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E&E Exam 3 > Surgery > Flashcards

Surgery Flashcards

1
Q

What does contamination mean?

A

(Bacteria are on the surface of a tissue that usually does not have bacteria related to it)

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2
Q

What are the three very basic possible outcomes of bacterial contamination?

A

(Bacteria die, bacteria leave, or bacteria infect)

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3
Q

(T/F) Only pathogenic bacteria can cause infection such as Staph. pseudintermedius, E. coli, and P. aeruginosa.

A

(T)

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4
Q

(T/F) There are no clinical signs related to contamination.

A

(T)

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5
Q

What are the two typical signs of infection?

A

(Purulent discharge and signs of inflammation)

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6
Q

What is the risk of contamination leading to infection based on? Three answers.

A

(Number of bacteria present, virulence of the bacteria present, and the resistance of the tissue the bacteria is trying to infect)

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7
Q

What are the four NRC wound classifications?

A

(Clean, clean-contaminated, contaminated, and dirty)

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8
Q

Described a clean wound as per the NRC wound classification.

A

(Surgical wound, maintained aseptic conditions throughout, non-traumatic, non-inflamed, and no luminal structures were entered)

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9
Q

What NRC wound classification is described as any traumatic wound with or w/o signs of infection, a surgical wound with gross spillage of contaminating contents, and/or a surgical wound with a major break in asepsis?

A

(Contaminated)

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10
Q

Describe a clean-contaminated wound as per the NRC wound classification.

A

(Surgical wound where a luminal structure is entered in a controlled manner or a clean wound with a drain (since you’re exposing a wound to the environment))

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11
Q

What NRC classification is an ovariectomy?

A

(Clean)

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12
Q

What NRC classification is a cystotomy?

A

(Clean-contaminated)

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13
Q

In what two ways can you reduce the number of bacteria present as a strategy for preventing infection?

A

(Aseptic technique and using perioperative antibiotics)

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14
Q

How do you increase/maintain tissue health as a way to prevent infection?

A

(Support the patients’ health primarily by reducing surgery/anesthesia time)

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15
Q

What is the prophylactic antibiotic protocol?

A

(Start abx 30-60 minutes before incision and stop within 24 hours of surgery)

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16
Q

What kind of cases, two specifically, are prophylactic antibiotics used for?

A

(Cases with a high risk of infection and cases in which consequences of infection would be disastrous (permanent implant))

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17
Q

(T/F) Increasing surgery time by 1 hour approximately doubles the risk of infection.

A

(T)

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18
Q

What are Halsted’s 6 principles of surgery?

A

(Gentle tissue handling, preserve blood supply, control hemorrhage, eliminate dead space, appose tissues accurately, and practice aseptic technique)

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19
Q

What are the three lateral muscles of the abdominal wall?

A

(External and internal abdominal obliques and the transversus abdominis)

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20
Q

What is the ventral muscle of the abdominal wall?

A

(Rectus abdominis)

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21
Q

What is the dorsal muscle of the abdominal wall?

A

(Quadratus lumborum)

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22
Q

What structures do the lateral muscles’ aponeuroses become? Two answers.

A

(Linea alba and rectus abdominis muscle sheath)

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23
Q

Is the cranial 2/3rd or caudal 1/3rd of the rectus abdominis associated with only an external rectus sheath?

A

(Caudal 1/3rd, cranial 2/3rd has both external and internal))

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24
Q

What does dissection of the SQ fat from the body wall in your ventral midline celiotomy increase the risk of?

A

(The formation of a seroma)

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25
Q

What is the purpose of tenting the body wall and using a reverse press cut (where the blade is upside down and horizontal) when you are initiating your body wall incision in a ventral midline celiotomy?

A

(To avoid inadvertent organ damage)

26
Q

What is the purpose of inserting your fingers into the initial hole you made in the body wall before extending your incision?

A

(To feel for adhesions)

27
Q

If you are using an absorbable suture to close the body wall of a ventral midline celiotomy, how long does the tension need to last?

A

(At least 4 weeks)

28
Q

Should you use a monofilament or a braided suture for closing the body wall of a ventral midline celiotomy?

