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Small Animal Surgery > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Wounds: Classification (Example)

A

clean (surgically created),
clean-contaminated (surgically created but bact containing organ is opened),
contaminated (clean-contaminated w/ gross spillage, traumatic wound),
dirty (infected wounds)

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2
Q

When does the risk of infection double during surgery?

A

every hour

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3
Q

When are prophylactic antibiotics given?

A

30-60min prior to incision

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4
Q

Traumatic Wound: Classification

A

penetrating (open), non-penetrating (closed)

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5
Q

Degloving Injuries: Types

A

physiologic - skin devitalized but still in place

Anatomic - skin avulsed from underlying tissue

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6
Q

Povidone-Iodine: Spectrum

A

Gram (+)/(-), viruses, yeast, fungi

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7
Q

Povidone-iodine: Residual Activity

A

4-6hrs

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8
Q

Chlorhexidine: Spectrum

A

Broad spectrum activity

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9
Q

Chlorhexidine: Duration

A

~12hrs, inc. w/ use

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10
Q

Debridement: Methods

A

surgical, autolytic, chemical/enzymatice, mechanical, biosurgical

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11
Q

Surgical Debridement: Examples

A

layered - excise rough edges

“en bloc” - pack wound then remove as a mass

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12
Q

Wound Dressings: Ca Alginate - Uses

A

hydrophillic dressing, promotes autolytic debridement, hemostasis

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13
Q

Wound Dressings: Ca Alginate - Indications

A

mod/heavy exudate, open wounds

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14
Q

Wound Dressings: Honey - Uses

A

cleans wound, promotes granulation, antimicrobial (osmotic, low pH)

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15
Q

Wound Dressing: Sugar - Uses

A

osmolytic antibiotic, reduces edema, promotes granulation

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16
Q

Wound Dressing: Maltodextrin - Uses

A

chemotactic for leukocytes, provides energy, promotes granulation tissue, antibacterial

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17
Q

Adherent Dressings: Types

A

Wet-to-dry, dry-to-dry

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18
Q

Wet-to-Dry: Indications

A

necrotic tissue, highly viscous exudate

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19
Q

Dry-to-Dry: Indications

A

degloving, bite, laceration, deep wounds

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20
Q

Adherent Dressings: Disadvantages

A

bact. can flourish, wet dressings can macerate surrounding skin, strikethrough

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21
Q

Nonadherent Dressings: Advantages

A

keeps wound moist, allows fluid to drain, doesn’t damage forming tissue

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22
Q

Wound Closure: Classifications

A

Primary, delayed primary, secondary, contraction and epithelialization

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23
Q

Primary Closure: Use and Examples

A

immediate closure of wounds

clean/clean contaminated

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24
Q

Delayed Primary Closure: Use and Examples

A

wound left open for 2-5 days (before granulation tissue forms), permits repeated lavage and debridement

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25
Q

Secondary Closure: Use and Examples

A

wound closure after granulation tissue forms

deep narrow wounds, wide wounds

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26
Q

What axis do you close the wound on?

A

along the long axis

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27
Q

What is primary contraction?

A

retraction of skin edges after tissue is cut

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28
Q

Where do you undermine skin?

A

below the cutaneous trunci muscle (if present)

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29
Q

What are walking sutures?

A

sutures used to hold stretched skin in place while advancing it
they decrease dead space

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30
Q

What layers do walking sutures engage?

A

dermis and fascia

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31
Q

Enhancing Local Skin Movement: Techniques

A

skin stretching, releasing incisions, multi-punctate incisions, adjustable horizontal mattress sutures

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32
Q

Surgical Drains: Indications

A

dead space can’t be obliterated, likely fluid accumulation, infection

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33
Q

Surgical Drains: Placement

A

never through or under incision line

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34
Q

Surgical Drains: Types

A

passive (gravity dependent), active (suction)

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35
Q

What’s the difference between Ingress and Egress?

A

Ingress - exit is dorsal to incision, used for lavage, cap when unused
Egress - exit is ventral to incision, normal drain

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36
Q

Surgical Drains: Removal

A

when drainage dec. (~3-7 days) +/ becomes serous/serosanguineous

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37
Q

Skin Flap: Definition

A

blood flow is maintained

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38
Q

Skin Graft: Definition

A

blood supply must be reestablished

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39
Q

Skin Flap: Classification

A

Type of Blood Supply -
subdermal plexus, axial pattern flap, revascularized
Distance from Wound -
local, distant

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40
Q

Skin Flap: Single Pedicle Advancement Flap

A

donor skin from 1 side, subdermal plexus flap

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41
Q

Skin Flap: Rotation Flaps

A

semicircle cut, rotate over wound

42
Q

Skin Flap: Transposition Flap

A

3-sided flap on different axis from wound (60-90 degrees), rotate over wound

43
Q

Skin Flap: Axial Pattern Flap

A

transpostion flap that incorporates a direct cutaneous artery/vein, connect by tubing the flap or bridging incision

44
Q

Axial Patter Flap: Locations

A

thoracodorsal, caudal superficial epigastric, etc.

