(Principles of Surgery) Flashcards
1
Q
Define:
Aseptic Technique
A
Describes the practices used to minimize risk of infection following surgical procedure
2
Q
What do aseptic techniques include? (5)
A
Management of the surgical facility, patient, surgical site, surgeon and equipment
3
Q
_____________ used to clean __________ in the _________ room, but they do not eliminate ______
A
Disinfectants
Facilities
Operating
Spores
4
Q
True or False:
Every surgical instrument is a potential source of contamination
A
True
5
Q
As every surgical instrument is a potential source of contamination, hence the importance of _____________ where all ______________, including ______, are killed
A
Sterilization
Microorganisms
Spores
6
Q
List means of sterilization (2)
A
Pressurized steam
Chemical
7
Q
Define:
Autoclave
A
Used to sterilize instruments using pressurized steam, and the instruments are packed in surgical wrap which the steam can penetrate
8
Q
What are used to distinguish equipment that has been sterilized?
A
Heat sensitive markers
9
Q
What are surgical packs often composed of? (6)
A
A needle holder
Forceps
Hemostats
Tissue scissors
Draping material
Absorptive gauze sponges
10
Q
Good quality instruments are made of _________ _____, allowing for __________ and minimizing _________
A
Stainless steel
Durability
Corrosion
11
Q
State the purpose of:
Scalpel
A
Allowing for incision to the tissues
12
Q
State the purpose of:
Needle holder
A
Holds the needle for suturing
13
Q
True or False:
There are several different styles of scissors available
A
True
14
Q
State the purpose of:
Curved scissors
A
Used for more maneuverability
15
Q
State the purpose of:
Straight blade scissors
A
Used to cut through tougher tissues
16
Q
Describe and state the purpose of:
Tissue forceps
A
Have the appearance of tweezers, tip has a serrated end for delicate handling of tissue
17
Q
State the purpose of:
Hemostatic Forceps
A
Clamp blood vessels so vessel can be ligated to prevent bleeding
18
Q
State the purpose of:
Retractors
A
Hold tissues to expose surgical area
19
Q
State the purpose of:
Towel Forceps
A
Surgical drapes to cover animal except for surgical incision region
20
Q
State the purpose of:
Spay hook
A
To bring uterus through small incision
21
Q
True or False:
Stainless steel can withstand high temp of autoclave
A
True
22
Q
True or False:
All surgical instruments can be sterilized with autoclave
A
False; Stainless steel can withstand high temp of autoclave, but other surgical instruments may be damaged
23
Q
How are other surgical instruments sterilized? What is used?
A
Sterilization via chemical means is used
Ethylene oxide is employed
24
Q
Ethylene oxide is _____ and requires special ________ for ______________
A
Toxic
Chambers
Administration
25
True or False:
Surgeons are not a source of contamination
False, surgeons ARE ALSO a source of contamination
26
Surgeons must be dressed with a ____ _____ and ________ ____, _______ ________ ____ and ______
Head cover
Surgical mask
Sterile surgical gown
Gloves
27
Describe:
The scrubbing procedure
Surgeons washing their hands and forearms with a surgical scrub
28
Why do surgeons have to be dressed with all the listed apparel and perform the scrubbing procedure?
Greatly decreases the number of bacteria present
29
_______ ____ with the use of ___________ is important
Contact time
Antiseptics
30
True or False:
Antiseptics kill the bacteria immediately
False; Antiseptics DO NOT kill the bacteria immediately, so prolonged contact is necessary
31
How long does the scrub last? Why?
Usually lasts ~5 minutes
So that the antiseptic can greatly reduce the number of bacteria present
32
State the position(s) during scrubbing and the reason for that position
Hands are held the highest (cleanest part is held the highest)
As elbow have higher bacterial count, water does not run from elbows to contaminate the hands
33
What is used to dry the hands and arms in scrubbing?
A sterile towel, dry the hands then the arms
34
True or False:
Surgical conditions greatly vary and impact the surgery
True
35
Describe and state an example of:
Clean surgeries
Involve healthy skin and tissue being removed
E.x. Spay and Castration
36
Surgeries involving the _____, __________ and ____________ ______ are riskie
Mouth
Intestines
Contaminated wounds
37
What is the relationship between the risk of infection and the degree of contamination?
The risk of infection is DIRECTLY PROPORTIONAL to the degree of contamination
38
Surgery creates a _____ and the _______ _______ - which occurs in ______ - is an important step in understanding surgery
Wound
Healing Process
Stages
39
Wound Healing:
What is the phase that begins right after the trauma or incision called?
Hemostasis phase
40
Wound Healing:
In __________ phase, ________ is beneficial in ________ the wound of _____________
Hemostasis
Bleeding
Flushing
Contamination
41
Wound Healing:
In __________ phase, the _____ _______ _________, slowing the ____ of _____
Hemostasis
Blood vessels constrict
Flow
Blood
42
Wound Healing:
In Hemostasis phase, what is signalled? What happens from this?
