Minor surgical conditions Flashcards
1
Q
define abscess
A
localised collection of purulent material lined with granulation and fibrous tissue
2
Q
what is the process of abscess formation?
A
pyogenic organisms cause cell death and inflammation
normally points and bursts for drainage
3
Q
what are complications associated with abscesses?
A
toxaemia
pyaemia
sinus
skin necrosis
4
Q
what are signs of an abscess?
A
pyrexia anorexia vomiting pain swelling discharge
5
Q
how are abscesses treated?
A
drainage
antibiotics
analgesia
6
Q
how is drainage provided to abscesses?
A
establishing drainage- lance with sterile scalpel and flush with saline, if deep or internal may need surgery for resection
maintaining drainage- keep open, regularly drain and flush
7
Q
define cellulitis
A
non-localised distribution of pus through tissues
8
Q
what causes cellulitis?
A
acute inflammation
9
Q
what are signs of cellulitis?
A
pain
areas sensitive to touch
pyrexia
generalised swelling
10
Q
how is cellulitis treated?
A
systemic antibiotics
anti-inflammatories
analgesia
11
Q
define sinus
A
infected blind ending tract from a focus of infection to body surface or MM
12
Q
describe the structure of a sinus
A
blind ended tract lined with granulation tissue
13
Q
state examples of sinus
A
foreign body tract
anal furunculosis
14
Q
list signs of a sinus
A
pyrexia
pain
sensitive to touch
disease specific signs
15
Q
define a fistula
A
abnormal tract between 2 epithelial surfaces or connecting epithelial surface to skin
16
Q
what are causes of fistulas?
A
injury or trauma
congenital
17
Q
what are fistulas lined with?
A
epithelium
18
Q
list signs of fistulas
A
chronic infection
visually abnormal
physically abnormal
19
Q
how are fistulas treated?
A
surgical repair
20
Q
define ulcer
A
loss of epithelial surface of a tissue
21
Q
describe the structure of ulcers
A
shallow lesions
22
Q
what are causes of ulcers?
A
trauma aggravated by poor blood supply or infection calici virus chemicals urine pressure
23
Q
what are common affected areas of ulcers?
A
skin
GI tract
cornea
24
Q
what are signs of ulcers?
A
pain
swelling
visual appearance
secondary problems including infection
25
how are ulcers treated?
remove cause
keep clean and dress if possible
surgery
often slow to heal
26
what are causes of corneal ulcers?
trauma
bacteria
eyelash or eyelid disorders
27
what are signs of corneal ulcers?
increased lacrimation
ocular pain
ocular discharge
blepharospasm
28
define decubitus ulcer
pressure sores
29
what are signs of decubitus ulcers?
```
pain
open wound
pyrexia from secondary infection
sensitive around area
restricted movement
```
30
define cysts
abnormal sac filled with fluid or semi solid matter lined with epithelium
31
list the types of cysts
```
sebaceous
interdigital
ovarian
hydatid
meibomian
```
32
define sebaceous cyst
swelling in skin arising in sebaceous gland, typically filled with yellowish sebum
33
define interdigital cyst
lesions growing between the toes
34
define ovarian cysts
fluid filled sacs in ovary or on surface
35
define hydatid cyst
larval cyst of a tapeworm occurring as a fluid filled sac containing daughter cysts in which scolices develop
36
define meibomian cyst
cyst in the eyelid usually due to blocked meibomian gland, typically in the middle of the eyelid
37
what are signs of cysts?
```
swelling
visual appearance
restricted movement
secondary problems
dependent on type
```
38
define haematoma
accumulation of blood in tissues due to bursting capillaries
39
list some causes of haematomas
trauma
surgery
clotting or blood vessel abnormality
40
what are signs of haematomas?
swelling
pain
discolouration of skin
41
state the 3 types of ruptures/hernias
reducible
irreducible/incarcerated
strangulated
42
what is meant by a reducible hernia?
contents can be repositioned to original anatomical location
43
how are reducible hernias treated?
gentle pressure corrects
| may be surgically repaired
44
what is a irreducible/incarcerated hernia?
contents cant be repositioned to original anatomical location due to adhesions or other complications
45
how are irreducible or incarcerated hernias treated?
surgery
46
what is a strangulated hernia?
contents devitalised due to restriction of blood vessels leading to necrosis
is a life threatening emergency
47
define rupture
protrusion of organs or soft tissue through unnatural opening or tear
48
what is the main cause of ruptures?
trauma causing weakness to predispose tears
49
what are signs of diaphragmatic rupture?
dyspnoeic as abdominal contents fall into chest
50
how are diaphragmatic hernias treated?
surgery using IPPV once abdominal cavity opened as air fills thoracic cavity
51
what is a ventral or abdominal rupture?
tear anywhere on abdominal wall other than umbilical or inguinal region
52
define hernia
abnormal protrusion of organs or soft tissue through natural opening
53
what predisposes to umbilical hernias?
young animals
| poor handling at birth may influence
54
how are umbilical hernias treated?
usually left alone unless large or already performing midline incision
55
what is the effect of umbilical hernias?
usually just a small amount of fat protrudes
| if large can involve abdominal cavity
56
what are signs of inguinal hernia in females?
swelling by the groin extending to vulva
57
what happens in males with inguinal hernias?
fat or intestine herniates into scrotal sac
58
what can be complications of inguinal hernias?
