SURGERY PIMPS EXAM QUESTIONS
WITH 100% CORRECT ANSWERS {
GRADED A+}
What is the Triangle of Calot (Cystohepatic Triangle)? - ✔✔The anatomic space
bordered by the common hepatic duct medially, the cystic duct laterally and the
cystic artery superiorly. (incorrect - inferior liver border)
What is Bile made of? - ✔✔Cholesterol, Lecithin (phospholipid), bile acids, and
bilirubin.
What does HIDA stand for? - ✔✔hepatobiliary iminodiacetic acid. AKA
cholescintigraphy.
What is a "positive HIDA"? - ✔✔Timing a dye visualization greater than 4 hours
What is ERCP? - ✔✔Endoscopic Retrograde Cholangiopancreatography
What is PTC? - ✔✔Percutaneous Transhepatic cholangiogram
,Why is CO2 most commonly used to inflate the abdomen during a Lap procedure?
What other gas types are used? - ✔✔More rapidly absorbed and decreases the
change of acidotic state.
Other types used - O2 (2nd), Nitrogen (3rd).
Less risk of gas embolism and is noncombustible.
Clear/yellow fluid leakage from gallbladder indicates what condition? -
✔✔Hydrops associated with cystic duct blockage, in which bile salts are
reabsorbed leaving mainly Lethicin and Cholesterol fluid. NOT a true Hydrops.
What is the "Violin String" sign? (Fitz-Hugh-Curtis syndrome) - ✔✔Rare
complication of PID, named after Thomas Fitz-Hugh, Jr and Arthur Hale Curtis in in
1934 and 1930 respectively. Causes liver capsule inflammation and perihepatic
adhesion's.
Perihepatic gonorrhea
What is the Falciform Ligament? - ✔✔The large ligament, a remnant of the
umbilical vein that separates the left and right liver lobes. It FUNCTIONALLY
separates the caudate lobe from the left lobe of the liver.
,What happens to the Falciform Ligament in a patient with Portal Hypertension? -
✔✔Becomes canalized, as blood congestion in the liver forces blood into the
ligament and towards the anterior of the abdomen.
How is the Liver divided surgically? What vessels are described? - ✔✔From a
surgical point of view, the liver is divided into right and left lobes of almost equal
size by a major fissure (Cantlie's line) running from the gallbladder fossa in front
to the IVC fossa behind. This division is based on the right and left branches of the
hepatic artery and the portal vein, with tributaries of bile (hepatic) ducts
following. The middle hepatic vein (MHV) lies in Cantlie's line. The left pedicle (left
hepatic artery [LHA], left branch of the portal vein, and left hepatic duct) has a
longer extrahepatic course than the right.
What is the blood supply to the Liver? - ✔✔Unique dual supply from the proper
hepatic artery (20-40%) and from the portal vein (60-80%)
PHA originates from the celiac trunk trifurcation off the abdominal aorta.
Portal originates from the Superior mesenteric and splenic, collecting blood from
the GI tract (lower esophagus to upper 1/3rd of rectum), stomach, pancreas,
gallbladder and spleen.
, What is the Portal System - ✔✔When a capillary bed pools into another capillary
bed through veins, without first going through the heart.
How much oxygen is supplied to the liver via the hepatic artery? - ✔✔30-40%
while only providing 20-40% of the total blood.
What is the Foramen of Windslow? - ✔✔Passage between the greater and lesser
sacs in which the omentum is found.
AKA epiploic foramen.
Why is the Foramen of Windslow surgically important? - ✔✔Can place fingers
through it to occlude the portal vein and hepatic artery in the case of a trauma.
During a surgical procedure, inflation of the abdomen is positive for what physical
finding? - ✔✔Tympany
What is Calots Node? - ✔✔The sentinel Lymph node of the gallbladder. It
increases in size in cholecystitis and cholangitis. It is an anatomic landmark and is
removed along with the gall bladder in cholecystectomy. Originally named after
Fred Bates Lund (1865-1950), an American Surgeon. Also named after the Italian
anatomist and physician, Paolo Mascagni (1752-1815), who first identified it
around 1787.