Coagulation factors are signalled
The blood begins to clot, protecting the animal from excess blood loss
43
Wound Healing:
In __________ phase, ______ ____ ____ the ______ and _____ it, as the ____ _____, a ____ is formed
Hemostasis
Fibrin clot fills
Wound
Seals
Clot dries
Scab
44
Wound Healing:
In Hemostasis phase, what is the purpose of the scab? (2)
Protects the damaged area
Allows for healing to happen underneath
45
Wound Healing:
Describe the Inflammation phase
Takes place when the blood vessels eventually dilate and release histamine and prostaglandins
46
Wound Healing:
What does the dilation and release of histamine and prostaglandins in the Inflammation phase do?
Brings more white blood cells to help destroy the damaged tissue and bacteria
47
Wound Healing:
In ____________ phase, ___________ and _________ protect the _____ from ________ and ______ ______
Inflammation
Neutrophils
Monocytes
Wound
Bacteria
Tissue debris
48
Wound Healing:
What do the monocytes in the Inflammation phase become? When? For what?
Macrophages
A few days later
Clear the wound of debris and bacteria
49
Wound Healing:
In ____________ phase, the _________ _____ ____ produced to the area results in... (4)
Inflammation
Increased blood flow
Plasma leakage, adding to the swelling, causing pain and possible redness
50
Wound Healing:
Describe the Repair/Proliferation phase
Describes fibroblasts entering the damaged area and forming fiber rich connective tissue
51
Wound Healing:
In ______/_____________ phase, there is an _________ _________ of ______ and ______
Repair/Proliferation
Increased deposition
Fibers
Matrix
52
Wound Healing:
In ______/_____________ phase, ___________ grow into newly forming ___________ ______, providing ______ and _________ to the new ______
Repair/Proliferation
Capillaries
Connective tissue
Oxygen
Nutrients
Tissue
53
Wound Healing:
In Repair/Proliferation phase, what is the healing tissue known as? Why?
Granulation tissue
Due to its granular appearance
54
Wound Healing:
In ______/_____________ phase, what cells move across the wound? What does this do? (3)
Repair/Proliferation
Epithelial cells
Minimize fluid loss, providing protection
55
Wound Healing:
In Repair/Proliferation phase, _________ ____ ___________ allows the ____ _____ to _______
Continued cell replication
Skin layer
Thicken
56
Wound Healing:
In Repair/Proliferation phase, more ________ is deposited after the ______ looks completely ______, allowing for the _____ to ________ in ____ over time
Collagen
Wound
Healed
Wound
Decrease
Size
57
Wound Healing:
What brings the skin closer together in Repair/Proliferation phase? For what?
Contraction
So that less time is required for epithelial cells to reach across the entirety of the wound
58
In a ________ ________, _________ are brought together with _______, the ____ edges are held close together to minimize the _______ _______
Surgical incision
Incisions
Sutures
Skin
Healing process
59
Define:
First intention healing
Describes a wound with the edges closely apposed
60
Define:
Golden period
Describes the first 6-8 hours where bacterial numbers are modest so the wound can be closed
61
What cannot be done past the "golden period"? Why?
Beyond this period, the wound cannot be sutured
Bacterial contamination may be too high to suture the wound
62
Define:
Second intention healing
Describes wound healing where granulation tissue is needed to fill the gap between the skin edges for epithelial cells to grow
63
What is Proud Flesh?
A condition affecting horses where an overgrowth of granulation tissue prevents epithelial tissue from growing across the wound
64
In Proud Flesh:
It is ideal to ______ ___________ on ______ immediately for _____ _________ _______
Suture lacerations
Horses
First intention healing
65
When suturing _________ ______, ____ ______ and ____________ within wound, _______ should be removed
Traumatic wounds
Dead tissue
Contaminants
Margins
66
Define:
Debridement
Describes the process where damaged and contaminated tissue are removed
67
Define:
Hematoma
Describes an accumulation of blood in the dead space
68
______ has fluid similar to _____ with a small number of ___ _____ _____
Seroma
Serum
Red blood cells
69
True or False:
Fluid in a seroma may be white (with no red blood cells) or light red
False; Fluid in a seroma may STRAW COLOURED (with no red blood cells) or light red
70
In Hematoma/Seroma:
This collection of _____ increases the _______ on the ________, preventing the ____ from ________ to the ______ underneath
Fluid
Tension
Incision
Skin
Adhering
Tissue
71
In Hematoma/Seroma:
This fluid needs to be removed for ________ _______, if great amounts of _____ accumulate, a ______ must be used to remove the _____
Complete healing
Fluid
Needle
Fluid
72
In Hematoma/Seroma:
If not removed, the excess _____ can cause a ________ buildup and fluid may ____ from the area
Fluid
Pressure
Leak
73
Define:
Dehiscence
The breaking of wound edges
74
Where may dehiscence occur? Why?
Can occur along the length of the suture line
This failure to heal may be due to excess tension of infection
75
How might dehiscence be caused in animals?
May be caused by the animal scratching or licking at their wounds
76
True or False:
Suture material varies greatly
True
77
Suture material varies greatly and depends on... (2)
The strength and type of tissue being sutured
78
How many major classes of suture material are there? What are they?
