General Surgery and Surgical Pathology Review

Comprehensive vocabulary flashcards covering general surgery foundations, including asepsis, antisepsis, hemostasis, blood transfusion, desmurgy, perioperative care, trauma and fractures, burns and cold injuries, surgical infections, oncology, congenital anomalies, and parasitic conditions.

Asepsis

A comprehensive system of prophylactic measures designed to prevent the introduction of pathogens and microorganisms into a wound, tissues, or the patient's body during diagnostic or surgical procedures. Founded conceptually by E. von Bergmann.

Sterilization

The complete destruction and elimination of all viable microorganisms, including bacterial spores, vegetative bacteria, viruses, and fungi, from objects, surgical instruments, solutions, and dressing materials.

Disinfection

The destruction and reduction of pathogenic and conditionally pathogenic microflora on inanimate objects and surfaces, without necessarily killing all bacterial spores.

Grossich-Filonchikov Method

A 4-step technique for antiseptic preparation of the surgical field using alcoholic iodine solution: applied before draping, after draping before the incision, before closing the cutaneous wound, and after skin suturing.

Spasokukotsky-Kochergin Method

A classical surgical hand preparation method where hands and forearms are washed successively in two sterile basins containing warm 0.5% ammonia solution for 3 minutes each, dried with sterile towels, and rubbed with 96% ethyl alcohol for 5 minutes.

Operating Room Zone of Sterile Regime

The most restricted architectural area of the operating theater suite with maximal sterility requirements, comprising the operating room itself, the scrub/preoperative room, and the rapid sterilization room.

Permissible Microbial Air Contamination in the Operating Room

The maximum allowed microbial count in operating room air is strictly up to $500\text{ microbes/m}^3$ before the start of an operation, and up to $1000\text{ microbes/m}^3$ during surgery provided no pathogenic strains are present.

Antisepsis

A complex of therapeutic and prophylactic measures aimed at suppressing, combating, or eradicating infectious agents directly within human tissues, contaminated wounds, and bodily fluids, pioneered by Joseph Lister.

Primary Surgical Debridement (PSD)

The initial mechanical intervention performed on freshly contaminated wounds (optimally within the first 6 to 12 hours post-injury), involving full excision of non-viable margins, walls, and wound floor down to healthy bleeding tissues to prevent wound infection.

Secondary Surgical Debridement (SSD)

A surgical intervention performed on already infected or suppurating wounds, aimed at opening purulent pockets, decompressing abscesses, and excising necrotic tissues and fibrin slough to halt progressing infection.

Biological Antisepsis

The use of biological agents or substances that directly kill microbes, lyse non-viable tissues, or augment the host's immune defense; examples include antibiotics, bacteriophages, proteolytic enzymes, antitoxins, and hyperimmune plasma.

Proteolytic Enzymes (in Surgery)

Enzymes of plant (papain, bromelain), animal (trypsin, chymotrypsin), or bacterial origin (streptokinase, terrilytin) that selectively lyse necrotic tissue, fibrin crusts, and viscous pus without damaging healthy intact cells.

Active Immunization

The administration of non-toxic antigenic derivatives (toxoids/anatoxins, such as tetanus or staphylococcal toxoid) to stimulate the patient's own immune system to generate specific antibodies.

Passive Immunization

The parenteral administration of pre-formed specific antibodies (antitoxic sera, antitetanic gamma-globulin, or hyperimmune antistaphylococcal plasma) providing immediate but temporary protection against severe infections.

Hematoma

A focal, circumscribed accumulation of extravasated liquid or clotted blood restricted within an anatomical soft tissue compartment or muscular plane.

Hemothorax

An accumulation of extravasated blood within the pleural cavity, classified radiologically and clinically into small (limited to the costodiaphragmatic sinus), moderate (reaching the inferior scapular angle), and large (filling the entire pleural space).

Hemoperitoneum

The effusion and accumulation of blood within the peritoneal cavity resulting from blunt or penetrating injury to parenchymal organs (liver, spleen) or major abdominal vessels.

Melena

Tarry, black, foul-smelling liquid stool produced by the degradation of hemoglobin into hydrochloric hematin in the presence of gastric acid and digestive enzymes, characteristic of upper gastrointestinal bleeding.

