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A U E R S & T > Chapter 15 - Laser in Veterinary Surgery > Flashcards

Chapter 15 - Laser in Veterinary Surgery Flashcards

1
Q

What are the four types of lasers currently used in veterinary medicine?

A) CO2, Nd, Ho, and diode
B) CO2, HeNe, Nd, and argon
C) Nd, diode, ruby, and excimer
D) CO2, argon, HeNe, and Ho
A

A) CO2, Nd, Ho, and diode

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2
Q

What is the wavelength range of visible light?

A) 100 to 400 nm
B) 400 to 700 nm
C) 700 to 1000 nm
D) 1000 to 1500 nm
A

B) 400 to 700 nm

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3
Q

At what wavelength are CO2 lasers most effective for tissue incision?

A) Greater than 2500 nm
B) 600 to 1400 nm
C) 1064 nm
D) 800 nm
A

A) Greater than 2500 nm

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4
Q

What is the power density of a CO2 laser set to 50 W with a focal spot size of 0.16 mm?

A) 6300 W/cm²
B) 248,880 W/cm²
C) 150,000 W/cm²
D) 100,000 W/cm²
A

B) 248,880 W/cm²

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5
Q

How many watts is the CO2 laser in continuous mode set to in the second example?

A) 50 W
B) 10 W
C) 8 W
D) 5 W
A

C) 8 W

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6
Q

What is the approximate power density of a CO2 laser set to 8 W with a focal spot size of 0.4 mm?

A) 248,880 W/cm²
B) 6300 W/cm²
C) 10,000 W/cm²
D) 5000 W/cm²
A

B) 6300 W/cm²

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7
Q

What is the energy equivalent of 1 joule?

A) 1 W × 1 sec
B) 2 W × 1 sec
C) 0.5 W × 2 sec
D) 1 W × 2 sec
A

A) 1 W × 1 sec

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8
Q

What type of tissue reaction occurs when the laser beam is absorbed?

A) Reflection
B) Transmission
C) Coagulation
D) All of the above
A

D) All of the above

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9
Q

What tissue component is primarily responsible for absorption in surgical lasers?

A) Air
B) Hemoglobin
C) Bone
D) Muscle
A

B) Hemoglobin

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10
Q

What is the typical effect of thermal energy generated by lasers?

A) Immediate healing
B) Vaporization
C) Cooling
D) None of the above
A

B) Vaporization

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11
Q

What temperature must tissue reach to be completely vaporized?

A) 50°C
B) 75°C
C) 100°C
D) 200°C
A

C) 100°C

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12
Q

How is power density expressed in surgical lasers?

A) W/m²
B) W/cm
C) W/cm²
D) J/m²
A

C) W/cm²

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13
Q

What is the typical range of wavelengths for diode lasers?

A) 2500 to 3000 nm
B) 600 to 900 nm
C) 400 to 600 nm
D) 700 to 1400 nm
A

B) 600 to 900 nm

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14
Q

What type of lasers are primarily used for coagulation?

A) CO2 lasers
B) Nd
lasers
C) Diode lasers
D) Both B and C
A

D) Both B and C

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15
Q

How does increasing the laser wattage affect power density?

A) It decreases power density
B) It does not affect power density
C) It increases power density
D) It only affects tissue reaction
A

C) It increases power density

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16
Q
A

Figure 15-1. Wavelengths of surgical lasers (in nm). Ultraviolet (UV) wavelengths are generally absorbed by protein, whereas the visible and infrared wavelengths are generally absorbed by water or pigmented melanin or hemoglobin. Wavelengths in common veterinary use are in gray. Er, Erbium; GAA, gallium-aluminum-arsenide; Ho, holmium; KTP, potassium titanyl phosphate; Nd, neodymium; YAG, yttrium-aluminum-garnet.

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17
Q
A

Figure 15-2. Tissue absorption of common surgical laser wavelengths. The visible spectrum is beneath the visible range. The near-infrared GAA diode and Nd:YAG lasers are highly absorbed by dark pigment. However, note the increased absorption of the GAA diode on the water curve compared with the Nd:YAG laser. The Ho:YAG and CO2 lasers are both highly absorbed by water. Er, Erbium; GAA, gallium-aluminum-arsenide; Ho, holmium; Nd, neodymium; UV, ultraviolet; YAG, yttrium-
aluminum-garnet.

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18
Q

The spot size of a laser beam is measured in millimeters and the following formula can be used to calculate the power density:

A
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19
Q
A

Figure 15-3. Power density decreases with the square of the increase in spot size, which in turn increases with distance from the surface. The beams depicted are all CO2 laser beams from machines set to 50 W. The power densities shown below each demonstrate the profound reduction in tissue effect by increasing spot size. Moving the hand piece away from the tissue increases spot size.

