№12 Topographical anatomy and surgery of stomach. Gastrostomy. Sew up of the perforate ulcer. Тopographical anatomy of spleen and pancreas. Operations on them.

1. Point vessels which can be injured in liver-stomach ligament in it’s injury:

а) right and left stomach-omental arteries and veins;

b) general liver artery and portal vein;

c) right and left stomach arteries and veins;

d) short arteries and veins of stomach;

e) right abd left liver arteries and veins.

2. Point vessels which can be injured in stomach-intestinal ligament in it’s dissection:

а) right stomach artery and veins;

b) right and left stomach-omental arteries and veins;

c) upper mesenteral artery and veins;

d) left stomach artery and veins;

e) general liver artery and portal vein.

3. Point vessels which can be injured in stomach-lien ligament in it’s injury:

а) left stomach artery and veins;

b) left stomach-omental artery and vein;

c) short arteries and veins of stomach;

d) right stomach-omental artery and vein;

e) right stomach artery and veins.

4. What lymphatic nodes can be enlarged first of all in metastasis of cancer of small flexion of the stomach:

а) near gates of spleen;

b) longitudinally through body and tail of pancreas;

c) into pyloric lymphatic nodes;

d) lymphatic nodes of the omentum;

e) abdominal trunk?

5. Definite kind of laparotomy for execution gastrotomy:

а) upper medial;

b) median medial;

c) leftside transrectal;

d) rightside transrectal;

e) upper transverse.

6. Point what stitches are used for sew up the perforative foramen of the body without recession of perforal edges:

а) two-rowed: first row – Shmiden’s stitch, second row – Lamber’s stitch;

b) two rowes of serous-muscular Lamber’s stitches;

c) Shmiden’s stitch;

d) P-liked stitches with gasping omentum on the peduncle;

e) two-rowed: first row – twined, second row – Lamber’s stitch.

7. Choose technique of sew up the wound of stomach after gastrotomy:

а) two-rowed: first row – Shmiden’s stitch, second row – Lamber’s stitch;

b) two rowes of serous-muscular Lamber’s stitches;

c) Shmiden’s stitch;

d) P-liked stitches with gasping omentum on the peduncle;

e) two-rowed: first row – tobacco-bag stitch, second row – Z-liked stitch.

8. How to renew possibility of coming food into the stomach after injury of gullet:

а) through gastrostome by Vitcel’s method;

b) through gastrostome by Toprover’s method;

c) continue feeding through sawn gullet;

d) through gastrostome by Sapozhkov method;

e) execute plasty of gullet?

9. How to renew possibility of coming food into the stomach in unoperable tumour of the gullet:

а) through gastrostome by Vitcel’s method;

b) through gastrostome by Toprover’s method;

c) continue feeding through sawn gullet;

d) through gastrostome by Shtamm-Senn-Cader’s metgod;

e) recession of gullet and replace it with artificial?

10. How do you put gastrostome by Toprover:

а) sew up the tube into anterior surface of the stomach with it’s next fixation in the foramen of stomach by tobacco-bag stitch;

b) dip rubber tube into gap of the stomach with it’s wall and fix it by three tobacco-bag stitches;

c) lead tube into cut on the conuse which is formed on the anterior surface of the stomach with the help of three tobacco-bag stitches;

d) lead tube into the stomach through the clutch, which is formed form the flap of the wall of stomach;

e) lead into the cut of stomach catheter with obturator?

11. Point volume of stomach which is recessed in economic resection of the stomach:

а) 2/3;

b) 4/5;

c) 3/4;

d) 1/2;

e) 1/3.

12. What method of formation the anastomosis is used in resection of the stomach by Bilrot I:

а) anterior “side by side”;

b) “end to side’;

c) “side to end”;

d) “end to end”;

e) posterior “side by side”?

13. What method of formation the anastomosis is used in resection of the stomach by Bilrot II:

а) anterior “side by side”;

b) “end to side’;

c) “side to end”;

d) “end to end”;

e) posterior “side by side”?

