Minor Sx cards from a quizlet Flashcards
1
Q
define Surgery
A
Branch of medical care which treats injuries, deformities by manual or operative methods.
2
Q
define laceration
A
The act of tearing OR a torn, ragged wound
3
Q
define superficial
A
Pertaining to tissue situated near the surface.
4
Q
define abrasion
A
Wearing away of a substance/structure through some unusual or abnormal mechanical process.
5
Q
define benign
A
Not malignant, not recurrent; favorable for recovery
6
Q
define lesion
A
Any pathological or traumatic discontinuity of tissue or loss of function of a part.
7
Q
define foreign body
A
Any material lodged in human tissue that is foreign (wood, metal, glass, etc.)
8
Q
define excise
A
cut off
9
Q
define incise
A
cut into
10
Q
define ligate
A
tie off
11
Q
sound (surgical)
A
to probe deeply with a blunt instrument
12
Q
debride
A
to clean away damaged or necrotic tissue
13
Q
- tome (suffix)
A
to cut” as in episiotome
14
Q
-ectomy
A
to remove” cut out completely as in appendectomy.
15
Q
Antiseptic
A
A substance that inhibits growth and development of microorganisms without necessarily destroying them
16
Q
Local anesthetic
A
Agent whose primary affect is to bring about a temporary loss of localized sensory nerve function.
17
Q
Number 1 Cause of Minor Surgery Complications
A
Patient Anxiety
18
Q
3 Most common complications from DC Minor Surgery
A
1) Pt. anxiety
2) Adverse reaction to anesthetic.
3) Pre- or Post-operative bleeding.
19
Q
best age range for minor sx
A
15-65
20
Q
Body type that is slowest to heal (hint: one of 3 types)
A
Endomorph
21
Q
Three basic labs required before minor surgery
A
CBC, UA, prothrombin
22
Q
After minor surgery rest for ___ hours (range)
A
2-3
23
Q
Follow-up with patient within ___ hours
A
24
24
Q
Most effective means of instrument sterilization killing both bacteria and spores. Boiling water under pressure (13 mins at 120*C and 750 mmHg pressure). blunts instruments.
A
steam autoclaving
25
Ethylene oxide used to kill both bacteria and spores but dangerous and expensive.
Gas autoclaving
26
sterilization in oven at 170*C for 1 hour. Kills most bacteria BUT not spores. Emergency sterilization technique.
Dry sterilization
27
Least effective method sterilization but emergency method. Iodine bath (providyne, beta dyne).
Cold sterilization
28
True/false: Shaving hair off patient considered Std Of Care in minor surgery
false
29
Minimum # of times surgical area cleansed with antiseptic (e.g. beta dyne).
5
30
Germicide
Material that actually kills bacteria
31
- Strength/effectiveness of an antiseptic is measured by this scale
Phenol coefficient
32
- Powerful antiseptic. Caustic to skin; used to cleanse counters and floors. AKA carbolic acid. Used in concn's of 2-20% for bacteriostasis.
Phenol
33
Ingredient in lotion of calamine (used for dermatitis).
Phenol
34
Camphorated Phenol
A cream consisting of 30% phenol, 60% camphor, and 10% liquid petroleum.
35
- Coal tar antiseptic. Has phenol coefficient 3X, brown liquid with tarry odor. Impregnates telephone poles and railroad ties to prevent decay
- Coal tar antiseptic in 50% concn linseed oil soap making it more soluble. Used to disinfect rooms and equipment. Very dilute concn (.25-0.5%) used as vaginal douche or bladder irrigation.
Cresol
36
AKA Creolin, Cresolin, Lysol
cresol
37
Coal tar antiseptic that is colorless, odorless crystal. Turns pink in light. Phenol coefficient of -1X.
Resorcinol
38
Coal tar antiseptic. Very soluble in water, alcohol, and glycerine. Primarily used as ointment 5-10% concn treating psoriasis, eczema, erysipelas.
Resorcinol
39
Coal tar antiseptic. Colorless, aromatic crystalline solid. Very soluble in alcohol. Primary use as mouth wash/astringent gargle. Useful as fungal antiseptic and hook worm treatment.