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20
Q
A

Figure 15-5. Absorption length of various wavelengths of surgical lasers in nonpigmented skin. Wavelengths commonly used in veterinary medicine are marked dark gray; wavelengths (nm) are stated beside the names. The far-infrared Ho:YAG and CO2 lasers are highly absorbed by water; therefore, they penetrate minimally into skin, whereas the near-infrared Nd:YAG or GAA Diode lasers are absorbed more by the darker pigments of the deeper layers. DTP, Diagnostic and therapy systems for psychology; GAA, gallium-aluminum-arsenide; Ho, holmium; Nd, neodymium; YAG, yttrium-aluminum-garnet.

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21
Q
A

Figure 15-4. Focusing hand piece that would be used on an articulating arm of a CO2 laser. The arrow points to the spot of maximum focus for creating a precise incision with minimal effect on margins of wound. The stylus contacts the tissue to fix the focal point and provide a feel on the tissue for making the incision. Below that point, power decreases with distance from the end of the stylus. Slight defocus allows vaporization of tissue with a relatively high-power density, and more distance reduces power density to coagulation of tissue protein.

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22
Q
A

Figure 15-6. Range of tissue changes from laser beam. With sufficient power density, a laser beam has a central area of tissue vaporization/ablation shown by the crater in this drawing. A layer of carbonization occurs when tissue that has been significantly heated cools to produce char. The area of thermal necrosis is where tissue is heated beyond physiologic limits and later sloughs off. The goal of incisive surgery is to use adequate power density to create as little carbonization and thermal necrosis as possible.

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23
Q
A

Figure 15-7. Pulsed laser energy compared with continuous laser energy. Pulsing higher power densities for short durations (vertical bars) produces a more efficient tissue effect with less collateral tissue heating compared with a continuous beam (horizontal bar) emitting the same average power (fluence). The tissue cools slightly between the pulses.

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24
Q

What is a common effect of multiple inefficient passes with a laser?

A) Decreased wound width
B) Increased thermal injury
C) Improved healing
D) None of the above
A

B) Increased thermal injury

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25
Q

How does the size of the focal spot influence laser interactions with tissue?

A) Smaller spot increases thermal injury
B) Larger spot improves cutting
C) Smaller spot improves cutting
D) Size has no effect
A

C) Smaller spot improves cutting

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26
Q

What happens to the edge of vaporized tissue?

A) It remains intact
B) It forms a char
C) It heals immediately
D) It undergoes hyperemia
A

B) It forms a char

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27
Q

How can the absorption of a laser beam by tissue be maximized?

A) By using a longer wavelength
B) By adjusting the chromophore content
C) By increasing the distance from the laser
D) By using a lower power setting
A

B) By adjusting the chromophore content

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28
Q

What is the effect of char on laser efficiency?

A) It enhances efficiency
B) It has no effect
C) It decreases efficiency
D) It causes immediate healing
A

C) It decreases efficiency

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29
Q

What does photocoagulation result in?

A) Complete tissue destruction
B) Reversible necrosis
C) Irreversible necrosis
D) Immediate tissue healing
A

C) Irreversible necrosis

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30
Q

What can contribute to inflammation at the surgery site?

A) Removal of black char
B) Presence of black char
C) Efficient tissue absorption
D) Proper laser settings
A

Presence of black char

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31
Q

What type of energy interaction is photoablation?

A) Transmission
B) Reflection
C) Complete ablation
D) Coagulation
A

C) Complete ablation

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32
Q

What is the ideal laser type for tissue incision?

A) Nd
B) Diode
C) CO2
D) Ho
A

C) CO2

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33
Q

What can cause iatrogenic damage during laser procedures?

A) Reflection of laser light
B) Excessive coagulation
C) Inadequate tissue absorption
D) All of the above
A

A) Reflection of laser light

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34
Q

What happens to tissue due to latent thermal necrosis?

A) Immediate healing
B) Ischemia and necrosis
C) Enhanced regeneration
D) None of the above
A

B) Ischemia and necrosis

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35
Q

How does increasing the focal spot size affect coagulation?

A) It decreases coagulation efficiency
B) It increases coagulation efficiency
C) It has no effect on coagulation
D) It makes cutting more efficient
A

B) It increases coagulation efficiency

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36
Q

What is the primary focus of a surgeon using a CO2 laser?

A) Maximize thermal injury
B) Incise tissue in a single pass
C) Coagulate blood
D) Increase wound width
A

B) Incise tissue in a single pass

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37
Q

What effect does prolonged exposure to a laser have on tissue?

