SASx - Surgery Lab Quiz Material Flashcards
1
Q
Which bandage layer is in direct contact with the wound or the patient surface?
A
primary layer
3
Q
This is the most common adherent bandage:
A
wet to dry
4
Q
What are the 3 primary components of bandages?
A
primary layer, secondary layer, tertiary layer
5
Q
What method of bandage anchoring is shown below?
A
torso strap
figure 8 bandage material around forelimbs further helps to hold the chest bandage in a cranial position
6
Q
What method of bandage anchoring is shown below?
A
tie over bandage
8
Q
A Spica Splint is a temporary splint for fractures or luxations at what location?
A
proximal to, or including the elbow or stifle
provides immobilization of upper extremities
-
Materials used:
- Porous tape
- Roll cotton
- Conforming bandage
- Elastikon
- Splint rod
9
Q
What sling would be recommended to create a non-weightbearing forelimb?
A
Velpeau Sling
- Creates non-weightbearing forelimb
- immobilization after reduction of shoulder luxation
- Primary stabilization for some scapular fractures
- Materials: cast padding, conforming gauze, elastikon
10
Q
What sling would be recommended to create a non-weightbearing hindlimb with inward hip rotation?
A
Ehmers Sling
- Figure of Eight sling
- Creates non weight bearing hind limb
- Provides femoral abduction
- Inward hip rotation
- Indication after reduction of cranial dorsal hip luxation
11
Q
What are some indications for a Robinson Sling (pelvic limb sling)?
A
- Tibial or femoral fracture repair
- Post-op coxofemoral or stifle surgery
12
Q
T/F: When applying the secondary bandage layer on small animal patients, it is important to always apply the rolled material proximal to distal on the limb
A
False
It is important to apply the material _distal_ to _proximal_. If we go proximal to distal, we almost always cause venous congestion in the distal limb and swelling of the paw
14
Q
What orthopedic examination is being performed in this image?
A
cranial drawer test
16
Q
What is shown here?
A
coxofemoral luxation
17
Q
What diagnostic modality is being used here?
A
nuclear imaging
-
Indications for Nuclear Imaging
- Normal radiographs in presence of clinical lesion
- Unable to localize the lesion
- Evaluation for suspected metastasis
- Monitor response to therapy
- CT has replaced this diagnostic in many instances
18
Q
What materials are used for a Modified Robert Jones bandage?
A
porous tape, cast padding, conforming bandage, elastikon or vet wrap
23
Q
What are some indications for a full leg cast?
A
-
Indications
- Minimally displaced stable fractures
- Distal to the elbow or stifle
- Young fast healing patients
- Used as adjunct following internal fixation or arthrodesis
24
Q
What are some contraindications for a full leg cast?
A
- Don’t apply over wounds
- Don’t apply with significant inflammation
- Don’t cast femur or humerus
26
Q
When using radiography for diagnosis of orthopedic limb disorders, __________ views are a necessity for making a proper diagnosis.
A
orthogonal views
29
Q
What fracture configuration is ideal for the use of cerclage wire?
A
Long oblique
30
Q
How far apart from the fracture ends should cerclage wires be placed?
A
0.5 cm
31
Q
Name the cerclage wiring technique used on short oblique fractures in conjunction with a K-wire:
A
Skewer pin
32
Q
Which fixation technique would be ideal for treatment for the fracture shown in this radiograph (avulsion fracture)?
A
Tension band
33
Q
What two types of Salter Harris fractures might go undiagnosed on initial radiographs?
A
SH-1 and SH-5
34
Q
What type of fixation would be best for treatment of a Grade IIIA open fracture?
A
External Skeletal Fixation
35
Q
What determines the bending strength of a screw?
A
Core diameter
36
What fractures must always be anatomically reconstructed?
**Articular fractures**
37
Name at least three ways to increase the rigidity of an external skeletal fixator construct:
* Frame type (I-III)
* Double bar
* Interconnecting bars
* Reduce bone-connecting bar distance
* Pin distribution à Pins close to ends of bone & fracture = most stable
* Increased number of pins
* Larger diameter of pins and connecting bar
38
Name the condition that can occur when a young animal’s comminuted femoral fracture is treated with rigid immobilization for an extended period of time
**Quadriceps contracture**
39
Of the four A’s that are evaluated in post-op fracture repair radiographs, which term relates to the positioning of the joints?
**Alignment**
40
In biomechanics, what is the term for the point at which a material transitions from elastic to plastic deformation?
