Instrumentation Flashcards
All information that was taught to me while attending Vanier College's "Animal Health Technology" Program, located in St-Laurent Montreal.
What is a stethoscope
An acoustical diagnostic instrument especially useful in the evaluation of heart and pulmonary sounds
What are the stethoscope ear tips made out of
Plastic, rubber, soft or hard. Many types and sizes available
What should ear tips do
Be cleanable, replaceable and comfortable. Seal the outer ear canal without entering the canal
In which direction should ear tips curve
Forwards
Describe the ear tube or binaural headpiece
Distributes the sound to each ear, should hold ear tips at a comfortable distance apart. Tension should be adjustable to accommodate a variety of head sizes
Describe the stethoscope tubing
Tubing should be flexible, smooth and thick walled to decreased ambient noise and improve sound transmission.
What is the variety of lengths that stethoscope tubing comes in
14-18 and 25-30
What are the two sound transmitted devices in the chest piece of a stethoscope
The diaphragm and the bell
Describe the role of a diaphragm in the chest piece of a stethoscope
Detects mainly high-frequency sounds and attenuates low-frequency sounds when diaphragm is applied firmly to the skin of the thoracic cage. Breath sounds, normal heart sounds, and some murmurs.
Describe the role of the bell in the chest piece of the stethoscope
Detects mainly low-frequency sounds, diastolic heart murmurs and bowel sounds. Apply lightly to skin if you press with too much pressure the underlying skin acts as a diaphragm that can mask low-frequency sounds
Describe the relationship between capacity of the Bell and diaphragm to register sounds and diameter
Larger equals better. Size dictated by practical means and patient size.
What are the two different arrangements that the bell and diaphragm can have
Two separate pieces, with one on either side of the chest-piece Combined into a single sided chest-piece
Describe how to use a one sided chest piece to pick up low and high frequency sounds
For the one sided chest piece a light pressure on the chest piece against the thoracic wall gives the effect of a bell and a firmer pressure converts it to a diaphragm
How many heart sounds do hear when you listen to a normal heartbeat
2 heart sounds
What is S one
Onset of ventricular Systole. Mitral and tricuspid valve’s close
What is S 2
Termination of ventricular systole. Aortic and pulmonary valves close
What is S3
Early diastole. Rapid ventricular filling
What is S4
Just after atrial contraction and just before ventricular systole. Large amount of blood entering quickly
What can you hear on the left side of the heart
Mitral valve, aortic valve, pulmonary valve
What can you hear on the right side of the heart
Tricuspid valve
How do you maintain the stethoscope
Can use soapy water or alcohol to wipe down surfaces. No steam sterilization. Ear tips can be removed for cleaning. Diaphragm can be removed to clean the chest piece
What possible reason we have for not hearing anything through the stethoscope
It’s been turned to the other side, not in the right area, obstruction of ear tip
What does the refractometer do
Measures protein concentration in a liquid, measures fluid specific gravity
How does the refractometer work
By refraction: bending of light rays as they pass from a medium into another with a different optical density
What fluid types can you measure protein concentration from in the refractometer
Plasma, body fluids, cerebrospinal fluid, liquids accumulating in body cavities
What is the unit for protein concentration
In grams per 100 mL
What is the specific gravity based off of
Weight of a substance compared to water.
What are exudate
Fluids containing a high amount of protein and cellular debris escaped from blood vessels. Usually a result of inflammation
What are transUdates
Fluids escaped from tissues or blood vessels. Contain small amount of proteins or solids
What is the built-in prisim used for in the refractometer
Deviation and dispersion of light
What is special about the scale of the refractometer
It needs to be calibrated and tested. Measures specific gravity of urine and protein concentration in grams per 100 mL
What are the four components of the refractometer
Eyepiece, cover plate, prism, calibration screw
Describe the AO TS refractometer
Plasma protein and urine specific gravity. Measures refractive index, protein concentration of plasma, urine specific gravity.
What does a uricon refractometer measure
Urine specific gravity, refractive index scale
What does the Leica vet 360 refractometer measure
Urine specific gravity for dogs and cats as well as serum or plasma protein in grams per 100 mL
How do you use the refractometer
Please drop of sample on prison plus gently close cover plate. Look at scale through eyepiece. Read result.
How do you clean the refractometer
Wipe clean with tissue paper and distilled water
Why do you avoid any gritty material on the prism
So that it doesn’t scratch the lens
How often should you calibrate the refractometer
Weekly
With what fluid should you calibrate the refractometer
Distilled water. Scale should read zero
How do you calibrate the refractometer
With the adjusting screw.
