Endoscopey Flashcards

1
Q

what are the different types of endoscopy in practice?

A

gastroscopy
bronchoscopy
colonoscopy
esophagoscopy
urethrocystoscopy
tracheoscopy
arthroscopy
laparoscopy
otoscopy
rhinoscopy

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2
Q

what can we do by endocopy?

A

visualise masses, foreign bodies, mucosa, inflmation etc
- allows for diagnostics

perform biopsies and cytology
- for lab tesing

can assist with feeding tube placements
- PEG tube

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3
Q

what are the features of an endoscope?

A

umbilical cord, handpiece, insertion tube

light source
insufflation
irrigation
suction
monitor

diameter
- varies from 1mm-14mm
- must be >2mm to have accessory channel and deflective tip

length
- 55-170cm
- use >125 in large breed dogs

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4
Q

what are the features of the insertion tube on an endoscope?

A

fibrinogenic glass bundles (fiberscope) or CCD chip (videoscope)

biopsy/suction channel

irrigation/insufflation channel
- allow to keep lens clean

defection control cables
- see 360 degrees
- control direction

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5
Q

what are the features of the hand piece?

A

accessory channel entrance
- allows for insertion of biopsy forceps

water for irrigation

direction dials
- up/down and left/right controls

controls for water, suction and inflation

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6
Q

what are the types of endoscopes?
which procedures are they used for?

A

flexible
- bronchoscopy
- colonoscopy
- esophagoscopy
- gastroscopy
- male dog urethrocystoscopy
- nasopharyngoscopy
- tracheoscopy

rigid
- arthroscopy
- female urethrocystoscopy
- laparoscopy
- otoscopy
- rhinoscopy
- thoracoscopy

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7
Q

what is the purpose of rigid endoscopes?

A

allow for internal structures within the body cavity

evaluation of non-tubular structures
- eg body cavity or joint spaces

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8
Q

features of rigid endocopes?

A

metal outer casing
glass optic lenses
optic fibres

diameter
- vary from 10-35cm
- use largest possible to maximise light and field of view

viewing angles
- dependent - manage 0-120 degrees

sheath/cannula
- channel for diagnostic/surgical instruments or management of gas/fluid

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9
Q

types of flexible endoscopes?

A

fiberscope
- have an eyepiece for visualisation
- less space needed
- increased portability
- cheaper
- reduced video quality
- breakage of fibres leading to blackspots

videoscope
- video linked to screen/display
- far better image quality
- no risk of broken fibres as better control due to better visualization
- allows you to save images - use again for staff/owners/education
- larger screen - more people involved

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10
Q

what are the features of the light source on an endoscope?

A

connected via umbilical cord to endoscope

xenon light sources are used for videoendoscopy

always have a spare

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11
Q

what are the features of insufflation?

A

essential for GI endoscopy to maintain open lumen
used to inflate abdomen, bladder or joints

use carbon dioxide
- better control rate and air pressure
- lower risk of air embolism when inflating

usage is painful
- only use min needed
- make sure all removed afterwards
- over-inflation caused hypoventilation and puts pressure on diaphragm and vena cava

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12
Q

what are the features of irrigation?

A

positive pressure forced fluid through insertion tube
- allow to clean the lens and improve visualisation

must be distilled water
- otherwise causes mineralisation

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13
Q

what are the features of suction?

A

allows you to
- remove fluid or debris obscuring view
- remove air at end of the procedure
- remove air if patient becomes respiratory compromised

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14
Q

what are the features of the monitor?

A

image is transmitted to a monitor
- single chip (CCD) or 3 chip (3 CCD) for high res.

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15
Q

how do you look after the accessory channel?

A

don’t pass instrument through a deflected tip
- damage instrument and endoscope

don’t force an instrument if there is a resistance
- stop, pull back, work out issue

ensure instrument diameter doesn’t exceed channel diameter

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16
Q

how do you handle endoscope?

A

left hand:
- index finger - suction valve
- middle finger - irrigation and insufflation valve
- thumb - control deflection knobs

fight hand:
- insertion tube

17
Q

how to clean and care for an endoscope?

A

do not
- drop (esp. tip)
- bend excessively
- leave over doors
- pack wet
- drown them

quick clean
- wipe clean as soon as finish
- leak test - prevents damage
- flush accessory channel with enzymatic cleaner - don’t leave long as corrodes rubber and glue
- rinse with distilled water
- dry with air - using a large syringe

okay between non-infectious GI procedures

18
Q

how do you sterilise an endoscope

A

rinse with cold water
dry with sterile towels
gas sterilisation
- ethylene oxide

19
Q

how to sort out an endoscope at the end of the day?

A

immerse in enzymatic cleaner for 10-15mins
flush and clean channel using brushes
rinse in distilled water
hang scope to dry - no doors!
store scopes:
- flexible - hanging
- rigid - protective case

20
Q

how would you prep a patient for different endoscopies?
what are the different risks/complications?

A

Laproscopy
- prep same as bitch spay - larger margins
- setting up means longer GA than normal spay
- distended abdomen high risk

gastroscopy
- must be starved 6hours prior
- blocked - regurge risk
- numbing/analgesia necessary

colonoscopy
- enemas and cleanprep prior
- clean GI tract necessary
- blockage - regurge risk likely

arthroscopy
- analgesia +++
- very high infection risk - sterility necessary

rhinoscopy
- small space - correct sized endoscope
- GA monitoring around face - lots of people
- epistaxis likely

esophagoscopy
- likely FB stuck - eg animal bones
- starve as soon as know block
- regurge very likely
- hard to repair

bronchoscopy
- hypoxic likely - obstructing lungs
- likely have lung disease - compromised

cystoscopy
- very high infection risk
- small/delicate area - bleeding and damage likely
- dorsal recumbency - pressure on diaphragm/lungs

21
Q

what are the risks of a badly prepped patient for endoscope?

A

bad imaging
infection
can’t diagnose