Allgöwer Shock Index

The hemodynamic ratio of heart rate (pulse beats per minute) to systolic arterial blood pressure: $\text{Shock Index} = \frac{\text{Heart Rate}}{\text{Systolic BP}}$. Normal baseline value is approximately $0.5$.

Rivilois-Grégoire Test

A diagnostic aspiration test for hemothorax where sampled pleural blood is observed in a test tube: non-clotting blood indicates ceased hemorrhage (due to defibrination), whereas rapid clotting confirms active ongoing bleeding.

Esmarch Arterial Tourniquet

An elastic compressive band applied proximal to a vascular injury; max continuous application time is 2 hours on the lower extremity, 1.5 hours on the upper extremity, and 1.5 hours in winter/cold environments.

Vascular Clamping Hemostasis

A temporary mechanical method of arresting hemorrhage by applying a hemostatic clamp directly to the bleeding end of a transected blood vessel.

Vessel Ligation

A definitive mechanical hemostasis technique consisting of securing a ligature around the lumen of a bleeding vessel.

Vascular Prosthesis / Grafting

A definitive surgical reconstructive technique replacing a damaged or resected major vascular segment with a synthetic or biological conduit.

Vascular Suture

A definitive surgical technique involving direct end-to-end continuous or interrupted coaptation of the vessel wall margins using fine non-absorbable monofilament sutures.

Packed Red Blood Cells (PRBCs)

A primary cellular blood component prepared by centrifugation of whole blood, stored at $+4\text{ to }+6^\circ\text{C}$, primarily indicated for grade III-IV acute blood loss, severe anemia, and hemorrhagic shock.

Fresh Frozen Plasma (FFP)

A plasma component separated and frozen within 6 hours of donation, maintained at $-20\text{ to }-25^\circ\text{C}$ for up to 90 days (or $-10^\circ\text{C}$ for 30 days), containing all functional clotting factors.

Biological Compatibility Test (Bedside)

A mandatory bedside transfusion safety test consisting of the rapid intravenous push of $15\text{ to }20\text{ mL}$ of blood three consecutive times at intervals of $3\text{ to }5\text{ minutes}$, while closely observing the patient for signs of incompatibility.

Hemodynamic Plasma Substitutes

Colloidal infusion solutions (such as Dextran 70/Polyglucin and Dextran 40/Rheopolyglucin) designed to expand circulating blood volume by increasing intravascular oncotic pressure and drawing interstitial fluid into the vascular bed.

Desmurgia

The branch of clinical surgery that studies dressings and bandages, their classification, properties, and specific application techniques.

Circular Bandage

A foundational bandaging technique in which each successive turn completely overlaps and covers the previous turn in identical circular tracks.

Spiral Bandage with Folds

A bandaging method applied to conical limb segments (such as the forearm, leg, or thigh) where the bandage is periodically folded over $180^\circ$ on each spiral pass to ensure uniform, snug adaptation.

Creeping (Snake-like) Bandage

A preliminary bandaging technique used to rapidly secure dressings or splints along a limb, where successive turns advance loosely and do not overlap, leaving spaces between adjacent loops.

Capeline / Cap Dressing (Чепец)

A standard cranial bandage anchored by a vertical chin ribbon held under tension, across which successive transverse loops of a roller bandage alternately fold back and forth to securely envelop the calvarium.

Desault's Bandage

An immobilizing shoulder-girdle dressing utilizing an axillary pad and specific circular and diagonal tours between the chest, elbow, shoulder, and uninjured axilla to immobilize clavicular fractures and shoulder dislocations.

Velpeau Bandage

An immobilizing upper-extremity bandage where the injured hand is placed on the opposite clavicle/shoulder and the entire arm is secured to the thorax using oblique and horizontal wraps.

Catabolic Phase of the Postoperative Period

The initial metabolic response phase after surgical intervention, typically lasting $3\text{ to }7\text{ days}$, characterized by sympathetic activation, elevated adrenocortical hormones, glycogenolysis, and negative nitrogen balance.

