Lab Final Flashcards
What are characterisitics of monofilament sutures
I strand, less traumatic, more memory, porrest knot security, and little capillarity
What are characteristics of multifilament sutures
> I strand, braided, twisted, sheathed, more traumatic, capillary action, flexible, no memory, good handing, and knot security
What are characteristics of natural suture material
Strongest tissue reaction, silk is very reactive, cotton, and chromic
What are characteristics of synthetic sutures
Not inflammatory and little tissue reaction
What are brands of synthetic sutures
Vicryl, Dexon, PDS, and Prolene
What are the characteristics of non-absorbable sutures
Not broken down by body, constant tensile strength, and can remain intact for 2 years
What are the types of non absorbable sutures
Nylon, polypropylene, and steel
What are characteristics of absorbable sutures
Broken down by the body and tensile strength decreases w/in 60 days
What are the 2 types of absorbable sutures
Phagocytosis and hydrolysis
What is the phagocytosis absorbable sutures
Natural material that is the strongest tissue reaction due to inflammation
What is the hydrolysis suture
Synthetic material that is less reactive due to a small inflammatory response
What is Pao2
Partial pressure of oxygen in arterial blood
What is Spo2
Oxygen saturation of peripheral blood
What is SO2
Measuring the percentage of oxygen-carrying hemoglobin in the blood
What is PO2
Represents the pressure of oxygen dissolved in the blood, indicating the effectiveness of the lungs in oxygenating the blood
How should monitoring instruments be used
As a supplement to a conscientious anesthetist for careful physical monitoring
How can a heartbeat be obtained in a patient in lateral recumbency and why
On the side of the dependent lung because of the gravitational effect
How can an anesthetist differentiate a sinus arrhythmia from another abnormal rhythm
By listening for the decrease in HR during expiration and an increase in HR during inspiration
Why should any change in cardiac rhythm be reported to the vet
Because even benign arrhythmias can quickly degenerate into a dangerous rhythm if not recongized
What is the best indicator of the blood perfusion of internal organs
The MAP
What is the mean arterial pressure
MAP is the average arterial pressure through the cardiac cycle
What does a MAP of 60-70 mmHg indicate
That blood perfusion of internal organs is reduced and tissues may become hypoxic
What is the appropriate MAP range in dogs and cats
60-90 mmHg but ideally it is above 70 mmHg
What Psys pressure should we strive to maintain in small animals when using a doppler blood flow detector and sphgyometer
80-90 mmHg
What is the difference between direct and indirect BP monitoring
Direct involves monitoring through a catheter inside the artery w/ a pressure transducer while indirect occurs on the outside of the body using an external sensor and cuff
What are the two indirect methods for acquiring BP
Doppler and oscillometric
How does the doppler and oscillometric methods for acquiring BP differ
While they both use a cuff to occlude and release blood flow they differ in how pressure is measured
What percentage of the circumference of the extremity should be covered by the cuff when obtaining BP
30-50% ideally 40%
In what plane should indirect BP be obtained
At the same horizontal plane as the heart
What do pale mucous membranes indicate
Intraoperative blood loss, anemia of any cause, or poor capillary perfusion
What does cyanotic mucous membranes indicate
Very low blood oxygen concentration
Why is oxygen saturation not a good indication of oxygen availability in anemic patients
Because their decrease in oxygenation is not due to a lack of the amount of oxygen molecules in the blood but from a decrease in the material that transports the oxygen
Why do Pao2 and Spo2 not give a good indication of oxygen availability
Because the carrying capacity of the blood is severely decreased due to the decrease in number of hemoglobin binding sites
What should oxygen saturation be if the patient is receiving 100% O2
Greater than 95%
What does a pulse ox of 90-94% indicate
Hypoxemia in the patient
What does a pulse ox of less than 90% indicate
Serious hypoxemia that is in need of therapy
What does a pulse ox of less than 85% for longer than 30 seconds indicate
A medical emergency
What does bagging or sighing the patient prevent/treat
Atelectasis
How often do most anesthetists bag their patients during surgery
Every 5-10 minutes
What 3 factors go into determining the blood CO2 levels
Rate of production by the cells, rate of transport to the lungs, and the rate of elimination from the lungs
What is a normal ETco2 in a nonanesthetized patient
35-45 mmHg
What is the acceptable limit of ETco2 in an anesthetized patient
Up to 60 mmHg but typical is 40-55 mmHg
What are the 4 aspects of evaluating a capnogram
The baseline value, the ETco2 value, the waveform shape, and the rate at which changes occur
What is the normal Paco2 value in anesthetized patients
45-60 mmHg
