GoConqr has a new look! Let us know what you think.

Sign up free

Flashcards

Surgery

Siobhan Ellis Medicine Level 4 English 88 cards

Surgery

Cards in this deck (88)

  1. 1For a Coeliotomy where should the incision be?Ventral midline 5cm caudal to Xiphoid and as far possible before mammary tissue
  2. 2How should you incise the lines alba?Lift with forceps and make a stab incision with a scalpel then cut along with scissor, round side down
  3. 3What do you need to record before you start an ET?How many corpus lutea
  4. 4Once the ovaries are exposed, what are the steps for ET?Stab incision into uterine horn after bifurcation by a small curved haemostat, insert catheter and inflate
    Inject 20mL fluid into lumen near utero-tubal junction with blunt 20G needle
    Collect fluid into petri dish
  5. 5What do you need to suture after an ET?The uterine horn with a single stitch
  6. 6What fluid is used for ET?Phosphate buffered saline
  7. 7How do you close the peritoneum and abdominal wall?Simple interrupted
    Do not have to include peritoneum
    Monofilament synthetic absorbable, size 0 or larger
  8. 8How do you close the SQ?Simple continuous or subcuticular suture
    2/0 or 3/0 monofilament synthetic absorbable
  9. 9How do you close the skin?Simple interrupted or interrupted vertical mattress
    2/0 coated multifilament often non absorbable
  10. 10What needs to be done before ET for the donor and recipient?Donor - super ovulated
    Recipient - synchronised with donor
  11. 11What day does ET occur in a cow?Day 7
  12. 12What is the different in technique of ET between large and small animals ?Small animals done surgically and large animals done through cervix
  13. 13Why can't older animals be ET donors?Do not respond well to super ovulation and may only have single embryo
  14. 14How does super ovulation occur?Prevents the dying of the first wave of follicles
    FSH to grow follicles, LH to prevent death and PG to remove CL
  15. 15What is the estimated survival of GDV?50%
  16. 16What are the two types of GDV?Air swallowed and stomach twisted
    Large quantities of dead food in working dogs and stomach twisted
  17. 17What is the normal rotation in a GDV?Ventromedially to lie on the left side of abdomen
  18. 18What is some anaesthetic considerations for GDV?Painful disease so requires higher level of anaesthetic
    Higher risk
    Pain relief
  19. 19Why is GDV associated with shock?Decreased venous return and hypovolaemia
  20. 20What are the breed predisposition for GDV?Great dane, hunt away and GSD
  21. 21What are the GI effects of GDV?Accumulation of gas increases pressure
    Capillary collapse and necrosis of mucosa
    Haemorrhage into stomach
    Bacterial infection
  22. 22What are the CV and respiratory effects of GDV?Pain causes tachycardia and tachypnoea
    Decreased venous return
    Compressed diaphragm reduces ventilation
  23. 23How do you differentiate from dilation and volvulus?Dilation won't be that sick, just uncomfortable
  24. 24What diagnostics should you do for GDV?Emergency so only radiographs to confirm
  25. 25What can be a good prognostic factor of GDV?Lactate
  26. 26What is the emergency stabilisation of GV?Catheter, fluids, pain meds and oxygen
    Decompression
    Antibiotics
    If have poor pulse and BP - lidocaine
  27. 27How do you decompress a GDV?Large long 14-16G bore needle into stomach
    Stomach tube
    Can remove contents during surgery
  28. 28How can you prevent an awake patient from biting a stomach tube?Cardboard tape roll in patients mouth
  29. 29What indication on surgery suggests direction of twist?Omentum stretched over stomach then twist is clockwise
  30. 30How do you derotate a GDV/Grabbing duodenum and rotating while pushing stomach down
  31. 31What suggests necrotic GDV?Shiny, silver, grey or green is necrotic
    Doesn't bleed
  32. 32Which Gastropexy is preferred?Incisional
  33. 33How do you preform a GDV?Incise abdominal wall muscles
    Assistant everts wall
    Pinch stomach wall to separate submucosa and mucosa and tunnel under with haemostat and cut over the top
  34. 34When is the best time to preform an OVE?Before second season or coming into heat (5-6 months)
  35. 35What is the difference between dogs and cats for OVE incision?Dogs - cranial extent of umbilicus scar
    Cats - between umbilicus and pubis
  36. 36What is a flank spay CI for?Point cats as fur may grow back a different colour
  37. 37What animal has a long term risk of EAN?Bitches - urinary incontinence
  38. 38Which animals should you break vs stretch ligament in for OVE?Cat - stretch
    Dog - break
  39. 39What type of ligature is used on the ovarian pedicle?Circumferential
  40. 40What does IM pins and cerclage prevent?IM pins stop bending
    Cerclage wire stops shearing and rotation
  41. 41What is a reconstructable fracture?Anatomical reconstructed
    Primary bone healing
    Load sharing with implants
  42. 42What is a non reconstructible fracture?Cannot put them back together to make load sharing so implant takes all weight
    Biological repair
    Leave fracture and blood supply intact
  43. 43When can you use an IM pin without cerclage?Interlocking simple fractures in young patients
