Celiotomy and Thoracotamy

Question 1

what is celiotomy?

Answer 1

ventral midline approach to abdomen

Question 2

what is laparotomy?

Answer 2

flank or paracostal approach to abdomen

Question 3

what is aseptically prepared for a celiotomy?

Answer 3

entire ventral abdomen

Question 4

what landmarks do you need to do an incision between for a full abdominal explore technically?

Answer 4

xyphoid
pubis

Question 5

what are the two grips for holding a scalpel blade?

Answer 5

finger-tip grip
pencil grip

Question 6

what part of the blade should you be cutting with when going through the skin?

Answer 6

not tip
main body of blade

Question 7

what are the positives of going through the linea alba, instead of through muscles, into the abdomen in an incision?

Answer 7

less discomfort than incision through muscle
less bleeding

Question 8

which organs should you check when running the gastrointestinal tract?

Answer 8

stomach
small intestine
colon

Question 9

what should you evaluate when running the gastrointestinal tract?

Answer 9

color
thickness and feel
palpate for obstruction or foreign material
note condition of vascular supply/lymph nodes
check for adhesions

Question 10

what should you be careful to not do while replacing the gastrointestinal tract into the abdomen?

Answer 10

twist root of mesentery

Question 11

what do you need to do before closing after a celiotomy?

Answer 11

lavage abdomen
count gauze and laparotomy sponges

Question 12

what do you use to lavage the abdomen?

Answer 12

warm, body temperature sterile saline

Question 13

what is the holding layer of the body wall for closure?

Answer 13

external rectus sheath

Question 14

what suture pattern is good for closing the subcutaneous layer?

Answer 14

simple continuous
intradermal/subcuticular pattern

Question 15

what are the two surgical approaches to the thorax?

Answer 15

intercostal thoracotomy
median sternotomy

Question 16

what retractor do we use in the thorax?

Answer 16

finochietto retractor

Question 17

what should you do before closing an intercostal thoracotomy or a median sternotomy?

Answer 17

warm saline lavage
count gauze and laparotomy sponges
place chest tube

Question 18

where should you place local blocks with intercostal thoracotomy/median sternotomy?

Answer 18

intercostal nerves around chest tube
incision

Question 19

where should you place sutures when closing an intercostal thoracotomy?

Answer 19

around rib in front and behind
muscle layers
subcutaneous
skin

Question 20

where should you place sutures when closing a median sternotomy?

Answer 20

wire or heavy gauge monfilament suture around each sternebra
muscle
subcutaneous
skin

Question 21

when is an intercostal thoracotomy useful?

Answer 21

access to one side of chest
access only to organs/structures in region of incision

Question 22

when lavaging the abdomen, how many times should you do it before closing?

Answer 22

1-2 if the GI tract was not opened
2-5 if the GI tract was opened

Question 23

what is the holding layer of the body wall?

Answer 23

external rectus sheath

Question 24

what type of suture is used for closing the subcutaneous layer?

Answer 24

short or long lasting monofilament, absorbable