Eventration

A severe acute surgical complication characterized by full-thickness dehiscence of an abdominal surgical wound with spontaneous prolapse or protrusion of intra-abdominal viscera through the separated edges.

Stange's Test

A functional respiratory evaluation test measuring the maximum duration of voluntary breath-holding at deep inhalation; normal healthy individuals maintain breath-holding for $30\text{ to }40\text{ seconds}$.

Hench (Sobraze) Test

A functional respiratory evaluation test measuring the maximum duration of voluntary breath-holding following a complete expiration.

Crush Syndrome (Bywaters / Traumatic Toxicosis)

A life-threatening systemic pathological state caused by prolonged external mechanical compression of large muscular masses (usually $\ge 4\text{ to }8\text{ hours}$), characterized by severe ischemic muscular necrosis, shock, hyperkalemia, myoglobinuria, and acute renal failure following decompression.

Positional Compression Syndrome

A variant of crush syndrome resulting from prolonged compression of soft tissues by the patient's own body weight, predominantly occurring in individuals during deep comatose states or acute alcohol/drug intoxication.

Healing by Primary Intention

The physiological union of a clean, aseptic wound with closely approximated viable edges, minimal tissue loss, and absence of hematoma or active infection, resulting in a thin, cosmetically neat linear scar.

Healing by Secondary Intention

Wound repair occurring when margins cannot be approximated, or when marked tissue loss, necrosis, and suppurative inflammation are present; healing proceeds through the formation of granulation tissue and extensive contracture/scarring.

Delayed Primary Suture

Sutures placed in a wound immediately or within 1 to 3 days after debridement, but tied only at 5 to 7 days post-injury provided there are no clinical signs of purulent inflammation.

Early Secondary Suture

Suturing of a granulating wound performed between the 8th and 15th day post-injury on healthy, clean granulation tissue before mature scar contraction occurs.

Pathological Dislocation

A persistent abnormal articular displacement occurring without major trauma, caused by destructive underlying disease (tuberculosis, tumors, osteomyelitis) weakening the joint capsule and ligaments.

Habitual Dislocation

A recurring joint dislocation triggered by trivial physiological movements, most commonly affecting the glenohumeral joint as a consequence of inadequate primary immobilization and residual capsular laxity.

Dzhanelidze Method for Hip Dislocation

A closed reduction maneuver performed with the patient lying prone on a table with the affected limb hanging down over the edge for 15-20 minutes to relax muscles, followed by downward pressure on the popliteal fossa with concurrent inward/outward rotation.

Kocher's Method for Shoulder Dislocation

A classic four-stage maneuver for anterior shoulder reduction: adduction and downward traction, external rotation of the arm, anterior horizontal adduction of the elbow toward the chest midline, and internal rotation placing the hand on the opposite shoulder.

Dzhanelidze Method for Shoulder Dislocation

A closed reduction method where the patient lies on their injured side on a high examination table with the arm hanging freely over the edge for 15-20 minutes, followed by axial traction and rotational manipulation at the elbow.

Epiphyseal Fracture

A fracture line running through the articular extremity or growth plate of a long bone.

Metaphyseal Fracture

A fracture situated in the cancellous transitional region between the epiphysis and the shaft (diaphysis) of a long tubular bone.

Diaphyseal Fracture

A fracture occurring across the main shaft or cortical cylindrical body of a long tubular bone.

Oblique Fracture

A fracture pattern where the break passes obliquely at an angle across the anatomical long axis of the bone.

Transverse Fracture

A fracture pattern where the mechanical fracture line runs strictly perpendicular to the longitudinal axis of the bone.

Spiral (Torsion) Fracture

A fracture resulting from severe torsional stress, causing the fracture line to encircle the bone shaft in a helical corkscrew pattern.

Comminuted Fracture

A fracture resulting in multiple loose, detached bone fragments or splinters between the two main proximal and distal osseous segments.

Impacted Fracture

A fracture pattern commonly occurring in metaphyseal cancellous bone where one cortical bone fragment is forcibly driven into the substance of the adjacent fragment.

Wedge Compression Fracture of the Spine

A vertebral fracture caused by hyperflexion or axial loading (such as falling onto the feet or buttocks), causing anterior cortical collapse and wedge-shaped vertebral body deformation.

