Shared Flashcard Set

Details

Surgery
Surgery EOC
260
Health Care
Graduate
12/06/2009

Additional Health Care Flashcards

 


 

Cards

Term

most common post-op complication?

affects ___% of pts

Definition

Atelectasis

 

25% of abd surgery pts

Term
most common cause of post op fever w/i 48 hrs of surgery?
Definition
atalectasis
Term
tx for post-op wheezing
Definition
albuterol
Term
DVT is more common in which iliac vv?
Definition

LEFT

 

**d/t aortic bifurcation crossing and compressing left vv.

Term
virchow's triad--> indicates risk for what?
Definition

stasis

endothelial injury

hypercoag state

 

**risk factors for THROMBOSIS

Term
gold standard for DVT
Definition
v-q scan (aka doppler ultrasound)
Term
most vulnerable time for an MI
Definition
w/i 6 months of the first MI
Term
in type 1 DM pts how much of LA and SA insulin shoud be admin the day of surgery?
Definition

1/3 of LA

1/3-1/2 of SA

Term
marked increase in glucose and insulin requirements post op indicates what?
Definition
occult infxn
Term
what meds can be used in pts w/ supravent arrythmias?
Definition

verapamil

esmolol

digoxin

Term
pts w/ valvular heart disease or prosthetic valves require what meds pre-op?
Definition

ABX for prophylaxis against bacteremia

ampicillin and gentamicin

Term
how many days before surgery should warfarin be stopped?
Definition
5 days
Term
when can heparin be resumed post-op?
Definition
12 hrs after surgery
Term
most common inherited coagulation disorder?
Definition
von willebrands disorder
Term
what is used for immediate reversal of heparin anticoag?
Definition
protamine sulfate
Term
for elective surgeries in pts w/ liver dz what should be given 1st?
Definition
vitamin k
Term
healing where tissue is cleanly incised and reapproximated. repair occurs w/o complications
Definition
first (primary) intention
Term
healing that occurs in open wounds through formation of granulation tissue and eventual coverage of the defect by spontaneous migration of epithelial cells.
Definition
second (secondary) intention
Term
most burns and infected wounds heal in this mannor
Definition
secondary intention
Term

combo of primary and secondary healing.

wound allowed to heal open under carefully maintained occlusive dressing for 5 days, then closed primarily.

Definition
delayed primary closure
Term
anastomoses of what parts of the GI system are MOST LIKELY to leak?
Definition

Colon and esophagus

 

**least likely --> stomach and sm intestine!

Term
most common bacteria in wound infxns and around foreign bodies
Definition
staph aureus
Term
systemic response results in infection
Definition
sepsis
Term
systemic response occurs in the absence of infection as in burns, trauma, and pancreatitis
Definition
SIRS (systemic inflamm response syndrome)
Term
what is the single most important procedure for preventing nosocomial infxn?
Definition
hand washing
Term
most cellulitis is caused by what organisms?
Definition
strep/staph
Term
crepitant abcess or cellulitis w/ brown seropurulent exudates and mously odor.  Also show air buubles (gangrenous gas) on X-ray indicates what type of infxn?
Definition
clostridium
Term
infection that starts in an infected hair follicle
Definition
furuncle (boil)
Term
infxn of the apocrine sweat glands of the axilla or groin area
Definition
hidradenitis
Term
most common technical causes of dehescence? (2)
Definition

infxn

excessively tight sutures

Term

in the abdomen, what does not need to be sutured?

what does and w/ what materials?

Definition

peritoneum does NOT

ant and post fasciae w/ nonabsorbable or slowly absorbable suture

Term
total body water comprise ____% of body wt?
Definition
45-60%
Term
ICF is __/__ of total body water?
Definition

2/3

= 40% of TBW

Term
ECF is divided into what 2 compartments?
Definition

1. plasma (5% TBW)

2. interstitial fluid (15% TBW)

Term
ECF contains what 3 components?
Definition

1. Na

2. Cl

3. HCO3

Term
ICF contains what 2 components?
Definition

1. K

2. Sulfate

Term
Plasma H2O contains more ________ than interstitial fluids?
Definition
proteins
Term

pure water deficits is represented biochemically as what electrolyte imbalance?

 

how to tx?

