Jr Sx final

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mayabug
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116280
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Jr Sx final
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2011-11-14 00:17:11
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Jr Sx final
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Jr Sx final
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  1. standard dressing forceps
    used on gauze
  2. Brown-Adson forceps
    • bilateral row of small teeth
    • used on tissues
    • do not use on viscera if possible
  3. rat-tooth forceps
    coarse interdigitating teeth
  4. Backhaus towel clamp
    secure quarter drapes
  5. Snook Ovariohysterectomy hook
    used for retracting uterine horn
  6. Metzenbaum scissors
    delicate soft tissue scissors
  7. Mayo scissors
    heavy tissue scissors (ie- linea alba)
  8. Wire suture scissors
    used for cutting wire suture and cerclage wire
  9. sharp-blunt operating scissors
    used for cutting non-metallic suture and paper drapes
  10. Crile forceps
    • hemostatic forceps
    • transverse serrations covering entire jaw
    • used for large bleeders
  11. Kelly forceps
    • hemostatic forceps
    • transverse serrations covering 1/2 of jaw
    • used for large bleeders
  12. Carmalt forceps
    • hemostatic forceps
    • longitudinal serrations
    • used to clamp large sections of tissue
  13. Allis tissue forceps
    • interlocking serrations at tip
    • crushing effect
    • used only on tissues to be excised
  14. Olsen-Hegar needle holders
    suture cutting capability
  15. Mayo-Hegar needle holders
    no suture cutting capability
  16. Bard-Parker #3 scalpel handle
    holds blade
  17. Doyen Intestinal Forceps
    used to occlude bowel to be anastomosed without causing tissue trauma
  18. ASA I
    • normal
    • elective
  19. ASA II
    • mild systemic dz
    • skin tumor, fracture, hernia
  20. ASA III
    • severe systemic disease
    • fever, dehydration, mod hypovolemia, anemia
  21. ASA IV
    • severe systemic disease that is a constant threat to life
    • toxemia, severe dehydration, severe hypovolemia, cardiac decompensation
  22. ASA V
    • moribund
    • extreme shock, severe trauma
  23. inc HR
    • light anesthesia
    • pain
    • hypovolemia
    • anticholinergics
    • catecholamines
    • hyperthermia
    • CO2 retention
    • metabolic acidosis
    • over distended urinary bladder
  24. dec HR
    • deep anesthesia
    • waning of anticholinergics
    • vagal stimulation- eyeball pressure, intubation, carotid pressure
    • hypothermia
    • hypoxemia
  25. inc RR
    • CO2 retention
    • metabolic acidosis
    • light anesthesia
    • hyperthermia
    • CNS stimulation
  26. dec RR
    • deep anesthesia
    • IPPV
    • hypothermia
    • muscle relaxtion
    • CNS edema
  27. order of loss of reflexes
    • swallowing- first
    • laryngeal response
    • withdrawal
    • palpebral
    • corneal
    • anal
  28. pupillary response under anesthesia
    • light- dilated
    • sx plane- constrict
    • deep- dilate
  29. eye position under anesthesia
    • light- ventral and medial
    • sx- slight medial
    • deep- dorsal
  30. inc HR and pulse
    light anesthesia
  31. inc HR, dec pulse quality
    low cirulationg volume
  32. dec HR and pulse
    deep anesthesia
  33. inc CRT
    poor perfusion
  34. injected mucous membranes
    • vasodilation
    • CO2 retention
    • hyperthermia
    • polycythemia
  35. pale mucous membranes
    • anemia
    • blood loss
  36. cyanosis
    hypoxemia
  37. causes of dead space
    • multiple strokes with blade
    • lifting while suturing
    • poor tissue handling
  38. epidermis
    lacks blood vessels
  39. dermis
    • vascular
    • provide nutrition to epidermis
  40. possible complications of skin incisions
    • infection
    • dehiscence of incision
    • self mutilation
    • hemorrhage and seroma
  41. mechanical dead space
    part of breathing system and tube where there is no gas exchange, y-piece
  42. anatomical dead space
    lips to bronchi
  43. clean operation
    nontraumatic wounds without inflammation or beaks in surgical technique
  44. clean-contaminated operations
    • GI or resp tracts are entered without significant spillage
    • minor break in aseptic technique
  45. contaminated operation
    • major break in sterile technique
    • gross spillage from GI tract, genitourinary tract, or biliary tract with infected urine or bile
  46. dirty operation
    • bacterial inflammation
    • traumatic wound
  47. PVI scrub
    • 5 minutes contact time
    • can be alternated with alcohol
  48. chlorhexidine scrub
    • 1 minute contact time
    • binds to keratin
    • continuous effect
  49. adverse effects of antibiotics
    • anaphylactic reaction
    • selecting for resistant strains
    • masking infections
    • increased cost
  50. basic principles of rational antibiotic useage
    • present at time of contamination
    • narrowest spectrum of activity that will protect
    • keep duration of administration to a minimum
  51. when should prohylactic Ab be given