Can you immerse the refractometer and water
No
What do we do blood testing for
Complete blood, biochemistry, coagulation profile, immunology testing, blood bank testing, DNA testing
When you do a biochem what are the components
Protein, glucose, lipids, electrolytes, enzymes, hormones
What is plasma and what is it used for
Plasma is obtained after centrifugation of blood with a tube containing an anticoagulant such as EDTA, sodium site trait, heparin. Can be used for biochemistry analysis and total protein
What are EDTA tubes used for
Plasma collection after centrifugation. Hematocrit determination by microhematocrit Capillary tube and a blood smear
What is serum and what is it used for
Obtained after centrifugation of blood that has been allowed to coagulate. The clot composition is red blood cells white blood cells platelets fibrin and coagulation factors. Serum is used for blood biochemistry, red top tubes, tiger top tubes
What are the uses of the centrifuge
To separate cells and particulates from liquid part by centrifugal force
What is the supernatant
The lighter part of the fluid
What is the sediment
To heavier part of the fluid
What is the G Force
Acceleration to be applied to a sample
If we use the same rpm but different centrifuge with a bigger radius what happens to the G force applied to the sample
It is bigger. Take-home message is that the bigger the radius the bigger the G Force
What happens if you centrifuge something for too fast or too long
Cells can rupture or morphology is altered
What happens if you centrifuge something for too slow and too short of a time
Incomplete separation of the elements
What are the different types of centrifuges based on design
Swinging bucket, fixed angle centrifuge, horizontal micro hematocrit
What are the different types of centrifuges based on speed
Benchtop, micro centrifuge, high-speed, ultra centrifuges (for research)
What is a swinging bucket centrifuge used for
For urine or blood samples.
What are the hanging specimen cups called in the centrifuge
Trunnions
What are the disadvantages of the swinging bucket centrifuge
Remixing of sediment or supernatant, at a very high speed there is heat buildup
What is a fixed angle centrifuge used for
Higher speeds and horizontal centrifuge without the heat buildup. For rapid sedimentation of small particles
What is the microhematocrit centrifuge used for
Used to separate blood from plasma using a very small sample. Separates packed cell volume, Buffy coat, plasma (containing clotting factor)
What is the timer used for on the centrifuge
Sets required time for spinning samples. Automatically turn centrifuge off after preset time
What is the tachometer
Dial setting the speed. Absent in some centrifuges run at preset speeds
How do you care and maintain the centrifuge
Should always be used on a level surface. Always balance samples in the centrifuge. Close lids. Clean spills immediately. Clean with mild detergents. Maintenance schedule as per manufacture
What are the safety musts with a centrifuge
Check power supply and cord, only operate with closed cover
What is special about the Triax centrifuge
Blood, urine, microhematocrit, break
What do you have to do to the triac when you want to run a microhematocrit tube test
Take out the trunnions. Position micro capillary hematocrit to correctly with the clay towards the outside. Use metal lid cover
What are some reasons that the Triax centrifuge will not work correctly
Poor balancing, instrument not level, forgot cover, wrong setting for time or speed, placed micro capillary hematocrit tube clay the wrong way
What are calibration and quality control needed for
Together ensure the accuracy of results. Complement each other and both are necessary
Define calibration
Establishes an initial point of measurement or data point. Think of scale that is zeroed. Think of refractometer who specific gravity is adjusted with the screw to read 0 when distilled water is used
Why is quality control necessary
It checks that the calibration is correct. This is the exam for the equipment.
How can you test a scale to make sure this reliably weighing your patient
Use a standard to verify, weight or concentration
What do calibration and quality control together determine
The accuracy of the method. Accuracy and precision equals reliability
What can you say if you analyze a sample And get the correct result
The instrument does demonstrates good accuracy
What can you say about an instrument if you repeat the same analysis on the same sample a few times and get results with little variation
It has good precision
When does something have good accuracy and good precision
Correct results and acceptable variation. The only good option
When can something have poor accuracy And good precision
Incorrect results but An acceptable degree of variation
When can something have good accuracy but poor precision
Correct results but unacceptable degree of variation
When does something have poor accuracy and poor precision
Incorrect results with unacceptable degree of variation
What are errors in scale measurements due to
Displacing, tare, surface, location on scale, care and maintenance
What is an otoscope used for
Observation of ear structures
What are the components of the otoscope
Handle, head, bulb, speculum
What is the ophthalmoscope used for
Observation of eye structures. Dilation of pupils.