45
Q

Skin Flap: Pouch Flap

A

create sleeve on trunk, slide distal wound through sleeve

46
Q

Skin Flap: Single Pedicle Direct Flap

A

create flap on trunk, wrap around distal wound

47
Q

Skin Graft: Indications

A

defects on extremities, extensive burns

48
Q

Skin Graft: Classification

A

full thickness, split thickness

49
Q

Skin Graft: Recipient Bed

A

healthy granulation, sufficient blood supply

50
Q

Cortical Fenestration: Function

A

speed granulation formation over exposed bone

51
Q

Skin Graft: Techniques

A

Sheet - full/split thickness, mesh, sieve, pie crust
Punch - seed, stamp
Strip - Tunnel

52
Q

Full Thickness Graft: Definition

A

consists of dermis, includes hair follicles, best cosmetic appearance

53
Q

Mesh Graft: Definition

A

sheet graft with parallel rows of staggered slits

54
Q

Punch/Seed Graft: Definition

A

full thickness plugs placed in granulation, heal by second intention

55
Q

Strain: Characteristics

A

tensile (pull), compressive, shear (opposite side), bending, torsion

56
Q

Yeild Point: Definition

A

point when material begins to deform plastically

57
Q

Ultimate Failure Point: Definition

A

material can’t withstand anymore strain and fails

58
Q

Viscoelastic: Definition

A

inc. speed of loading => inc. material stiffness

59
Q

Anisotorpic: Definition

A

elastic curve is dependent on loading direction

60
Q

Open Fracture Type I: Appearance

A

small wound, no visible bone, mild/mod soft tissue contusion

61
Q

Open Fracture Type II: Appearance

A

mod. wound from external force, no flaps

62
Q

Open Fracture Type IIIA: Appearance

A

adequate soft tissue for coverage

63
Q

Open Fracture Type IIIB: Appearance

A

extensive soft tissue loss, bone exposure, stripped periosteum

64
Q

Open Fracture Type IIIC: Appearance

A

compromised blood +/- nerve supply

65
Q

How fracture displacement determined?

A

movement of distal portion in relation to proximal portion

66
Q

Fracture Fixation: Types

A

non-surgical - external coaptation (cast)

Surgical - external fixator, internal fixation

67
Q

Fracture Fixation: Goals

A

restore length and alignment, min. fracture end movement, balance bone healing and resorption

68
Q

External Coaptation: Indication

A

fractures below stifle/elbow, min. displaced, simple transverse closed fractures

69
Q

Primary Implants: Examples

A

bone plates, interlocking nails, External fixator

70
Q

Secondary Implants: Examples

A

Kirschner wires, cerclage wire, inter-fragmentary screws

71
Q

Bone Plates: Types

A

Dynamic Compression Plate, Limited DCP, Vet. cuttable plates, lengthening plate, reconstruction plate, locking plate

72
Q

How do DCP work?

A

screw holes designed to promote compression, contact create bone stability

73
Q

How do Limited-DCP work?

A

same as DCP but less contact w/ bone and less stress at screw holes

74
Q

How to Lengthening plates work?

A

no compression, good for highly comminuted fractures

75
Q

How do Locking Plates work?

A

screw head/hole are threaded => no need for plate-bone contact, greater forces needed for instability, takes on all compression forces

76
Q

Screw: Types

A

Cortical, Cancellous, locking

self-tapping, cannulated

77
Q

What’s the difference between Cortical and Cancellous screws?

A

cortical screws have a greater core diameter, but smaller threads

78
Q

Bone Plate: Placement

A

on tension side, contoured to bone, purchase 6 (4 w/ locking plates) cortices (3 (2) screws) on either side of fracture

79
Q

Bone Plate: Function Modes

A

compression mode, neutralizing mode, buttress mode, bridging mode

80
Q

Interlocking Nail: Indications

A

comminuted diaphyseal fractures

81
Q

Interlocking Nail: Placement

A

IM Pin with screw placed through the pin

82
Q

Steinman Pin: Applications

A

IM, cross pinning, rush pinning, diverging pins

83
Q

External Skeletal Fixators: Indications

A

comminuted +/ open fractures

84
Q

ESF: Pin Types

A

smooth, (+) profile, (-) profile, center/end threaded

85
Q

ESF: Pin Placement

A

pin diameter less than 25% bone diameter, purchase 6-8 cortices per segment, pins placed 1/2 bone diameter from fracture line and each other

86
Q

ESF Type 1A: Appearance

A

Unilateral, uniplanar - 1 set of pins are connected to 1 rod in 1 line

87
Q

ESF Type 1B: Appearance

A

Unilateral, Biplanar - 2 sets of pins are connected to 1 rod in 1 line 60-90 deg. from eachother (poss connecting bar)

88
Q

ESF Type 2A: Appearance

A

Bilateral, Uniplanar - 1 set of pins connected to 2 rods in 1 line

89
Q

ESF Type 2B: Appearance

A

combo of type 1A and 2A

90
Q

ESF Type 3: Appearance

A

combo of type 1B and 2a (poss. connecting bars)

91
Q

ESF Circular: Appearance

A

small diameter fixators (optimize bone purchase)

92
Q

ESF Circular Indications

A

complicated tibia and radius fractures, corrective orthopedics

93
Q

Dynamization: Definition

A

incremental destabalization to inc. axial loading to enhance callus hypertrophy

94
Q

Where do oseophytes form?

A

at synovial/articular margins

95
Q

Where do Enthesiophytes form?

A

at tendon/ligament attachment

96
Q

Ankylosis: Definition

A

spontaneous fusion of joint

97
Q

Arthrodesis: Definition

A

sx fusion of a joint

98
Q

Osteochondrosis: Definition

A

defect in endochondral ossification

99
Q

Osteochondrosis: Pathophysiology

A

focally thicker cartilage due to failed ossification

100
Q

Ostechondrosis: Tx

A

NSAIDs + cage rest, sx

Small Animal Surgery (3 decks)

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