Nike Flashcards
By definition a suture is a ?
How are sutures categorized
Foreign body
Material Configuration Strength Absorbability Diegradation
What type of suture material causes a more intense inflammatory reaction?
Define Tensile Strength
How is this strength annotated?
Natural
Amount of weight required to break a suture
#-0 (number indicates number of 0s: 3.0= 0.001)
Define Configuration
What type of configuration has an increased risk for infection
Number of filaments
Braided
What are the absorbable types of sutures?
What are the non-absorbable types?
Gut- monofilament
Monocryl- monofilament
Vicryl- multifilament
Ethilon- monofilament
Prolene- monofilament
Silk- miltifilament
Proper sutures should cause wound edges to take on ? appearance
When are Simple Interrupted sutures used?
How long are they left in place?
Evert
External closures
7-10 days
5 days- face
When are horizontal mattress sutures used and how long are they left in place?
When are vertical mattress sutures used?
Larger lacerations
7-10 days
Poorly everting lacerations
When are running sutures used?
Why would these be preferred?
What type of know is used at the end of the suture?
Subcuticular closures (buried)
Cosmetic- pastics/dec scar
Holds skin closed
Aberdeen knot (Fisherman)
Epidermal cysts are AKA ?
Why are these difficult to remove?
Sebaceous cyst
Recur if wall is not removed
Pilar cysts are AKA ?
When are time outs conducted in pre-op?
EIC/sebaceous cyst of the scalp
Prior to anesthetic injection
What type of scalpel blades make smaller/larger incisions?
What is the only exception to close a wound transversely and not longitudinally?
10- larger, hump of blade
15- smaller
11- puncture/cutting
Flexor surface
What are the three benefits of using staples for closure?
What is the down side?
High tensile strength
Quickly placed
Resistant to infection
More prominent scar
Wound care needs to be exercised to minimize scarring for ?mon after surgery?
What tool is used for suture removal?
12mon
Scissors or,
Elevate w/ Adson’s, cut w/ scissors, pull w/ Adson’s
The ideal anesthetic would be ?
Non-PILSNRS Non-irritating Penetrates Inexpensive Low toxicity Soluble Non-addictive Reversible Short latency
What is the drug used for:
Altering consciousness
Analgesia
Amnesia/anxiolysis
Muscle relaxation
Anesthesia adjunct
Propofol
Opioid
Benzo
Depolarizing agent
Dexemed, Ketamine
Anesthetics are classified in to ? or ?
What classification are the MC used in GenSurg and how can you tell them apart?
Amides- metabolized by liver
Esters- metabolized by plasma cholinesterase into PABA (allergen)
Amides- ‘i’ before ‘-caine’
Advantages and disadvantage of adding Epi to local anesthetics
These combos need to be avoided in ? PT populations?
What part of the body can these combos NOT be used in?
Adv: Inc duration
Dec bleeding/volume needed
Dis: Inc myocardial activity
Cardiac Dz
HTN DM Hyperthyroid
Tissues supplied by end arteries- penis ear nose toe finger
What are the MC adverse effects of using local anesthetics?
How are these adverse effects Tx?
Dermatitis Urticaria Edema Erythema
Steroid Antihistamine Fluid Epi O2
What are the prodomal Sxs of local anesthetic toxicity?
What are the S/Sxs of cardiovascular toxicity
Metallic taste
Curcumoral numbness/tingle
Light headed
Tinnitus
Hyper to HypoTN
Tachy/Brady
V-fib
Collapse
What are the S/Sxs of severe CNS toxicity from local anesthetics?
Max dose of Lidocaine w/ and w/out Epi
What is the ratio of lidocaine to Epi mixtures?
Tonic clonic
AMS
W/ Epi: 7mg/kg, max 500mg
W/out: 4mg/kg, max 300mg
1: 10mg/ml
2: 20mg/ml
What is the onset/duration of lidocaine?
Max dosage of Bupivacaine but don’t use in ? PTs?
Onset and duration of Bupivacaine?
On: 2-5min
Dur: 30-120min
2mg/kg, max 100mg
<12yrs
On: 5-10min
Dur: 2-4hrs
Anesthetic induced CNS toxicity is exacerbated by ? so how are they Tx?
How are CV Sxs Tx
Hypercarbia
Hyperventilate to dec CO2
Benzos for seizure
Fluids for HOTN
Shock wide/drug narrow
What types of anesthetics are more likely to cause malignant hyperthermia?
How do PTs present w/ this issue?
How are they Tx?
Volatile/succinylcholine
Hypermetabolic- fever, tetany, HyperK
Cool, BiCarb, Dantrolene
How is malignant hyperthermia avoided?
What is the sequence of effects exerted by local anesthetics?
Mix small amounts of multiple different agents
Loss of tone, dilation
Loss of pain/temp
Loss of pressure
Loss of motor
Peripheral nerve blocks are goof for ? use
Digital blocks can be done in ? areas?
Rib/digital blocks
Plantar/palmar aspects