What are the components of the ophthalmoscope
Handle, head, bulb
What is the woods lamp used for
Dermatological conditions, ocular conditions, ethylene glycol poisoning in humans
What are the two types of tattoo devices for small animals
Clamp or tattoo gun
What do microchips do
They use RFID technology it goes under the skin in dogs and cats. Intramuscular in avians. Ear tags in farm animals.
Describe the schiotz tonometer for measuring intraocular pressure
Use weight and gravity. Must be used vertically. Requires local anesthetic
Describe the tonopen
Weight measured to produce a specific amount of flattening the cornea. Can be used in any position. Requires local anesthetic. much less contact surface then Schiotz.
What can the laser cyte hematology analyzer do
Check red blood cells, Reticulocytes, white blood cells, platelet count
What species can lasercyte hematology analyzer analyze samples from
Cat dog equine
Which white blood cells are granulocytes
All the Phils
Which white blood cells are agranulocyte’s
All the cytes
How does the lasercyte hematology analyzer work
Each cell goes through a laser beam. Light is scattered by the cell and measured by four detectors based on size, complexity, granularity, light absorption. The time of flight through the laser beam is also recorded
What are the main components of the lasersight hematology analyzer
Reagent compartment containing sheath reagent bottle and waste bottle. Air filter, status light, loading tray
In the CBC5R kit which tubes are contained
Purple top tubes, gray top tube, red top tubes, yellow top tubes
What is inside the purple top tube
EDTA
What’s inside the grey top tube
Quality beads, and new methylene blue stain to stain reticulocytes.
What is inside the red top tube
Discard tube
What is inside the yellow top tube
Automated enzymatic cleaner
What does the sheath reagent do
Lyses red blood cells to isolate the white blood cells for analysis
Go through the steps of analyzing a sample with the lasercyte
Collect a sample, Fill purple top that collect tubes with 0.5 to 1.5 mL. Invert eight times before collecting and running. Put sample and gray top tube in the analyzer. Enter patient info and run it.
What are the different ways you can verify results from the laser sight analyzer
Dot Plot, blood smear
How do you calibrate the laser sight analyzer
It’s done at the factory
How is quality control run on the lasersight analyzer
Quality beads in reagent tubes and two different hemoglobin readings are done
How does maintenance on the lasersight analyzer work
It’s automated. After every sample, every four hours, and every 24 hours it flushes and rinses. After every 20 samples the extensive enzymatic clean happens. Weekly the air filter must be cleaned, the system is rebooted and backed up, sheath reagent amount is checked, waste bottle is emptied
What does the catalyst DX analyzer do
Chemistry analysis, electrolytes, UPC fructosamine phenobarbital.
How does the catalyst DX analyzer work
By chemical reaction
What are the main components of the catalyst DX analyzer
Touchscreen interface, sample drawer, waste drawer, maintenance access doors, tip and diluent drawer
What are the pre-loaded clips you can put into the catalyst DX on a laser
Chem: 17 for canine, chem: 15 feline, Chem: 10 Preanesthetic, Lyte 4: electrolytes
What are some other main components of the catalyst DX analyzer
lithium Heprin whole blood separator, pipettes, sample cups
How do you prepare a whole blood sample for the catalyst DX analyzer
.7 mL in lithium heparin separator. Swirl five times
How do you prepare a plasma sample for the catalyst DX analyzer
Whole blood in lithium heparin tube, mix, centrifuge. 300 µL in sample cup with no bubbles
How do you prepare a serum sample for the catalyst DX analyzer
Dry or SST tube, allowed to Claude, centrifuge, 300 µL in sample cup with no bubbles
How do you prepare a urine sample for the catalyst DX analyzer
Centrifuge, 300 µL of supernatant in sample cup
How do you analyze the sample in the catalyst DX analyzer
Select patient data, load sample, load clip or slides with the Lyte 4 first, run, view results on catalyst or vet lab machine.