**Yield Point**
41
What antibiotic is the best first choice for treatment of an open fracture?
**Cefazolin**
42
What is the most common complication associated with external skeletal fixation?
**Pin tract morbidity/drainage/infection**
43
What percentage of the medullary canal should be filled by a Steinmann pin if it is the primary means of fixation?
**70%**
44
What fixation methods (2) cannot be used in the radius?
**Interlocking nail and intramedullary pin**
45
When placing cerclage wires, how should they be positioned in reference to the long axis of the bone?
**Perpendicular**
46
After achieving compression of a short oblique fracture using a lag screw, you also place a plate to protect the compression and apposition achieved lag screw. What plating mode is demonstrated in this example?
**Neutralizing plate**
47
Briefly describe this fracture. What immobilization method is recommended (external coaptation or surgical fixation)?
**closed transverse comminuted laterally displaced fracture of the radius and ulna**
## Footnote
* Repair with surgical fixation (could use DCP plate, LC-DCP plate in bridging mode, external fixator)*
* You would not use external coaptation on a comminuted fracture*
48
This is a closed transverse comminuted laterally displaced fracture of the radius and ulna. How quickly do we expect this fracture to heal once it is stable?
**~6-8 weeks**
49
This radiograph is from a 5-month-old, male intact mixed breed dog. He presented with a left hindlimb lameness after jumping off the couch.
What type of fracture is this? What immobilization/fixation metho is recommended for this fracture?
**closed, proximally displaced left tibial avulsion fracture**
*_Pin and tension band_ is recommended for this fracture.*
50
This is Sadie, an 8 month old, FS, Labrador Retriever. What kind of fracture is present here?
Why is external coaptation not recommended for this type of fracture?
**Salter Harris 4 fracture of the right lateral humeral condyle with proximal and lateral displacement**
*External coaptation is not recommended for this type of fracture because this is a fracture that involves a joint surface*
51
The image below shows a Salter Harris 4 fracture of the right lateral humeral condyle with proximal and lateral displacement. What type of repair must be acheived in this patient?
**anatomical reduction**
*What type of screw was likely used to maintain reduction across the condyle? Most likely a cancellous screw placed as a lag screw*
52
This is Stuart, an 8 month old, MN Yorkshire terrier. Describe the fracture. Can external coaptation be recommended in this patient?
**transverse fracture of the radius and ulna**
*External coaptation can be recommended for this fracture. It is a transverse fracture, and is not comminuted. You should be able to reduce this and it should be able to bear weight*
53
Any surgical incision into the abdominal cavity is termed:
**celiotomy**
*Laparotomy refers to a flank approach. The terms are often used interchangeably*
54
What procedure has been performed here?
**enteroplication**
*for prevention of intussusception*
55
\_\_\_\_\_\_\_\_\_\_ refers to a foreign object, such as a mass of cotton gauze or a sponge, that is left behind in a body cavity during surgery
**gossypiboma**
56
What is the most common surgical approach to a **celiotomy**?
**ventral midline**
57
What surgical approach is indicated by the red dotted line?
**paramedian approach**
* This approach is usually done by accident. Ideally you don't want to go paramedian because you would be cutting through muscle tissue, which bleeds a whole lot more than the linea alba. It also carries higher surgical complications.*
* AVOID A PARAMEDIAN APPROACH WHENEVER POSSIBLE*
58
What surgical approach is indicated by the blue dotted line?
**paracostal approach**
*Incision is made ~1-2 cm caudal to the last rib. This approach is useful when you're managing surgical structures in the cranial ventral abdomen (ex: liver, diaphragm, stomach, etc.)*
59
What surgical approach is indicated by the dark green dotted line?
**flank approach**
*helps for visualization of more dorsal structures (ovaries, kidneys, adrenal glands)*
60
When performing a **ventral midline approach**, the aim is to incise through the ________ and avoid the ________ muscle
When performing a ventral midline approach, the aim is to incise through the **_linea alba_** (visualized best at the umbilicus) and avoid the **_rectus abdominus_** muscle
61
For a ventral midline approach, if you make your initial stab incision **cranially**, what would you use for the rest of your incision?
**scalpel and groove director**
62
For a ventral midline approach, if you make your initial stab incision **caudally**, what would you use for the rest of your incision?
**scissors**
63
When performing a ventral midline approach, you may run into a structure called the falciform ligament, primarily composed of adipose tissue. What options do you have for moving past the falciform ligament?