A) It cools the tissue
B) It causes increased thermal damage
C) It heals the tissue
D) It has no significant effect
A

B) It causes increased thermal damage

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38
Q

What is the primary characteristic of laser beams?

A) Divergent
B) Diffuse
C) Collimated
D) Scattered
A

C) Collimated

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39
Q

What is the acronym of LASER?

A

Light Amplification by Stimulated
Emission of Radiation

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40
Q

How many types of laser exist in veterinary medicine?

A

carbon dioxide (CO2),
neodymium:yttrium-aluminum-garnet
(Nd:YAG ),
holmium:yttrium-aluminum-garnet (Ho:YAG ), and diode

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41
Q

What happens when laser light is transmitted through tissue?

A) Absorption occurs
B) Reflection occurs
C) Iatrogenic damage may occur
D) Coagulation occurs
A

C) Iatrogenic damage may occur

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42
Q

What does increased laser contact time typically lead to?

A) Decreased coagulation
B) Increased thermal necrosis
C) More efficient cutting
D) Immediate healing
A

B) Increased thermal necrosis

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43
Q

How many watts does a typical CO2 laser operate at for cutting?

A) 5 W
B) 10 W
C) 50 W
D) 100 W
A

C) 50 W

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44
Q

What type of laser is best for tissue ablation?

A) CO2 laser
B) Nd
laser
C) HeNe laser
D) Both A and B
A

D) Both A and B

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45
Q

What is one potential complication from excessive laser use?

A) Decreased energy transfer
B) Improved healing
C) Necrosis of adjacent tissue
D) Increased visibility of tissue
A

C) Necrosis of adjacent tissue

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46
Q

What effect does laser energy have on water-rich tissues?

A) It cools them
B) It enhances cutting
C) It causes rapid vaporization
D) It has no effect
A

C) It causes rapid vaporization

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47
Q

What type of interaction involves complete destruction of target tissue?

A) Absorption
B) Reflection
C) Photoablation
D) Coagulation
A

C) Photoablation

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48
Q

What is the typical characteristic of laser beams compared to ordinary light?

A) They spread out quickly
B) They are less intense
C) They are monochromatic and directional
D) They are incoherent
A

C) They are monochromatic and directional

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49
Q

How does the wavelength affect laser-tissue interactions?

A) Longer wavelengths are absorbed more
B) Shorter wavelengths cause more scattering
C) Wavelength has no effect on interactions
D) Both A and B
A

D) Both A and B

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50
Q

What is the hallmark of coagulating-type surgical lasers?

A) Low thermal damage
B) Minimal scatter
C) Latent thermal necrosis
D) High cutting efficiency
A

C) Latent thermal necrosis

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51
Q

What is the power density of a CO2 laser set at 50 W with a 0.16-mm focal spot size?

A) 248,880 W/cm²
B) 398,680 W/cm²
C) 1,990,446 W/cm²
D) 1592 W/cm²
A

) 248,880 W/cm²

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52
Q

At what frequency do pulsed lasers deliver energy, as mentioned in the text?

A) 100 Hz
B) 200 Hz
C) 300 Hz
D) 400 Hz
A

B) 200 Hz

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53
Q

What is the power density provided by 400 W power spikes in pulsed mode?

A) 248,880 W/cm²
B) 1,990,446 W/cm²
C) 50,000 W/cm²
D) 398 W/cm²
A

B) 1,990,446 W/cm²

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54
Q

What is the wavelength range of the Nd
or diode laser?

A) 800 to 900 nm
B) 980 to 1064 nm
C) 500 to 600 nm
D) 1000 to 1100 nm
A

B) 980 to 1064 nm

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55
Q

How many days postoperatively does tissue sloughing occur after laser coagulation?

A) 1 to 3 days
B) 2 to 5 days
C) 5 to 7 days
D) 10 to 14 days
A

B) 2 to 5 days

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56
Q

What is the recommended dosage of phenylbutazone for horses?

A) 1.0–2.2 mg/kg, BID
B) 2.2–4.4 mg/kg, BID
C) 4.0–6.0 mg/kg, SID
D) 1.5–3.0 mg/kg, SID
A

B) 2.2–4.4 mg/kg, BID

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57
Q

How many doses of dexamethasone are initially recommended postoperatively?

A) 1 to 2 doses
B) 2 to 3 doses
C) 3 to 4 doses
D) 5 to 6 doses
A

B) 2 to 3 doses

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58
Q

What percentage of the heat applied is required to cool tissue in thermal relaxation time?

A) 25%
B) 50%
C) 75%
D) 100%
A

B) 50%

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59
Q

In contact laser surgery, how many different fiber types are mentioned for delivering heat?

A) One type
B) Two types
C) Three types
D) Four types
A

B) Two types

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60
Q

What is the effective power range of Nd
lasers typically used?

