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(1) VSRUG > Introduction to Surgery > Flashcards

Introduction to Surgery Flashcards

1
Q

What is SURGERY?

A

Is that branch of medicine, in which diseases are treated wholly or in part by manual or operative procedures

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2
Q

Attributes of a good surgeon
A surgeon must have::

A
  1. Eye of an eagle - good vision
  2. Heart of a lion - connotes courage
  3. Hand of a women - connotes dexterity
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3
Q

Hand of a women connotes?

A

dexterity

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4
Q

Heart of a lion connotes?

A

courage

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5
Q

Eye of an eagle

A

good vision

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6
Q

Competence in these areas, distinguishes the surgeon from the mere “operator”.

A

pre and post operative care

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7
Q

Categories of surgery

A

art & science

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8
Q

It is not an exact science because judgement & skills are involved.

A

surgery

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9
Q

Judgement consists of these two leading to rational decision

A

appraisal and opinion

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10
Q

TRUE or FALSE

It has been said that the ultimate product of responsible surgical judgement is the decision not to operate.

A

TRUE

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11
Q

the keys to a successful surgery

A

Good decisions & judgements

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12
Q

what to know in performing surgery

A

“know when not to cut, then when & where to cut, and when to stop cutting”

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13
Q

System of Rules by which the art of surgery is practiced

A

Asepsis
Anesthesia
Tissue manipulation
Suturing

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14
Q

These rules are probably the most crucial to an acceptable outcome.

A

asepsis

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15
Q

Otherwise known as complete asepsis

A

Integral Asepsis

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16
Q

Integral Asepsis also known as what?

A

complete asepsis

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17
Q

it refers to exclusion of all micro-organisms, this degree of asepsis is impossible (e.g. it is impossible to sterilize skin or the environment)

A

Integral Asepsis or Complete Asepsis

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18
Q

It implies that all practical steps are taken to achieve complete asepsis.

A

Relative Asepsis

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19
Q

In this context, micro-organisms can gain access to surgical wound without resulting an infection.

A

Relative Asepsis

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20
Q

Involves the relative exclusion of micro-organisms and careful handling of tissues to preserve an inherent defenses.

A

Surgical Asepsis

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21
Q

How to protect tissue defenses?

A
  1. Limit exposure.
  2. Minimize imposition of foreign materials (sutures, blood clots etc.).
  3. Preservation of circulation.
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22
Q

How much less than ideal aseptic tech. can be & still preclude infection depends on:

A

Species involved

Susceptibility of tissues to become inflamed

The type and number of micro-organisms present

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23
Q

Sources of Contamination:

A

Surgical Instruments
Environment
Personnel
Animal patient

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24
Q

2 types of 2 types:

A

Cold Sterilization process
Heat sterilization process

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25
Q

Type of Sterilization process with the use of chemical solutions

A

Cold Sterilization process

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26
Q

Type of Sterilization process with the use of dry heat (oven), autoclave (steam under pressure), moist heat (boiling)

A

Heat sterilization process

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27
Q

tool use for dry heat sterilization

A

oven

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28
Q

tool use to steam under pressure

A

autoclave

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29
Q

tool use for moist heat

A

boiling

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30
Q

Other factors that influence wound infection include:

A

Duration of surgery
Surgical technique
Impaired host resistance
Contamination of the wound

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31
Q

What is the most widely used and efficient method of sterilization?

A

Autoclave

32
Q

Items w/c may be sterilized in the Autoclave

A

surgical instruments
drapes
gowns
swabs
most rubber articles
glassware
some plastic goods

33
Q

Items which may be damaged in the autoclave:

A
  1. fibre-optic equipment
  2. lenses and plastics
  3. disposable items like catheters
34
Q

The surgical team:

A
  1. Surgeon
  2. Assistant surgeon/Scrubbed nurse
  3. Anesthetist
  4. Circulating assistant
35
Q

Duties/responsibilities of the Surgeon:

A
  1. Considered as the team captain.
  2. Take responsible in the pre-op, intra-op and post-op.
  3. Take responsible in the surgical judgment.
36
Q

Duties of the Asst. Surgeon

A

~ Prepare the instrument trolley.
~ Assist in draping the patient.
~ Pass instruments, swabs, etc. to the surgeon.
~ Assist with surgery: retract tissue, cut sutures, etc.
~ Be responsible for all equipment, swabs, sutures, needles etc.

37
Q

Duties of the Anesthetist

A

~ Responsible in the objective assessment of the surgical patient.

~ Administer the appropriate pre-anesthetic and anesthetic drugs. Has the authority on what anesthetic agents to use to a particular patient and type of operation.

~ Responsible in monitoring the vital signs, maintenance & level of surgical sleep.

38
Q

Duties of the Circulating Assistant

A

~ Help prepare theatre, instruments & equipment for surgery.
~ Tie the surgical team into gowns.
~ Help position the patient on the table.
~ Preparation of the surgical site.
~ Connect apparatus (diathermy, suction, etc).
~ Open packs of sutures/instruments etc.
~ Count swabs, sutures etc. with the asst. surgeon.
~ Be in theatre at all times when surgery is in progress.
~ Assist the anesthetist.
~ Prepare post-operative dressings.
~ Help clear theatre at the end of surgery.

