Flashcards
Week 2
Cards in this deck (101)
- 1Approaches to abdominal surgery (5)Midline
Paramedian
Flank/paralumbar
Inguinal
Paracostal - 2Adv/Dis and examples of Midline surgeryAdvantage: Avascular and good strength
Dis: Visceral weight over incision
eg. Midline spey - 3Location and examples of Paramedian surgeryParallel to midline through rectus abdominal muscle
Used in cattle and to avoid midline vessels in reptiles - 4Adv/Dis and examples of Flank surgeryAd: Less weight of viscera
Dis: Visible incision area
Example: Flank spey - 5Location and examples of Inguinal surgeryOver inguinal canal to access reproductive organs or inguinal hernias
- 6Location and examples of Paracostal surgeryFlank approach parallel to last rib
- 7Ex lap approach in Cats and dogs Horse RuminantsCat and dog: midline
Horse: Midline and palpation
Ruminant: Flank and palpation - 8Process of ex lapGI inspection from beginning to end followed by urinary tract, liver, spleen and adrenals
- 9Protection of organs during ex lap.Keep organs moist and warm
Surround by packing sponges - 10Complications of a laparotomyPeritonitis
Wound breakdown
Non retrieved swabs or instruments - 11Stages of wound breakdownEarly breakdown - evisceration
Breakdown partial - suture breakdown but body wall intact
Late breakdown - Skin healed but body wall not intact leading to hernia - 12Diagnosis of uroabdomen before surgeryCreatinine levels and biochem
Abdominocentesis
Ultrasound and radiology - 13Types of hernias (5)Umbilical
Inguinal
Ventral
Perineal
Diaphragm - 14What is a hernia?A prolapse of a viscus through an abdominal opening/defect of the body cavity it normally lies in
- 15What is a true hernia?Has hernial ring, hernial sac and hernial contents
- 16What is a false hernia?Have no hernial sac
- 17Symptoms of hernial strangulationSudden increase in size
becoming painful
Firm and warm with oedema
Skin discolouring - 18Umbilical herniasCongenital, usually omental fat
Surgical correction not usual as they can spontaneous - 19Inguinal/scrotal herniasHerniation through internal inguinal ring, can become scrotal in males either beside or within the vaginal tunic
Common in pugs, inguinal weakness is heritable. Occurs later in life due to physiological stress eg. whelping - 20Surgical technique for inguinal herniasClosed castration in males
Milk + amputate sac in females
Close external inguinal ring - 21Ventral herniaRupture of abdominal wall in any part of the abdomen, also caused by rupture of prepubic tendon
- 22Diaphragmatic herniasCan be traumatic or congenital
Traumatic most common, requires closed glottis on impact
Most common type of congenital is PPDH - 23Symptoms of diaphragmatic herniaHistory of previous trauma
Respiratory symptoms: Tachypnoea and dyspnoea and muffled heart sounds
Emergency: Tympany, continued haemorrhage and strangulation - 24Respiratory and cardiovascular compromises in diaphragmatic herniasResp: can't generate negative pressure and pain
Cardio: Myocardial damage and decreased venous return - 25Surgical technique for diaphragmatic herniasMidline laparotomy with ventilator
- 26Post op care for diaphragmatic herniasChest drain
Pain relief and oxygen
Gradual reinflation of lungs - 27Perineal herniasIn older and intact male dogs. Causes defecation problems. Surgery to recreate pelvic diaphragm, castration and diet change to reduce straining and prevent recurrence
- 28HydronephrosisProgressive dilation of the renal pelvis
- 29PyelonephritisInfection within renal pelvis
- 30Ectopic ureterCongenital abnormality where ureter terminates distal to the trigone of the bladder
- 31Partial cystectomyPart of the bladder surgically removed
- 32UrohydropulsionForcible removal of calculi from from urethra back into the bladder
- 33Indications for a nephrectomyIdiopathic haematuria
Neoplasia
Pyelonephritis
Trauma - 34Indications for a nephrotomyObstruction by calculi
- 35Common ureter conditionsEctopic ureters - urinary incontinence
- 36Common bladder conditionsCommon calculi formation site
