Gastrointestinal

Bilary, Pancreas

Spleen

Breast

• abnormal passage from abscess or hollow organ to body surface

•          localized death of tissue

•          - localized tissue anemia due to obstruction of the inflow of arterial blood.

narrow crack of considerable length and depth.

Stenosis

•          outward growth from a mucous membrane.

•          - ring-like muscle that closes orifice.

•          - spontaneous new growth of tissue forming an abnormal mass.

•          - tending to infiltrate, metastasize; cancerous

•          - torsion of a loop of intestine causing obstruction.

•          - transfer of disease from one site to another.

Name the Anatomy related to General Surgery

•          Thyroid/Parathyroid•          Breast

•          Biliary system – Gallbladder, Liver, & Pancreas•          Spleen

•          Esophagus•          Stomach

•          Intestines

•          Anorectal area

Anatomy & Physiology of the
Thyroid & Parathyroids

Thyroid

Parathyroids

•          largest endocrine organ, has 2 lobes with the ‘isthmus’ connecting them.

•          Located on the anterior surface of the trachea.

•          four small yellow-brown masses on the posterior side of the thyroid.

They maintain proper concentration of blood calcium

Pathology of the
Thyroid & Parathyroids

–        – hypertrophic thyroid tissue; goiters are

–        – a hyperactive thyroid producing too much hormone

Pathology of the
Thyroid & Parathyroids

•          Parathyroids –

–        Hyperparathyroidism –       

 Hypoparathyroidism –

–        Parathyroid adenoma – –       

Tetany –

–        Cancer

–

–        causes increased calcium in the blood

–        causes decreased calcium in the blood

–        – tumor of the parathyroids, causes hyperparathyroidism

Surgery  Practices of the
Thyroid & Parathyroids

–        Pt in hyperextended neck position (pillow or shoulder roll)

–        Prep from jawline to shoulders

–        General anesthesia

–        Incision = collar

–        Post-op drain

–        Parathyroids preserved

Instruments used on the
Thyroid & Parathyroids

Green Thyroid Retractor

Lahey Retractor

Beckman-Weitlaner Retractor

Green Thyroid Retractor

Anatomy & Physiology of the
Breast

Breast tissue

•          There are 12-20 lobes contained in each breast tissue.  These lobes further divide into lobules that surround the lactiferous ducts.

•          Tail of Spence – contain an average of 53 lymph nodes on each side.

•          There are 12-20 lobes contained in each breast tissue.  These lobes further divide into lobules that surround the lactiferous ducts.

•          contain an average of 53 lymph nodes on each side.

Pathology of the Breast

•          Cancer – early, advanced, or disseminated

•          Breast ‘lumps’ – Benign or Malignant

•          Fibroadenoma

•          Gynecomastia

•          Mastitis

•          Breast ‘lumps’ – Benign or Malignant

Surgery practices of the Breast

•          Multiple procedures = separate setups, preps, drapes, gowns, etc…

•          Local or General anesthesia for biopsies

•          General anesthesia for mastectomies

•          Keep specimens SEPARATE! No fixative on frozen sections going to the lab

•          Gentle prep and handling of breast tissue to prevent dissemination of cancer cells

•          Patient position = supine

•          Prep = GENTLE : betadine scrub and paint clavicle to umbilicus

•          Incisions = infraareolar, inframammary, supraareolar, radial, axillary