Celiotomy and Thoracotamy Flashcards
what is celiotomy?
ventral midline approach to abdomen
what is laparotomy?
flank or paracostal approach to abdomen
what is aseptically prepared for a celiotomy?
entire ventral abdomen
what landmarks do you need to do an incision between for a full abdominal explore technically?
xyphoid
pubis
what are the two grips for holding a scalpel blade?
finger-tip grip
pencil grip
what part of the blade should you be cutting with when going through the skin?
not tip
main body of blade
what are the positives of going through the linea alba, instead of through muscles, into the abdomen in an incision?
less discomfort than incision through muscle
less bleeding
which organs should you check when running the gastrointestinal tract?
stomach
small intestine
colon
what should you evaluate when running the gastrointestinal tract?
color
thickness and feel
palpate for obstruction or foreign material
note condition of vascular supply/lymph nodes
check for adhesions
what should you be careful to not do while replacing the gastrointestinal tract into the abdomen?
twist root of mesentery
what do you need to do before closing after a celiotomy?
lavage abdomen
count gauze and laparotomy sponges
what do you use to lavage the abdomen?
warm, body temperature sterile saline
what is the holding layer of the body wall for closure?
external rectus sheath
what suture pattern is good for closing the subcutaneous layer?
simple continuous
intradermal/subcuticular pattern
what are the two surgical approaches to the thorax?
intercostal thoracotomy
median sternotomy
what retractor do we use in the thorax?
finochietto retractor
what should you do before closing an intercostal thoracotomy or a median sternotomy?
warm saline lavage
count gauze and laparotomy sponges
place chest tube
where should you place local blocks with intercostal thoracotomy/median sternotomy?
intercostal nerves around chest tube
incision
where should you place sutures when closing an intercostal thoracotomy?
around rib in front and behind
muscle layers
subcutaneous
skin
where should you place sutures when closing a median sternotomy?
wire or heavy gauge monfilament suture around each sternebra
muscle
subcutaneous
skin
when is an intercostal thoracotomy useful?
access to one side of chest
access only to organs/structures in region of incision
when lavaging the abdomen, how many times should you do it before closing?
1-2 if the GI tract was not opened
2-5 if the GI tract was opened
what is the holding layer of the body wall?
external rectus sheath
what type of suture is used for closing the subcutaneous layer?
short or long lasting monofilament, absorbable