Thymol
40
Coal tar antiseptic. AKA picric acid
Trinitrophenol
41
- Coal tar antiseptic
| Yellow crystalline powder with bitter taste and odorless. Stains skin. Phenol coefficient 7X!
Trinitrophenol
42
. Primary use in burn treatment and superficial wounds. Soaked dressing applied directly to burn. Caustic substance generally. Max allowable surface area ~one extremity of entire body.
Trinitrophenol
43
Groups of antiseptics which often contain mercury and most effective as antiseptic or chemotherapeutic agents.
Dye Group
44
Dye antiseptic no longer commonly used. Used in isotonic saline soln with concn 1:1000. Used prior to antibiotics.
Proflavine dihydrochloride
45
Dye antiseptic used frequently prior to antibiotics to saturate gauze, for conjunctival gonorrhea, otitis media, and pack wound cavities. Used for furunculosis and carbunculosis.
Proflavine dihydrochloride
46
Dye antiseptic AKA gentian violet, deep purple soln in 3% water/alcohol concn. Used to treat RING WORM; very effective against gram + bacteria (Staph.). Used as jelly for cystitis, fungus, and burns
Methylrosaniline
47
Dye antiseptic AKA methylene blue. Dark green powder that forms blue solns. Urinary antiseptic, also used diagnostically to locate ano-vaginal fistulas.
Methylthionine chloride
48
Dye antiseptic AKA thymerol and thmersol. Contains up to 50% mercury. Very effective general antiseptic - even spores. Useful for lacerations/abrasions. Antiseptic of choice for final scrub in preoperative skin preparation in 1:2000 concon
Merthiolate
49
Antiseptic group containing chlorine, iodine, or bromine
halogen group
50
Halogen antiseptic. Yellowish irritant gas. Widely used as disinfectant in drinking water.
Chlorine
51
- Sodium hypochlorite. Dilute chlorine solution contain .45-.5% sodium. Freshly mixed and kept in light-resistant bottle for up to 48 hours. Effective antiseptic for open wounds of all sizes. Dissolves bacteria, pus, necrotic tissue without disturbing clots. Coat unprotected normal skin with petroleum jelly
Dakin Solution
52
Halogen antiseptic. Blue-black crystal with metallic odor. Soluble with potassium in water. Popular surgical scrub/skin prep. Used in wound lavage.
Iodine
53
Halogen antiseptic. AKA beta dyne or providyne in 10% concn. Used for skin prep and cold sterilization methods. 7% used open wounds, 5% external mucosa lining (vaginal packs).
Iodine
54
% iodine vaginal pack is called...
Logol solution
55
Antiseptic. Solid form on wooden stick applicator. Used for warts, excess tissue, ulcers, canker sores, and cauterization. Fast acting and may cause burns.
Silver nitrate
56
Antiseptic. Historically used in .25-1.0% concn for mucus membranes, sinuses, throats, conjunctiva gonorrhea.
Silver nitrate
57
An old school treatment. Silver nitrate placed in eyes of newborns to kill off conjunctival gonorrhea.
Crede treatment
58
Silver antiseptic. Protein precipitate used for chronic/acute sinusitis. Cotton-tipped applicator placed into nasal passages for one hour. Repeated for three consecutive days. Used in many DC offices.
Argyrol
59
- Poor Antiseptic. Mostly used in 20-70% concns. >80% concn hardens protein coats of bacteria but <80% tends to dehydrate bacteria. NOT recommended as sterilization technique.
Alcohol
60
Antiseptic. Oxidizes bacterial proteins. A gas soluble in water at 40% concn. Extremely powerful; never used on living patients. Commonly used 10% soln for biopsy transfer.
Formaldehyde
61
- Brand name is formalin. Used to transfer biopsy samples.
Formaldehyde
62
Weak antiseptic. MOA liberates oxygen. On open wounds bubbles and forces debris to surface. Found in 3% solns at most stores. Wash/lavage wound/ulcer. Debrides tissue and removes dirt. Damages tissue while killing bacteria. Used in 1:5 dilution for gingivitis.