    • 30 min prior to sx incision, depends on how long it takes to reach effective concentration
    • during sx q2-4hr
    • discontinue 3-6hr after sx
    • given if sx longer than 90 min
  52. elliptical defect
    • parallel to lines of tension
    • length:width 4:1
    • relieve tension
    • V becomes Y
    • Z plasty has the central limb perpindicular to ellipse
  53. changes in angle of z-plasty will inc length
    • 30 degree angle- 25% inc length
    • 45 degree angle- 50% inc length
    • 60 degree angle- 75% inc length
  54. -ostomy
    • btw 2 things
    • open and leave open
  55. -otomy
    create opening, implies closure
  56. dec effectiveness of Ab
    • steroids
    • malnourished
    • hypoproteinemia
  57. possible complications of rumenotomy
    • peritonitis
    • wound infection/dehiscence
    • intra-abdominal adhesions
    • inadvertent injury to an organ
  58. laparotomy
    open and close flank
  59. reasons for right flank exploratory laparotomy
    • SI obstruction- strangulation, mesenteric volvulus, intussusception
    • cecal volvulus/torsion/intussesception
    • correct left displaced abomasum
    • abomasal impaction
    • palpate rumen, reticulum, omasum, abomasum, pylorus, duodenum, kidneys, liver, gall bladder, jejunum, cecum, spiral colon
    • biopsy kidney or liver
  60. holding layer of the abdomen
    external rectus sheath
  61. layers to suture when doing intestinal anastomosis
    • serosa and muscularis
    • muscosa and submucosa- do not leave and mucosa sticking when apposed
  62. complications of intestinal anastomosis
    • dehiscence of anastomosis
    • adhesions
    • strciture at anastomotic site
    • septic peritonitis
    • incisional dehiscence
    • strangulating hernia thru rents in mesentery
  63. reasons for right paramedian celiotomy
    • correct left displaced abomasum
    • palpate rumen, reticulum, omasum, abomasum, pylorus, duodenum, kidney, liver, gall bladder
    • correct abomasal torsion/volvulus
  64. why biopsy?
    • dx
    • determine therapy
    • indicate prognosis
  65. fluid bolus
    • 25% of blood vol over 10 min
    • 90 ml/kg dog
    • 60 ml/kg cat
  66. try to maintain what mean BP
    70 mmHg
  67. complication of OHE
    • hypotension due ot maniplulation of gut
    • hemorrhage due to inadequate ligation of vessels
    • incomplete removal of ovary resulting in signs of estrus
    • adhesions from excessive trauma or surgical sponges left in abdomen
    • adhesion of uterine pedical to bladder or colon
    • infection
    • stump pyometra
    • ureteral ligation
    • fistulus draining tracts- wrong suture used
    • incontinence
    • eunuchoid syndrome- attitude changes
    • suture rxn
    • seroma
    • patient induced trauma
  68. ID uterine horns
    • longitudinal striations of horn
    • blood vessels running parallel to horn
    • uterine bifurcation
    • presence of ovaries
  69. complications of castration
    • scrotal hematoma
    • cellulitis
    • infection
    • dehiscence of incision
    • self mutilation of scrotum or incision
    • hemorrhage
    • penile/urethral trauma
  70. complications in early spay/neuter
    • hypoglycemia
    • hypothermia
  71. incision location for OHE
    • adult- cranial 1/3
    • young- middle 1/3
  72. advantages of spaying cats early
    dec abscesses, agression, sexual behavior, urine spraying, asthma, gingivitis
  73. advantages of spaying/neutering dogs early
    dec separation anxiety, escaping behavior
  74. disadvantages to spaying too early
    • cystitis
    • incontinence
    • inc hip dysplasia (males also)
  75. safe age to spay puppy
    3 mth
  76. why spay/neuter at early age?
    • eliminate mammary neoplasia
    • eliminate unwanted litters
    • eliminate pyometra
    • eliminate prostatic hyperplasia
    • dec aggression
    • dec aggression and territoriality
    • faster recovery
    • easier for doctor
  77. non-preventable complications during spay
    • estrogen responsive eunuchoid syndrome
    • obesity
    • suture rxn
  78. pregnant uterus removal
    • more vascular and friable
    • great blood/fluid loss
    • individual ligatiion of uterine aa and vv
    • milk fetus cranially before clamping
  79. scrotal ablation
    • bc neoplasia, trauma, pendulous
    • don't remove too much
    • be cautious of lacerationg underlying spermatic cord
  80. pyometra
    • pus filled uterus
    • mild, chronic problem to acute and life threatening
    • dz of diestrus
    • need ovarian or exogenous PG
    • E. coli
    • closed cervix- always sx, more clinical signs
    • pre and post op care very important
    • friable uterus
    • ligatures placed in cervix
    • lavage
    • samples for culture
  81. cesarian section
    • dystocia
    • dam exhausted
    • lift horns out
    • milk puppies/kittens thru incision
    • genlty pull out placenta
    • if keeping uterus then double ligate- cushing then Lmebert
    • omentum tacked over uterine incision
  82. cryptorchid
    • faillure of testes to descend
    • can become neoplastic
    • always remove both
    • intra-abdominal
  83. holding layer of SI
    submucosa
  84. longest side suring SI anastomosis
    mesnteric

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