Definition

HYPERnatremia

 

pure water replacement :)

Term
what hormone is released as a result of anesthesia?
Definition

ADH

 

(loss of na)

Term
electrolyte imbalance that is cheifly a loss of water
Definition
HYPERnatremia
Term
renal potassium excretion is regulated by what hormone?
Definition
aldosterone
Term
what types of pts are at greater risk of HYPERkalemia?
Definition

burn

trauma

crush injuries

Term
Adrenal insufficiency leads to what electrolyte abnormality?
Definition
HYPERkalemia
Term
what to T-waves look like in pts w/ HYPERkalemia?
Definition
PEAKED t-waves
Term
5 approaches to emergent tx of HYPERkalemia?
Definition

1. insulin

2. NaHCO3

3. Calcium

4. kayexalate

5. albuterol

Term
what pts are at risk of developing HYPOkalemia
Definition

elderly

alcoholics

Term
Likely causes of hypokalemia (3)?
Definition

1. diuretic use

2. alkalosis

3. incr aldosterone activity

Term
after what types of surgery should serum calcium levels be checked?
Definition
thyroid or parathyroid surgery
Term
HYPOcalcemia reflected by what EKG changes?
Definition
prolonged Q-T interval
Term
+ Chvostek sign indicates what type of electrolyte abnormality?
Definition

HYPOcalcemia

(tap on facial nn)

Term
Most frequent causes of HYPERcalcemia?
Definition

HYPERparathyroidism

cancer

hyperthyroid

milk-alkalai sx

Term
serum Ca levels above what level is a MEDICAL EMERGENCY?
Definition
12mg/dL
Term
Management for HYPERcalcemia includes use of what diuretic?
Definition
furosemide
Term
clinical manifestation of HYPOmagnesemia resembles what other electrolyte abnormality?
Definition

HYPOcalcemia

--> hyperreactive tendon reflexes!

Term
Antacid use can ultimately lead to what electrolyte abnormality?
Definition

HYPOphospatemia

-->antacids bind to phosphate

Term
In Resp Acidosis are CO2 levels are Incr or Decr?
Definition
INCR-->d/t HYPOventilation?
Term
Resp Alkalosis CO2 levels incr or decr?
Definition

DECREASE!--> d/t HYPERvent

 

give off CO2!

Term
most common acid/base disturbance in surgical patients?
Definition

Metabolic alkalosis

Incr in HCO3

Term
most common noscocomial infxn?
Definition
UTI
Term
most common example of mixed acid/base disturbances in surgical pts?
Definition

metabolic ACIDOSIS and Resp ALKALOSIS

 

only small change in [H] ion

Term
what is used as a measurement of nutritional status?
Definition
albumin
Term
what hormones are released by the body during hypovolemic shock?
Definition
aldosterone and vasopressin (ADH)
Term
how long does the burn surface remain sterile for? (hrs)
Definition
24-48 hrs
Term
what is the most common cause of hospitalized burn victim DEATH?
Definition
burn wound sepsis
Term
what type of nutritional deficiency is seen in a burn victim?
Definition
protein deficiency--> d/t incr met demands
Term
most serious type of electrical burns?
Definition
flame burns from ignited clothing
Term
in electrical burns, the greatest muscular injury occurs where?
Definition
closest to the burn
Term
palatine tonsils, lingual tonsils, and adenoids compose what?
Definition
Waldeyer's ring (lymph tissues)
Term
submental, submandibular, parotid, retroauricular, and occipital areas compose what lymphatics?
Definition
transitional lymphatics
Term
internal jugular chain, and supraclavicular areas compose what area of lyphatics?
Definition
cervical lymph nodes
Term
lung, breast, and GI cancers drain primarily into what lymph nodes?
Definition
supraclavicular
Term
cervical lymphatics drain into what structures on the left and right?
Definition

L-thoracic duct

R- accessory thoracic duct

Term
thoracic duct empties into what structure?
Definition
internal jugular vv at the junction of the internal jugular and subclavian vv
Term
most common lesion of the oral cavity?
Definition
squamous cell carcinoma
Term
most common oral site for malignant melanoma?
Definition
palate
Term
thyroid gland gets blood supply w/ what aa?
Definition
superior and inferior thyroid aa
Term
thyroid gland lies anterior to what structure?
Definition
trachea
Term
what connects thyroid to trachea?
Definition
ligament of berry
Term
these thyroid cells produce, store, and release T4 and T3
Definition
follicular
Term
these thyroid cells secrete calcitonin?
Definition
parafollicular cells
Term

80% of circulating hormone is what form?