    Transverse fracture
  44. 44When is cerclage CI?Young animals as may cause ring bark bone
  45. 45What bone should you never put an IM ipn in?Femur, tibia and humerus
  46. 46What should you ensure your pin in in ?Medullary bone from either end
  47. 47When is IM CI?Communited fractures, open fractures, wide bones
    Never as sole means of fixation for transverse
  48. 48What bones do you approach normograde for IM?Femur to avoid hip joint and sciatic nerve
    Tibia to avoid stifle joint
  49. 49What is dowel pinning?IM pin that has no access points (all internal)
  50. 50When do you use dowel pinning?Paired bones as stability is from multiple pins and splint
    Metacarpal bones as no way of pinning without damaging joint
  51. 51What is the benefit of a Jacobs Chuck over a electric drill?Complete sterility
  52. 52How do you not hold a Jacobs Chuck?Back end in the palm (pin may go through)
  53. 53What is the minimum cerclage wires you can use?2
  54. 54What wire sizes are appropriate for different sizes of animals?Large dog - 18G
    Medium dog - 20G
    Small dog and cat - 22G
  55. 55What part of the bone must you place your cerclage?Narrowest
  56. 56What is interfragmentary cerclage?Small IM pins have cerclage wire looped around external part
  57. 57What is tension banding?Compression using two wires in the bone in a figure of 8
  58. 58What are the problems of cerclage?Loose loops damage blood supply
    Prevent bone growth in young animals
  59. 59What may cause implant failure?Incorrect placement
    Undersized or of poor quality
    Infection
    Excessive movement
    Damage to BV
  60. 60What are the potential outcomes of fracture repair failure?Malunion - functional or non-functional
    Delayed Union
    Non-union
    Sequestrum and involucrum
  61. 61What does hypertrophic bone activity appear like?Elephants food
    Indicates lack of stability
  62. 62What increases the risk of surgical infection?Long surgeries, implant use, tissue trauma
  63. 63Why does implant use increase the risk of surgical infectionAllows biofilm to form which harbours bacteria and the body cannot fight
    If the immune system is compromised or there is movement bacteria is release and spread haematogenously
  64. 64What is done to reduce the risk of sruvial infection?High dose of IV cephalosporin at induction
  65. 65What type of fracture still has a high risk of infection despite proper care?Grade 3 open fracture - skin, muscle and ligament removes with a possible open joint
  66. 66What should be done with an open fracture to reduce contamination?Cover as soon as possible
    Only use sterile equipment
    High hygiene standards to prevent contamination from hospital bacteria
  67. 67What is a dystrophic non union?Bone has been remodelled at the end
  68. 68What is the different types of inactive non unions?Dystrophic, necrotic, defective, and atrophic
  69. 69What is a defective inactive non union?May not try to bridge the bone gap
  70. 70What is atrophic inactive non union?May never heal completely
  71. 71What is inactive non unions common in toy breeds?Small amount of blood supply from muscle and medullar cavity
  72. 72What is most important for recruitment of new blood supply for bone?Extra osseous muscle
  73. 73How do toy breed fractures heal?Primary bone healing - anatomical reconstruction and complete immobilisation (plate)
  74. 74What are the different types of plates?Compression, neutralisation, bridging
  75. 75Where should the plates be placed?On the tension side of the bone
  76. 76What is a compression plate used for?Load sharing transverse or very short oblique
  77. 77What is a neutralisation plate used for?Oblique fractures to stop rotation
  78. 78What does a bridging plate do?Takes all the load across a fracture
  79. 79What size should a bridging plate be?The entire length of the bone
  80. 80What should be done before you do the lateral fabellar suture?Arthrotomy to examine ligament and meniscus for damage
  81. 81How do you preform a lateral fabellar suture?Pass suture around cranial half of fabellar proximal to distal
    Drill hole with IM pin through tibial crest from lateral to medial
    Crimp suture
  82. 82What can be used to repair the tendon and ligament?3-loop pulley or locking loop suture
  83. 83What type of instrument is this and what is it used for?Jacobs chuck
    IM pin insertion    What type of instrument is this and what is it used for?
  84. 84What type of repair is this?Hemi-cerclageWhat type of repair is this?
  85. 85What type of repair is this?Inter-fragmentary K wiresWhat type of repair is this?
  86. 86What type of repair is this?Lateral fabella suture for cruciate repairWhat type of repair is this?
  87. 87What type of repair is this?Locking loop sutureWhat type of repair is this?
  88. 88What type of repair is this?Three loop pulley systemWhat type of repair is this?

Information

Description
Level 4 Medicine (Practicals) Flashcards on Surgery, created by Siobhan Ellis on 28/09/2016.
Created by
Siobhan Ellis
Views
2
Rating

Feedback

What is it about?

What do you think of the new look?

How do you like it?