Intramedullary Metal Osteosynthesis

A surgical fixation technique for diaphyseal fractures involving the insertion of an intramedullary metallic nail, pin, or rod into the marrow cavity across the reduced fracture line.

Extramedullary Metal Osteosynthesis

A surgical fixation method where stability is achieved by applying metallic plates, screws, cerclage wires, or bolts externally to the cortical bone surface.

Ilizarov Transfixion Apparatus

An external circular ring-and-wire transfixion fixation system providing rigid stabilization and calibrated compression or distraction osteogenesis without exposing the fracture site.

Glisson's Loop Traction

A specialized fabric halter apparatus slung under the chin and occiput used to deliver continuous non-invasive cervical spinal skeletal traction in fractures of the cervical or upper thoracic spine.

Pseudarthrosis (False Joint)

A definitive cessation of bone healing consolidation characterized clinically and radiologically by sclerosis and rounding of bone fragment ends, obliteration of the medullary canal by a compact bony plate, and abnormal painless mobility at 9 to 10 months post-fracture.

Diterichs Splint

A classic rigid wooden orthopedic traction-immobilization device used for transport stabilization of femur fractures and hip joint injuries, incorporating traction via a footplate, inner/outer struts, and a twist-cord mechanism.

Elansky Splint

A specialized profiled foldable wooden splint designed for rapid transport immobilization of injuries to the skull, calvarium, and cervical spine.

Lucid Interval (Светлый промежуток)

A temporary period of recovered or clear consciousness following traumatic brain injury, after which progressive neurological deterioration and compression signs (anisocoria, focal hemiparesis) appear due to an expanding intracranial hematoma.

Tension (Valvular) Pneumothorax

A life-threatening thoracic emergency where a tissue flap permits one-way ingress of air into the pleural space during inhalation but seals upon exhalation, generating positive intrapleural pressure that collapses the lung and shifts the mediastinum to the contralateral side.

Bülau Pleural Drainage

A continuous passive siphon underwater-seal drainage method for the pleural space using a silicone/rubber tube with its distal end submerged in antiseptic solution below chest level, typically inserted at the 7th-8th intercostal space along the posterior axillary line.

Frank Burn Index

A prognostic burn scoring index where each percent of superficial burn (grades I-IIIa) equals 1 point and each percent of deep burn (grades IIIb-IV) equals 3 points: $\text{Frank Index} = (\%\text{ Superficial}) + 3 \times (\%\text{ Deep})$.

Rule of One Hundred (Burn Prognosis)

A rapid prognostic rule calculated by adding the patient's age in years to the total percentage of burned body surface area: values below 60 have a favorable prognosis, while values exceeding 100 predict a grave or lethal outcome.

Furuncle

An acute necrotic suppurative inflammation centered on a single hair follicle, its associated sebaceous gland, and the surrounding subcutaneous adipose tissue, forming a central necrotic core.

Carbuncle

An extensive acute suppurative and necrotic inflammatory lesion involving multiple adjacent hair follicles and sebaceous glands with a coalesced inflammatory infiltrate, leading to sieve-like cutaneous necrosis.

Hydradenitis

An acute purulent inflammation localized to the apocrine sweat glands, most frequently encountered in the axillary and inguinal regions.

Fluctuation Sign (Симптом флюктуации)

A physical examination finding during palpation indicating the presence of encapsulated or free purulent fluid within an inflammatory cavity or abscess.

Phlegmon

An acute, diffuse, non-circumscribed suppurative inflammation of adipose and fascial tissue planes lacking an encapsulating pyogenic barrier and having a marked propensity to spread along neurovascular pathways.

Paraproctitis

An acute phlegmonous suppurative inflammation of the perirectal and pelvic fat compartments surrounding the rectum, classified into subcutaneous, submucosal, ischiorectal, and pelviorectal forms.

Adenophlegmon

A diffuse suppurative phlegmon of surrounding loose adipose tissues resulting from purulent capsular breakdown and extracapsular spread of suppurative lymphadenitis.

Erythematous Erysipelas

A rapidly progressive cutaneous streptococcal infection characterized by bright, hot, fiery erythematous skin patches with sharply demarcated, scalloped margins resembling a geographic map or tongues of flame.