Cystoliths: cause recurrent haematirua, cystitis and stranguria
Removal by cystotomy - 37Common urethra conditionsBlockage by calculi in males leading to stanguria and haematuria
Complete obstruction can cause post obstructive renal failure - 38Pre-operative care for urinary patientsAssessment of renal function: biochem
Radiography and ultrasonography for diagnosis
Record appetite, drinking, vomiting and urination frequency and character - 39Peri-operative care for urinary patientsFluid and electrolytes
Prophylactic antibiotics - 40Post operative care of renal patientsMonitor vital signs, particularly urine volume and character
IV fluids
Closed catheter system monitoring - 41Catheters for dogs (3)Rigid plastic
red rubber/silicone
Foley (balloon) - 42Catheters for cats (3)Plastic tomcat catheters
Slippery sam
IV catheters - 43Oxygenation for respiratory patientsPre-and post op ventilation via a mask, chamber or O2 line
- 44Common respiratory conditionsBrachycephalic airway syndrome
Laryngeal paralysis
Thoracotomy - 45Anatomic abnormalities causing BASStenotic nares
Thick and long soft palate
Shorter bones
Laryngeal collapse - 46Laryngeal paralysis cause, symptoms and treatmentCaused by nerve degeneration
Symptoms: Stridor, exercise intolerance and hyperthermia
Arytenoid cartilage lateralisation surgery - 47Purpose and approaches for thoracotomyGain access to thoracic cavity for tumors, lobe torsion, cysts etc.
Lateral intercostal and medial sternotomy - 48Pre and post op care for respiratory surgeryPre: Check ABC and airway, pre oxygenate, give IV fluids and place in sternal recumbency
Post: Chest drain, O2 via nasal catheter and close monitoring - 49Treatment for Aural haematomasAural haematoma - remove clot and stitch skin to cartilage
- 50Treatment for severe aural disease in cats and dogsDogs:
Total ear canal ablation and lateral bulla osteotomy: removal of external and middle ear canal
Cats:
Ventral bulla osteotomy - removal of middle ear only - 51What is horner's syndrome?Damage to nerve during ventral bulla osteotomy causing third eyelid prolapse on operated side
- 52Presentation of arthritic patientsReluctance to exercise and tiredness
Stiff getting up
Reduced muscle mass and appetite
Changes in gait and walk or run - 53Difference between rheumatoid and osteoarthritisInflammatory vs. degenerative.
Rheumatoid less common - 54Development of degenerative arthritisUsually secondary to dysplasia
- 55Diagnosis of arthritisClinical exam, joint manipulation and radiology
Joint fluid cytology - 56Structure of the most common jointsDiarthrodial / synovial
Bones have articular cartilage surrounded by fluid in the joint capsule - 57What is degenerative joint disease?Deterioration of the joint causing cartilage wear, thickened tissue around the joint, subchondral bone thickening and osteophyte development
- 58What is an osteophyte?Bony proliferation around the joint
- 59Cause and consequences of cartilage wearStress on cartilage
Causes cracks. Deep cracks cause inflammatory mediator release. Cracked cartilage continues to degrade under stress/weight - 60Other causes of degenerationTrauma
Luxation
post op complication
Articular fracture
Neoplasia - 61What is ankylosisFusion of joint by new bone formation
End result of osteoarthritis - 62What is arthrodesisJoint replacement
- 63Treating asymptomatic patientsPositive on radiographs but no symptoms are treated via dietary intervention
- 64Treatment optionsNSAIDs
Chondraprotective drugs
Weight management
Neutraceuticals
Exercise
Physio - 65Weight management to prevent DJDFeed at 80% RER of target weight
Ideal dog condition: 4/9 - 66Nutritional supplements and dietsOmega 3 decreases inflammatory response or Hills J/D
- 67Cartrophen and pentrosanInjectable form of cartilage constituent
Helps ~80% patients but expensive and pentrosan can affect blood clotting - 68Using NSAIDsCan overdose and cause GI symptoms
Should give lowest dose possible with food and not given if animal dehydrated.
