Chapter·SurgeryMinimally Invasive Surgery

Laparoscopic surgery principlesDownloads

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1

A research scientist attempts to understand the influence of carbon dioxide content in blood on its oxygen binding. The scientist adds carbon dioxide to dog blood and measures the uptake of oxygen in the blood versus oxygen pressure in the peripheral tissue. He notes in one dog that with the addition of carbon dioxide with a pressure of 90 mmHg, the oxygen pressure in the peripheral tissue rose from 26 to 33 mmHg. How can this phenomenon be explained?

AHigh partial pressure of CO2 in tissues decreases peripheral blood volume

BBinding of O2 to hemoglobin in lungs drives release of CO2 from hemoglobin

CHigh partial pressure of CO2 in tissues causes alkalemia, which is necessary for O2 unloading

DHigh partial pressure of CO2 in tissues facilitates O2 unloading in peripheral tissues

EThe sum of the partial pressures of CO2 and O2 cannot exceed a known threshold in blood

2

A 67-year-old woman has fallen from the second story level of her home while hanging laundry. She was brought to the emergency department immediately and presented with severe abdominal pain. The patient is anxious, and her hands and feet feel very cold to the touch. There is no evidence of bone fractures, superficial skin wounds, or a foreign body penetration. Her blood pressure is 102/67 mm Hg, respirations are 19/min, pulse is 87/min, and temperature is 36.7°C (98.0°F). Her abdominal exam reveals rigidity and severe tenderness. A Foley catheter and nasogastric tube are inserted. The central venous pressure (CVP) is 5 cm H2O. The medical history is significant for hypertension. Which of the following is best indicated for the evaluation of this patient?

AX-Ray

BUltrasound

CPeritoneal lavage

DCT scan

EDiagnostic laparotomy

3

A 27-year-old man is brought to the emergency department after a motor vehicle accident. He was the unrestrained driver in a head on collision. The patient is responding incoherently and is complaining of being in pain. He has several large lacerations and has been impaled with a piece of metal. IV access is unable to be obtained and a FAST exam is performed. His temperature is 98.2°F (36.8°C), blood pressure is 90/48 mmHg, pulse is 150/min, respirations are 13/min, and oxygen saturation is 98% on room air. Which of the following is the best next step in management?

AReattempt intravenous access

BObtain intraosseous access

CPlace a central line

DAdminister oral fluids

EExploratory laparotomy

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