39
Q

Preparation of the Surgical Team

A

~ Scrubbing-up
~ Putting on a Surgical gown
Back-tie
Side-tie
~ Putting on Surgical gloves
Closed gloving
Open gloving
Plunge method

40
Q

Types of Putting on a Surgical gown

A

Back-tie
Side-tie

41
Q

Types of Putting on Surgical gloves

A

Closed gloving
Open gloving
Plunge method

42
Q

Surgical cases may be categorized as follows

A

~ Elective & Non-urgent
~ Necessary or Urgent
~ Emergency surgery

43
Q

Surgical case for healthy & often young

A

Elective & Non-urgent

44
Q

Surgical case for not immediately life threatening but require prompt attention

A
45
Q

Surgical case for life threatening condition

A

Emergency surgery

46
Q

Pre-operative preparation of the Patient

A
  1. Starvation
  2. Starvation Clipping
  3. Bathing
  4. Administration of Enema
  5. Preparation of the skin
  6. Preparation of the eyes & mucous
  7. Positioning the patient for surgery
  8. Draping the patient
47
Q

food is usually withheld for 12 hrs prior to surgery.

A

Starvation

48
Q

clipping the surgical site is necessary in most procedures (except intra-oral)

A

Clipping

49
Q

ideally all patient should be bathed before surgery to decrease the risk of contamination but this is not always feasible.

A

Bathing

50
Q

food is usually withheld for how many hrs prior to surgery?

A

12 hrs

51
Q

for some surgery (e.g rectal/colonic, intestinal anastomosis)

A

Administration of Enema

52
Q

are the 2 greatest sources of wound contamination as it is not possible to remove all bacteria from the skin. Common bacteria found in the skin (Staph. spp., Bacillus spp., and ocasionally Streptococcus spp.)

A

skin & coat

53
Q

Common bacteria found in the skin

A
  1. Staph. spp.
  2. Bacillus spp., and ocasionally Streptococcus spp.
54
Q

Potent scrub solutions

A

~ chlorhexidine
~ povidone iodine

55
Q

Preparation of the eyes & mucous membranes – for surgery in this area this solution is commonly used to irrigate as antiseptic.

A

0.1-0.2% diluted povidone iodine

56
Q

Draping the patient using the ff drapes

A
  1. Plain drapes
  2. Fenestrated drapes
  3. Adhesive barrier drapes
57
Q

Immediate post-operative care:
Recovery from anesthesia:
1. The patient should not be left unattended until it is conscious and sitting-up.
2. The Endotracheal tube is usually removed just before the cough reflex returns.
3. Color of the mucous membrane, absence or presence of resp. noise and effort will be indicators of effective ventilation by the animal.

A
58
Q

This should be done before the animal regains its consciousness. Take care not to apply too tightly.

A

Application of Dressings or Cast

59
Q

A normal naked individual may disquamate:
___________ particles/minute
___________ are microbes

A

100T- 30 M
3T – 50 T

60
Q

Scrubbing-up should take how many minutes

A

5-10 minutes

61
Q

The hands are kept inside the sleeves while gloving takes place. This tech has the advantage that it minimises the chances of contaminating the gloves, since the outside of the gloves do not contact the skin.

A

Closed gloving

62
Q

The hands are extended out of the sleeves while gowning. This technique has the disadvantage that the gloves are relatively easily contaminated by skin contact.

A

Open gloving

63
Q

With this method the sterile glove is hald open by a scrubbed assistant and the hand inserted. There is a risk of contaminating both personnel involved. This technique is not commonly employed in vet. operating theatre.

A

Plunge method:

64
Q

Commonly performed surgeries in dogs and cats

A
  1. SPAY/OVH
  2. CASTRATION
  3. lump removal
  4. digit amputation
  5. exploratory laparotomy
  6. orthopaedics
  7. enucleation
65
Q

Spaying of bitches is recommended for the following reasons:

~ prevents unwanted pregnancy/puppies
~ no psuedo-pregnancy
~ avoids pyometra and other uterine diseases
~ reduced risk of mammary cancer

A
66
Q

uterine infection

A

pyometra

67
Q

Castration should be considered:

~ treatment to limit straying
~ treatment for unacceptable sexual behaviour
~ medical reasons e.g. prevent or remove testicular cancer, reduce risk of prostatic hyperplasia and peri-anal adenoma
~ to prevent perpetuation of genetic defects

A
68
Q

Routine bitch spay type of incision

A

ventral midline incision, laparoscopy (keyhole surgery

69
Q

Routine bitch spay premedicate with what drugs

A

Atropine SO4
ACP
opioid e.g. buprenorphine

70
Q

Routine bitch spay induce with thee ff:

A

propofol
intubate
isoflurane/sevoflurane or IV gen.
Anesthetic e.g. Zoletil, Ketamine etc.

71
Q

example of Anesthetic

A

Zoletil
Ketamine

72
Q

Routine bitch spay total surgical time

A

20 - 90 minutes depending on patient

73
Q

Routine bitch spay post operative analgesia (NSAIDs)

A

meperidine

74
Q

Routine dog castration surgical time

A

2 - 10 minutes

75
Q

Routine dog castration incision

A

Single midline prescrotal incision

(1) VSRUG (10 decks)

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