Hydrogen peroxide
63
Astringent antiseptic. Mild, soothing antiseptic reduces mucous membrane swelling. 2% soln for conjunctivitis and open wounds and vaginitis. 10% concn for skin irritation.
Boric acid
64
Astringent AKA alum. Skin lotion for irritation treatment. 0.5-1% concn used in solid stick form as hemostatic. Septic pencil for shaving nicks in men.
Potassium aluminum sulfate
65
Astringent soluble salt. Sulfate form strong astringent and topical antiseptic. Oxide form ointment effective burns/skin diseases. Used in sunscreen.
Zinc
66
Wound lavaging agent. 1/4 grain tablets (1 tab per oz water). Good antiseptic and fungicide. Used in cuts, abrasions, animal scratches, insect bites, athlete's foot. DC's use this for irrigating ears.
Hydroxyquinoline sulfate
67
General purpose antiseptic and fungicide. From Australian tree. Must be diluted in mineral oil. useful in Staph infections. DO NOT take internally.
Tea tree oil
68
Topical antibiotic/antibacterial ointment of neomycin polymycin. Over-counter topical used post-operative dressing.
Bacitracin
69
Antibiotic ointment. Over-counter purchase w/ neomycin polymycin. Most frequently used topically post-operatively.
Neosporin
70
A Complex of halogen antiseptic w/ carrier molecule. Effective wound lavaging agent for gram +/- bacteria, fungi, and viruses. Stains clothing. AKA Betadine, Operand, Acu-Dyne, Clonidine.
Providone-Iodine
71
Wound lavage agent. Effective gram + bactericidal. Used for hand scrubbing primarily; direct wound contact discouraged. AKA Hibiclens, STERIS tat.
Chlorhexidine
72
Wound lavage agent with hyphenated chemical name. Non-ionic detergent. May be used directly on wounds but has no antibacterial activity. Best for facial wound cleansing. AKA Shur-Clens.
Pluronic-F-68
73
Wound lavage agent. Bacteriostatic agent effective for gram + bacteria. Potential toxicity & teratogenicity. AKA PHisoHex.
hexachlorophene
74
Interruption of sensory nerve conduction without subjecting the patient to unconsciousness.
Anesthesia
75
T/F: All anesthetics are toxic.
True
76
This type of medication interferes with neural depolarization and transmission of impulses along axons.
anesthetic
77
T/F: Anesthesia inhibits nociception before pressure/touch sensation.
True
78
Properties of ___ to consider before application in minor surgery.
1) onset of action
2) effectiveness
3) duration
anesthetics
79
- Maximum allowable dose of anesthetic used by DC's is ___ cc's. (there is one exception
30
80
Maximum allowable dose of 1% lidocaine with epinephrine in adult is ___ cc's
50
81
T/F: Pregnant females should be given local anesthetics
False
82
T/F: Higher concn anesthetic MORE toxic than increased volume anesthetic
True
83
T/F: Anything greater than 2% anesthetic concn is WRONG for injectable local anesthetic.
True
84
Average dose of Epi-enhanced lidocaine, (___ cc's).
35
85
- Lidocaine enhanced with ___
epinephrine
86
Advantage of epi with lidocaine
Advantage: vasoconstrictive and decreases bleeding.
87
Cons of epi with lidocaine
Con's: Increased % infection, cannot use on distal or end organs d/t decrease bloodflow
88
Always use (larger/smaller) syringe than required for amount anesthetic needed
Larger
89
A ___ gauge needle used for venipuncture
21
90
An ___ gauge needle is used for joint aspiration.
18
91
Needle gauges used for introducing local anesthetic range from ____-____.
25-27
92
Superficial topical anesthetic used as refrigerant pre-injectable for squeamish patients. Comes in pressurized bottle and applied by inverting and spraying in area of injection for 5 seconds. Anesthetic effect lasts 15-30 seconds.
Ethyl Chloride
93
T/F: Never inject patient in an upright position.
True
94
T/F: Acceptable injection positions include supine or prone.
True
95
T/F: It is acceptable to perform minor surgery on patients who do not speak your language, have great fear of needles, their own blood, or the elderly
False
96
T/F: After placing syringe needle in chosen tissue site, pull back on plunger to test for bloodflow.
