Surgery And Theatre Flashcards
What does ‘-otomy’ mean?
A temporary opening eg a spey
What does ‘-ostomy’ mean?
A permanent opening eg tracheostomy
What does ‘-ectomy’ mean?
To remove a part of the body eg splenectomy
What does ‘Exploratory laparotomy’ mean?
Opening the abdomen
What is the minimum age of the person giving consent?
18 years
What is the routine food withholding period for adult cats and dogs?
3 hours (previously 6-12 hours)
What is the routine food withholding period for puppies and kittens less than 2 weeks?
0 hours
From what time is water withheld for dogs and cats?
Water is taken away at time of premed (taken away at 6am for my clinic)
State 2 factors influencing scheduling of surgeries
Emergencies
Vets/nurses available
Clean surgeries first, then dirty
What are 3 advantages of IV induction over mask/chamber induction?
Smoother induction Faster Less anaesthetic agents used Less cost Reduces patient stress
Acepromazine:
- purpose: S…… and r…… of dose of induction agent.
- other effects: vaso-…… which reduces b…… pressure and causes h…..thermia. it also causes p…… of the 3rd eyelid.
- precautions: do not use in conditions causing l…..blood pressure (such as s….k or d……n). do not use in the b…… breed, nor in cases of known ep……, nor in c……. section.
- sedation and reduction
- vaso-dialation, blood, hypothermia, protrusion
- low blood pressure, shock and dehydration, boxer breed, epilepsy, caesarean section
Atropine:
- Main purpose: reduce o….. and r…… secretions and prevent or manage …….cardia
- other effects: …….. pupils, dries e…… and reduces g… motility
- precautions: contraindicated if pre-existing c….. disorders.
- oral and respiratory, brady cardia
- dialates pupils, dries eyes, gut motility
- cardiac disorders
methadone:
- main purpose: a…… and s…….
- other effects: ……cardia and ……pnoea
- precautions:may be contraindicated if patient has increased i…..-……. pressure
- analgesia and sedation
- bradycardia and bradypnoea
- increased intra-cranial pressure
thiopental:
- is known as thiopentone?
- belongs to the barbiturate class of anaesthetic agents ?
- is strongly alkaline but not irritant if injected perivascularly?
- is classified as a rapid induction agent
- true
- true
- false
- true
“thiopental is NOT SUITABLE for maintaining anaesthesia for prolonged periods by topping up as required”?
true, it is not suitable.
the pressure regulator (and its gauge):
- indicates the quantity of oxygen remaining in the oxygen tank?
- is adjusted by the anaesthetist to regulate the flow of o2 into the patient (mL/min)?
- provides constant pressure in the line even though pressure in the cylinder falls?
- true
- false
- true
“for most vaporisers the anaesthetic dial should be turned to OFF when refilling with anaesthetic”?
true, should be off
“most re-breathing circuits are also known as circle systems”?
true
“most non-re-breathing systems are functionally t-piece circuits”
true
“parallel tubing is also known as bi-axial tubing”
true
“tube-in-tube is also known as co-axial tubing”
true
2 disadvantages of non-rebreathing systems compared with rebreathing systems.
using lots of oxygen, less heat=lower body temp, more anaesthetic used
what are 2 ways to determine that sodalime needs to be replaced?
colour change, not generating heat, granules become non-crushable
principles to minimising human exposure to waste anaesthetic gases:
- use an effective s……… system
- perform a p……. l……. test each morning
- avoid m….. inductions. use facemasks with good s…..
- remove the box to a w……..-v………. area
- scavenging
- pressure leak
- mask, seal
- well-ventilated
principles to minimising human exposure to waste anaesthetic gases:
- allow patient to breathe only o……..
- to speed up recovery from rebreathing system d………. the patient from tubing, block end with t……., anaesthetic vapour is removed by the s……… system, then purge the circuit by pressing the …………… until bag is refilled
- oxygen
6. disconnect, thumb, scavenger, by-pass valve
what are 2 reasons why we place an E.T tube for anaesthesia rather than mask?
control of airways, less leakage of gases, less dead space
when placing E.T tube, span is usually:
mouth entrance to point of shoulder
what are two animal species or age groups which an un-cuffed ET tube is used?
neonates, rabbits, ferrets
spontaneous ventilation where there has been “endobronchial” intubation:
- can result in over-inflation of the intubated lung?
