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FCP > Surgery > Flashcards

Surgery Flashcards

1
Q

What 3 surgical scrub solutions could we use and what are there benefits /disadvantages, percentage and contact time .

A

-chlorhexidine - 2% for 5 minutes , in open wounds kills cells and slow healing
-povidone iodine - good if have a sensitivity to chlorhexidine , 7.5% for 3 minutes , not good with gross contaminates
-isopropyl alcohol

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2
Q

What do we use for oral prep ?

A

0.1% chlorhexidine in dogs can cause ulcers in cats

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3
Q

What do use to prep for ocular surgery ?

A

0.2%-2% or 1:50 dilution of povidone iodine - as chlorhexidine shown to irritate mucous membrane

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4
Q

What do we use to prep for aural surgery ?

A

-flushed with saline then 0.2% chlorhexidine

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5
Q

What do we use to prep for foot surgery ?

A

-wrap in bag with 2% chlorhexidine then clipped then done again for another 5 min

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6
Q

What to remember when prepping the skin ?

A
  • don’t make the skin too wet
    can make the patient cold during surgery
    can cause burns due to heat generated by heat mat
    strike through
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7
Q

Name the 4 draping styles

A

-plain 4 corner draping
-draping a limb
-fenestrated drapes
-adhesive barrier drapes

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8
Q

Different origins of suture material .

A

-natural e.g catgut, silk
-synthetic
-metal

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9
Q

Different behaviours of suture material and def

A

-absorbable - will be fully degraded and absorbed by body once placed
-nonabsorbable -stay in place for indefinite period e.g 60 days without changing or breaking down

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10
Q

Different structures of suture material

A

-monofilament - single filament
-multifilament - bundles of very fine filaments usually braided together

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11
Q

Definition of tensile strength.

A

breaking strength per unit area

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12
Q

TRUE/FALSE : Monofilament has a higher memory than multifilament

A

true - therefore monofilament isn’t as good to tie knots

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13
Q

Definition of chatter/tissue drag

A

lack of smoothness or friction whilst passing through tissues

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14
Q

TRUE/FALSE : monofilament have less tissue drag than multifilament

A

true

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15
Q

Advantages and disadvantages of absorbable suture.

A

+disappear
+low risk of long-term foreign body reaction
-lose strength
-limited period of wound support

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16
Q

Advantages and disadvantages of nonabsorbable suture.

A

+permanent
+provide indefinite wound support
-don’t disappear
-delayed reactions possible e.g foreign body reaction

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17
Q

Advantages and disadvantages of multifilament.

A

+easy to handle
+good knotting - very secure
-greater friction/tissue drag/chatter
-more tissue trauma - thicker

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18
Q

Advantages and disadvantages of monofilament.

A

+minimal tissue trauma
+passes through tissues easily
+no capillary action
-harder to handle
-harder to knot
-need different knotting techniques for more security

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19
Q

why is monofilament better for lower risk of infection ?

A

multifilament has a lot more areas where bacteria can harbour and divide

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20
Q

TRUE/FALSE hydrolysis of suture causes less of a tissue reaction than phagocytosis

A

true - cat gut absorbed via phagocytosis , many synthetics absorbed via hydrolysis

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21
Q

What are the 2 kinds of grades for suture size ?

A

-USP - united states pharmacopia - 11-0 , 2-0
-metric

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22
Q

What does swaged mean ?

A

needle is already attached to suture

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23
Q

Disadvantages of eyed needles .

A

-double stranded suture - more trauma
-multiple use - blunt
-increased tissue trauma

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24
Q

Benefits of swaged needle

A

-minimal trauma
-single use
-optimal penetration properties

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25
Q

TRUE/FALSE : the deeper the wound the more curved the needle

A

true

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26
Q

What different needle curvatures are there ?

A

1/4
3/8
1/2
5/8

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27
Q

Different shapes of needle

A

-blunt - circular,elliptic
-sharp - polygonal
-compound -tapercut,short cutting point

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28
Q

What is ductility in relation to needles ?

A

will bend before they break - warns surgeon too much force on needle

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29
Q

What are mayo scissors used for ?

A

tough tissues e.g linea alba

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30
Q

what are Metzenbaum used for ?

A

delicate for subcut tissue and viscera

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31
Q

What are iris scissors used for ?

A

for fine cuts

32
Q

Which forceps are the least traumatic ?

A

debakey - serrations less tissue damage

33
Q

What are haemostatic forceps used for ?

A

occlude bv and prevent haemorrhage

34
Q

Halsteds principles

A

gentle tissue handling
strict asepsis
haemostasis - minimise blood loss

35
Q

TRUE/FALSE = an ectopic island of pancreas is normal not pathological

A

true

36
Q

How quick does stomach heal ?

A

7 days

37
Q

How long does fracture take to heal ?

A

2 months

38
Q

How long do tendons take to heal ?

A

very slowly - always going to need suture support

39
Q

How long does intestine take to heal ?

A

1-2 weeks

40
Q

What 5 regions can the abdominal cavity be seperated into ?