A) 10–30 W
B) 50–100 W
C) 100–150 W
D) 150–200 W
A

B) 50–100 W

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61
Q

What percentage of laser energy is absorbed by pigmented tissues?

A) 25%
B) 50%
C) 75%
D) 100%
A

C) 75%

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62
Q

What power density results from a focused CO2 laser beam?

A) 1592 W/cm²
B) 248,880 W/cm²
C) 398 W/cm²
D) 1,990,446 W/cm²
A

B) 248,880 W/cm²

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63
Q

What is the power density of a defocused CO2 laser beam at a 4-mm spot?

A) 1592 W/cm²
B) 248,880 W/cm²
C) 398 W/cm²
D) 50 W/cm²
A

C) 398 W/cm²

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64
Q

What is the typical duration for administering pharyngeal spray?

A) 3 days
B) 5 days
C) 7 days
D) 10 days
A

C) 7 days

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65
Q

Which laser’s maximum depth of tissue penetration is only 0.03 mm?

A) Nd
B) Diode
C) CO2
D) Helium Neon
A

C) CO2

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66
Q

What is the duration of time recommended for the administration of corticosteroids?

A) 2–3 doses, then daily
B) 3–5 doses
C) 5 days
D) 7 days
A

B) 3–5 doses

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67
Q

What minimum power density should be avoided to reduce latent thermal necrosis?

A) 100 W/cm²
B) 250 W/cm²
C) 500 W/cm²
D) 50 W/cm²
A

D) 50 W/cm²

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68
Q

What is the interval time range for cooling between laser pulses?

A) 0.5 to 1 second
B) 1 to 3 seconds
C) 2 to 5 seconds
D) 5 to 10 seconds
A

B) 1 to 3 seconds

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69
Q

What is the difference in tissue damage from CO2 laser compared to Nd
?

A) CO2 has more necrosis
B) Nd    has more necrosis
C) Both have the same necrosis
D) Neither causes necrosis
A

B) Nd has more necrosis

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70
Q

How many specific techniques are recommended for avoiding tissue overheating?

A) One
B) Two
C) Three
D) Four
A

C) Three

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71
Q

What is the total amount of fluid commonly administered for topical pharyngeal medication?

A) 5 mL
B) 10 mL
C) 15 mL
D) 20 mL
A

B) 10 mL

72
Q

What percentage of eye protection is required for surgical procedures?

A) 50%
B) 75%
C) 100%
D) 125%
A

C) 100%

73
Q

In CO2 laser surgery, what is the collateral tissue effect at 50 W?

A) 0.05 mm
B) 0.1 mm
C) 0.2 mm
D) 0.3 mm
A

B) 0.1 mm

74
Q

What is the highest wattage associated with Nd
or diode lasers?

A) 50 W
B) 100 W
C) 150 W
D) 200 W
A

B) 100 W

75
Q

What is the approximate power density achieved when using a defocused 2-mm CO2 laser beam?

A) 398 W/cm²
B) 1592 W/cm²
C) 248,880 W/cm²
D) 1,990,446 W/cm²
A

A) 398 W/cm²

76
Q

What is the recommended dosage of prednisolone?

A) 0.5 mg/kg, SID
B) 1 mg/kg, SID
C) 1.5 mg/kg, BID
D) 2 mg/kg, BID
A

B) 1 mg/kg, SID

77
Q

What is the length of time for the CO2 laser to ablate all tissues with high water content?

A) Immediately
B) Seconds
C) Minutes
D) Hours
A

B) Seconds

78
Q

What is the maximum distance of laser energy penetration in water?

A) 0.01 mm
B) 0.03 mm
C) 0.05 mm
D) 0.1 mm
A

B) 0.03 mm

79
Q

In the event of fire during laser surgery, what should be avoided?

A) Wet towels
B) Alcohol for prep
C) Helium oxygen mixture
D) Laser-safe instruments
A

B) Alcohol for prep

80
Q

How much of the laser plume is made up of viable cellular material?

A) 10%
B) 25%
C) 50%
D) Varies
A

D) Varies

81
Q

What type of laser requires a trained safety officer for operation?

A) CO2 laser
B) Nd
laser
C) Diode laser
D) All surgical lasers
A

D) All surgical lasers

82
Q

What is the appropriate response for eye safety during laser procedures?

A) Use regular goggles
B) Cover the patient's eyes
C) Use specific laser safety goggles
D) No precautions needed
A

C) Use specific laser safety goggles

83
Q

What is the laser power density when using a 50 W CO2 laser focused on a 0.16-mm spot?

A) 1,990,446 W/cm²
B) 248,880 W/cm²
C) 398 W/cm²
D) 1592 W/cm²
A

B) 248,880 W/cm²

84
Q

In what context is the CO2 laser NOT recommended?

