the inner _____ layer is closed with ___ sutures and the outer _____ layer with ____ sutures - ✔I️nner MUCOSAL layer with absorbable Outer SEROSAL layer with non absorbable Combine in antrectomy or gastroenterostomy, ____ is the most common op procedure for peptic ulcer: - ✔V️agotomy Pancreas functions as an ___ gland , secreting insulin and ___ directly into the ____ - ✔E️NDOcrine gland, secreting insulin and GLUCAGON, directly into BLOOD SERUM As a consequence of ligating the inferior mesenteric artery and vein, it is necessary to remove the entire _____ colon and anastomose the ____ colon to the ____ colon - ✔L️EFT colon and anastomose the TRANSVERSE colon to the Sigmoid colon The operative procedure for carcinoma of the head of the pancreas or ampulla of water is a - ✔W️hipple Which structures are amenable to stapling:j Bronchus Galea Bowel Split thickness graft Ankle bones - ✔A️LL of the above SBO leads to electrolyte imbalances. First to ____ from loss of ____-, then to _____ due to loss of ____ - ✔F️irst, ALKALOSIS from loss of HYDROCHLORIC ACID Then ACIDOSIS from loss of WATER AND SODIUM In gastric bypass for morbid obesity, stapling the ____ portion of the stomach provided a small ____Outlet - ✔P️ROXIMAL GASTROJUJENOSTOMY Which can cause intestinal obstruction: Volvulus Hernia Mesenteric infarction paralytic ileus intussusception - ✔A️LL Causes of peritonitis include which of the following: Ruptured spleen Puerperal infection gangrenous obstruction of bowel acute pancreatitis ulcerative colitis - ✔A️LL OF THE ABOVE Dumping syndrome occurs after gastric resection because of the - ✔r️apid entry of food into jejunum After completion of anastomosis in colon resection procedures, the mesentery is carefully reapprximated to - ✔P️revent internal hernia with bowel entrapment Which statement concerning parenteral hyperalimentation therapy following GI surgery is false? Catheter is inserted into a large diameter vein with high blood flow too rapid flow of suction causes hyperglycemia Constant monitoring is necessary Basic solution consists of hypotonic glucose and amino acids. - ✔B️asic solution consists of hypotonic glucose and amino acids. Purpose of vagotomy is treating patients with peptic ulcers is to - ✔D️ecrease gastric acid hypersecretion ______ is a life threatening obstruction in which the intestinal lumen is obstructed both proximally and distally, leading to bowel necrosis , perforation and peritonitis - ✔V️olvulus Many post op patients are in state of _____ due to ____ depletion, a condition that retards wound healing - ✔n️egative nitrogen balance protein The ____ is most common site for cancer of large intestine - ✔R️ectosigmoid To provide necessary calories in the nutritionally deficient post op patient, parenteral hyperalimentation is preferred over routine IV therapy because - ✔I️V fluid volume could surpass boys fluid tolerance