Workshop 19 Visceral surgery icon

Workshop 19 Visceral surgery




НазваWorkshop 19 Visceral surgery
Дата01.02.2013
Розмір70.7 Kb.
ТипДокументи

Workshop 19

Visceral surgery.


  1. What are the most typical approaches for surgical intervention on the liver, gall bladder and bile ducts?

  2. What is the way to perform Kocher’s cutting?

  3. What is the way to perform Fedorov’s cutting?

  4. What is the job of a surgeon when the diagnosis of traumatic break of the liver has been made?

  5. What must be done by the surgeon at considerable damage of the liver?

  6. What is the way to perform Kuznetsov-Pensky suture?

  7. What is the way to perform the drainage of extrapleural hepatic abscess according to the method of Melnikov?

  8. What is the next stage after the incision of the skin and muscles to open the extrapleural hepatic abscess according to the method of Melnikov?

  9. Which of the following approaches are used to revise pancreas?

  10. What is the most suitable way to revise posterior wall of duodenum and the head of pancreas?

  11. What is the way to mobilize duodenum according to Kocher’s method?

  12. How can the appearance of ascitis in case of cancerous head of pancreas be explained from the topographic anatomic point of view?

  13. During the operation it was necessary to find the place of formation of v. porta. Where is it identified?

  14. What is the most effective way to get to the pancreas?

  15. What part of duodenum does ductus choledochus enter?

  16. What part of the common bile duct is located in ligamentum hepatoduodenale?

  17. What are the reasons to perform cholecystectomy?

  18. What method of cholecystectomy allows decreasing the appearance of stones in the common bile duct from the gall bladder during the operation?

  19. In what cases is “from the bottom” cholecystectomy performed?

  20. Why is it necessary to peritonize a gallbladder after its removal?

  21. During the operation “from the neck” it was necessary to identify the topography of a common bile duct. The union of what ducts is it composed of?

  22. During the operation “from the neck” a surgeon identifies the artery of the gallbladder. What artery does a. cystica branch off?

  23. Name the stages of cholecystectomy:

  24. Name the stages of cholecystomy:

  25. Name the stages of transduodenal papilosfincteroplasty:

  26. Name the stages of choledochoduodenostomy according to the method of Yurash-Vinogradov:

  27. Name the stages of cholecystoduodenostomia:

  28. What is the way to open the abdominal cavity at splenectomia?

  29. What ligament is incised by the surgeon to get to the vessels of the spleen?

  30. What is the procedure to ligature the elements of vascular pedicle of the spleen at its removal?



! What are the most typical approaches for surgical intervention on the liver, gall bladder and bile ducts?

Kocher’s and Fedorov’s

#Rio-Branco and Czerny’s

Melnikov’s and Volkmann-Israel’s

Kehr’s and Bevin


! What is the way to perform Kocher’s cutting?

beginning with the medial line and 3-4 cm lower and parallel to the costal arch; the length is 15-20 cm

#along the medial line from the xiphoid process to the bottom without two finger approaching the umbilicus,

then turning right and upward till the end of X rib

beginning from the xiphoid process along the medial line to the bottom 3-4 cm long and then parallel to the

right costal arch

transrectal cutting 15-20 cm long


! What is the way to perform Fedorov’s cutting?

beginning from the xiphoid process and along the medial line to the bottom 3-4 cm long, and then going

parallel to the right costal arch 15-20 cm long

#along the medial line from the xiphoid process to the bottom and without two finger approaching the

umbilicus and then turning right and upward to the end of X rib

beginning from the medial line 3-4 cm lower and parallel to the costal arch, 15-20 cm long

pararectal cutting 15-20 cm long


! What is the job of a surgeon when the diagnosis of traumatic break of the liver has been made?

hepatic suture and tamponade with omentum

#interrupted suture on the liver

uninterrupted blanket suture and tamponade with omentum

tamponade with omentum


! What must be done by the surgeon at considerable damage of the liver?

resection of a hepatic lobe

#hepatic suture and tamponade with omentum

interrupted suture on the liver

biological tamponade of a damaged part of the liver


! What is the way to perform Kuznetsov-Pensky suture?

A liver is sutured through the total thickness by a thick dull needle with double catgut thread that is moved up

and down the surface of the liver. Then the loop is cut and the ends of the threads are bound in turn.