A) Removing cutaneous masses
B) High-power vascular surgeries
C) Arthroscopy
D) Laryngeal surgeries
A

B) High-power vascular surgeries

85
Q

How many types of lasers are primarily mentioned for surgical procedures?

A) One
B) Two
C) Three
D) Four
A

B) Two

86
Q

What is the power level to consider to avoid latent thermal necrosis in soft tissues?

A) Below 50 W
B) Below 100 W
C) Below 150 W
D) Below 200 W
A

A) Below 50 W

87
Q

What method is suggested to limit heating during procedures?

A) Ice packs
B) Laser-specific goggles
C) Surgical suction
D) Increased power settings
A

A) Ice packs

88
Q

What is the maximum wattage commonly associated with laser safety precautions?

A) 30 W
B) 50 W
C) 100 W
D) 200 W
A

C) 100 W

89
Q

What is the primary mechanism by which laser surgery sterilizes surgical wounds?

A) Heat
B) Light
C) Laser energy
D) All of the above
A

D) All of the above

90
Q

What is the wavelength of the Nd
laser?

A) 980 nm
B) 1064 nm
C) 2100 nm
D) 400 nm
A

B) 1064 nm

91
Q

What is the typical output power range of most diode lasers?

A) 10 to 30 W
B) 15 to 50 W
C) 50 to 100 W
D) 100 to 150 W
A

B) 15 to 50 W

92
Q

Which laser is generally larger and often on wheels?

A) Diode laser
B) Nd     laser
C) Ho     laser
D) CO2 laser
A

B) Nd laser

93
Q

How much more is the 980-nm GAL diode laser absorbed by water compared to the Nd
laser?

A) Twice as much
B) Three times as much
C) Four times as much
D) Equal
A

B) Three times as much

94
Q

What is the recommended output for adequate cutting with a 600-μm fiber?

A) 5 to 10 W
B) 10 to 15 W
C) 15 to 25 W
D) 25 to 50 W
A

C) 15 to 25 W

95
Q

What is a key difference between contact and noncontact laser applications?

A) Noncontact requires less power
B) Noncontact requires higher power settings
C) Contact is less precise
D) Noncontact uses larger fibers
A

B) Noncontact requires higher power settings

96
Q

What type of laser is used for lithotripsy in both humans and small animals?

A) CO2 laser
B) Nd    laser
C) Ho    laser
D) Pulsed dye laser
A

C) Ho laser

97
Q

Which laser produces a visible wavelength between 400-700 nm?

A) Nd    laser
B) Ho    laser
C) Pulsed dye laser
D) Diode lase
A

C) Pulsed dye laser

98
Q

What is the typical output of the Ho
laser?

A) 15 to 50 W
B) 50 to 100 W
C) 100 to 150 W
D) It varies widely
A

D) It varies widely

99
Q

What is the primary method of hemostasis using a GAL diode laser?

A) Direct incision
B) Compression with a contact tip
C) Vaporization
D) Pulsed delivery
A

B) Compression with a contact tip

100
Q

What is the recommended technique to prolong the life of the laser fiber?

A) Activate when not in contact with tissue
B) Cleave the fiber regularly
C) Use higher power settings
D) Avoid any cooling methods
A

B) Cleave the fiber regularly

101
Q

For which procedure is the CO2 laser particularly suited?

A) Bone drilling
B) Lithotripsy
C) Removal of cutaneous masses
D) Soft tissue ablation
A

C) Removal of cutaneous masses

102
Q

What is the effect of the Ho
laser in a fluid medium?

A) It produces less noise
B) It is less efficient
C) It enhances energy concentration
D) It requires less power
A

C) It enhances energy concentration

103
Q

What type of tissue is primarily targeted by the 980-nm diode laser?

A) Soft tissue
B) Hard tissue
C) Cartilage
D) None of the above
A

A) Soft tissue

104
Q

What should be done if the end of the laser fiber is not visible during surgery?

A) Continue with the procedure
B) Activate the laser
C) Place the laser on standby
D) Change the fiber
A

C) Place the laser on standby

105
Q

What should be avoided to prevent overheating when using smaller fibers?

A) High power settings
B) Direct contact with tissue
C) Frequent cleaving
D) Use of coaxial fibers
A

A) High power settings

106
Q

What is the diameter range of sculpted quartz fibers commonly used?

A) 200 to 400 μm
B) 600 to 1000 μm
C) 150 to 300 μm
D) 400 to 600 μm
A

B) 600 to 1000 μm

107
Q

Which laser produces the most precise skin margins during incision?