WITH 100% CORRECT ANSWERS {
GRADED A+}
What is the Triangle of Calot (Cystohepatic Triangle)? - ✔✔The anatomic space
bordered by the common hepatic duct medially, the cystic duct laterally and the
cystic artery superiorly. (incorrect - inferior liver border)
What is Bile made of? - ✔✔Cholesterol, Lecithin (phospholipid), bile acids, and
bilirubin.
What does HIDA stand for? - ✔✔hepatobiliary iminodiacetic acid. AKA
cholescintigraphy.
What is a "positive HIDA"? - ✔✔Timing a dye visualization greater than 4 hours
What is ERCP? - ✔✔Endoscopic Retrograde Cholangiopancreatography
What is PTC? - ✔✔Percutaneous Transhepatic cholangiogram
,Why is CO2 most commonly used to inflate the abdomen during a Lap procedure?
What other gas types are used? - ✔✔More rapidly absorbed and decreases the
change of acidotic state.
Other types used - O2 (2nd), Nitrogen (3rd).
Less risk of gas embolism and is noncombustible.
Clear/yellow fluid leakage from gallbladder indicates what condition? -
✔✔Hydrops associated with cystic duct blockage, in which bile salts are
reabsorbed leaving mainly Lethicin and Cholesterol fluid. NOT a true Hydrops.
What is the "Violin String" sign? (Fitz-Hugh-Curtis syndrome) - ✔✔Rare
complication of PID, named after Thomas Fitz-Hugh, Jr and Arthur Hale Curtis in in
1934 and 1930 respectively. Causes liver capsule inflammation and perihepatic
adhesion's.
Perihepatic gonorrhea
What is the Falciform Ligament? - ✔✔The large ligament, a remnant of the
umbilical vein that separates the left and right liver lobes. It FUNCTIONALLY
separates the caudate lobe from the left lobe of the liver.
,What happens to the Falciform Ligament in a patient with Portal Hypertension? -
✔✔Becomes canalized, as blood congestion in the liver forces blood into the
ligament and towards the anterior of the abdomen.
How is the Liver divided surgically? What vessels are described? - ✔✔From a
surgical point of view, the liver is divided into right and left lobes of almost equal
size by a major fissure (Cantlie's line) running from the gallbladder fossa in front
to the IVC fossa behind. This division is based on the right and left branches of the
hepatic artery and the portal vein, with tributaries of bile (hepatic) ducts
following. The middle hepatic vein (MHV) lies in Cantlie's line. The left pedicle (left
hepatic artery [LHA], left branch of the portal vein, and left hepatic duct) has a
longer extrahepatic course than the right.
What is the blood supply to the Liver? - ✔✔Unique dual supply from the proper
hepatic artery (20-40%) and from the portal vein (60-80%)
PHA originates from the celiac trunk trifurcation off the abdominal aorta.
Portal originates from the Superior mesenteric and splenic, collecting blood from
the GI tract (lower esophagus to upper 1/3rd of rectum), stomach, pancreas,
gallbladder and spleen.
, What is the Portal System - ✔✔When a capillary bed pools into another capillary
bed through veins, without first going through the heart.
How much oxygen is supplied to the liver via the hepatic artery? - ✔✔30-40%
while only providing 20-40% of the total blood.
What is the Foramen of Windslow? - ✔✔Passage between the greater and lesser
sacs in which the omentum is found.
AKA epiploic foramen.
Why is the Foramen of Windslow surgically important? - ✔✔Can place fingers
through it to occlude the portal vein and hepatic artery in the case of a trauma.
During a surgical procedure, inflation of the abdomen is positive for what physical
finding? - ✔✔Tympany
What is Calots Node? - ✔✔The sentinel Lymph node of the gallbladder. It
increases in size in cholecystitis and cholangitis. It is an anatomic landmark and is
removed along with the gall bladder in cholecystectomy. Originally named after
Fred Bates Lund (1865-1950), an American Surgeon. Also named after the Italian
anatomist and physician, Paolo Mascagni (1752-1815), who first identified it
around 1787.