 

which form is most active?

Definition

80% circulating = T4

 

T3 most active!

Term
how is toxic multinodular goiter different from grave's dz?
Definition
no exopthalamus in toxic multinod.
Term
What TSH levels indicate thyrotoxicosis?
Definition
LOW TSH
Term
most important study in evaluating thyroid nodule?
Definition
FNA bx
Term
how is acute supperative thyroiditis tx?
Definition
drainage!
Term
how is subacute thyroiditis tx?
Definition

ASA or steroids

SELF-LIMITING!

Term

what test elicits the feeling of strangulation when hands are raised above head??

what is it used to diagnose?

Definition

pemberton's test

Thyroid CA

Term

most common thyroid cancer?

arises in what cells?

Definition
papillary-->from follicular cells
Term
FNA cannot dx what type of thyroid CA?
Definition
Follicular
Term
hyperparathyroidism clinical presentation include what characteristics?
Definition

stones

bones

moans

groans

psych overtones

Term
aa supply to breast come from what 4 aa?
Definition

1. internal thoracic aa

2. lateral thoracic aa

3. thoracoacromial aa

4. post. intercostal aa

Term
vv drainage of breast (2)
Definition

1. axillary vv

2. internal thoracic vv

Term
____% of breast lymph drains to axillary lymph nodes?
Definition
75%
Term
leading cause of death of women ages 40-55
Definition
breast CA
Term
most common site for breast CA
Definition
upper outter quad (50%)
Term
best time to perform self-breast screening?
Definition
1 wk AFTER menst. cycle
Term
in what type of breast cancer is tx w/ CHEMO 1st then radiation, mastectomy, or both?
Definition
inflammatory!
Term
squamous cell carcinoma of lung originate in what tissues?
Definition
epithelial tissues of proximal airway (trach, mainstem bronchi, lobar and segmental bronchi)
Term
adenocarcinoma of the lungs originate in what tissues?
Definition
goblet cells of MAJOR BRONCHI
Term
tx for NSCLC
Definition
SURGERY!
Term
preffered tx for SCLC
Definition
CHEMO!
Term
type of lymphoma more likely in younger age groups?
Definition
hodgkins
Term
what type of lymphoma has a better prognosis?
Definition
hodgkin's
Term
type of lymphoma seen in older age groups (> 50 yoa)
Definition
Non-hodgkin's
Term
PE with decr breath sounds, decr diaphragmatic excursion, dullness to percussion, local tenderness
Definition
pleural effusion
Term
type of pleural effusion that usually occurs in the case of underlying supperative lung dz?
Definition
thoracic empyema
Term
most likely pathogen in thoracic empyema
Definition
STAPH > e. coli > pseudomonas ect
Term

most important noninvasive test to diagnose thoracic empyema?

proceedure of choice for diagnosis?

Definition

CXR

 

thoracocentesis

Term
most hemothoraces are tx w/
Definition
large bore closed chest tube drainage
Term

this type of of pleural effusion is most often associated with a surgical proceedure (CT or esophageal operation)?

how is it tx?

Definition

chylothorax

tx w/ closed tube drainage and low fat diet

Term
tension ptx and open ptx are both what?
Definition
SURGICAL EMERGENCIES!
Term
spontaneous ptx occurs most commin in what types of pts
Definition

tall thin males

marfan sx

COPD

Term
PE w/ decr breath sounds, decr fremitus on involved side, pt. tachycardia/tachypnic indicate what disorder?
Definition
PTX
Term

standard test for diagnosing PTX? 

what is seen?

Definition
PA and lat CXR--> show absence of pulm vasculature and defining lung border
Term
where is a chect tube placed?
Definition

5th intercostal space at the midaxillary line

use blunt dissection

Term
mediastinal masses found in this area are more frequently malignant?
Definition

Anterior

thymoma>lymphoma

Term
diagnostic test of choice for mediastinal mass?
Definition
CT scan W/ CONTRAST
Term
neurogenic tumors generally found in this area of the mediastinum
Definition

superior portion of posterior mediastinum

 

from intercostal or symp nn

Term
characterized as abnormal dilation of the bronchi?
Definition
bronchiectasis
Term
are gastric cancers more common in the greater or lesser curvature?
Definition
lesser
Term
most common pathogen seen in bronchiectasis?
Definition
H. FLU > Staph > K pneumo > psuedomonas
Term
imaging study of choice for confirmation of bronchiectasis
Definition
high resolution CT scan
Term
most common cause of broncholithiasis in the US
Definition
histoplasmosis
Term
most common cause of cancer related deaths in both women and men?
Definition
lung CA
Term
what type of lung CA makes up majority?
Definition
NSCLC
Term
esophageal motility d/o w/ failure of the esophagus to relax and loss of peristalsis-->painless dysphagia and dilation.
Definition
achalasia
Term
achalasia has dysphagia for what type(s) of food?
Definition
solid and liquid
Term
heller proceedure is used for what disorder?
Definition

achalasia

= esophageal myotomy

Term
esophageal diverticulum (zenker's) originates in what area?
Definition
killilan triangle --> post. wall of esophagus
Term
most common sx of esophageal diverticulum?
Definition
dysphagia
Term
most common GI disorder in the western world?
Definition
GERD
Term
Endoscopy that hows "salmon pink" epithelium is seen in what disorder?
Definition
Barrett's Esophagus
Term
spontaneous postemetic esophageal perforation is also known as
Definition
boerhaave's sx
Term
strong alkali ingestion produces what type of necrosis?
Definition
liquefaction
Term
acid ingestion produces what type of necrosis?
Definition
coagulation--> eschar formation (shields deeper tissues)
Term
nearly all severe injuries of corrosive esophagitis is caused by what type of agents?
Definition
strong alkali
Term
esophageal CA presents with dysphagia of what type(s) of foods?
Definition
solids then progresses to liquids over months
Term
radiographic studies show an "apple core" appearance in what disease?
Definition
esophageal cancer
Term
Unexplained hyperglycemia in a patient w/ a central line can indicate what?
Definition
INFXN!
Term
main source of small bowel nutrition
Definition
glutamine
Term
main source of colonic nutrition
Definition
butyrate
Term
where is calcium absorbed
Definition

duodenum-actively

jejunum-passively

Term
where is iron absorbed
Definition
duodenum
Term
where is B12 absorbed
Definition
terminal ileum
Term
most gallstones are made of
Definition
cholesterol
Term
what is the blood supply to the liver?
Definition

75% hepatic vv

25% hepatic aa

Term
most common cause of acute abdomenal surgery in US
Definition
acute appendicitis
Term
how do patients w/ peritonitis present differently than those w/ kidney stones?
Definition

stones can't stand still!

peritonitis curled in a ball

Term
abdominal pain out of proportion to the exam-->must r/o
Definition
mesenteric ischemia
Term
hypotension and pulsatile abdominal mass--> must r/o
Definition
AAA
Term
most common cause of RUQ pain
Definition
cholelithiasis
Term
most common cause of GI tract LLQ pain
Definition
diverticulitis
Term
what endocrine disorders can cause abdominal pain?
Definition

Addisonian Crisis

DKA

Term
most common type of inguinal hernia
Definition
indirect
Term
boundaries of hesslebach's triangle
Definition

1. inferior epigastric vessels

2. inguinal ligament

3. lateral border of the rectus sheath

Term
what nn runs w/ the spermatic cord in the inguinal canal?
Definition
ilioingiunal nn
Term
most common hernia in both men and women
Definition
indirect inguinal hernia
Term
what abdominal mm layer is the inguinal ligament derived from?
Definition
external oblique mm
Term
where does the inguinal ligament attach?
Definition
ASIS and pubic tubercle
Term
what are the boundaries of the femoral canal?
Definition

1. coopers ligament posteriorly

2. inguinal ligament anteriorly

3. femoral vv laterally

4. laclunar ligament medially

Term
do men or women suffer more frequently from femoral hernias?
Definition
women
Term
for a femoral catheter, how can the anatomy of the right groin be remembered?
Definition

NAVEL

Nerve, Artery, Vein, Empty space, Lyphatics

 

vv in MEDIAL to femoral aa pulse

Term
what direction is the femoral vv from the femoral arterial pulse?
Definition
MEDIAL!
Term
most commonly injured abdominal organ with blunt trauma
Definition
liver
Term
what type of burn exhibits blisters?
Definition
second degree
Term
what lab value is used to asses smoke inhalation?
Definition
carboxyhemaglobin
Term
what fluid is used in pts w/i the first 24 hrs of a burn?
Definition
colloid:  D5W and albumin
Term
what prophylaxis is MANDATORY in all burn pts?
Definition

tetanus

 

except those who are actively immunized w/i last 12 mos

Term
what electrolyte must be closely monitored in burn pts?
Definition
Na
Term
name of gastric/duodenal ulcer seen in burn pts?  prophylactively tx'd w/ what?
Definition

Curling (think curling iron=burn)

 

tx w/ H2 blocker!