* Simply push it out of the way
* Remove it
* Electrocautery
* Ligation and resection
64
Identify this structure in the cranial quadrant of the abdomen:
**ruptured diaphragm**
65
Identify this structure in the cranial quadrant of the abdomen:
**stomach**
*it's being held out of the abdominal cavity with babcock forceps*
66
Identify this structure in the cranial quadrant of the abdomen:
**gall bladder and liver**
67
Identify this structure in the cranial quadrant of the abdomen:
**pancreas**
68
Identify this structure in the right quadrant of the abdomen:
**duodenum**
69
Identify this structure in the right quadrant of the abdomen:
**right kidney**
70
Identify this structure in the right quadrant of the abdomen, just below the hemostats:
**ureter**
*This structure is bigger than normal - this is a hydroureter*
71
Identify this structure in the left quadrant of the abdomen:
**descending colon**
* IMPORTANT: This is the structure that you would have to retract in order to visualize a ruptured left ovarian pedicle*
* The procedure shown is a colopexy*
72
Identify this structure in the central quadrant of the abdomen being held in the fingers?
**cecum**
73
Identify this structure in the central quadrant of the abdomen:
**jejunum and mesentery**
74
Identify this enlargement in the mesentery in the central quadrant of the abdomen:
**mesenteric lymph node**
75
Identify this structure in the central quadrant of the abdomen:
**ascending colon**
76
Identify this structure in the central quadrant of the abdomen:
**ventral ligament of the bladder**
*(remnant of the urachus)*
77
What scalpel grip provides the best accuracy and stability for long incisions?
**fingertip grip**
78
What is the layer of strength (holding layer) for abdominal wall closure?
**external rectus sheath**
79
How many layers of closure should be used for the urinary bladder?
**TWO**
* *First layer - simple continuous*
* *Second layer - inverting pattern (Cushing or Lembert)*
80
What suture should be _avoided_ when closing the abdomen after a celiotomy?
**chromic gut, silk, vicryl rapid, polymerized caprolactam**
81
When performing a subcutaneous closure, why do we bury the knot?
**minimizes chance of suture tags or knots being exposed through skin**
82
What are the acceptable suture patterns for skin closure after a celiotomy?
**simple interrupted, simple continuous, cruciate, ford interlocking**
83
Removal of both testicles, regardless of location is termed:
**castration**
84
What surgical approach is most often used for routine elective castration?
**pre-scrotal**
85
What surgical approach is most often used for castration of mature, large breed dogs?
**scrotal approach**
*scrotal approach is used when also removing scrotum (scrotal ablation)*
86
When performing a pre-scrotal castration, you want to incise over the testicle on midline through the skin, subcutaneous tissue, and spermatic fascia to expose the __________ tunic
**parietal vaginal tunic**
*When performing a pre-scrotal castration, you want to incise over the testicle on midline through the skin, subcutaneous tissue, and spermatic fascia to expose the **_parietal vaginal tunic_***
Be careful not to cut *through* the parietal tunic
87
When positioning the testicle for incision (for a pre-scrotal castration), what is the name of the incisional landmark?
**median raphe**
88
For a closed castration, a three-clamp technique is typically used and the pedicle is double ligated. What ligatures are typically used?
* **Miller's knot in proximal crush**
* **2nd ligature: transfixing**
* Absorbable, monofilament suture
* 2-0 suitable for most dogs
89
T/F: For an open castration, it is important not to incise through the parietal tunic
**False**
For an closed castration, you will not incise through the parietal tunic. _For an open castration, you will incise through the parietal tunic to expose the testicle (NOT the visceral tunic - if you incise into the visceral tunic, you're actually incising into the testicle)_
90
When performing an open castration, it's important to ligate the vascular and non-vascular components separately. What are the vascular components? What are the non-vascular components?
* **Vascular**: artery, nerve, pampiniform plexus
* **Non-vascular**: parietal tunic, cremaster muscle, ductus deferens
91
For feline castration, if you incise through the spermatic fascia, this is considered a(n) ________ castration. If you incise through the parietal tunic, this is considered a(n) ________ castration
For feline castration, if you incise through the spermatic fascia, this is considered a **_closed_** castration. If you incise through the parietal tunic, this is considered an **_open_** castration
92
What procedure is shown below?
**feline open castration**
93
What are some complications associated with castration?
* **Scrotal bruising or hematoma** (most common)
* **Hemorrhage** - inadequate ligation
* **Infection**
* **Dehiscence**