A

(Monofilament)

29
Q

What is the holding layer that you should be sure to engage when closing a body wall incision?

A

(The linea)

30
Q

What type of approach is indicated in procedures involving dorsal or retroperitoneal organs?

A

(‘Grid approach’ → paracostal laparotomy)

31
Q

(T/F) In a paracostal laparotomy, because you are incising into three different muscles, they should each be closed separately at the conclusion of the procedure.

A

(T)

32
Q

What are the three muscles that you will encounter in a paracostal laparotomy from outermost to innermost?

A

(External abdominal oblique, internal abdominal oblique, and transversus abdominis)

33
Q

What can result if ruminants cannot eructate during a surgical procedure? Two general answers.

A

(Respiratory and cardiovascular compromise)

34
Q

In what two ways can you minimize the issue of eructation in ruminant surgeries?

A

(Hold off feed for 24 hours and performing standing procedures when able)

35
Q

What three nerves are specifically blocked for a paralumbar fossa approach for a ruminant?

A

(Last thoracic nerve and the first two lumbar nerves)

36
Q

What three vertebrae should be your guides for where to perform your injections for paralumbar fossa approaches to a ruminant abdomen?

A

(L1, L2, and L4)

37
Q

Is the 7/inverted L block a local line block or specific nerve block?

A

(Local line)

38
Q

How far should you be from the transverse processes and the last rib when performing your paralumbar fossa incision in a cow?

A

(2-3 inches)

39
Q

How long should your paralumbar fossa incision be in inches in a cow?

A

(8-10 inches)

40
Q

What are the five layers that you are incising through in the paralumbar fossa approach to the cow abdomen from outermost to innermost?

A

(Skin, external oblique, internal oblique, transversus abdominis, peritoneum)

41
Q

What is the indication for a right paramedian celiotomy approach in a cow?

A

(Abomasal displacement)

42
Q

What are the five layers that you are incising through in the right paramedian celiotomy approach to a cow abdomen from outermost to innermost?

A

(Skin, external linea alba, rectus abdominis, internal linea alba, peritoneum)

43
Q

What approach allows for better exposure of the abdomen in calves and in general, good access to the abomasum?

A

(Right paracostal approach)

44
Q

What approach is typically used in horses and pigs when you want to gain access to their abdomen?

A

(Ventral midline celiotomy)

45
Q

What is the holding layer of the GI tract?

A

(Submucosa)

46
Q

What layer(s) of the stomach do you ONLY cut through in a gastropexy?

A

(Seromuscular layer → serosa + muscularis)

47
Q

If your word ends in -otomy, what does that mean?

A

(To cut into (and typically close it at the end))

48
Q

If your word ends in -ostomy, what does that mean?

A

(To create an artificial opening)

49
Q

If your word ends in -ectomy, what does that mean?

A

(To remove part or all of something)

50
Q

If your word ends in -plasty, what does that mean?

A

(To change the shape of something)

51
Q

If your word ends in -pexy, what does that mean?

A

(Surgical fixation of an organ)

52
Q

If your word ends in -rrhaphy, what does that mean?

A

(To suture together)

53
Q

What are three ways to atraumatically handle stomach tissue?

A

(Your fingies, stay sutures, specialized forceps → Babcock)

54
Q

The GI healing time is about what time period?

A

(Two weeks)

55
Q

Why do surgeons avoid using multifilament suture in small animal GI tracts?

A

(Braided suture can cut through fragile tissue)

56
Q

What are cutting needles used for? Two answers.

A

(Skin or linea alba)

57
Q

How is the stomach isolated and held in the large animal flank approach to the stomach?

A

(By suturing the edges of the rumen to the body wall incision)

58
Q

How can a septic abdomen result from a gastrotomy?

A

(Dehiscence of the incision during the healing period)

59
Q

In what time period does dehiscence typically occur after a gastrotomy?

A

(3-5 days)

60
Q

What region of the stomach should you make your incision on when performing an incisional gastropexy?

A

(The pyloric antrum area)

61
Q

Through what layers of the body wall should you make your incision in an incisional gastropexy procedure?

A

(Through the parietal peritoneum and the transversus abdominis)

E&E Exam 3 (8 decks)

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