CHAPTER 15 OBSTETRIC AND GYNECOLOGIC SURGERY

What is the general term for the treatment method that destroys genital condylomata with a carbon dioxide laser?

ablation

Which anatomical structure is located anterior to the symphysis pubis and superior to the vaginal opening?

mons pubis

Which of the following is used for creating pneumoperitoneum in laparoscopy?

carbon dioxide

Cephalopelvic disproportion is a component of which of the following indications for a cesarean section delivery?

dystocia

Which instrument is used to test the patency of the fallopian tube during tuboplasty?

lacrimal probe

Which procedure involves an en bloc removal of the uterus, bilateral ovaries and fallopian tubes, supporting ligaments, upper third of the vagina, and pelvic lymph nodes?

radical hysterectomy

Which self-retaining retractor has the shape of a figure-of-eight (8) when in the closed position?

O'Sullivan-O'Connor

All of the following are paired ligaments that support the uterus in the lower abdomen and attach it to the pelvis, EXCEPT:

Cooper's

Which anatomical area is located between the posterior vaginal opening and the anus?

perineum

What is a Veress needle used for?

laparoscopic insufflation

Total abdominal hysterectomy is assigned which wound classification?

Class II

Radionuclide seeds are used to treat:

uterine/cervical carcinoma

Laparoscopic linear stapling devices are often used to ligate and cut the uterine ligaments and vessels during LAVH.

true

Bulb syringes are used in obstetrical delivery procedures to:

suction the mouth and nares of the neonate

Tubal ligation is performed for:

elective sterilization

What is the name of the routine surgical treatment of infected Bartholin's gland cysts?

marsupialization

Which gynecologic procedure is performed for treatment of urinary incontinence or cystocele?

anterior colporrhaphy

Delivery of the placenta is the conclusion of which stage of labor?

third

Which instrument is used to manipulate the fallopian tubes without compression or damage?

Babcock tissue forceps

What is the procedure name for the removal of fibroid tumors of the uterus with the preservation of fertility?

myomectomy

In which of the following procedures would the patient be left without a vagina or any of the female reproductive organs and have a permanent colostomy and ileostomy?

exenteration

Which of the following statements is CORRECT regarding anatomical changes following pelvic exenteration?

Colostomy will exit on the left and ileostomy on the right side of the abdomen.

Which pistol-grip type of instrument might be found in a D&C tray for cervical biopsy?

Tischler

Clamp, clamp, cut, tie (CCCT) is a way to anticipate routine dissection steps during hysterectomy procedures.

true

What is the name of the anatomical area where the fallopian tubes are attached and enter the uterus?

cornu

What color is the abnormal tissue after staining with Lugol's solution in a cervical biopsy?

no color change

Which paired ligaments are encountered and ligated last in an abdominal hysterectomy and first in a vaginal hysterectomy?

uterosacral

What is the main purpose of putting a bolster sheet or roll under the right hip of a patient just prior to C-section?

It reduces the pressure of the gravid uterus on the vena cava.

Which of the following is routinely done first in a basic gynecologic laparoscopy that may require a small separate setup and glove change before proceeding?

insertion of uterine manipulator

Which of the following is the largest supporting ligament in the female pelvis that has anterior and posterior leaves?

broad

For which procedure would the surgical technologist want to be sure to have adequate numbers of Allis or Allis-Adair tissue forceps?

A&P Colporrhaphy

Which method of tubal ligation (sterilization) is most frequently used?

Pomeroy

When is the first "uterine count"  performed in a cesarean section?

when the first suture is given for closure of the uterus

Which gynecologic procedure is used for visualization of the endometrium and may be used to treat polyps or myomas?

hysteroscopy

Instruments used for closure of the vaginal cuff in total abdominal hysterectomy are:

isolated as contaminated

Which maneuver might be performed by the surgical technologist during a cesarean section to aid in the delivery as the surgeon gently manipulates the head of the fetus out of the uterus?

application of external pressure over the fundus of the uterus

Which muscle is incised in transverse abdominal approaches for gynecologic procedures?

anterior rectus

The term adnexa refers to which gynecologic anatomical structures?

fallopian tubes, ovaries, and infundibulum

In which procedure would the surgeon likely request 8-0 or 9-0 suture?

tuboplasty

What is used to achieve tissue destruction in an endometrial balloon ablation?

hot dextrose water

Which incision is MOST frequently used for cesarean sections?

Pfannenstiel

Which of the following is a weighted vaginal speculum?

Auvard

What color is the abnormal tissue after staining with acetic acid in a cervical biopsy?

white

For a dilation and curettage (D&C), which of the following orders of instrument use is CORRECT for endometrial biopsy?

weighted vaginal speculum, tenaculum, uterine sound, cervical dilators, endometrial curettes

Which radiological study might be ordered preoperatively for a patient scheduled for tuboplasty?

hysterosalpingogram

Cherney, Maylard, and Pfannenstiel are examples of gynecologic:

transverse abdominal incisions

Adhesion formation is a normal physiologic inflammatory response to abdominal surgery that cannot be prevented or minimized.

false

What is another name for the ovarian suspensory ligament?

infundibulopelvic

What is the name of the fingerlike projections at the terminal end of the fallopian tube that guides oocytes into the lumen?

fimbria

For which procedure would the gynecologist likely wear surgical loupes?

tubal reanastomosis

What is the MOST common surgical intervention for a vaginal delivery?

episiotomy

Which of the following procedures would likely be assigned a Class III or Class IV wound and may require aerobic and anaerobic culture tubes?

marsupialization of Bartholin's cyst

Cervical cerclage is performed to:

prevent spontaneous abortion

Which of the following procedures does NOT require an incision, use of trocars, or distention with gas or fluid?

colposcopy

Which instrument should the surgical technologist have ready to provide exposure during cesarean section procedures when the uterine incision is made?

bladder blade

Which medication may be injected into the uterus for hemostasis, before closure of the uterus in a cesarean section?

oxytocin

Which of the following is a serum analysis done to detect ovarian carcinoma?

CA-125

Which piece of operating room furniture would likely be unnecessary for many vaginal surgical procedures?

Mayo stand

The fallopian tubes are located bilaterally in the mesosalpinx of which uterine-pelvic ligaments?

broad

What is the preferred method of anesthesia for a cesarean section delivery?

epidural

Which instrument is used to grasp the cervix and provide traction during cervical dilation?

single-tooth tenaculum

What is the name of the heavy, right-angle scissors frequently used to dissect around the cervix during hysterectomy?

Jorgenson

Radionuclide seeds are placed in infected Bartholin's gland cysts to treat the infected contents.

false

Which term means the number of times a woman has been pregnant?

gravida

What is the name of a bivalve speculum frequently found in a vaginal procedure tray?

Graves

How many stages of labor and delivery does the patient go through?

four

Which type of needle holder is curved and frequently used for hysterectomy procedures?

Heaney

In a robotically assisted hysterectomy, the surgical technologist may be responsible for removing the specimen from the vagina after the vaginal cuff closure has been completed.

true

Which of the following types of stirrups would likely be used for a laparoscopically assisted vaginal hysterectomy (LAVH)?

Allen low lithotomy

Which of the following structures is NOT part of the anatomy of the vulva?

cervix