14. What method of formation the anastomosis is used in resection of the stomach by Bilrot II in Gofmayster-Finsterer modification:

а) anterior “side by side”;

b) “end to side’;

c) “side to end”;

d) “end to end”;

e) posterior “side by side”?

15. Choose kind of vagotomy in which stomach’s and branches of vagus are cut:

а) trunk;

b) proximally selective;

c) proximal;

d) selective;

e) distal.

16. Violation of blood supply of what anatomical structure can rise after recession of spleen:

а) tail of pancreas;

b) bottom of the stomach;

c) body of pancreas;

d) cardiac region of the stomach;

e) diaphragm.

17. What kind of laparotomy do you use in the injury of spleen:

а) upper median;

b) left transrectal;

c) upper transverse;

d) left pararectal;

e) left sub-rib?

18. Choose optimal method of open the omental bag in the access to pancreas:

а) through lesser omentum;

b) through mesentery of transverse-colon intestine;

c) through stomach-colon ligament;

d) through omental aperture;

e) through transverse region.

19. Choose operative interference in chronic pancreatitis with duct hypertension:

а) leftside hemipancreatectomy;

b) caudal pancreato-jejunostomy;

c) pancreato-duodenal resection;

d) total pancreatectomy;

e) marginal neurotomy.

20. Choose operative interference in benigh tumour of the tail of pancreas:

а) leftside hemipanectomy;

b) caudal pancreato-jejunostomy;

c) pancreatoduodenal resection;

d) total pancreatotomy;

e) marginal neurotomy.

21. Choose operative interference in benigh tumour of the caput of pancreas:

а) leftside hemipancreatoectomy;

b) caudal pancreato-jejunostomy;

c) pancreato-duodenal resection;

d) total pancreatotomy;

e) marginal neurotomy.

22. Choose paliative operative interference in chronic pancreatitis in painful form:

а) leftside hemipanectomy;

b) pancreato-jejunostomy Pyestov-Dzhilesbi;

c) proximally selective vagotomy;

d) neurotomy by Napalkov-Trunin;

e) longitudinal pancreato-jejunostomy.

23. Formation of what anastomosis is executed after pancreato-duodenal resection of pancreas:

а) gastro-jejuno- and choledocho-jejuno-anastomosis;

b) gastro-jejuno- and pancreato-jejuno-anastomosis;

c) pancreato-jejuno- and choledocho-jejuno-anastomosis;

d) choledocho-gastro- and choledocho-jejuno-anastomosis;

e) gastro-jejuno-, choledocho-jejuno-, and pancreato-jejuno-anastomosis.

24. Choose operative interference which isn’t used in cysts of pancreas:

а) Malle-Gi operation;

b) cystogastrostomy;

c) marsupialization;

d) cholecystocystostomy;

e) cystoduodenostomy.

25. In what case in perforative ulcer of the stomach is it expedient the resection of stomach:

а) from the moment of the perforation passed 12 hours;

b) perforation is complicated with peritonitis;

c) patient is 65 years old;

d) patient has attendant lung and heart-vessel pathology;

e) ulcer is complicated with stenosis of pylorus in 35-years-old patient?

26. Point vessels which can be injured in stomach-pancreas ligament in it’s injury:

а) duodeno-pancreal arteries and veins;

b) left stomach-omental arteries and veins;

c) left stomach arteries and veins;

d) pancreal arteries and veins;

e) left stomach arteries and veins.

27. Choose method of pyloroplasty in which you have to use longitudinal cut of pylorus with next sew up of it in transverse direction:

а) by Heyneke-Mickulich;

b) by Finney;

c) by Zhabule;

d) by Shalimov;

e) by Vitcel.

28. Choose method of pyloroplasty in which you have to use transverse cut of stomach and duodenum near the pylorus with next formation of “side by side” anastomosis:

а) by Heyneke-Mickulich;

b) by Finney;

c) by Zhabule;

d) by Shalimov;

e) by Vitcel.

29. Choose kind of vagotomy in which short sectoral branches are cut, but long are saved:

а) trunk;

b) proximally selective;

c) proximal;

d) selective;

e) distal.