A

-cranial abdomen
-GI tract
-right paravertebral region
-left paravertebral region
-caudal abdomen

41
Q

What is the duodenal manoeuvre?

A

when you use the mesoduodenum on right to push the above onto the opposite site so you can see underneath ( exposes the paravertebral region )

42
Q

What is the coelic manoeuvre?

A

use colon to move mesenteric root struc to the animals right hand side so you can see underneath ( left kidney )

43
Q

What’s the difference between grading and staging ?

A

grading = how aggressive - malignant or benign ( cytology -FNA , histology -biopsy)
staging = spread - radiograph chest

44
Q

What is cytoreduction ?

A

using chemotherapy/radiotherapy to reduce tumour

45
Q

Define the term metastasis

A

when cancer cells spread to other part of the body

46
Q

What is debulking/intralesional/cytoreduction excision?

A

leave macroscopic volumes of tumour that you’ll treat with cytoreduction

47
Q

What is a marginal excision ?

A

known as local
go just around the tumour pseudocapsule
try not to get any other tissue outside tumour

48
Q

What is a wide incision ?

A

remove tumour with complete margins of normal tissue

49
Q

What is radical excision ?

A

removing an entire anatomical struc containing the tumour e.g limb amputation

50
Q

Name the layers of bowel/bladder ( both the same )

A

serosa
muscular layer - longitudinal then circular
submucosa
mucosa

51
Q

TRUE/FALSE = the sub mucosal layer is the most important layer when closing ( in the case of the bladder/bowel )

A

true

52
Q

(very )briefly explain how would you conduct a gastrotomy

A

incision
find stomach
exteriorise and pack off so don’t contaminate the peritoneal cavity
then put in stay sutures
and make incision into stomach
omentalise at end

53
Q

How would you close in a gastrotomy

A

-use absorbable monofilament 0-3 or 0-2
-1 layer ( full thickness simple interrupted/continuous or continuous inverting )or 2 layer ( sub mucosa /mucosa and serosa/muscular )

54
Q

What is intussusception

A

when a portion of the bowel invaginates into adjacent segment next to it
-causes bowel obstruction

55
Q

What clamps would you use for a enterotomy ?

A

-non crushing - fingers best

56
Q

Best pattern for enterotomy suture

A

simple continuous or interrupted

57
Q

What suture material would you use for enterotomy ?

A

monofilament absorbable
0-3, 0-4

58
Q

Define enterectomy

A

remove portion of bowel

59
Q

TRUE/FALSE = its good to starve after GI surgery

A

false - can be very harmful - vilous atrophy , ulceration

60
Q

How might you conduct a cystotomy ?

A

-incision
-locate bladder
-drain it
-put in stay sutures
-exteriorise
-insicison into bladder abd take out what need to
-close

61
Q

How would you close for a cystotomy ? pattern, material

A

-absorbable monofilament
-0-3,0-4,0-2
-pattern - either 1 or 2 layer like the bowel

62
Q

How long does urinary bladder take to heal

A

month

63
Q

Define dehiscence .

A

breakdown

64
Q

Name some postoperative complications

A

-woudn infection
-peritonitis
-uroabdomen
-dehiscence

65
Q

How would you close the linea alba ?

A

-continuous suture patterns
-absorbable monofilament - but that will last a logn time as linea alba takes 60-80 days to heal - 0( small dog ) 0-2 , 0-3 ( cat , dog )

66
Q

TRUE/FALSE = primary problems are usually structural

A

true

67
Q

DAMNIT-V

A

Degenerative - gets worse over time
Anomalus - genetic
Metabolic
Neoplasia
Inflammation
Trauma , TOXINS
Vascular

68
Q

What’s important in shared decision making ?

A

informed consent

69
Q

When would you use an IM pin and what is it ?

A

-nomograde -place pin proximally along long axis of the bone into medullary cavity
-retrograde - enter the proxixmal fragment distally -go in opposite direction
-stops bending and poor axial compression

70
Q

What’s an IM interlocking nail ? when would you use ?

A

-nail going through bone and screws to hold in place
-stops rotation and compression

71
Q

What is an external fixator ?

A

-series of pins placed through skin through the bone and connected to connecting bar on the outside of the body
-all forces - can be combined with an IM pin

72
Q

What forces are plates good and bad at preventing ?

A

-good stopping compression *not as good as IM pin
-good against torsion

73
Q

How can you combat distractive forces ? ( e.g tension/avulsion fractures )

A

-place screw and compress using lagging technique
-or can convert the distractive forces into compressing using a tension band

74
Q

What is a lag screw and when do you use it ?

A

-make hole you put in one side of the fracture bigger then screw in the screw - so it goes into the other side ( this pulls the far side against the near side )
-use to compress fractures

75
Q

What is a tension band and how is it used ?

A

pull fracture together and fixed in place by two pins then apply a wire in figure of 8 opposite to distractive forces
-creates compressive force

76
Q

Where do triceps insert ?

A

olecranon

77
Q

Wolfs law

A

bone will adapt to the force it is placed under

FCP (24 decks)

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