#The liver is sutured by separate double threads. After that the ends of the threads are bound on the superior

and inferior surfaces of the liver

the liver is sutured by chain-like suture that is composed of separate mattress sutures which threads are

tightened

parenchyma of the liver is sutured by a long catgut thread like a mattress suture, at first in one direction and

then in the opposite one


! What is the way to perform the drainage of extrapleural hepatic abscess according to the method of Melnikov?

the skin is cut two-three fingers upper and parallel to the costal arch, 12-15 cm long

# the skin is cut beginning from the xiphoidal process at first along the medial line to the bottom 3-4 cm long

and then parallel to the costal arch 15-20 cm long

the skin is cut from the medial line 3-4 cm lower and parallel to the costal arch; the length is 15-20 cm

pararectal cutting 12-15 cm long


! What is the next stage after the incision of the skin and muscles to open the extrapleural hepatic abscess

according to the method of Melnikov?

subperiosteal resection of two ribs and opening of the pleural sinus, the pleura is exfoliated from the diaphragm

and is cut along the passage of the operational wound, its superior margin is sutured to thorax muscles by a

layer of loop sutures

#the abscess cavity is opened, the pus is removed and the cavity is drained by a rubbed tube or gauze napkins

the liver is punctuated by a thick needle or trocar in the most sclerotic area in the center of which fluctuation is

observed

subperiosteal resection of two ribs and opening of the pleural sinus


! Which of the following approaches are used to revise pancreas?

through gastrocolic ligament, through the lesser omentum, through nonvascular zone of transverse colon

mesentery

# through the left gastropancreatic ligament, pancreosplenic ligament, gastrocolic ligament

through gastrocolic ligament, non-vascular zone of transverse colon mesentery, gastrolienal ligament

through omentum minus, through non-vascular zone of mesocolon, through the non-vascular zone of transverse

colon mesentery, gastrocolic ligament


! What is the most suitable way to revise posterior wall of duodenum and the head of pancreas?

by cutting peritoneum along the lateral margin of descending part of duodenum

#by cutting gastrocolic ligament

through the foramen epiploicum

opening of duodenum


! What is the way to mobilize duodenum according to Kocher’s method?

parietal peritoneum is dissected along the hepatic flexion of the large intestine, along the descending duodenal

part, extraperitoneal cellular tissue is separated and duodenum together with pancreatic head are led to the left

#ligament of Treitz is dissected and parietal peritoneum along the horizontal and ascending parts of duodenum

and intestine are separated from extraperitoneal cellular tissue

parietal peritoneum located to the right from descending duodenal part is dissected, ligament of Treitz is

dissected too, and the intestine is separated from extraperitoneal cellular tissue

parietal peritoneum located to the right from descending duodenal part is dissected, ligament of Treitz is

dissected too, parietal peritoneum is dissected along pars horisontalis and the intestine is separated


! How can the appearance of ascitis in case of cancerous head of pancreas be explained from the topographic

anatomic point of view?

compression of v. porta

#compression of inferior v. cava

pancreatic duct obstruction

obstruction of pancreatic part of the common bile duct


! During the operation it was necessary to find the place of formation of v. porta. Where is it identified?

behind the head of pancreas

#behind the body of pancreas

in hepatic duodenal ligament

behind duodenum


! What is the most effective way to get to the pancreas?

cutting of gastrocolic ligament

# cutting of hepatogastric ligament

cutting of pancreosplenic ligament

entering the finger into the Winslow foramen


! What part of duodenum does ductus choledochus enter?

pars descendens

#pars superior

pars ascendens

pars inferior


! What part of the common bile duct is located in ligamentum hepatoduodenale?

pars supraduodenalis

#pars intramuralis

pars retroduodenalis

pars retropancreatica


! What are the reasons to perform cholecystectomy?

calculous cholecystitis

#gastroduodenitis

dyskinesia of extrahepatic bile ducts

chronic gastritis


! What method of cholecystectomy allows decreasing the appearance of stones in the common bile duct from

the gall bladder during the operation?

from the neck

#from the bottom

the method itself is of no importance

from the body


! In what cases is “from the bottom” cholecystectomy performed?

marked adhesive process

#at chronic cases

at calculous cholycystitis

at periprocesses


! Why is it necessary to peritonize a gallbladder after its removal?

to prevent bile and blood from running into the gallbladder after its removal

#to avoid the appearance of commissures

to avoid the formation of stones

to prevent the development of purulent and septic complications


! During the operation “from the neck” it was necessary to identify the topography of a common bile duct. The

union of what ducts is it composed of?

common hepatic and cystic duct

#left hepatic and cystic duct

common hepatic and right hepatic ducts

left and right hepatic ducts


! During the operation “from the neck” a surgeon identifies the artery of the gallbladder. What artery does

a. cystica branch off?

a. hepatica dextra

#a. hepatica propria

a. hepatica sinistra

a. mesenterica superior


! Name the stages of cholecystectomy:

lig. Hepatoduodenale is cut, cystic duct and common bile duct are opened, bound and crossed with a. cystica

and gallbladder duct in Kalo triangle, the gallbladder is removed subserously and its bed is peritonized

#the gallbladder is removed subserously, lig. Hepatoduodenale is cut, the gallbladder duct and common bile

duct are opened and bound to a. cystica in Kalo triangle, the bed of the gallbladder is peritonized

lig. Hepatoduodenale is cut, binded and transected a. cystica and ductus choledochus are bound and crossed in

