Endoscopy Flashcards
Endoscopy definition
“Endo” = Inside
“Skopeein” = To see
Endoscopy
What is it and what does it do?
- What is it:
- Very small cameras attached to either a flexible or rigid tube. - Direct viewing of the interior of an organ is often helpful in determining the cause of a problem & helpful in establishing a diagnosis, especially small animal GI disorders.
What are the types of Endoscopies? (5)
- Endoscopy
- Visualization of the esophagus, stomach, and duodenum. - Colonoscopy
- Visualization of colon - Cystoscopy
- Visualization of the urinary bladder - Bronchoscopy
- Visualization of the trachea & bronchi - Rhinoscopy
- Visualization of nasal passages & pharynx
Indications of GI endoscopy (3)
- Evaluation: gastro motility disorders, remove foreign bodies, evaluation of mucosal lesions of the esophagus, stomach, duodenum or colon.
- Sampling: for mucosal biopsies of GI tract for histopathological examination or fluid aspiration for analysis.
- Therapeutic procedures: esophageal stricture dilation
- Placement of gastrotomy tube in stomach for nutritional support.
T/F: Endoscopy is a minimally invasive diagnostic medical procedure used to evaluate interior surfaces of an organ
True!
Flexible vs Rigid endoscopes
Flexible:
- GI, urinary bladder, airway visualization.
Rigid:
- Nasal, joint (arthroscope), body cavity (laparoscope) visualization.
What are the three basic parts to a fiberoptic endoscope?
- Insertion tube
- Hand piece
- Umbilical cord
Endoscopy equipment needs… (4)
- Scope
- Rigid or flexible - Light source
- Halogen or xenon - Air & water source
- Instrument attachments
- Biopsy, graspers, snares
- Others
Advantages of endoscopy (4)
- Diagnostic as well as therapeutic applications
- Minimum stress & mortality
- Less traumatic than standard Sx
- Amount & duration of anesthesia much less than standard surgical procedure
Disadvantages of endoscopy (4)
- Requires expensive, flexible equipment, & specialized operator training.
- Biopsies usually adequate, but not as good as full thickness surgical biopsies.
- Cannot examine entire intestinal tract; lesion may be beyond reach of scope.
- Inexpert handling of the endoscope may lead poor diagnostics & complications such as punctured organ or vagal effects or over inflation.
Patient GI endoscopy prep/set up (5)
Hint: Think of patient positioning!
- Patient is well fasted
- General anesthesia with intubation
- EKG strongly recommended
- Oral speculum must be placed
- Patient placed in left lateral recumbency
Endoscopy biopsy steps (3)
- Multiple samples are taken (about 5) from each region of the stomach & duodenum.
- Gently placed on balsa wood or cassette with 22G needle.
- Rapidly placed in formalin or test medium to prevent drying.
Helicobacter Testing, what is it? (2)
- Direct visualization on histopathology
- Urease production test (CLOtest)
- Positive within 4 hours
Foreign body removal from the GI tract with endoscopy must be done with ___ care in order to protect the ___.
This is limited to the gastric objects that can be brough back through the ______ junction that instruments can grasp.
- Extreme
- Esophagus
- Gastroesophageal
Colonoscopy indications (4)
- Chronic diarrhea
- Recurring constipation
- Chronic tenesmus
- Chronic blood, mucous in feces
Colonoscopy patient prep (3)
- Patient fasted for at least 24hrs
- Go-lytely or other osmotic for 2 days
- Warm water enemas (no irritant additives) if fecal material in colon seen on radiographs just prior to procedure.
Colonoscopy instrumentation (3)
Hint: Similar to GI endoscopy
- Colonoscope is shorter, larger diameter then upper GI endoscope.
- Patient usually placed in sternal recumbency.
- General anesthesia!
Rhinoscopy
1. Indications (4)
2. Patient prep (3)
- Indications:
- Chronic nasal discharge
- Epistaxis
- Violent sneezing
- Nasal stridor - Prep
- General anesthesia
- Topical lidocaine
- Sternal recumbency
Rhinoscopy
Instrumentation (6)
- Rigid scope (arthroscope)
- Flexible endoscope (retroflex view)
- Light
What are the TWO goals of endoscopy equipment care?
- Patient safety!
- Maintaining proper endoscope function
What does endoscopy equipment care entail? (not goals) (3)
- Proper cleaning & disinfection.
- Routine inspection of the instrument
- Careful inspection of each stage of instrument use:
- Before use
- During use
- After use
Endoscopy handling (4)
- Extreme care to NOT BEND the flexible scope aggressively!
- Tight bends in the scope result in fiber breakage. - Use mouth gag on patients.
- Biting the scope will cause severe damage to the fibers of the scope. - Once broken fiber obscures the image, the instrument must be discarded!
- Do not drop the scope!
Endoscopy leak testing things you need to know (3)
- Leak testing should occur before cleaning, before use, & after use.
- Submersion of an endoscope that has a leak will allow water to enter into the instrument & potentially ruin it.
- Teeth of animals have a high risk of damaging (causing leaks) the flexible scope & care must be used over the teeth.
Signs of endoscopy leak (3)
- Image stains
- Foggy images
- Electrical malfunction
To conduct a leak test, apply ___ pressure to the inside of the endoscope ___ tube and watch for either a drop in the pressure ___ or for ___ ___ where there are leaks in the exterior or a channel wall.
- Air
- Insertion
- Gauge
- Air bubbles
Endoscope cleaning steps (5)
- Immediately after procedure, copious amounts of fresh water suctioned thru channels.
- Manual cleaning with enzymatic detergent. Then rinse with fresh water.
- Including: brushing/flushing channels - Air blown thru instrument & air dried.
- Remove all possible parts for this step. - Alcohol on cotton used for hand piece parts.
- Instrument MUST be sealed prior to submersion.
T/F: Cold sterilization & sterile rinse only needs to occur after procedures with the endoscope
False. This should be done immediately PRIOR to procedures.
- Do keep in mind the “cold tray” has been known to grow on culture mediums, so take this with a grain of salt.
Bronchoscopy
Bronchoscopy
Arthroscopy
Laparoscopy
The Loresectoscopy
Cystoscopy/Urethroscopy
