Surgical And Theatre Flashcards
Otomy definition
Temporary cut through tissue eg. Spey
Ostomy definition
Creating a permanent opening in tissue eg. Tracheostomy
Ectomy definition
Removing a structure eg. Spleenectomy
Exploratory laparotomy means?
To open up the abdomen
Minimum age of person giving informed consent
18 years old
Routine food- withholding period for adult dogs and cats
3hrs (6-12hrs)
Routine food-withholding period for puppies and kittens under 2wks (neonates)
0hrs
From what time is water withheld from dogs and cats for routine surgery
Water is removed at time of pre-med
Factors influencing scheduling of surgeries
Emergencies
Clean vs. dirty
Elective/ non-elective
Available staff
ACEPROMAZINE
Purpose: … and … of induction agent dose
Other effects: …. which …. BP, … thermia, … of 3rd eyelid
Precautions: not used in … BP conditions (shock/ dehydration), do NOT use in …. breeds, not used in cases of …. or …
Purpose: sedation and reduction of induction agent dose
Other effects: vasodilation which reduces BP, hypothermia, protrusion of 3rd eyelid
Precautions: not used in low BP conditions (shock/ dehydration), do NOT use in boxer breeds, not used in cases of epilepsy or caesareans
ATROPINE
Purpose: prevent or manage …, reduce … and … secretions
Other effects: … pupils, … eyes, reduces ….
Precautions: contraindicated if pre-exisiting … disorders
Purpose: prevent or manage bradycardia, reduce oral and respiratory secretions
Other effects: dilates pupils, dried eyes, reduces gut motility
Precautions: contraindicated if pre-exisiting cardiac disorders
METHADONE (methone)
Drug group: ….
Purpose: … and …
Other effects: …. and ….
Precautions: contraindicated in cases of …. (intracranial pressure)
Drug group: opioids
Purpose: analgesia and sedation
Other effects: bradycardia and bradypnoea
Precautions: contraindicated in cases of head trauma (intracranial pressure)
Advantages of IV induction over face mask or chamber induction:
Faster
Smoother induction
Reducing patient stress
Less anaesthetic agent used (ISO)
Thiopental/ thiopentone
What class of anaesthetic agents?
It is a rapid induction agent?
Not irritant or highly irritant if injected perivascularly
Belongs to barbiturate class
Rapid induction agent
Highly irritant if injected perivascularly
Is thiopental suitable for maintaining anaesthesia for long periods by topping up?
No, not suitable to be topped up to maintain prolonged anaesthesia
What does a pressure regulator do?
Indicates quantity of oxygen left in tank and maintains constant pressure within cylinder
Vaporisers should be ON/ OFF while refilling anaesthetic?
OFF
Rebreathing circuits are also known as?
Circle systems
Non- rebreathing circuits are also known as ?
T-piece circuits
Parallel tubing is also known as?
Biaxial tubing
Tube in tube is also known as ?
Coaxial tubing
Disadvantages of non-rebreathing systems?
More O2 and ISO used
Lowers body temp due to cold and dry air
2 ways to determine if soda lime needs replacing?
Colour change
No heat is generated when in use (soda lime should generate heat when efficiently removing expired CO2 from the circuit)
Principles of minimising human exposure to waste anaesthetic gases:
- Use an effective … system
- Perform … test
- Avoid … induction and use masks with a good …
- If chamber induction is used remove box in a … area
- At end of procedure allow patient to breathe only …
- Speeding recovery= … patient, block end of tube with … open pop off valve and squeeze bag, anaesthetic from circuit is removed by … system, purge using … and repeat then close pop off as required and reconnect patient so they breathe only O2.
- Scavenger
- Pressure leakage
- Mask induction, seal
- Well ventilated
- Oxygen
- Disconnect patient, block with thumb, removed by scavenger, purge using by pass valve
Reasons why ET tube is placed for maintenance of gaseous anaesthesia instead of face mask?
Less leakage of anaesthetic gases
Control of airways (IPPV)
Less dead space
Eliminates chance of aspirating on vomit if placed correctly
ET tube is placed ?
From mouth entrance to the point of shoulder
Animal species/ group which Un-cuffed ET tubes are used ?
Reptiles Birds Neonates Ferrets Rabbits
Spontaneous ventilation where endobronchial intubation occurs
- Can result in over inflation of inhabited lung?
- Occurs when tip of tube lies within one bronchus?
- Can result in severe hypoxaemia?
- Can result in the collapse of the lung that is not intubated?
- No
- Yes
- Yes
- Yes
Endobronchial intubation causes hypoxaemia which doesn’t respond to increasing ventilation or oxygen because there is a mismatch of … and … whereby the blood flowing from non intubated lung is deoxygenated which mixes with the blood from oxygenated lung.
Ventilation and perfusion
STAGES OF ANAESTHESIA Stage I Stage II Stage III Stage and plane ideal for routine abdominal surgery
- Voluntary excitement
- Involuntary excitement
- Surgical anaesthesia
Ideal stage is 3, and plane medium
Ideal maintenance flow rate on a RE-BREATHING (circle) system?