Term
most common cause of significant GI bleed?
Definition
PUD
Term
diagnostic test of choice in UGI bleed
Definition
EGD
Term
is pain increase or decreased with food intake in pts w/ duodenal ulcers
Definition
decreased
Term
what syndrome is associated w/ duodenal ulcers?
Definition
Z-E sx
Term
what artery is involved in bleeding duodenal ulcers?
Definition
gastroduodenal aa
Term
what marks the end of the duodenum and the beginning of the jejunum
Definition
ligament of treitz
Term
most common indicaction for abdominal surgery in pts w/ crohns
Definition
SBO
Term
#1 cause of SBO in adults of industrialized world?
Definition
postop adhesions
Term
#1 cause of SBO WORLDWIDE?
Definition
hernia
Term
absolute signs for operation on a partial SBO?
Definition

peritoneal signs

free air under diaphragm

Term
what type of cancer is classically associated w/ mets to the small bowel?
Definition
melanoma
Term
most common general surgical abdominal emergency in pregnant women?
Definition

appendicitis

***may be in RUQ bc of large uterus!

Term
what is the difference bw McBurney's incision and Rocky-Davis incision
Definition

McBurney's=angled down w/ ext. oblique fibers

 

Rocky-Davis=transverse (straight across)

Term
how do you locate the appendix during surgery?
Definition
follow taenia down to where they converge onto the appendix
Term
what do carcinoid tumors secrete?
Definition
serotonin
Term
most common cause of colonic fistula
Definition
diverticulitis
Term
most common type of colonic fistula? how does it present?
Definition

colovescicular (colon and bladder)

presents w/ incr UTI's

Term
most common GI cancer?
Definition
colon CA
Term
most common sx of rectal cancer?
Definition
hematochezia (BRB PR)
Term
microcytic anemia in a man or post menopausal female is what until proven otherwise?
Definition
colon CA!
Term
where are most colon polyps found?
Definition
rectosigmoid
Term
most common site of diverticuLOSIS
Definition
sigmoid
Term
best test for diverticuLITIS
Definition
CT scan
Term
most common cause of massive GI bleeding in adults
Definition
diverticuLOSIS
Term
which type of volvulus is a emergency, cecal or sigmoidal?
Definition

Cecal!

Simoidal can be reduced endoscopically at first!

Term
is crohn's or UC generally associated w/ anal fissures?
Definition
both!
Term
is crohn's dz seen more in males of females
Definition
females
Term
is U.C seen more in males of females
Definition
males
Term
what is the hallmark of UC (in terms of initial sx)
Definition
bloody diarrhea
Term
which type of IBD is mouth to anus
Definition

crohns

 

(UC think "col"itis-->colon)

Term
which IDB is associated w/ skip lesions?
Definition

crohns

(healthy tissue bw 2 areas of diseased tissue)

Term
crohn's disease involves what part of the bowel wall?
Definition
full thickness
Term
UC affects what part of the bowel wall?
Definition
mucosa/submucosa
Term
which IBD more commonly has anal involvement
Definition
crohns
Term
which IBD is more likely to have rectal involvement
Definition
UC
Term
which IBD can lead to toxic megacolon as a complication
Definition
UC
Term
which IBD places someone at greater cancer risk?
Definition
UC > Crohns (appros 2x's)
Term
what meds are used for IBD flare-ups
Definition
steroids
Term
which IBD shows "cobblestoning" lesions
Definition
crohns
Term
which IBD is associated w/ pseudopolyps
Definition
UC
Term
which IBD has a "lead pipe" appearance on barium enema
Definition
UC (chronic)
Term
most common cause of portal htn in the US?
Definition
cirrhosis
Term
most common physical finding in pts w/ portal htn
Definition
splenomegaly
Term
clinical findings of portal htn? (4)
Definition