How do you maintain the catalyst DX analyzer
Empty the waste drawer, clean the internal components
How do you clean the internal components of the catalyst DX analyzer
Do it monthly and before quality control, lint free wipes with 70% alcohol
When do you do the quality control
Monthly,after the analyzer has been movedto verify system performance
How do you do a quality control sample
Client equals QC, patient equals lot number of QC clip, sample equals 300 µL vettrol solution, load QC clip and lyte 4 clip, compare results to pass fail values on QC log
What does the vet lab station do
Integrates results into a single report, organizes results, reduces manual data entry, integrates with clinics computer system
Why do we use an endotracheal tube
Protecting in maintaining a patient airway helps minimize anesthetic risk
What are the different types of material that endotracheal tubes are made out of
Red rubber, PVC, silicone
What are some different types of endotracheal tubes
Murphy, McGill, Cole
What is the purpose of endotracheal tube
Deliver anesthetic gas from breathing circuit to trachea and into patient’s lungs. To keep an open airway when in a critical condition
Describe the patient and of a endotracheal tube
The slanted end of tube that’s passed through the mouth and into the trachea
Describe the machine or circuit end of the tube
That end up or truths from the mouth and connects to the breathing circuit
Describe some general qualities of red rubber endotracheal tubes
Common, flexible, may collapse, difficult to detect occlusions due too solid colors, may absorb disinfectant solutions, short longevity.
Give some general characteristics of PVC tubes
Transparent, stiffer, higher risk of tissue trauma, less porous, has a radio opaque line
Describe some general qualities of silicone rubber tube
Expensive, strong and pliable, less irritating, resistant to cleaning
What are two special types of endotracheal tubes
Metal coiled tubes, fire resistant metal tubes
What is a stylet
Guides and facilitates insertion of small or flexible endotracheal tubes into the trachea
Describe the difference between the Murphy and McGill endotracheal tube
The Murphy has an eye
Describe the cole endotracheal tube
Short, uncuffed, for very small patients
Describe the sizing of tubes
French scale system. Pick three sizes of tube, one that will fit perfectly one that is one size larger, one that is one size smaller
How do you select the correct size of tube
Through gentle palpation of trachea, widest tube that will fit comfortably past larynx and into trachea without excessive force
What happens if you have increased mechanical dead space
You have decreased ventilation
How do you tell the length of an ET tube
Tip of nose to the thoracic inlet
What happens if the endotracheal tube goes beyond the thoracic Inlet
Risk of ventilation of only one lung.
What are the advantages of using cuffed endotracheal tubes
Decreased risk of aspiration, prevents leak of waste gas, prevents inspiration of room air
What are the disadvantages of cuffed tubes
Damage to trick your wall, compression of endotracheal tube lumen
Why is it important to attach the endotracheal tube properly to the patient
To prevent movement of the tube which can cause trauma to the trachea
How do you check the cuff prior to intubation
Fill it up with air and leave it for five minutes
What are some important points to remember about endotracheal tubes
Endotracheal tubes should be lubricated to avoid trauma to the trachea, never move or turn the patient while the endotracheal tube is connected to anesthesia machine, do not over inflate a cuff, deflate the cuff before extubating
How do you clean endotracheal tubes
So can mild soap detergent, scrub insides with a brush, and fleet cough slightly to clean fold, rinse well, air dry
How do you disinfect endotracheal tubes
Chlorhexidine, Excel, glutaraldehyde which is unstable
Which tubes can you autoclave
Silicone tube
Describe some general characteristics of endotracheal tubes
Allows control of airway, oxygen and inhalant delivered closer to lungs, lower oxygen flow required, allows for positive pressure ventilation if apnea, decreases anatomical dead space, prevent aspiration
Describe some general characteristics of facemasks
Relies on patient to maintain respiratory rate, uptake of oxygen and inhalant depends on patient respiration, higher oxygen flow required, cannot assist with ventilation
What is a laryngoscope used for
Increases visibility of pharynx larynx and the tracheal opening.
What are the five components of the laryngoscope
Handle, Blade, slip groove, light source, light pipe
What is a Macintosh blade
A curved laryngoscope Blade
What is a miller blade
A Straight laryngoscope Blade
How do you maintain and clean laryngoscope’s
Gently scrub blade in soapy H2O, Renton clean top water. Disinfect handle with alcohol.
What do you check if the unit fails to light or flickers
Check the lamp, batteries, replace parts
What are hair clippers used for
Used for hair removal. Surgical prep, around wounds, aesthetic procedures. Either electric or battery operated. Interchangeable blades.
How do you shave an open wound with the clipper
Put lube in the wound and shave around it
How do you hold the razor
With a pencil grip.
