Appendicectomy

Layers of facia and skin.

Classic post op fever pimp question and mnemonic

WIND =atelectasis or pneumonia
WATER = UTI
WALKING = Not walking leading to DVT
WOUND = wound infection
WONDER DRUGS = drug rxn.

Laporoscopy

What are unique complications:
Back and shoulder pain from refereed diaphragm pain from insuflation.
Increase is PAco2 from the gas.

Cholecystectomy

Feared complication: common bile duct injury.

What is the portal triad: portal vein, hepatic artery, common hepatic bile duct (splits into left and right)

Blood supply to liver: ~75% is from the portal.

Temporal artery biopsy

Why do we take so much:
giant cell arthritis has "skip lesions." Sensitivity increases with longer biopsy.

Why is diagnosis so important:
Risk of blindness with ophthalmic artery occlusion. Steroids are not benign.

Any operation on abdomen or pelvis.

What are the layers i am cutting through on the skin:
dermis, epidermis, subq, campers, scarpa's

What are the layers of rectus sheeth above and below the arcuate line:
external abdominal oblique, internal abdominal oblique and rectus. Below the sheeth in the trasversalis. The order of layers varies depending how caudal or cephalad you are.
Above arcuate


Below arcuate


Dont forget the pyramidalis. This will be superior to some of the lower rectus and fanning out laterally.

What is the pyramidalis for: Belly dancing!

hysterectomy classic pimp question

what artery runs in the round ligament:
Samson's.

what is the landmark for the level of the uterine artery:
cervical os.

Know the blood supply and ligaments: