Initial steps of cesarean section? - correct answer 1. Test anesthesia adequacy (Adsons)
2. Pfannenstiel incision through skin and subcutaneous tissue (10 blade)
3. Stretch subcutaneous tissue to expose fascia
4. Extend incision through fascia
5. G...
Initial steps of cesarean section? - correct answer 1. Test anesthesia adequacy
(Adsons)
2. Pfannenstiel incision through skin and subcutaneous tissue (10 blade)
3. Stretch subcutaneous tissue to expose fascia
4. Extend incision through fascia
5. Grasp fascia and elevate superiorly (using Bonney forceps, extend with curved mayos)
How should anesthesia adequacy be checked? - correct answer -in all four
quadrants using Adsons
Benefits of transverse incision either by pfannenstiel or maylard? - correct answer
-superior cosmetic results
-decreased rates of postoperative pain
-decreased rates of fascial dehiscence
-decreased rates of incisional hernia
When is use of pfannenstiel incision discouraged? - correct answer -when a
large operative space is required
What neurovascular structures can be encountered during transverse incisions? - correct answer
-ilioinguinal n.
-iliohypogasric n.
-superficial and inferior epigastric vessels
Where should the pfannenstiel incision be made? - correct answer -two finger
breadths/3 cm above the superior border of the pubic symphysis
How wide should the incision be? - correct answer 12-15 cm
, What is a good way to measure the length of a pfannensteil? - correct answer -
mark the length of an alice clamp from the hinge to the clamp on each side
What layers of fascia sit immediately below the subcutaneous layer? - correct answer
-camper's fascia
-scarpa's fascia
What vessels are found halfway between the skin and the fascia? - correct answer
-superficial epigastric vessels
How can the incision be extended through these layers of fascia? - correct answer
-knife
-bovie
-blunt dissection
Where do the inferior epigastric vessels typically lie? - correct answer -outside
the lateral border of the rectus abdominis muscle
What tools should be used to extend the incision through the fascia after it has been exposed? - correct
answer -grasp fascia with bonnies
-extend incision with upward facing mayo scissors
Next steps of cesarean section after initial fascial incision? - correct answer 6.
Grasp fascia and elevate superiorly (kocher clamps)
7. Dissect fascia off the underlying muscle superiorly
8. Grasp fascia and elevate inferiorly
9. Dissect fascia off of the underlying muscle inferiorly
10. Separate rectus muscles in the midline and dissect bluntly down to the peritoneum
What tool should be used to grasp the fascia and elevate superiorly? - correct answer
-kocher clamps
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