strangulation or rupture
59
how is severity of inguinal hernias determined?
ultrasound
| radiography
60
when do perineal hernias mainly occur?
older dogs with chronic constipation excessively straining causing gradual breakdown of muscle layers around anal sphincter
61
define pre-op
before surgery
62
define peri-op
start of GA to patient waking up from anaesthesia
63
define post-op
return to normal after GA or surgery, including long and short term monitoring
64
what is the period of recovery?
from post-op period, ending when full consciousness is present and physiological values are normal
65
what is involved in pre-op period?
preparation
pre med
induction of GA
66
what is the importance of post op period?
high percent of deaths in this time, mainly due to lack of monitoring
67
define dysphoria
state of generalised unhappiness, restlessness or frustration
68
what is needed for immediate post op management?
close monitoring until staying in sternal unaided
in clean comfy and dry kennel
safe area in case aggressive, thrashing or dysphoric
69
when are ETT removed in dogs?
when swallow or move tongue
70
when do ETT get removed in cats?
blink reflex
71
what should you do to patients who have just been extubated?
extend neck and head and pull tongue forward to keep patent airway
72
why is it important to monitor temperature post op?
heat is lost during anaesthesia and surgery
| cold patients recover slower
73
list the parameters that need monitoring during post op period
```
TPR
BP
pain
eating and drinking
wounds
excretion
hydration
```
74
when should you give IVFT post op?
if given peri operatively
animals at risk of AKI, CKD
sick animals
low BP
75
when should you give water post op?
as soon as can hold in sternal themselves
76
when should you give food to recovering patients?
soft bland food when fully conscious
| rabbits as soon as possible
77
what is the importance of monitoring rabbit droppings post-op?
observe for signs of gut stasis
78
when is it especially important to monitor excretions post op?
surgery involving urogenital tract
79
how should you care for rabbits post op?
keep low stress- reduce risk of gut stasis, keep away from predators
monitor defecation
pro-kinetics
eye lube
80
what are signs of pain post op?
```
pain scales
facial expression
changed behaviour
inappetence
reluctance to move
```
81
how is pain post op managed?
analgesia
82
what are signs of haemorrhage post op?
```
slow CRT
pale MM
low BP
tachycardia
lethargy
dull behaviour
```
83
how is post op haemorrhage managed?
surgery
| exploration
84
state risk factors for aspiration pneumonia post op
dental surgery
vomiting and regurgitation
brachycephalic
long surgery
85
what are signs of aspiration pneumonia?
fluid from nose
crackles on lung auscultation
dyspnoea
86
how is aspiration pneumonia managed post op?
close monitoring
oxygen
antibiotics and diuretics as needed
87
how is long recovery times managed post op?
manage temperature
| antagonise drugs
88
what predisposes to gut stasis post op?
abdominal surgery
| rabbits
89
what are signs of gut stasis post op?
lack of faeces produced
| inappetence
90
how is gut stasis managed post op?
manage complicating factors such as pain
promotility agents
IVFT
careful monitoring
91
what are signs of dehiscence post op?
strike through of dressing
| disrupted sutures
92
how is dehiscence managed?
surgery
93
how is aggression and dysphoria managed post op?
anticipate before waking, place muzzle and buster collar
94
what are signs of crashing post op?
bradycardia
apnoea
non-responsive
95
how is crashing post op managed?
CPR
| advanced life support
96
when are opioids used post op?
routine surgery
| providing strong analgesia
97
what are examples of opioids used post op?
methadone
buprenorphine
fentanyl
98
what are side effects of opioids?
```
respiratory depression
bradycardia
panting
salivation
vocalisation
urination
defecation
```
99
how long does methadone last?
4 hours
100
what are the routes of admin of methadone?
IV
IM
SC
101
what is the benefit of methadone?
large dose range so can tailor to individuals
102
what are the routes of admin of buprenorphine?
IM
IV
SC
sublingual in cats
103
how long does buprenorphine last?
6-12 hours
104
how is fentanyl administered?
IV
| dural patch
105
what NSAIDs are used post op?
metacam
| carprofen
106
what are side effects of NSAIDs?
```
vomiting
diarrhoea
lethargy
renal failure
gastric ulcers
```
107
when are antiemetics used post op?
nauseous patients
108
what antiemetics can be used?
maropitant
ranitidine
metoclopramide
109
when is maropitant used and how is it administered?
GI pain relief
| SC, IV, PO
110
when is ranitidine used and how is it administered?
pro motility so used in rabbits
| SC, IV, PO, every 8 hours
111
when is metoclopramide used and how is it adminisered?
pro motility so used in rabbits
| SC, IV, IM, PO
112
what are side effects of anti emetics?
maropitant- pain on SC injection
ranitidine- hypotension, weakness, cardiac arrhythmia
metoclopramide- rare, behavioural changes, sedation
113
when are antibiotics used post op?
orthopaedic patients
sick patients
surgery over 2 hours
already infected wounds
114
when are probiotics used post op?
diarrhoea in post op period
| rabbits to prevent gut stasis
115
what antibiotics are used post op and how are they administered?
amoxicillin-clavulanic acid- IV, SC
| cephalosporin and metronidazole- IV
116
what are side effects of antibiotics?
```
vomiting
neuro effects
nausea
diarrhoea
skin rash
```