Bullous Erysipelas

A severe form of cutaneous erysipelas characterized by epidermal detachment and the formation of serous or hemorrhagic blisters on the inflamed erythematous plaque.

Erysipeloid

An acute zoonotic occupational bacterial skin infection of the fingers and hands caused by Erysipelothrix rhusiopathiae, acquired through contact with contaminated raw meat, poultry, or fish.

Paronychia

An acute purulent inflammation of the periungual soft tissue fold and epionychium bordering the nail plate of a digit.

Tendovaginitis (Purulent Tenosynovitis)

An acute purulent infection of the digital flexor tendon sheath characterized by uniform sausage-like swelling, flexed posture of the finger, severe tenderness along the sheath, and intense pain on passive digit extension.

Pandactylitis

A devastating purulent infection of a digit involving all its anatomical layers simultaneously: skin, subcutaneous fat, tendons, joints, and phalangeal bone.

U-Shaped (Crossed) Phlegmon of the Hand

A severe deep palmar space infection arising from communicating purulent tenosynovitis between the thumb (radial bursa) and the little finger (ulnar bursa).

Pirogov Space (Forearm)

A deep quadrilateral fascial compartment located in the distal anterior forearm between the pronator quadratus and deep flexor tendons, communicating directly with the palmar synovial sheaths.

Septicemia

A clinical form of sepsis characterized by continuous high-grade fever without significant diurnal fluctuations ($\approx 39^\circ\text{C}$), profound systemic toxicity, and absence of metastatic purulent foci.

Septicopyemia

A form of sepsis characterized by remittent, hectic fever with shivering chills, marked temperature spikes, and the formation of metastatic purulent abscesses in lungs, liver, joints, and subcutaneous tissues.

Cryptogenic Sepsis

A generalized septic condition where the primary gateway, initial portal of entry, or originating purulent focus cannot be identified despite comprehensive diagnostic investigation.

Sequestrum

A fragment of non-viable, necrotic cortical or cancellous bone that has separated completely from adjacent living vascularized bone tissue as a result of suppurative osteomyelitis.

Brodie's Abscess

A primary chronic hematogenous osteomyelitis characterized by a solitary, rounded, sclerotic-rimmed radiolucent cavity within the metaphysis of long bones without sequestra or severe acute symptoms.

Olecranon Bursitis

An acute or chronic inflammatory process within the subcutaneous synovial bursa overlying the olecranon process of the ulna, presenting as a localized fluctuant dorsal elbow mass.

Clostridial Gas Gangrene

A rapidly lethal, necrotizing soft-tissue and muscular infection caused by anaerobic spore-forming bacteria (Clostridium perfringens, C. oedematiens, C. septicum) producing marked tissue edema, extensive gas infiltration, and toxemia.

Anthrax Carbuncle

The cutaneous presentation of Bacillus anthracis infection characterized by a painless central black necrotic eschar surrounded by a halo of vesicles and massive non-pitting gelatinous edema.

Opisthotonos

A profound spastic postural deformity seen in severe generalized tetanus where intense tonic contractions of the dorsal paraspinal musculature hyperextend the spine, arching the body so that only the occiput and heels touch the surface.

Tetanus Symptom Triad

The hallmark clinical triad of generalized tetanus: trismus (painful tonic spasm of the masseter muscles preventing mouth opening), sardonic smile (risus sardonicus caused by spasm of facial muscles), and dysphagia.

Dry Gangrene

Ischemic coagulation necrosis of a limb segment occurring under conditions of arterial occlusion with preserved venous drainage and minimal moisture, producing shriveled, blackened, mummified tissue bordered by a sharp demarcation line.

Trophic Ulcer

A chronic cutaneous or mucosal tissue defect exhibiting defective cellular reparative processes and minimal healing tendency, resulting from severe chronic vascular, neurological, or metabolic disturbances.

Decubitus Ulcer (Bedsore)

Localized ischemic necrosis of the skin and deeper soft tissues developing over bony prominences (sacrum, greater trochanters, heels) under the influence of prolonged mechanical pressure and shear forces.