True
97
T/F: Best to introduce anesthetic 'on the move.'
True
98
Method of introducing anesthetic where a portal of entry has already been established (into a laceration to avoid second puncture of skin).
Direct infiltration
99
AKA parallel margin infiltration (method of anesthetic application).
Field Block
100
Most frequently used method of anesthesia application. Preferred method when wound is dirty or contaminated. Decreases risk of spreading infection.
Field Block
101
This type of conduction anesthesia used for sebacous cystectomy, lipomectomy excision, and foreign body removal.
Field Block
102
- Method of anesthesia whereby sensory nerves are anesthetized by injecting into nerve plexus.
nerve block
103
Nerve block uses ___-___ cc's anesthesia per side.
1-2
104
Most common nerve blocks are ___ (AKA volar blocks).
digital
105
T/F: Epinephrine is acceptable in digital nerve blocks (fingers).
False
106
Facial anesthesia utilizes nerve blocks in the supr/infraorbital and ___ foramen.
Mental
107
AKA novocaine
Procaine
108
Anesthetic soln used for all methods. comes w/ and w/o epinephrine. Ester-based soln packaged in concn's of 0.5, 1.0, 1.5, and 2.0%. In minor surgery highest concn needed is 1.0%. Commonly used in dentist offices.
novocaine
109
AKA pontocaine
Tetracaine
110
Potent and toxic anesthetic. 10X more potent than procaine. Limited to few procedures like spinal blocks. Not used in DC offices.
Pontocaine
111
AKA Xylocaine
lidocaine
112
Most popular and frequently used local anesthetic. Comes in 0.5, 1.0, 1.5, 2.0% concn w/ and w/o Epi. Has low toxicity compared to novocaine, rapid diffuses, topical activity and chemical stability. Very good stuff.
Xylocaine
113
AKA Carbocaine
mepivacaine
114
Amide-base anesthetic soln widely used in minor surgery that ISN'T Lidocaine. Used for procedures with longer time frames. Possesses slightly vasoconstrictive properties and CAUTION indicated in distal end organs.
carbocaine
115
AKA Marcaine
Bupivacaine
116
- A newer amide-based anesthetic soln. Not widely used in minor surgery but getting there. Con's: Slow onset of action. Pro's: Duration of action surpasses lidocaine and mepivacaine.
Marcaine
117
Non-injectable topical anesthetic. Useful in pediatric patients for simple lacerations/wound care. Mixture 0.5% tetracaine, Epi 1:2000 concn, 11.8% cocaine. Applied directly via soaked gauze sponge 5-10 mins. No needle stick required!
TAC
118
T/F: Can TAC be used on distal organs?
False
119
- AKA proparacaine hydrochloride
Ophthaine
120
0.5% soln anesthetic with glycerine for topical eye application. Suitable for foreign body removal of ocular pressure testing. One drop in eye achieves complete anesthesia in 13 seonds and lasts 15-20 minutes.
Ophthaine
121
T/F: Ophthaine contraindicated in hyperthyroidism.
True
122
AKA Rostra Spray
Cetacaine
123
___ spray: Topical anesthetic effective on mucous membranes but not conjunctiva. Anesthesia takes ~1 minute. Useful for overriding gag reflex. Contains tetracaine and benzocaine.
Rostra
124
Flammable topical skin refrigerant used as pre-injectable. Useful for lancing furuncles and carbuncles. Anesthesia lasts 15-30 seconds.
Ethyl chloride
125
- T/F: Redness, itching, swelling at inoculation site usually resolves.
True
126
Cardiovascular reactions to inoculation include hypotension and ___
bradycardia
127
CNS rxn's to anesthesia can include excitatory phenomena and ___.
seizures
128
The most common rxn to anesthetic injection is ___ AKA passing out
vasovagal syncope
129
Anesthesia S/E most common because injecting into a ___.
vein
130
Supplement with ___ to increase clotting factor ability
vitamin K
131
T/F: Acceptable to bring up surgical options with patients, (i.e. I can get that mole removed for you?).
False
132
If you expect a procedure to take 15 minutes, tell the patient it will take ___.
45
133
T/F: Acceptable to use a bactericide on patient tissue?