2
Absorbable and Nonabsorbable
79
For absorbable suture material:
It is used within the ____. The body eventually destroys the ________ for it to be completely __________
Body
Material
Eliminated
80
What is the primary requirement for absorbable suture material?
The material should maintain strength for a long enough time for complete healing to take place
81
_____________ suture material is not destroyed by the ____ and are later _______
Nonabsorbable
Body
Removed
82
True or False:
Suture needle type and pattern is the same regardless of surgery
False; Suture needle type and pattern DEPEND ON THE SURGERY
83
Define and Describe:
Simple interrupted pattern
A suture pattern
Describes the suture passes straight through the 2 sides of the incision, is tied and the ends are cut
84
Define and Describe:
Simple continuous pattern
A suture pattern
Describes an initial simple interrupted suture which is then tied, the resulting end is not cut
85
True or False:
Tying knots is a good skill for surgeons
False; Tying knots is an ESSENTIAL skill for surgeons
86
Multiple ______ ____ are tied to secure the ______
Square knots
Suture
87
The knot ________ of materials varies, so some materials require a _______ number of _____
Security
Greater
Knots
88
What is the purpose of the suture? What is not the purpose?
To appose the edges, not overtighten the tissues
89
What are endoscopes?
A technological advancement that provide a light source and means to see inside a body cavity in surgery
90
On endoscopes:
It is less ________ than ____________ surgery and is ________ for tracking through structures such as the _________
Invasive
Conventional
Flexible
Intestine
91
True or False:
Instruments can be placed at the end of the endoscope
True
92
What instruments can be placed at the end of the endoscope? (3)
Forceps, needle holders, scissors, and others
93
Define:
Recumbent patients
Describe animals under anesthesia
94
What can't animals under anesthesia maintain?
Can't maintain their body temperature
95
Describe what is done to animals under anesthesia to maintain their body temperature
A heavy towel or blanket between the animal and table provide minimized heat transfer and supplemental heat
96
What is important to note for surgeries? (2)
There is not just one standardized method to performing surgeries
Many variations are possible given the approach or situation
97
What is a common abdominal surgery in pets?
Ovariohysterectomy, otherwise known as the Spay
98
In ovariohysterectomy:
The animal is ____________ and secured to the _______ _____. _______ is _______ and _______ prior to surgery
Anesthetized
Surgery table
Abdomen
Clipped
Scrubbed
99
In ovariohysterectomy:
A _______ _______ ________ is performed, where the ________ allows for __________ ______ from both sides of the _________ ____ to meet
Ventral midline incision
Midlines
Connective tissue
Abdominal well
100
In ovariohysterectomy:
An ________ through the ____ and ____________ ______ to expose the _____ ____
Invision
Skin
Subcutaneous tissue
Linea alba
101
In ovariohysterectomy:
What is used to locate the uterus?
A spay hook
102
In ovariohysterectomy:
Once the ______ is locate, the ____ of the uterus is brought to the _______ and the _____ is identified
Uterus
Horn
Surface
Ovary
103
In ovariohysterectomy:
A ______ is placed around the _______ _______
Suture
Ovarian vessels
104
True or False:
In ovariohysterectomy, the entire uterus and ovaries are removed
True
105
What can be closed when the entire uterus and ovaries are removed in ovariohysterectomy?
The abdominal incision can be closed
106
Define:
Intestinal Anastomosis
Describes the procedure where 2 regions of the intestine are joined
107
How is intestinal anastomosis done?
Manually or with stainless steel staples
108
Describe an intestinal anastomosis
The damaged section of the intestines is removed and entail that this procedure is used to join the 2 areas of the intestine
109
True or False:
Gastric Dilatation-Volvulus Syndrome is a surgical emergency in cats
False; Gastric Dilatation-Volvulus Syndrome is a surgical emergency in DOGS
110
Who does gastric dilatation-volvulus syndrome occur in? (3)
Usually occurs in large, deep-chested dogs where:
Dogs have consumed a large meal/volumes of water
Have been physically active following this
111
In Gastric Dilatation-Volvulus Syndrome:
Factors caused the accumulation of ___ and ________ of the _______
Gas
Rotation
Stomach
112
In Gastric Dilatation-Volvulus Syndrome:
The dogs make attempts to ____ and compromises ___________ to the _______
Omit
Circulation
Stomach
113
In Gastric Dilatation-Volvulus Syndrome:
What can be done to drain the stomach?
A ventral midline incision can be made in the cranial region of the abdomen to drain the stomach
114
________ regions of the _____ should _______ during the _______
Necrotic
Organ
Removed
Surgery
115
In surgeries involving the lung tissue, what must the anesthetist do??
Must breathe regularly for the animal
116
The breaths in surgeries involving lung tissue must be coordinated with who?
The surgeon
117
In lung tissue surgeries:
The added challenge of working with the _______ _____ and expanding _____ mean that special care to avoid __________ the ______ with the ______/_____ instrument must be taken
Beating heart
Lungs
Puncturing
Tissue
Needle/sharp
118
An ________ ____ must also be created to avoid ________ of ___
Airtight seal
Leakage
Air