Kalo triangle

lig. Hepatoduodenale is cut, перев`язують a. cystica and ductus hepaticus communis are bound and crossed in

Kalo triangle


! Name the stages of cholecystomy:

The bottom of the gallbladder is performed with a purse-string suture, it is then punctuated, cut and the content

is removed, the gallbladder cavity is drained and fixed with a purse-string suture, the wall of the gallbladder is

sutured to the peritoneum

#lig. Hepatoduodenale is cut, a. cystica and ductus cysticus are bound and crossed in the Kalo triangle

the wall of the gallbladder is sutured to the anterior wall of duodenum, on the distance of 0,5 from sutures’ line

the lumens of the organs are opened and anastomosis is performed

lig. Hepatoduodenale is cut, on the supraduodeno-jejunale part of the duct the suture holder is put and between

them the duct is cut in longitudinal direction, after removing the concrements the common bile duct is drained


!:Name the stages of transduodenal papilosfincteroplasty:

duodenum is mobilized, duodenotomy is performed, the sphincter is cut by sonde and the calculus is removed,

mucosa of ductus choledochus and duodenal opening are sutured

#lig. hepatoduodenale is cut and common bile duct is opened by longitudinal direction, duodenum is cut by

transversal cutting and anastomosis is performed

duodenotomy is performed, the sphincter is cut by sonde in the direction of 10-11 hours, duodenal opening is

sutured by two-row suture

the bottom of the gallbladder is performed with purse-string suture, it is cut, the cavity is drained and fixed with

purse-string suture


! Name the stages of choledochoduodenostomy according to the method of Yurash-Vinogradov:

lig. Hepatoduodenale is cut and common bile duct is opened, supraduodenal part of the duct is cut in longitudal

direction, transversal cutting of duodenum and anastomosis is performed

#lig. Hepatoduodenale is cut, on the supraduodenal part of the duct the suture holder is put and between them the duct is cut in longitudinal direction, concrements are removed, the duct is drained

the wall of the gallbladder is sutured to the anterior wall of duodenum, on the distance of 0,5 from sutures’ line the lumens of both organs are opened and anastomosis is performed

duodenotomy is performed, the sphincter is cut by sonde, after the removal of concrements duodenal opening is sutured by the two-row suture


!:Name the stages of cholecystoduodenostomia:

the wall of the gallbladder is sutured to the anterior wall of duodenum, on the distance of 0,5 cm from the sutures the lumens of both organs are opened and anostomosis is performed

#lig. Hepatoduodenale is cut and common bile duct is opened by longitudal cutting, duodenum is cut transversally and anostomosis is performed

the bottom of the gallbladder is performed with a purse-string suture, the bottom in the center of the suture is cut, the stones are removed, a rubbed tube is enetered fixed by a purse-string suture

mobilization of duodenum, duodenotomy, cutting of the sphincter, removal of the stone, the mucosa of choledochus and duodenum is sutured, duodenal opening is sutured


! What is the way to open the abdominal cavity at splenectomia?

By oblique or angular cutting along the left costal arch

#transrectal or pararectal cutting, 15-20 cm long

supramedian laparotomy

middlemedian laparotomy


! What ligament is incised by the surgeon to get to the vessels of the spleen?

gastrolienal ligament

# splenophrenic ligament

gastrophrenic ligament

gastrocolic ligament


! What is the procedure to ligature the elements of vascular pedicle of the spleen at its removal?

at first on the artery, then on the vein

#at first on the vein, then on the artery

simultaneously on the artery and vein

on the artery






Схожі:

Workshop 19 Visceral surgery iconProcedure of state examination in speciality “surgery with pediatric surgery”
move to 1910-1614
Workshop 19 Visceral surgery iconProcedure of state examination in speciality “surgery with pediatric surgery”

Workshop 19 Visceral surgery iconWorkshop on academic recognition

Workshop 19 Visceral surgery iconWorkshop 18 Surgical anatomy of the superior level of peritoneum

Workshop 19 Visceral surgery icon«physical rehabilitation in surgery, traumatology and orthopedics.»

Workshop 19 Visceral surgery iconTopics of the lectures on Pediatric Surgery for students of 5th course

Workshop 19 Visceral surgery iconThe calendar plan of the lectures in Topographical Anatomy and Operative Surgery

Workshop 19 Visceral surgery iconThe topic plan of the lectures in Topographical Anatomy and Operative Surgery

Workshop 19 Visceral surgery iconList of practical skills to module №1 on operative surgery and topographical anatomy

Workshop 19 Visceral surgery iconThe thematic plan of the practical training on discipline "clinical медсестринство in surgery"

Додайте кнопку на своєму сайті:
Документи


База даних захищена авторським правом ©zavantag.com 2000-2013
При копіюванні матеріалу обов'язкове зазначення активного посилання відкритою для індексації.
звернутися до адміністрації
Документи