False
134
Six steps in healing process. Step 1 is
Immediate response to injury
135
Six steps in healing process. Step 2 is
Inflammatory phase
136
Six steps in healing process. Step 3 is
Epithelialization , scab forms
137
Six steps in healing process. Step 4 is
Neovascularization
138
Six steps in healing process. Step 5 is
Collagen synthesis
139
Six steps in healing process. Step 6 is
Wound contraction
140
T/F: Sew them up if wound is primary union.
True
141
T/F: Sew them up if wound is secondary union.
False
142
Most common cause of primary union wounds (clean with minimal tissue loss).
knife
143
Primary union wounds have a 'golden period' in which they can be closed with sutures or skin tapes. This period lasts ___ hours
6
144
- T/F: You can sew up a tertiary union wound after observation and lavage greater than 12 hours.
True
145
T/F: Antibiotic ointment required in tertiary union wounds.
True
146
- A wound into the muscle tissue that does NOT involve nerve rupture is a (superficial/deep) wound...
superficial
147
A wound that involves tendon and vasculature is a (superficial/deep) wound
deep
148
A 2nd degree burn is a (simple/complex) wound...
complex
149
A puncture wound is a (simple/complex) wound...
simple
150
if a wound will probably become infected if closed is considered a ___ wound
dirty
151
wounds older than ___ hours are considered 'dirty' wounds...
5
152
Erythema extending beyond ___ cm from the wound margin is suggestive of infection
1
153
Wound redness accompanied by palpable induration greater than ___cm suggests infection
0.5
154
- critical mass of ___ organisms per gram tissue to be considered 'infection'
100,000
155
most common organism to be active in infection
staph
156
Other common infective organisms include E coli, Proteus, Enterobacter, Klebsiella, and ___
strep
157
___X increase in infection rate with 20% weight loss in chronically ill patient
3
158
When required, give tetanus booster shots every ___ hours.
5
159
Minimum # dozes tetanus toxoid to be considered 'fully immunized'.
3
160
___x___ size gauze sponge helps 'maintain hemostasis in wound closures
4x4
161
amount of tissue taken when placing a suture needle in skin or fascia.
bite
162
Each knot of a suture consists of a series of ___(s).
knot
163
___ suture: placed on surface of skin for final closure using nonabsorbable materials.
superficial
164
___ suture: made from absorbable material placed in superficail fascia or deris with knot buried in wound.
deep
165
- ___ suture: single sutures tied separately.
interrupted
166
- ___ suture: wound closure effected by taking several bites the full length of the wound without tying individual knots. AKA 'running' suture
continuous
167
Number __ scalpel used for debriding devitalized (dead/dying) damaged tissue from a wound.
15
168
Most common surgical knot technique for clean wounds without complications.
simple interrupted
169
Surgical knot technique that uses a shallow first loop, a deep second loop and then ties off. Used in flexed areas or places under regular stress.
vertical mattress
170
Surgical knot technique. Used for cuts that have 'flaps'. Apex of cut must be pointing toward heart.
apical suture
171
Suture material. AKA PGA - synthetic polymer, less reactive and resists infection. Primary for superficial and deep fascia and ligatures.
Polyglycolic acid
172
PG 910 suture material. Workable but not the best for tight knots. Preferred for deep wound support for prolonged periods
Polyglycan-910
173
Suture material. Make from animal tissues. Treated with chromic acid to delay absorption
gut
174
Suture material - AKA ethilon - Used for minor wounds/lacerations, resists infections, good tensile strength.
monofilament
175
- Intradermal subcuticular 'pull out' sutures are used because they decrease ___.
scarring
176
Sutured wounds are vulnerable to infection up to ___ hours post application.
