Surgery Flashcards
What are the 3 obstacles of surgery?
Bleeding
Pain
Infection
20th century
ABO sys (Landsteiner) Diathermy
Birth of modern age in anesthesiology (1846)
Ether
1956-1980
Its use in dev countries has been mostly replaced by newer anesthetic agents s/a sevoflurane
Halothane
1847
Hand washing - Ignaz Semmelweis
1867
Sterility abd Gloves - Joseph Lister
1928
Penicillin - Alex Flemming (wöw alex close kau)
An operation that involves surgical implementation of implants for purpose of repairing a bone.
It may be made of stainless steel, titanium, alloy, cobalt-chrome alloy
Internal fixation
What is a surgical procedure to restore normal bld flow to an obstructed coronary artery?
Coronary artery bypass graft (CABG)
-ectomy
Remove surgically
-orraphy
Surgical repair
-otomy
Surg incision
-ostomy
Create opening between 2 organs, or organ and skin
-plasty
Surg shaping or formation
Going in the direction of flow
Antegrade
A collection of pus in a body cavity
Empyema
Surgical removal of the inner lining of an artery that is clogged with atherosclerosis
Endarterectomy
On mass; all together
En bloc
A surgical procedure making tucks in the fundus of the stomach around the lower end of the oesophagus
Fundoplication
Localized necrosis resulting from obstruction of the bld supply
Infarction
The infolding of one segment of the intestine within another
Intussusception
An inadequate supply of bld to a part of the body c/b blockage of an artery
Ischemia
Curved inti 2 directions
Sigmoid
Surgical opening
Stoma
Obtaining pictures of the interior of the body
Tomography
A non-traumatic discontinuity of an epithelial surface
Ulcer
What is the oldest known disinfectant?
- wc are toxic to nb, corrosive to skin
- found in mouthwashes, disinfectant soaps, and handwahes
Phenol
Exhibits efficacy against difficult to kill non-enveloped viruses s/a norovirus, rotavirus, or polio
Quaternary ammonium compounds (quats)
- Benzalkonium Chloride
What is the most common chemical sterilization mtd?
ETO
What is the most common ethylene oxide processing mtd?
Gas chamber mtd
Loss of response to pain (general anesthesia)
Analgesia
Loss of motor reflex (general anesthesia)
Immobility
Unconscious
Hypnosis
Skeletal muscle relaxation and normal muscle relaxation (general anesthesia)
Paralysis
In general anesthesia, thus us the period between adm of induction agents and loss of consciousness
Px progress from analgesia w/o amnesia to analgesia w amnesia
Stage 1 (Induction) - can conversate
Period ff loss of consciousness and marked by excited and delirious activity
Respiration and HR = irregular
May have unctrlled movements, vomiting, suspension of breathing, and pupillary dilation compromising px qirway
Stage 2 (Excitement Stage)
The skeletal muscle relax, vomit stops, respi depression occurs, and eye movements slow then stop
Px unconscious and ready for surg
Stage 3 (Surgical anesthesia)
Sever brainstem or medullary depression
Results in a cessation of respi and potential cardiovascular collapse
Stage 4 (OD)
Below L1/L2, where spinal cord ends Inj: subarachnoid space (dura mater) --> CSF appears Doses: 2.5-3.5mL Bupivacaine 0.5% heavy Rapid 2-5 mins More dense Headache is prob a complication
Spinal anesthesia
Any lvl Inj: epidural space Peridural space 15-20mL Bupivacaine 0.5% Slow Less dense
Headache probs NOT a complication
Extradural anesthesia
What are the ways to decrease complications?
Incentive spirometry
Early postop ambulation
Chest physical therapy
DVT prophylaxis by sequential compression device (SCD) and subcutaneous heparin
Cockcroft Gault Equation
[(140-age) x Ideal body wt in kg]/72 x plasma crea (mg/dL)
Non per os hrs prior to surgery
Solids 6-8 hrs
Liq 2-3 hrs
Aspirin
Avoid 7-10 days preop to allow plt to regenerate
Clopidogrel (Plavix)
Hold for 5-7 days
Antihypertensives
Continue esp Beta blockers; hold diuretics the morning of surgery
Antithyroid meds
Hold in morning of surgery
5Ws of Post-op Fever
Wind (most common cause of fever day 1) Water (UTI dehy) Wound Walking (DVT) Wonder drugs (unexplained origin)
Collection of fluid in the vicinity of a wound that isn’t bld or pus
D/t creation of potential space combined w disruption of local draining lymphatic cahnnels
Seroma
Must be done to avoid permanent disability or death, but can be postponed for a short time
Semi-elective surgery (urgent)
Must be done promptly to save a life, limb, or fxnal capacity
Emergency surgery (w/in 6 hrs)
Process of wound healing
HIPR
Hemostasis
Inflammation
Proliferative phase
Remodelling phase
Proliferative phase 3 distinct stages
Filling the wound
Contraction of the wound margins
Covering the wound (epithelialization)
How many days can proliferative phase last?
4-24 days
Remodelling phase lasts
Often from 21 days to 2 years
FORE SURGICAL SPEAK
Go to notes