A) Nd    laser
B) GAL diode laser
C) CO2 laser
D) Ho    laser
A

C) CO2 laser

108
Q

What type of energy does the Ho laser primarily utilize for tissue ablation?

A) Photothermal
B) Chemical
C) Mechanical
D) Electric
A

A) Photothermal

109
Q

What technique is recommended for removing ocular masses?

A) General anesthesia only
B) Laser scanner for precise removal
C) Standard scalpel incision
D) Noncontact laser application
A

B) Laser scanner for precise removal

110
Q

What is the primary risk when using a bare fiber inside an endoscope?

A) Increased efficiency
B) Fiber burnout
C) Enhanced visibility
D) Improved cutting
A

B) Fiber burnout

111
Q

What type of cooling is often available for Nd
lasers?

A) Air cooling only
B) Liquid cooling only
C) Gas or liquid cooling
D) No cooling available
A

C) Gas or liquid cooling

112
Q

Which laser can “drill” cortical bone due to its water absorption?

A) Nd    laser
B) Ho    laser
C) GAL diode laser
D) CO2 laser
A

B) Ho laser

113
Q

What should be applied to the skin margins after CO2 laser surgery for cutaneous masses?

A) Sutures set back 2 to 3 mm
B) Direct closure
C) No treatment required
D) Topical steroids
A

A) Sutures set back 2 to 3 mm

114
Q

What is necessary to prepare a surgical site for CO2 laser surgery?

A) Alcohol scrub
B) Chlorhexidine and sterile saline
C) Hydrogen peroxide
D) Betadine solution only
A

B) Chlorhexidine and sterile saline

115
Q

What can cause the 980-nm diode laser to have increased efficiency?

A) Higher output power
B) Smaller fiber diameter
C) Greater water absorption
D) Increased tissue contact
A

C) Greater water absorption

116
Q

What is the primary advantage of using a laser scanner for ocular surgery?

A) Faster operation
B) Greater precision
C) No need for anesthesia
D) Lower power settings
A

B) Greater precision

117
Q

What is the effect of the pulsed dye laser on urinary calculi?

A) Vaporization
B) Mechanical fragmentation
C) Ablation
D) Both A and C
A

D) Both A and C

118
Q

How should remaining neoplastic cells be treated after excision?

A) With heat
B) With laser scanner at 40 W
C) By waiting for natural healing
D) No treatment necessary
A

B) With laser scanner at 40 W

119
Q

What should be done to the laser fiber before use?

A) Cover with a black marker
B) Remove the plastic coating
C) Attach a cooling tip
D) Use it as is
A

B) Remove the plastic coating

120
Q

What type of laser energy does the 980-nm diode laser primarily utilize?

A) Photothermal
B) Photochemical
C) Radiofrequency
D) Microwave
A

A) Photothermal

121
Q

Which laser is typically recommended for soft tissue ablation?

A) Nd    laser
B) Ho    laser
C) CO2 laser
D) Pulsed dye laser
A

C) CO2 laser

122
Q

What is the effect of char accumulation on laser cutting?

A) Increases penetration
B) Limits penetration
C) Has no effect
D) Enhances cutting efficiency
A

B) Limits penetration

123
Q

How should the endoscopic biopsy channel be managed during laser surgery?

A) Keep the fiber visible at all times
B) Deploy the fiber at any depth
C) Use larger diameter fibers
D) Maintain low power settings
A

A) Keep the fiber visible at all times

124
Q

What is a drawback of using the Ho
laser for equine procedures?

A) High cost
B) Inefficient for compact uroliths
C) Difficulty in positioning
D) Excessive noise during operation
A

B) Inefficient for compact uroliths

125
Q

Which laser requires the use of a computer-controlled laser scanner for optimal results?

A) Nd    laser
B) GAL diode laser
C) CO2 laser
D) Ho    laser
A

C) CO2 laser

126
Q

What is a benefit of using gas-cooled coaxial fibers?

A) Increased fiber flexibility
B) Reduced risk of fiber burnout
C) Lower cost
D) Increased rigidity
A

B) Reduced risk of fiber burnout

127
Q

What technique should be used to remove ocular squamous cell carcinoma?

A) Scalpel incision
B) Laser ablation with precise control
C) Cryotherapy
D) Chemical cauterization
A

B) Laser ablation with precise control

128
Q

What should be done with incomplete excisions to ensure no neoplastic cells remain?

A) Observe for growth
B) Inject with cisplatin
C) Re-excise immediately
D) Use topical antibiotics
A

B) Inject with cisplatin

129
Q

What is the primary reason for the preference of the 600-μm fiber for most endoscopic procedures?