30mL/kg/min
Ideal maintenance flow rate on a NON-REBREATHING (t-piece) system?
300mL/kg/min
I general what is a safe flow rate to start a RE-BREATHING circuit on?
2L/min
Which system with usually achieve faster mask induction?
Non-rebreathing
An animal with poor circulation will be anaesthetised by MASK induction MORE/LESS quickly than expected?
Will they be anaesthetised by IV induction MORE/LESS quickly than expected?
An animal with poor circulation (heart failure/shock/dehydration) will be MORE quickly anaesthetised by induction with a face mask and LESS quickly than normally expected by IV induction
2 values of ARTERIAL BP
Systolic
Diastolic
Units to measure ARTERIAL BP
mmHg (mm of mercury)
Units used to measure VENOUS BP?
cmH2O
Methods to measure ARTERIAL BP?
Doppler
Oscillometric cuff
Hypotension is present if SYSTLOIC arterial pressure is below?
<80mmHg
Organ injury is expected if MEAN arterial pressure remains below?
<60mmHg
PQRST wave
P represents?
QRS represents? And generates what?
T represents?
P presidents atrial contraction
QRS represents ventricular contraction and generates a palpable pulse
T represents repolarisation
Which of the following correct low SpO2
- 100% oxygen
- Assisted ventilation
- Reducing depth of anaesthesia
- Correcting endobronchial intubation
- Giving drugs which increase cardiac output
- Giving IV fluids
All of the above
- Capnography gives approximation of … levels.
2. ETCO2 stands for …
- Blood CO2 levels
2. End tidal CO2
Hypercapnia means
Increase levels of CO2 in blood
Units to measure blood CO2
MmHg (mm of mercury)
Causes of hypercapnia?
Hypoventilation
Dead space
Expired soda lime therefore rebreathing CO2
Hypercapnia results in the mucous menbrane colour changing to … or … or … caused by sympathetic response
Brick red
Injected
Flushed
HYPOcapnia is cause by
Hyperventilation
Major determinant as to when an ET tube is removed in dogs is the ?
Return of swallow reflex
In cats the major determinant as to when the ET tube is removed is return of ?
Movement (limbs, ear twitches, tongue flicking, tail movements)
Fluid commonly used in prolonged surgeries
Hartmanns (lactated ringers solution)
Rate of IV fluids in a prolonged surgery
Generally 10mL/kg/hr
(Dogs 5-10mL/kg/hr)
(Cats 3-7mL/kg/hr)
Conditions where fluids are contraindicated?
Heart failure
Brian trauma
Obese animals should have their dose of IV anaesthetic calculated on their … ?
Estimated lean body weight
Obese animals require increased effort to what?
Breathe
Reasonable recommendation for managing post induction apnoea?
1 bag squeeze every 30 seconds
Which of the following conditions is supplemented oxygen beneficial in?
- Respiratory failure
- Toxaemias
- Head trauma
- Circulatory failure (shock)
All of the above
An epidural injection is made where?
On top of the outer meningeal layer of the spinal cord
AUTOCLAVE
- Pack size ?
- Pack orientation?
- Pack separation?
- Bowls?
- Screw caps?
- Sterilisation indicator placed?
- Small
- Upright
- Loose
- Sideways
- Screw caps loosened
- Deep
STERILE FIELD
- Instrument table?
- Patient?
- Torso?
- Arms?
- Yes within sterile drapes
- Yes within sterile drapes and scrubbed area
- Yes front of body within waist to mid thorax
- Yes up until elbows
List 2 common Needle holders
Olsen hegar
Mayo hegar
Other 2 types (gillies, Matthieu)
3 SCISSORS and purpose
- Mayo: heavy dissection
- Metzenbaum: fine dissection
- Surgical scissors: sharp blunt used for sutures and general purposes
What are dressing forceps is used for?
Holding swabs and delicate tissue?
Forceps with teeth are called ?
Ads on rats tooth thumb forceps
Use of mosquito forceps?
Clamping delicate vessels
Use of allis tissue forceps
Holding tissue
Use of Carmalts?
Clamping thick fatty vascular stumps (uterine stump, ovarian pedicle)
Bowel clamps used for?
Clamping intestine
3 types of towel clamps
Roeder
Backhaus
Crossaction
Hohmann retractors (BONE LEVERS) use??
Dislocating joints
Retracting/ levering muscles, tendons, ligaments
Gelpi retractor use?
Exposure of deep joints and muscles
Weitlaner retractor use?
Exposure of muscles and joints
Balfour used for?
Commonly used in ex-laps
Abdominal retractors
Periosteal elevators used for?
Lifting periosteum off bone
Bone curettes used for?
Debriding bone
Oestotome and bone chisel used for?
Cutting bone
Rongeurs used for?
Nibbling bone
Point to point reduction forceps
Clamping into bone
Jacobs chuck used for?
Driving pins into bone
Wire twisters and wire passers used for?
Twisting wire
Passing wire around a bone
Swaged (atraumatic) needles DO/DONT have an eye through where suture is threaded?
DON’T
Protect open wounds using … or …
Saline soaked swabs
Sterile lube
Decubital ulcers are more simply known as …
Pressure sores