- occurs when the tip of a long tube lies within one bronchus?
- can result in severe hypoxaemia?
- can result in the collapse of the lung that is not intubated?
- false
- true
- true
- true
endobronchial intubation causes hypoxaemia which does not respond to either increasing ventilation or to increasing oxygen concentration because there is a mismatch of v……….. and p……….
ventilation and profusion
- stage I is known as the stage of v……….. e……….
- stage II is known as the stage of involuntary E……….
- stage III is known as the stage of s………. anaesthesia
- for routine abdominal surgery an ideal stage/plane would be stage ……., plane……..
- voluntary excitment
- involuntary excitment
- surgical anaesthesia
- stage 3, plane medium
ideal maintenance flow rate for rebreathing system?
30mL/kg/min
ideal maintenance flow rate for non rebreathing system?
300mL/kg/min
it is safest to start a rebreathing circuit anaesthesia with a total flow rate of 2L/min and pop off valve partially opened. true or false
true
which system will usually achieve the fastest mask inductions?
non- rebreathing
an animal with poor circulation will be anaesthetised by:
- mask induction (more/less) quickly than normally expected
- intravenous induction (more/less) quickly than normally expected
- more
2. less
what are 2 values of arterial blood pressure which can be directly measured?
systolic
diastolic
what are the units traditionally used to measure arterial blood pressure?
mmHg = mm of mercury
what are the units traditionally used to measure venous blood pressure?
cmH2O = cm of water
2 methods of measuring arterial blood pressure?
doppler
oscillometric
hypotension is present if systolic arterial pressure is less than?
80mmHg
organ injury is expected if mean arterial pressure remains below?
60mmHg
when talking about heart beat pattern (PQRST),
P= a………. c…………
QRS= v………. c……….., and this force normally generates the palpable p…….
T= re……….
P= atrial contraction QRS= ventricular contraction, palpable pulse T= repolarisation
Low SpO2 can be corrected by?
- 100% o2
- assisted ventilation
- reducing depth of anaesthesia
- correcting endobronchial intubation
- giving drugs which increase cardiac output
- giving IV fluids
all true
capnography gives an approximation of blood ………… levels.
The acronym ETCO2 stands for ………………..
blood CO2 levels
end tidal co2
hypercapnia means ………..
elevated levels of co2 in the blood
the units used to measure blood co2 are…………
mmHg
what are some causes of hypercapnia?
hypoventilation rebreathing co2 dead space expired sodalime high metabolism
hypercapnia results in the mucous membrane colour changing to ……-red or i…….. or f……… caused by a sympathetic response.
brick-red
injected or flushed
in dogs the major determinant as to when an ET tube should be removed is the return of the …..?
swallowing reflex
in cats the major determinant as to when an ET tube should be removed is the return of ……..?
movement
name one kind of fluid routinely used for prolonged sugery
hartmanns
what is the rate of IV fluids normally used for prolonged surgery?
10mL/kg/hour
state one condition in which fluids would be contraindicated?
heart failure, brain trauma
obese animals should have their dose if IV anaesthetic calculated on their estimated (lean/obese) body weight?
lean
how many bag squeezes should be given every 30 seconds when managing post-induction apnoea
one bag squeeze every 30 seconds
giving supplementation oxygen prior to anaesthesia is beneficial in which of the following?
- respiratory failure
- toxaemias
- head trauma
- circulatory failure (shock)
all of them
where is an epidural injection made?
on top of the outer meningeal layer of the spinal cord
important points for properly loading a steam autoclave:
- packsize? (large/small)
- pack orientation? (flat/upright)
- pack separation? (loose/tight)
- bowls? (upside up/upside down/sideways)
- screw caps? (tight/loosened)
- sterilisation indicator placed where? (deep/superficial)
- small
- upright
- loose
- sideways
- loosened
- deep
limits of the sterile field?
- instrument table?
- patient?
- torso of fully gowned person?
- arms of fully gowned person?
- yes, within sterile drapes
- only sterile in surgical field
- yes, sterile
- yes, sterile
swaged needles (do/don’t) have an eye through which the suture material is threaded
dont
needle tip types:
- circle
- triangle
- upside down triangle
- oval
- taper
- cutting
- inverted cutting
- side cutting
protect open wounds using s…….-soaked s…… or s…….. l……
saline-soaked swabs or sterile lube
decubital ulcers are more simply known as p…….. s…….
pressure sores