A) It cuts better
B) It is more flexible
C) It has a higher power output
D) It is cheaper
A

B) It is more flexible

130
Q
A

Figure 15-11. Bronchoesophageal grasping forceps (75 cm) used to provide traction for endoscopic laser surgery in the upper airway. (Courtesy 1404-881MT, Sontec Instruments.)

131
Q
A

Figure 15-12. (A) Bronchoesophageal grasping forceps and blunt epiglottic hook manufactured by Optomed. The jaws of the grasping forceps are horizontally positioned, which aids in grasping of the laryngeal vocal cord. (B) The blunt epiglottic hook is positioned under the aryepiglottic fold to protect the epiglottic cartilage from the laser fiber. (C) Intraoperative endoscopy photograph depicting positioning of the epiglottic hook under the entrapping membrane in a horse with epiglittic entrapment.

132
Q
A

Figure 15-13. Intraoperative endoscopic photograph of postoperative standing laser palatoplasty.

133
Q
A
134
Q
A

Figure 15-15. Transection of a moderately thickened epiglottic entrapment. The grasping forceps elevates and stabilizes the entrapping membrane while the laser fiber transects the membrane dorsally to ventrally. The membrane should be reduced below the epiglottis periodically to be sure the laser does not contact the cartilage.

135
Q
A

Figure 15-16. (A) The epiglottis is being elevated with bronchoesophageal grasping forceps to reveal a subepiglottic cyst. The grasping forceps are being used to grasp (B) and elevate (C) the subepiglottic cyst in preparation for laser amputation.

136
Q

What is the typical length of the nerve segment exposed during palmar digital neurectomy?

A) 3 cm
B) 4 cm
C) 5 cm
D) 6 cm
A

C) 5 cm

137
Q

At what power setting is the CO2 laser used for nerve transection in PDN?

A) 5 W
B) 7 W
C) 10 W
D) 15 W
A

B) 7 W

138
Q

What wattage is used during the CO2 laser ablation of the cricoarytenoid joint?

A) 10 W
B) 12 W
C) 15 W
D) 20 W
A

C) 15 W

139
Q

During laser palatoplasty, what is the total energy delivered until the procedure is terminated?

A) 1200 J
B) 1800 J
C) 2400 J
D) 3000 J
A

C) 2400 J

140
Q

What is the range of energy delivered during laser ventriculocordectomy?

A) 2000 to 5000 J
B) 5000 to 10,000 J
C) 10,000 to 15,000 J
D) 15,000 to 20,000 J
A

B) 5000 to 10,000 J

141
Q

What is the reported recurrence rate of ethmoid hematoma?

A) 5% to 20%
B) 8% to 50%
C) 20% to 35%
D) 50% to 70%
A

B) 8% to 50%

142
Q

In what percentage of cases are guttural pouch tympany occurrences bilateral?

A) 10%
B) 30%
C) 50%
D) 70%
A

C) 50%

143
Q

What is the minimum power required for effective photoablation of progressive ethmoid hematomas?

A) 50 W
B) 75 W
C) 100 W
D) 150 W
A

B) 75 W

144
Q

What is the common setting used for diode laser contact application during endometrial cyst removal?

A) 10 W
B) 15 W
C) 20 W
D) 25 W
A

B) 15 W

145
Q

How many people are typically required for standing upper airway laser procedures?

A) 2
B) 3
C) 4
D) 5
A

C) 4

146
Q

What is the on/off time setting for the diode laser during laser palatoplasty?

A) 2 seconds on, 1 second off
B) 1 second on, 2 seconds off
C) 1 second on, 1 second off
D) 3 seconds on, 1 second off
A

C) 1 second on, 1 second off

147
Q

Which laser is described as more efficient for equine uroliths?

A) Nd     laser
B) CO2 laser
C) Ho    laser
D) Pulsed dye laser
A

D) Pulsed dye laser

148
Q

What wattage should Nd
lasers be set to for contact techniques in laryngeal procedures?

A) 10 to 15 W
B) 15 to 25 W
C) 25 to 30 W
D) 30 to 35 W
A

B) 15 to 25 W

149
Q

For laser surgery, what should the laser energy be delivered until in terms of total joules for an effective procedure?

A) 5000 J
B) 8000 J
C) 10,000 J
D) 12,000 J
A

C) 10,000 J

150
Q

What is the recommended fiber size for grasping forceps during laser surgery?

A) 400 mm
B) 500 mm
C) 600 mm
D) 700 mm
A

C) 600 mm

151
Q

What percent of horses with arytenoid chondropathy are more suited for traditional arytenoidectomy?

A) 20%
B) 40%
C) 60%
D) 80%
A

D) 80%

152
Q

What is the distance a laser fiber tip should be visible before activation?

A) 1 cm
B) 2 cm
C) 3 cm
D) 5 cm
A

B) 2 cm

153
Q

What wattage setting is typically used for Nd
laser in urolith fragmentation?

