Eye And Ear Treatment And Wound Healing And Bandaging

Front 1

Name for ear examination

Back 1

Otoscopy

Front 2

What is it called when you take something from the ear an put it on a slide?

Back 2

Otic cytology

Front 3

Aural Hematoma

Back 3

pocket of blood between the cartilage

Usually caused by otitis externa in dogs and ear mites in cats.

Incision made and left upen, then the ear is sutured into a matress pattern. This pattern keeps blood from pooling again by holding the cartilage down.

Front 4

Schirmer tear test

Back 4

Tear roduction tet (measures tear production)

KCS

Fold at notch on the end,m place in lower lid, close eye and hold for 1 minute. Remove and measure

Front 5

Intraocular pressure - glaucoma screen

Back 5

Use an ocular anesthetic and wait for 5 minutes. Calibrate the tonometer according to the directions.

Gently rest the tonometer on the cornea and take two readings frrom each eye

OR

Use a tonopen!

Similar to tonometers. Use a latex seath on it to prevent contamination and calibrate. Touch the tip to the cornea until you hear a beep. Take multiple readings from each eye

Front 6

Entropion

Back 6

Inward rolling of the lower eyelid

Front 7

Ectropion

Back 7

outward turning of the lower eyelid. Cornea may be exposed if the eyelids do not shut properly

Front 8

Cherry eye

Back 8

Protrusion of the tear gland associated with the 3rd eyelid

Front 9

Glaucoma

Back 9

Causes increase in intra occular pressure

Diabetic animals have higher risk of glaucoma.

The retina can get detached and cause blindness

Front 10

Cataracts

Back 10

Opaque oval/ circular structure over the lenses. Causes cloudiness of the eyes

Front 11

First intention healing

Back 11

Fresh clean wound with minimal trauma and minimal contamination thaat is treated within 8 hours.

Closed with suture

Delayed primary is a 1st intention that is closed after 3-5 days before development of granulation tissue

Front 12

Second intention healing

Back 12

Wound heals without surgical closure (Contraction and epitheliazation)

Front 13

Third intention healing

Back 13

Secondary closure of a wound that is allowed to granulate and closed after 3-5 days.

Severely contaminated wounds, severely traumatized wounds and requries lots of debridement

Front 14

Abrasions

Back 14

"Road rash"

Exposure to the deep dermis.

You will want to keep the surface moist and protected. Change bandage every 3-4 days and allow for 2nd intention healing

Front 15

Lacerations

Back 15

Sharply incised edges and can be superficial or deep

If it is less than 12 hours - Debridement, lavage and primary closure

More than 12 hours - En bloc debridement and primary closure

Not jagged or ripped/torn

Front 16

Burns

Back 16

Prone to infection, needs to be managed as an open wound

Repeated debridement, sterile bandage material used and changed often. DO NOT COAT WITH LOTIONS OR SALVES

Front 17

Puncture wounds

Back 17

Deep tisue damage.

Exploration, debridemnt, lavage and first intention closure

If contaminated, place a drain.

Front 18

Degloving

Back 18

Allowed to heal by second intention.

Removal of skin and deep tissue

Skin necrosis 3-5 days post injury

Front 19

What is the purpose of bandaging a wound?

Back 19

Wound healing
Protects from additional trauma/contamination
Immobilizes
Minimizes edema
Absorbs exudate
Lift away foreign material
Promotes an acidic environment (prevents CO2 loss, absorbs ammonia produced by bactera and increases O2 availability to the wound)
Keeps the wound warm which improves healing and oxygen availability

Front 20

How many layers are in a bandage

Back 20

Three!

Primary - adherent
Secondary- padding
tertiary - conforming, protective

ALSO STIRRUPS

Front 21

Ehmer Sling

Back 21

Imobilizes hind limbs and prevents weight bearing (luxation)



Minimal padding suggested and applied with adhesive tape alone to prevent slippage

Front 22

Velpeau Sling

Back 22

Holds the flexed forelimb and prevents movement in all joints

indicated in Luxation reduction and capular fractures

Front 23

Carpal Flexion sling

Back 23

Immobilizes the carpus and maintains flexion after tendon repair

Relieves tension on flexor tendons

Front 24

Splinting

Back 24

Can be made with tongue depressor, cast material, spoon splint, etc

Temporarily immobilizes certain fractures and supports traumatized distal limbs

Should be well padded to prevent pressure points and ALWAYS placed on the caudal aspect off the limb

Front 25

Casting

Back 25

Cast material is applied instead of a tertiary layer. Usually made of fiberglass and is ligght weight

Extends one joint above and below and has minimal padding - prevents cast loosening, prevents movement and excessive compression.

