part 1 Flashcards
-otomy
A surgical procedure in which a structure is cut.
-ectomy
A surgical procedure in which a portion of tissue is removed / resected.
-stomy
A surgical procedure in which a new opening is created on a temporary or permanent basis.
-plasty
A surgical procedure in which an alteration is performed to an organ or body structure, it is usually permanent. Think of plastic surgery. The term ”-plasty” is also used as a suffix when an artificial prosthesis is implanted to replace an original body part.
-pexy
A surgical procedure in which a permanent or temporary adhesion is created between two structures (usually using suture, sometimes using atube).
-oscopy
A surgical procedure involving the use of an optical instrument (an endoscope, an otoscope, an arthroscope, etc.) to visualize organs or structures.
-rrhaphy
A surgical procedure in which a structure is sutured or repaired.
-centesis
A surgical procedure in which a cavity or structure is punctured in order to aspirate fluid, air or tissue. Paracentesis is sometimes used synonymously.
A ___ and ___ must be worn upon entering the surgical area.
The ___ is essential for walking into the room while the ___ should be worn at the time of preparation of the patient.
hat, mask
Before the pack is opened, one should ensure that the pack has not expired and that ____________ indicating sterilization.
the tapes have changed colours
The surgeon or technician should never reach ___ a pack and should rather _______ the pack to prevent contamination.
over, move around
If the instrument package tears during opening, then the instrument is not considered ____ as it may have touched the outside edge of the paper
sterile
If something contaminated touches an open surgical pack, what do we do?
replace the entire pack
Each linen pack contains _______ followed by ________. This pack should be opened _________.
four ground drapes, a gown and hand towel
a second gown and hand towel
just prior to going to scrub
The gloves shall be opened prior to _____ in order to ensure you do not need to wait for assistance.
going to scrub
The instruments can only be set up by _____.
a sterile surgeon or technician
______ need to be counted prior to surgery (and also at the end) to ensure none are left behind in the patient.
the gauze sponges
The main scrub products used at this institution are:
povidone-iodine, chlorhexidine gluconate, and alcohol
The ideal scrub products possess _______, ________, ________ and ________.
_______ and _________ fulfill these criteria the best.
-a broad spectrum of activity
-a rapid antimicrobial activity
-are not irritating to the skin
-allow for prolonged residual activity
-Chlorhexidine and iodophors
Alcohols such as ethyl and isopropyl alcohol are used in concentrations of _____ percent to kill _____.
70 to 99, bacteria
alcohol kills bacteria via what mechanism? How fast? Alcohol is also effective against what other pathogens, and ineffective against what?
cell membrane damage and protein denaturation
-Bactericidal activity takes effect immediately, but evaporation over a few minutes is required for greatest activity
Alcohol is effective against what pathogens, and ineffective against what?
Mostly used for bacteria. Also effective against fungi but its activity against viruses and spores is poor
_____ increases the activity of chlorhexidine and iodophors.
alcohol
Alcohol is useful to help remove ___ from the skin and allows more thorough skin cleaning.
oils
Iodophores are effective against what pathogens? They are ineffective against what?
-used to kill bacteria, enveloped and some non-enveloped viruses, fungi, protozoa, and yeasts but have poor activity against spores.
Povidone-iodine requires at least _____ contact time to be effective.
2 minutes
Iodophors kill by ___ and ___ when free iodine is released.
iodination, oxidation
Iodophors may have persistent activity for ____ after use.
several hours
Alcohol can increase the killing action of iodophors by ____
increase, liberating free iodine.
disadvtanges of iodophores
-Iodophors are corrosive to metals, making them a poor choice for sterilization of instruments, can be cytotoxic and can cause thyroid dysfunction with prolonged use.
-Povidone-iodine may also cause allergic responses in some individuals.
-Iodophors are inactivated by organic debris and will stain fabric and tissues.
Chlorhexidine is a _____ that is useful for killing___, ___, and ___.
bisbiguanide
bacteria
viruses
fungi
Chlorhexidine has a broad spectrum of activity but is more effective against gram-___ bacteria than gram-___ bacteria (i.e. Pseudomonas sp.) and ___.
positive
negative, fungi
chlorhexidine is better at killing viruses with what characteristic?
enveloped
chlorhexidine has poor activity against ____
spores
When used for scrubbing hands or patients, Chlorhexidine is not ____ and works within ____ to kill organisms.
Despite a rapid onset of action, contact times of ____ are still recommended to reach maximum killing and better residual activity.
irritating to the skin
30 seconds
2 minutes
drawbacks of chlorhexidine
Chlorhexidine is irritating to the eye, ototoxic and neurotoxic if it contacts the brain or meninges.
how does chlorhexidine kill microorganisms
It kills microorganisms by increasing cell membrane permeability and precipitation of the cell contents.
how long is the residual activity of chlorhexidine and why? does effectiveness change with repeated use?
Residual activity that lasts at least 6 hours is present due to binding to keratin, and effectiveness increases with repeated uses.
how does the presence of organic debris effect chlorhexidine?
it does not
Phenol and its derivatives are used as ____, ____, and ____.
antiseptics
general disinfectants
in cold sterilants
____ and ____ are phenol derivatives that are used as antiseptics.
Bisphenols
halogen-substituted phenols
a bacteriostatic bisphenol that only possesses bacteriostatic activity against gram-positive bacteria.
Hexachlorophene
Hexachlorophene kills at a ____ rate and has a residual effect lasting several hours.
slow to intermediate
several hours
drawbacks of hexachlorophene
-It can cause photosensitivity and dermatitis to people sensitive to phenols and should not be used on broken skin or mucous membranes due to irritation and absorption into the blood.
-Many skin preparations are more effective than hexachlorophene, reducing its use in veterinary medicine.
what phenol is inactivated if contacted with alcohol or other soaps but is not inactivated by organic debris?
Hexachlorophene
____ (PCMX) is a halogen-substituted phenol that kills gram-___ bacteria by cell wall disruption and enzyme inactivation but has reduced activity against gram-___ bacteria.
Parachlorometaxylenol
positive
negative
what is often done with PCMX to potentiate its activity against gram-negative bacteria
combined with other agents
Onset of action of PCMX is ____ and contact times of ____ are recommended
slow to intermediate
a few minutes
PCMX may be toxic to ___ because it requires hepatic glucuronate conjugation for excretion.
cats
_____ (i.e. benzalkonium chloride) are slow acting and are neutralized by gauze, cotton, iodine, rubber and anionic detergents and their efficacy can be decreased by other soaps and organic debris.
Quaternary ammonium compounds
quaternary ammonium kills what? How? Poorly effective against what?
-Bacterial killing occurs by cell wall phospholipid destruction and is more effective against gram-positive than gram-negative bacteria. -They are poorly effective against viruses, fungi or spores.
what is the residual activity of quaternary ammonium after use?
none
drawbacks of quaternary ammonium
may cause mucosal ulceration.
Triclosan is a diphenyl ether that has good killing action by ______. It is effective against both gram-positive and gram-negative bacteria but specifically is not effective against _____ spp. Speed of killing is ____ and residual activity is present.
disrupting the bacterial cell wall
Pseudomonas
rapid to intermediate
triclosan is effective against what?
gram + and- bacteria