1. caput medusae

2. hemorrhoids

3. splenomegaly

4. esophageal varies

Term
what is budd-chiari sx?
Definition
thrombosis of the hepatic vv
Term
most feared complication of portal htn
Definition
bleeding from esophageal varices
Term
diagnostic test of choice to find esophageal varices
Definition
EGD
Term
what lab values correlate w/ degree of encephalopathy
Definition
serum ammonia levels
Term
what medication is used to tx encephalopathy?
Definition
lactulose
Term
what is the name of the lymph node generally found over the cystic duct?
Definition
Calot's node
Term
which aa is susceptible to injury during cholecystectomy?
Definition
R hepatic aa
Term
what are the boundaries of calot's triangle
Definition

1. cystic duct

2. common hepatic duct

3. cystic aa

Term
what is elevated when the common bile duct is obstructed
Definition
alk phos
Term
where are bile acides reabsorbed?
Definition
terminal ileum
Term
what is a kocher incision and what is it used fr?
Definition
right subcostal incision used for cholecystectomy
Term
what the boas' sign?
Definition
referred right subscapular pain in biliary colic
Term
what is a major feared complication of ERCP
Definition
pancreatitis
Term
most common sign of pancreatitis on AXR
Definition
sentinel loops
Term
ranson's cirteria is used categorize what disorder?
Definition
pancreatitis
Term
least common cause of pancreatitis
Definition
scorpion bites
Term
what is cullen sign
Definition
bluish discoloration near the periumbilical area
Term
what is grey turner sign
Definition
ecchymosis or discoloration of the flank
Term
what is fox's sign
Definition
ecchymosis of the inguinal ligament
Term
where do most pancreatic cancers arise?
Definition
head
Term
boundaries for breast dissection
Definition

Superior: axillary vv

Posterior: Long thoracic nn

Lateral:  Latissimus dorsi mm

Medial: Pectoral minor mm

Term
what 4 nerves must be identified during axillary dissection
Definition

1. long thoracic nn

2. thoracodorsal nn

3. medial pectoral nn

4. lateral pectoral nn

Term
where is the long thoracic nn located and what does it innervate?
Definition

midaxillary line

innervates serratus anterior mm

Term
location of thoracodorsal nn and what mm it inervates
Definition

LATERAL to the long thoracic nn

innervates lattisimus dorsi mm

Term
location of medial pectoral nn and what does it innervate?
Definition

runs lateral/through to pec minor and LATERAL to lateral pec nnn

innervates both pec minor and major

Term
location of lateral pectoral nn and what does it innervate
Definition

runs MEDIAL to medial pec nn (orientation to brachial plexus)

innervates pec major

Term
what deformity is seen when the long thoracic nn is cut?
Definition
winged scapula
Term
what are the lateral and medial lyphatic drainage of the breast
Definition

lateral: axillary lymph nodes

medial:  parasternal that run w/ the

internal mammary aa

Term
most common type of breast cancer
Definition
infiltrating ductal carcinoma
Term
how does drainage of the L and R adrenals differ?
Definition

L drains into L renal vv

R into IVC

Term
2 classic clues of primary hyperaldosteronism
Definition

1. HTN

2. HYPOkalemia (keep Na, lose K)

Term
what is the blood supply to the PARAthyroid glands?
Definition
inferior thyroid aa
Term
most common cause of hypercalcemia in hospitalized pts
Definition
CA
Term
what aa supply the spleen?
Definition

splenic (from celiac trunk)

short gastric aa (from gastroepiploic aa)

Term
what is vv drainage from the spleen?
Definition
portal vv via splenic vv and gastroepiploic vv
Term
what is kehr's sign and what is it assoc w/?
Definition
L shoulder pain seen w/ splenic rupture
Term
most common bacteria in ICU pneumo
Definition
gram - rods
Term
what is leriche's sx
Definition

1. claudication

2. impotence

3. atrophy

Term
most common cause of embolus  from the heart
Definition
afib
Term
what must you look for postoperatively after reperfusion of a limb?
Definition
compartment sx
Term
can a pt have a pulse and have compartment sx?
Definition
yes!
Term
which vv crosses the neck of the AAA proximally?
Definition
L renal vv
Term
which renal vv is longer?
Definition
L
Term
pfannensteil incision used most commonly for what proceedures?
Definition

gyno

for c-section/hysterectomy

Term
chevron or mercedes benz insicion of the abdomen used for what proceedure?
Definition
liver transplant
Term
which vagus nn in anterior?
Definition
Left-->rotated during embryology
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