Monitor weekly

Has least amount of padding

Front 26

Monitoring of bandage, sling, and cast monitoring

Back 26

Inpatients - daily
Outpatients - weekly

Check toes - warmth, color, and swelling

Check for odor or chafing of cast

Cover for walks and restrain from chewing

Limit execise to brief leash walks

Front 27

What initiates wound healing? What are the 4 stages of wound healing?

Back 27

Platelets initiate wound healing

1. Inflammatory - Begins immediately after injury, characterized by formation of a blood clot, platelets stimulate other stages by release of growth factors

2. Debridement - Characterized by influx of white blood cells (macrophages, monocytes, neutrophils) into wound. Occurs approx. 6-8 hrs after injury

3. Repair - Begins 3-5 days after wound. Characterized by invasion of fibroblasts and development of granulation tissue. Wound strength increases exponentially

4. Maturation - Characterized by remodeling of the collagen of the scar and slow gain in wound strength. Begins approx 3 weeks after injury and may take weeks to years to complete

Front 28

Inflammatory Phase

Back 28

1st phase

Begins immediately after injury. Vasocontriction (5-10 min) then vasodilation leaks fluid with clotting factors and WBC

Blood clot forms which then forms a scab

Front 29

Debridement phase

Back 29

second stage
\
Begins around 6 hours after injury

Neutrophils and macrophages appear in the wound

They remove necrotic tissue, bacteria, foreign material

Front 30

Blood clot formation

Back 30

1st part of clot is platgelets

2n part of clot - Clotting factors

3red part of clot - fibrinogen

4th part of clot - fibroblasts and collagen

Wound gets stronger and stronger

Front 31

Repair phase

Back 31

3rd phase

Active for 3-5 days (lag phase)

Invasion of fibroblasts that produce collagen (matures into scar tissue)

New capillaries start to appear, along with fibroblasts and fibrous tissue it creates granulation tissue (3-5 days) under the scab

Fills in the tissue deficit, protects the wound, provides a barrier against infection and provides surface for new epithelial cells (epithelialzation)

Wound contraction helps reduce the size of the wound and new skin is formed

Front 32

Maturation phase

Back 32

4th phase of wound healing

Wound strength increases to the maximum level

# of capillaries decrease )Scar becomes pale)

Can continue for several years

Front 33

External factors that can affect wound healing

Back 33

Foreign material in the wound
Infection
tight bandages
movement
drugs
radiation/chemo
Steroids
NSAIDS
Aspirin

Front 34

Immediate wound care

Back 34

Cover until stabilized
Dont use antibiotic creams ointments or powders

Remove the bandage after stabilization and pack with sterile gauze or ky jelly to keep hair from entering the wound when clipped. Then make a temporary closure with suture or towel clamps (if applicable)

Clip and prep

Front 35

Surgical, En Bloc, and enzymatic debridement

Back 35

Both done by vet.

Surgical - excising the affected tissue in layers

En Bloc - Complete excision/cut out entire area (Small wounds)

Enzymatic debridement - wounds that are not suitable for surgical debidement. Trypsan used (breaks down protein like hairs, etc). This process is slower and can damage normal tissue

Front 36

Ear care - What is needed?

Back 36

Otoscope and correct otoscope head

Ear loop to remove debris

Ceruminalytic agent to soften wax

Cotton balls

Normal saline initially as a cleaning agent until the tympanic membrane can be assessed

Soft rubber bulbs, syringe and and catheter or automatic device

+/- anesthetic agent/tranquilizer and you may need to pluck the hair w/in the ear with forcepts or your fingers

Alligator forceps

Front 37

Lag phase

Back 37

During the first 3-5 days of wound healing where wound strength is minimal

Front 38

Lag phase

Back 38

During the first 3-5 days of wound healing where wound strength is minimal

Front 39

Lag phase

Back 39

During the first 3-5 days of wound healing where wound strength is minimal

Front 40

Wound lavage

Back 40

Removes debris and loose particles from wound.

Large volumes of warm, sterile, balanced electrolyte olution used. ABO's should not be added along with soap, detergents, antiseptic solutions, etc.

Moderate pressure with a 35 ml syringe and 19 g needle