Not as safe - 69Three aspects of wound managementCleaning
Closing
Covering - 70Classification of wounds (4)Clean
Clean-contaminated
Contaminated
Dirty (infected) - 71Clean woundsNon traumatic and no break in sterile technique. No entry to resp or GI tract. No drains. External.
- 72Clean-contaminated woundsEnters non infected urinary, resp or GI tract but no spillage
- 73Contaminated woundsTraumatic wound <4 hours old with entry into infected tract with spillage. Inflammation but no abscess
- 74Dirty woundsPus present, perfourated viscus or traumatic wounds >4 hours old
Has fecal or environmental material present
Bite wounds
Require drainage, closing causes abscesses - 75Factors that influence wound healingSite of wound
Local wound and systemic factors
Duration of pre op stay
Post op care and cleaning
Hair removal
Bowel prep
Theatre practice - 76Stages of wound careAddress cause and contributing factors
Prevent further contamination
Clean and lavage thoroughly
Debridement and sample taking
Antibiotics and drainage
Selective closure and bandaging - 77How to prevent further contaminationCover on arrival
Dry or wet to dry dressing - 78Non selective vs. selective debridementNon selective - removal of necrotic and viable tissue. Can't use wet to dry bandages anymore
Selective: Necrotic only - 79When to use antibioticsMuscle fascia disrupted
Questionable tissue remains after debridement
Immunocompromised patient
Signs of systemic infection - 80Passive vs active drainsPassive: Use gravity
Active: use vacuum - 81Types of wound closure (4)Primary closure
Delayed primary closure
Secondary closure
Healing by contraction - 82Primary closureFor fresh and clean wounds, closure at first treatment
- 83Delayed primary closureClosure 3-5 days after injury
Moderately contaminated and traumatic wounds - 84Secondary closure>5 days after wound
For severely contaminated wounds - 85Healing by contractionNo closure by surgeon
Healing by contraction and epithelium - 86Complications of surgical woundsWound breakdown
Infection
Seroma
decreased blood supply - 87Aftercare of wounds (4)Dress wound for protection
Monitor the wound and patient
Prevent self mutilation
Timely suture removal - 88Functions of a bandagePromote healing
Protect wound
Absorb exudate
Eliminate dead space
Apply or relieve pressure
Administer topical meds
Modulate pain
Aesthetics
Restrict/allow safe movement
Stabilise underlying structures - 89Dressing surgical woundsAbsorbs exudate from wound
Protection from contamination - 90Dressing contaminated woundsWet-dry bandage to help debridement
Heal by second intention - 91Layers of bandagesContact layer
Intermediate layer
Outer layer - 92Layered vs en bloc surgical debridementLayered: Large wounds debrided superficially to deep
En bloc: Complete excision of small wounds - 93Types of and function of contact layerTouches the wound and helps with healing, debridement and forms a seal to protect the wound and to maintain a moist environment
Dey & wet adhesive - debrides necrotic tissue
Non adhesive in repair phase - doesnt disrupt healing tissue on removal - 94Ointment for wounds (2)Intrasite gel: supportes epithelial development in granulating wounds and facilitates autolytic degeneration.
Si;vazine: Good for wounds with bacterial contamination - 95Function of primary layer of bandageTo keep the contact layer in place
stockimette material that you can wrap the secondary layer over - 96Function of secondary/intermediate layerTraps discharge and draws fluid away from the wound, must be thick. Adds structural support to prevent movement and keep primary layer in place
- 97Tertiary/outer layer of bandageHolds all other layers in place and prevent contamination. Lets fluid evaporate but must be kept dry
- 98Types of bandages (5)Foot dressing
light/medium padded
Robert Jones
Ehmer sling
Velpeau sling - 99Function of skin graftsPromote epithelialisation over wounds
Useful for large areas or after surgical skin defect - 100Complications to look out for during wound healing (7)Exudate and character
Patient comfort
Erythema
Oedema
Haematoma
Pain
Odour
Also monitor sings of systemic disease, demeanor and vital signs - 101Timing for suture removal7-10 days plus inspect wound and healing
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- Surgery and Imaging Flashcards on Week 2, created by Kelly Scott on 04/02/2020.
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- Kelly Scott
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