chpt, 31 Flashcards
LASER acynom
light amplification by stimulated emission of radiation
uniform in wavelegnth and frequency
coherent ligth
what is a laser that causes delayed cellular death?
latent thermal damange
a laser that causes cellular damage or death wider than actual path of the laser
collateral thermal damage
a type of laser beam produced from a gas medium
CO2 laser
type of laser bean that transmits through a quartz fiber
diode laser
lasers are divided into how many classes?
into four different classes in which most laser beams are a class 4
what is an MPE level?
maximum permissible exposure level
What are 3 types of stapling devices?
Ligate-divide-separate (LDS)
Thoracoabdominal (TA)
Gastrointestinal anastomosis (GIA)
device that sllows from ligation (closing off) of vessels with pressure and energy
Vascular Sealing Devices
What are the 2 uses of vascular sealing devices?
Open surgical techniques (laparotomy and thoracotomy)
Minimally invasive
Basic operative pack for ophthalmic procedures
specialized scapel (#7), fine scissors, thumb forceps, needle holders, retractors (chalazion and graffe), and lacrimal duct cannulas
what is the most commonly used periosteal elevator used in small animal orthopedics?
freer elevator
Total hip prosthesis
1) Addresses severe arthritis
2) Long stem placed inside proximal femur
3) Ball replaces femoral head
4) Cup replaces acetabulum
Device that helps remove osteochondral fragments and osteochondritic lesions
Arthroscope
most commonly used arthroscope for canine arthroscopy
30-dedree angled lens
During an ancillary arthroscopic procedure, the sharp trocar and sleeve are used to what?
Penetrate the joint capsule
An ancillary arthroscopic instrument that replaces the trocar and penetrates the synovial membrane then replaced by arthroscope?
Blunt obturator
arthroscopic fluid delivery is given in what delivery methods?
Gas (CO2) or sterile fluid
What are the 2 types of arthroscopic fluid deliveries?
Pressurized bag system
Automated pump system
used to probe cartilage and subchondral bone in the joint
blunt probe
cut the attachments of an osteochondral fragment
rongeurs
cut or breakdown attatchments of an osteochondral fragment and elevate it
elevators and osteotomes
debride a defect in the cartilage or bone after a removal or lesion
curettes
Motorized arthroplasty system
Motorized burrs
used to prevent damage to surrounding articular cartilage and remove defects left
motorized burs
allow for hemostasis of blood vessels and cutting out damaged soft tissue within a joint
Radiofrequency arthroscopic probes
surgical tool used to examine the abdominal and thoracic cavities
laparscopy
Where should we access the abdominal cavities in equine and canines?
Paralumbar fossa (equine)
Ventral abdomen (canine/equine)
gas that is used to distend the abdomen during a laparoscopic procedure
CO2
Penetrate subcutaneous tissue and peritoneal lining
Sharp trocar and cannula
Replaces sharp trocar
Blunt trocar
Automatically maintains abdominal
distention
Insufflator, CO2
What is the best way to pack instruments?
1) Commonly used instruments most accessible
2) Infrequently used instruments wrapped
3) Items always in same location
Instrument care
1) Delicate instruments handled separately
2) Disassemble multi-component instruments
3) After surgery, all used instruments should immediately be rinsed using cold, distilled, or deionized water
most surgical equipment is made of what?
satin-finished stainless steel
Instruments should be inspected then washed in what?
warm h20 and neutral pH instrument detergent
what is the main rule for ultrasonic cleaners?
Only instruments of similar material
After care of instruments
1) Rinse with deionized water then air dry
2) Lubricate instruments with hinges or box
locks
3) Inspect before repacking
What should you look for when inspecting instruments before repacking?
frozen hinges, improper jaw alignment, or broken parts
Drapes and Gowns are either these 2 types of material
paper- disposable
cloth- repeated use
what type of method is used when folding gowns?
accordion fold
what is an exogenous source of contamination?
air, surgical instruments and supplies, patients skin, and surgical team
what is an endogenious source of contamination?
from within the patients such as bacteria from the oral cavity (gingivitis) or skin (dermatitis)
What factor influences wound contamination and subsequent infection?
the length of time the patient is under anesthesia
risk of infection does what after every hour the patient is under anesthesia?
doubles
Typically an elective surgery in a non-contaminated, non-traumatic and non-inflamed surgical site
clean surgery
surgery involves the respiratory, GI or genitourinary system, ie often a hollow organ
clean-contaminated
Similar surgeries, but with leakage or a major break in aseptic technique
contaminated
debridement (removal) of a cutaneous abscess
dirty surgery
What are types of physical sterilization?
Filtration
Radiation
Heat
Autoclave
most commonly used in pharmaceuticals and uses a filter to separate material from liquid or gases
filtration
destroys microorganisms without causing significant temp. elevations (gloves, suture materials)
radiation
sterilize materials that cannot tolerate moisture but can withstand high temps
dry heat
sterilization by boiling water or stream under pressure, ex.autoclaves
moist heat
most autoclaves in veterinary practices are
gravity displacement
Proper pack preparation
1) All materials thoroughly cleaned
2) Complex instruments disassembled
3) Labeled with handler, date of sterilization,
contents
4) Indicator strip
Proper loading of autoclave
1) 2.5 to 7.5 cm of space around pack
2) pyramid style
temps and times of autoclaves
minimum standard- 121C (250F) for 20 min
prefered- 121C (250F) for 30-45 min
Flash sterilization
3 min at 131C (370F)
Four types of sterilization indicators
autoclave tape, melting pellet glass, culture tests, and chemical sterilization indicators
useful for identifying packs and articles that have been exposed to steam
autoclave tape
indicates temp of approximately 118C (244F) has been reached
melting peller glass indicator
contain controlled-count spore population of particular strains of bacterium
culture tests
Penetrates paper and plastic packaging
ethylene oxide
Eposure time of ethylene oxide
12 hours at room temperature
quarantine time of ethylene oxide
well-ventilated area for 7 days
12 to 18 hours in aerator