72
177
Used during healing to absorb exudates from wound. Small section surgical rubber inserted into inferior aspect of wound
penrose drain
178
Occlusive wound dressing type. Transparent polyurethane. Transmits water, O2, and CO2. Can pull up scab once epithelialization begins.
flim
179
Occlusive wound dressing type. Nonadherent material taped in place over a wound
foam
180
Occlusive wound dressing type. This is an opaque, gas IMpermeable, absorbant material. Over time fluid leaving wound separates dressing from wound itself.
hydrocolloids
181
Occlusive wound dressing type. Semitransparent, nonadhesive, absorbent material
hydrogel
182
Occlusive wound dressing type. AKA "Doctor Spenko's Second Skin"
hydrogel
183
Coating for dressings used in burns and skin grafts.
petrolatum
184
Controlled cell proliferation; ie adapting to stresses (callus).
hyperplasia
185
- Adaptive substitution of cell type (e.g. squamous) for another type. Used in inflammation.
metaplasia
186
'Pre-cancerous' cell substitution. These cells exhibit pelomorphism (change in nucleus materials).
dysplasia
187
__% of all head/neck cancers begin in the oral cavity.
75
188
Basal cell carcinomas are caused by exposure to ___.
UV light
189
Squamous cell carcinomas are caused by exposure to ___. These are rapid metastasizers.
UV light
190
Jet black, most dangerous type of skin cancer (most rare). If it invades Clark's level 4, prognosis grim.
Melanoma
191
T/F: Fractures are often overlooked in open wounds or bleeding injuries.
True
192
Used instead of iodine if Pt is allergic to it. AKA Zephiran in a 1:750 concn soln.
benzalkonium chloride
193
Patients who have had three Tetanus boosters but none in ___ years still need a booster for preventative care.
10
194
Benign skin tumor. Scar hypertrophy d/t collagen deposition. Usually result of improper surgical technique done against natural tension lines in the fascia.
keloid
195
Benign skin tumor. Encapsulated fat tissue often d/t blunt force trauma. If there are multiple lesion it's typicaly from familial predisposition.
lipoma
196
- Benign skin tumor. Caused by duct blockage of oil gland adjacent to hair follicle. DDX from lipoma via small central well @ middle of raised lump (hair follicle).
sebaceous cyst
197
Benign skin tumor. AKA verrucae vulgaris. Benign papillae growth. Often on hands and feet; surgical removal rapid and effective.
wart
198
Benign skin tumor. AKA skin tag. These have vascular and neurological supply.
papilloma
199
- Benign skin tumor. Hornlike projection extending above skin level. About 12% are MALIGNANT
cutaneous horn
200
Benign skin tumor. These are hard, movable, non-inflammatory lesion within the skin layers..
fibroma
201
Benign skin tumor. Cystic swelling surrounded by fibrous tissue that occur within vicinity of joint capsules.
ganglia
202
Skin lesion treatment. Liquid nitrogen typically used. Minimal scarring, often more than 1 treatment needed.
cryosurgery
203
skin lesion treatment. A small cordless instrument with local anesthesia is used.
electrocautery
204
Skin lesion treatment type. Great for superficial skin lesion but may cause scars. Requires sterilization
hyfrecator
205
Skin lesion treatment type. Minimal thermal damage caused, best for cosmetic treatments, self-sterilizing.
radiosurgery
206
Skin lesion treatment. Electrical energy is converted into light energy (used in many DC offices for purposes other than minor surgery).
laser
207
Infected sebaceous gland with central necrotic induration most commonly caused by staph infection.
pustule
208
A singular furuncle in a large bulbous presentation.
boil
209
Takes ___-___ days for a carbuncle to become 'fully ripened.'
4-6
210
Distal phalanx infection that appears along base of nail from Staph. aureus.
Paronychia
211
- Most common organism to infect bite wound from human bite injury. REFER OUT
eikenella corrodens
212
Anti-venom used for black widow spider bites.
lyovac
213
___% of animal bites presenting at minor surgical offices are from dogs.
90
214
Brown spiders with particularly strong venom. Symptoms include anorexia, dehyrdation, apathy. Tissue will begin to necrose within a week of bite.
loxoscles
215
Frostbite. Heat loss caused by wet clothing in contact with metal.
conduction
216
Frostbite. Heat loss caused by wind chill.
convection
217
Which degree burn? Redness, epidermis only. No blisters. Recovers in 1-2 days.
1st
218
Which degree burn? Redness and blister. Capillary wall destruction with edema.
2nd
219
Which degree burn? Redness, blister, tissue damage. Subsequent scarring; refer to hospital.
3rd