A) 10 W
B) 15 W
C) 30 W
D) 50 W
A

B) 15 W

154
Q

What percentage of cases of guttural pouch tympany are affected unilaterally?

A) 40%
B) 60%
C) 70%
D) 90%
A

D) 90%

155
Q

What wattage range is generally used for noncontact photoablation techniques?

A) 10 to 20 W
B) 20 to 30 W
C) 50 to 100 W
D) 100 to 150 W
A

C) 50 to 100 W

156
Q

How much energy should be used to puncture and ablate an endometrial cyst?

A) 1000 J
B) 5000 J
C) 7500 J
D) 10,000 J
A

D) 10,000 J

157
Q

In laser palatoplasty, how far should the diode laser be applied beyond the epiglottis?

A) 1 cm
B) 2 cm
C) Just beyond
D) 5 cm
A

C) Just beyond

158
Q

What is the maximum wattage for lasers used in noncontact techniques for laryngeal procedures?

A) 25 W
B) 30 W
C) 50 W
D) 100 W
A

D) 100 W

159
Q

What percent of horses may require a prosthetic laryngoplasty alongside laser ventriculocordectomy?

A) 25%
B) 50%
C) 75%
D) 100%
A

C) 75%

160
Q

For laser treatment of distal tarsal joints, what percentage improvement in comfort was reported?

A) 20%
B) 30%
C) 40%
D) 50%
A

D) 50%

161
Q

What is the average duration for which the laser is set to be on during the incision in endoscopic procedures?

A) 1 second
B) 3 seconds
C) 5 seconds
D) 10 seconds
A

B) 3 seconds

162
Q

How many watts does the CO2 laser operate at during standard nerve transection?

A) 7 W
B) 10 W
C) 15 W
D) 20 W
A

A) 7 W

163
Q

What is the maximum energy delivered during laser procedures on endometrial cysts?

A) 5000 J
B) 7500 J
C) 10000 J
D) 15000 J
A

C) 10000 J

164
Q

What is the total energy that should be delivered during the treatment of progressive ethmoid hematomas?

A) 2000 J
B) 5000 J
C) 10000 J
D) 15000 J
A

C) 10000 J

165
Q

What percentage of ethmoid hematoma cases are reported as unilateral?

A) 20%
B) 30%
C) 60%
D) 80%
A

D) 80%

166
Q

What is the typical power setting for diode lasers in soft tissue procedures?

A) 5 W
B) 10 W
C) 15 W
D) 20 W
A

C) 15 W

167
Q

What percentage of guttural pouch diseases can be resolved with laser surgery?

A) 50%
B) 70%
C) 80%
D) 90%
A

C) 80%

168
Q

What percentage of horses with laryngeal issues also show signs of arytenoid chondropathy?

A) 10%
B) 30%
C) 50%
D) 80%
A

C) 50%

169
Q

What is the typical power setting used for noncontact techniques in soft tissue procedures?

A) 20 W
B) 30 W
C) 40 W
D) 50 W
A

B) 30 W

170
Q

In the context of guttural pouch tympany, what percentage of the cases are typically treated surgically?

A) 20%
B) 40%
C) 60%
D) 80%
A

D) 80%

171
Q

What is the duration of stay for horses undergoing laser palatoplasty?

A) 1 day
B) 2 days
C) 3 days
D) 4 days
A

B) 2 days

172
Q

What percentage of cases of progressive ethmoid hematoma have successful outcomes after laser treatment?

A) 60%
B) 70%
C) 80%
D) 90%
A

C) 80%

173
Q

What wattage is used for noncontact laser procedures on soft tissues?

A) 10 to 20 W
B) 20 to 30 W
C) 30 to 40 W
D) 40 to 50 W
A

B) 20 to 30 W

174
Q

What percent of laser surgeries are reported to have minimal complications?

A) 10%
B) 15%
C) 20%
D) 25%
A

A) 10%

175
Q

What percentage of procedures show a reduction in laryngeal swelling after laser treatment?

A) 30%
B) 50%
C) 70%
D) 90%
A

C) 70%

176
Q
A

Figure 15-20. Laser treatment of the distal tarsal joints. The horse is positioned in dorsal recumbency and the needles are placed in the medial aspect of the tarsometatarsal and distal intertarsal joints. Laser energy is being applied to the more proximal joint and a plume is escaping from the vent needle.

177
Q
A

Figure 15-19. Endoscopic laser lithotripsy of a cystic urolith. The pulsed dye laser is turning the substance of the stone to a “plasma,” which is floating away. Fragments that have fallen from the stone litter the foreground.

A U E R S & T (15 decks)

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