How do you know how much to shave for surgical prep
Minimum 10 cm in all directions from planned incision
How do you care in maintaining the clipper
Apply lubricating oil to blades and brush off organic material
What does the electrosurgery unit get used for
Uses high-frequency electric current to cut or coagulate tissue in a controlled manner
Describe the components of an electro surgery unit
Electrode, electrosurgical unit, ground plate, footpad
What happens when the footpedal of the electrosurgery unit is pressed
Current runs through the active electrode then runs through the tissue being incised through the patient into the ground plate. The ground plate brings the current from the patient back to the generator. A complete circuit is needed for the current to flow
Describe the active electrode in the electrosurgery unit
In contact with a very small area of the patient. High current density at that point. Maximizes the effects on the tissue.
Describe the ground electrode in the electrosurgery unit
In contact with a large area of patient. Low current density. Minimizes damage to tissues which are not in surgical site
What are some safety concerns with the electrosurgery unit
Risk of Burns to patient, current leakage
What are the advantages of the electrosurgery unit
Reduced blood loss, reduced foreign material, ease of hemostasis, reduced surgical time, small cutting element
What are some disadvantages of the electrosurgery unit
Greater tissue damage, reduced resistance to infection, can burn patient, fire and explosion hazard
How do you care and maintain the electrosurgery unit
White electrodes with alcohol moistened gauze pad while operating, sterilize electrodes. Clean the unit with mild soap or water
Why is proper surgical instrument care important
Patient safety, longevity of instruments
What can spotting, staining and corrosion do
Impaired function of surgical instruments, interfere with sterilization, shortening instrument life
How does spotting staining and corrosion impair function of surgical instruments
Rust in box lock area impair opening of instruments. Rusted scissor blades become doll
How can spotting staining and corrosion interfere with sterilization
Spores are protected from distruction by layers of iron oxide
Describe characteristics of spots on surgical instruments
Loose or semi adherent deposits on instruments surface. Usually wiped off with a cloth with minimal friction. Don’t physically or chemically effect instruments if they are removed
What can cause spots on surgical instruments
Mineral water deposits, chemical residues, steam residue, poor soil removal
Give some general characteristics of stains on surgical instruments
Tightly adhered deposits on instrument surface, can be an integral part of the surface, don’t physically or chemically effect instruments if they removed
What can cause stains on surgical instruments
Replating of metals, impure steam
What are surgical residues and what do they cause
Blood, tissue, pus. Contain chloride ions that cause corrosion. Primary cause of pitting, staining and discoloration of surgical instruments
How do you resolve surgical residues
Clean and dry instruments immediately after surgery, open hinged instruments
What can cause corrosion
Tapwater, harsh cleaners, residual detergent on surgery drapes
How can you test for rust
Taking an eraser and if there’s a pit mark under the stain then it is rust
What does an orange brown stain usually mean
Phosphate deposit. Caused by autoclave water, dirty autoclave, bleach, surgical wrappings
What does a dark brown stain mean
Caused by dry blood missed at cleaning stage, acidic solutions
What is a bluish black stains caused by
Plating which is contact between dissimilar metals
What is a multicolor or rainbow color caused by
Excessive heat during autoclaving
What are the steps for basic cleaning
Presoaking, manual cleaning, ultrasonic cleaning, inspection and repair, lubrication
What is Sterility
State of being free of viable micro organisms
What is sterilization
Process of killing micro organisms that remain on a clean instrument
What are four important conditions for the autoclave
Adequate contact between steam and micro organisms, sufficient moisture, exposure to temperatures lethal to heat resistant micro organisms, adequate time
What are four important parameters for ethylene oxide gas sterilization
Concentration of gas, exposure time, temperature, relative humidity
Is there any difference in the specific gravity of urine pre-versus post centrifugation
No because it measures the dissolved solute not the supersaturated particles
Do you use fresh or centrifuge sample of urine on the Chemstrip
Fresh
What does the laser cyte machine measure
Total number of red blood cells, hematocrit value, hemoglobin, erythrocyte
How does the laser cyte machine works
Using a laser it shines to the cells and registers size absorption granularity
What type of changes in blood can interfere with the analysis from the catalyst DX analyzer
Hemo lysis, coagulation of blood, agglutination
State three causes of hemolysis
Shake too hard, stressed Cat or dog, the needle is too small
Can you run a Chem 15 test while there is a phenobarbital test in progress
No
Name 5 objects used in the analyzer
PipetteClipsSample cupLithium heparin whole blood separator Pipette tips
In what type of tube should you collect your blood sample if you want to use plasma for your analysis and how much do you need
300 µL and a lithium heparin top