What does a Paco2 value greater than 60 indicate
Hypoventilation is significant and requires intervention
When is body temperature loss greatest during an anesthetic event
In the first 20 mins
What body temperature range prolongs anesthetic recovery and a decreased anesthetic dose is required
89.6-93.2 F
What are the 3 techniques for warming hypothermic patients
External passive warming, external active rewarming, and core rewarming
What is external passive warming
Helps minimize hypothermia by using various methods to conserve body heat such as towels and blankets
What is external active rewarming
Raises body temperature by using external heat producing devices
What is core rewarming
Use of various devices and practices to either warm the patient internally or prevent excessive heat loss from the respiratory tract
What are the 3 ways blood oxygen is measured
Calculated oxygen content, partial pressure of oxygen, and percent oxygen saturation
What are the 3 groups vitals are separated into
Circulation, oxygenation, and respiration
What are the principles of patient monitoring
Monitor patients frequently using your hands, eyes, and ears, always check multiple parameters, never depend on instruments alone, and do not attempt to judge depth of anesthesia on the basis of drug doses or dial settings
What type of drape folding always for easy unfolding and placement on the patient
Accordion
What is sterilization
Elimination or destruction of all living organisms from a material
What is disinfection
Destruction of vegetative forms of bacteria but not spores
What are the different degrees of surgical aseptic maintenance
Clean, clean-contaminated, contaminated, and dirty
What are the two categories of sterilization
Physical and chemical
What are the 3 forms of physical sterilization
Filtration, radiation, and heat
What is filtration sterilization
Use of a filter to separate particular material from liquids or gases
What is radiation sterilization
Destroys microorganisms w/o causing significant temperature elevation
What are the 2 forms of heat sterilization
Wet and dry
What is dry heat sterilization
Sterilizing materials that cannot tolerate moisture but can withstand high temperatures avoiding rust or corrode but is more difficult to control
What is moist heat sterilization
Accomplished by boiling water or by steam under pressure
What position should instruments w/ hinges or box locks be left in when in the autoclave
In the unlocked position
What is the minimum standard for autoclave sterilization
121 degrees C for 20 minutes
What is flash sterilization
Emergency sterilization that is at 131 degrees C for 3 minutes
Why should packs be left to cool slowly
To reduce condensation
What are the 4 types of sterilization indicators
Autoclave tape, melting pellet glass, culture tests, and chemical sterilization indicators
Why is hydrogen peroxide replacing ethylene oxide
Due to the high toxicity of ethylene oxide
Why is chlorhexidine a popular antimicrobial
Because of its rapid onset and long residual activity
What tools should never be sterilized
Arthroscope/laparoscope, fiberoptic light cable, and the camera
Why is it important that CidexPlus is rinsed thoroughly from laparoscopic instruments
Because glutaraldehyde is carcinogenic and can lead to chemical synovitis and injuries to chondrocytes
How should operating room cleaning be maintained
W/ daily and weekly schedules
How many times should the surgical site be scrubbed and rinsed
3 times
How long is the contact for sterile scrub like povidone-iodine
At least 5 minutes
Why are one step preps beneficial
They are easy to apply, faster than traditional scrubbing, effective for antimicrobial kill, rapid onset, and a long residual effect if used properly
What is the most common position for surgical patients
Dorsal recumbent
What should anyone entering the OR be wearing
Cap, mask, booties, and scrub suit
What are the requirements of hand scrub
Contact w/ the surfaces of the fingers, hand, and forearm and contact time for 5 minutes
Can waterless hand antiseptics replace or supplement surgical hand scrubbing
Supplement because it is easy to apply, effective against microorganisms, and nonirritating to the skin
What are the 2 methods for putting sterile gloves on
Closed gloving and open gloving
Can nonsterile personnel lean or reach across sterile fields
No
What is the sterile region after gowning and gloving
The front of the gown between the waist, just below the shoulders, and the sleeves
What is the optimal approach to draping a surgical site
2 drape layers the first being the four quarter drapes and a large drape that covers the entire animal
What drapes can be added to improve antiseptic techniques
Incisional drapes or antiseptic-impregnated adhesive drapes
What is important to remember when opening a surgical pack
Make sure the opening faces away from you
Why should drapes that get splashed w/ saline or blood be replaced and removed
Because they are no longer impermeable to bacteria known as strike through
What is open gloving
What is closed gloving
