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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
Secondary Closure: Use and Examples
wound closure after granulation tissue forms | deep narrow wounds, wide wounds
26
What axis do you close the wound on?
along the long axis
27
What is primary contraction?
retraction of skin edges after tissue is cut
28
Where do you undermine skin?
below the cutaneous trunci muscle (if present)
29
What are walking sutures?
sutures used to hold stretched skin in place while advancing it they decrease dead space
30
What layers do walking sutures engage?
dermis and fascia
31
Enhancing Local Skin Movement: Techniques
skin stretching, releasing incisions, multi-punctate incisions, adjustable horizontal mattress sutures
32
Surgical Drains: Indications
dead space can't be obliterated, likely fluid accumulation, infection
33
Surgical Drains: Placement
never through or under incision line
34
Surgical Drains: Types
passive (gravity dependent), active (suction)
35
What's the difference between Ingress and Egress?
Ingress - exit is dorsal to incision, used for lavage, cap when unused Egress - exit is ventral to incision, normal drain
36
Surgical Drains: Removal
when drainage dec. (~3-7 days) +/ becomes serous/serosanguineous
37
Skin Flap: Definition
blood flow is maintained
38
Skin Graft: Definition
blood supply must be reestablished
39
Skin Flap: Classification
Type of Blood Supply - subdermal plexus, axial pattern flap, revascularized Distance from Wound - local, distant
40
Skin Flap: Single Pedicle Advancement Flap
donor skin from 1 side, subdermal plexus flap
41
Skin Flap: Rotation Flaps
semicircle cut, rotate over wound
42
Skin Flap: Transposition Flap
3-sided flap on different axis from wound (60-90 degrees), rotate over wound
43
Skin Flap: Axial Pattern Flap
transpostion flap that incorporates a direct cutaneous artery/vein, connect by tubing the flap or bridging incision
44
Axial Patter Flap: Locations
thoracodorsal, caudal superficial epigastric, etc.
45
Skin Flap: Pouch Flap
create sleeve on trunk, slide distal wound through sleeve
46
Skin Flap: Single Pedicle Direct Flap
create flap on trunk, wrap around distal wound
47
Skin Graft: Indications
defects on extremities, extensive burns
48
Skin Graft: Classification
full thickness, split thickness
49
Skin Graft: Recipient Bed
healthy granulation, sufficient blood supply
50
Cortical Fenestration: Function
speed granulation formation over exposed bone
51
Skin Graft: Techniques
Sheet - full/split thickness, mesh, sieve, pie crust Punch - seed, stamp Strip - Tunnel
52
Full Thickness Graft: Definition
consists of dermis, includes hair follicles, best cosmetic appearance
53
Mesh Graft: Definition
sheet graft with parallel rows of staggered slits
54
Punch/Seed Graft: Definition
full thickness plugs placed in granulation, heal by second intention
55
Strain: Characteristics
tensile (pull), compressive, shear (opposite side), bending, torsion
56
Yeild Point: Definition
point when material begins to deform plastically
57
Ultimate Failure Point: Definition
material can't withstand anymore strain and fails
58
Viscoelastic: Definition
inc. speed of loading => inc. material stiffness
59
Anisotorpic: Definition
elastic curve is dependent on loading direction
60
Open Fracture Type I: Appearance
small wound, no visible bone, mild/mod soft tissue contusion
61
Open Fracture Type II: Appearance
mod. wound from external force, no flaps
62
Open Fracture Type IIIA: Appearance
adequate soft tissue for coverage
63
Open Fracture Type IIIB: Appearance
extensive soft tissue loss, bone exposure, stripped periosteum
64
Open Fracture Type IIIC: Appearance
compromised blood +/- nerve supply
65
How fracture displacement determined?
movement of distal portion in relation to proximal portion
66
Fracture Fixation: Types
non-surgical - external coaptation (cast) | Surgical - external fixator, internal fixation
67
Fracture Fixation: Goals
restore length and alignment, min. fracture end movement, balance bone healing and resorption
68
External Coaptation: Indication
fractures below stifle/elbow, min. displaced, simple transverse closed fractures
69
Primary Implants: Examples
bone plates, interlocking nails, External fixator
70
Secondary Implants: Examples
Kirschner wires, cerclage wire, inter-fragmentary screws
71
Bone Plates: Types
Dynamic Compression Plate, Limited DCP, Vet. cuttable plates, lengthening plate, reconstruction plate, locking plate
72
How do DCP work?
screw holes designed to promote compression, contact create bone stability
73
How do Limited-DCP work?
same as DCP but less contact w/ bone and less stress at screw holes
74
How to Lengthening plates work?
no compression, good for highly comminuted fractures
75
How do Locking Plates work?
screw head/hole are threaded => no need for plate-bone contact, greater forces needed for instability, takes on all compression forces
76
Screw: Types
Cortical, Cancellous, locking | self-tapping, cannulated
77
What's the difference between Cortical and Cancellous screws?
cortical screws have a greater core diameter, but smaller threads
78
Bone Plate: Placement
on tension side, contoured to bone, purchase 6 (4 w/ locking plates) cortices (3 (2) screws) on either side of fracture
79
Bone Plate: Function Modes
compression mode, neutralizing mode, buttress mode, bridging mode
80
Interlocking Nail: Indications
comminuted diaphyseal fractures
81
Interlocking Nail: Placement
IM Pin with screw placed through the pin
82
Steinman Pin: Applications
IM, cross pinning, rush pinning, diverging pins
83
External Skeletal Fixators: Indications
comminuted +/ open fractures
84
ESF: Pin Types
smooth, (+) profile, (-) profile, center/end threaded
85
ESF: Pin Placement
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
ESF Type 1A: Appearance
Unilateral, uniplanar - 1 set of pins are connected to 1 rod in 1 line
87
ESF Type 1B: Appearance
Unilateral, Biplanar - 2 sets of pins are connected to 1 rod in 1 line 60-90 deg. from eachother (poss connecting bar)
88
ESF Type 2A: Appearance
Bilateral, Uniplanar - 1 set of pins connected to 2 rods in 1 line
89
ESF Type 2B: Appearance
combo of type 1A and 2A
90
ESF Type 3: Appearance
combo of type 1B and 2a (poss. connecting bars)
91
ESF Circular: Appearance
small diameter fixators (optimize bone purchase)
92
ESF Circular Indications
complicated tibia and radius fractures, corrective orthopedics
93
Dynamization: Definition
incremental destabalization to inc. axial loading to enhance callus hypertrophy
94
Where do oseophytes form?
at synovial/articular margins
95
Where do Enthesiophytes form?
at tendon/ligament attachment
96
Ankylosis: Definition
spontaneous fusion of joint
97
Arthrodesis: Definition
sx fusion of a joint
98
Osteochondrosis: Definition
defect in endochondral ossification
99
Osteochondrosis: Pathophysiology
focally thicker cartilage due to failed ossification
100
Ostechondrosis: Tx
NSAIDs + cage rest, sx

Small Animal Surgery (3 decks)

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