Surgery Exam 4

Front 1

what is shock?

Back 1

failure of the circulatory system to maintain adequate blood flow and O2 delivery to vital organs.

Front 2

what do we mean when we say that an animal has hypovolemic shock?

Back 2

when there is inadequate blood volume

Front 3

what do we mean when we say that an animal has cardiogrnic shock?

Back 3

hwne there is inadequate cardiac function

Front 4

what do we mean when we say that an animal has distributive shock?

Back 4

when there is inadequate vascular tone or peripheral resistance.

Front 5

what is the "classic" cause of distributive shock?

Back 5

sepsis and or endotoxemia

Front 6

list five signs of hypovolemic/cardiogenic shock.

Back 6

depression/weakness
hypotension
tachycardia
rapid repirations
reduced uring output

Front 7

what clinical sign is commonly different for distributive shock compared to hypovolemic/cardiogenic shock?

Back 7

memcranes become hyperemic

Front 8

list the two main components of shock therapy

Back 8

fluid and O2 therapy.

Front 9

what category of drugs are often used to treat hypovolemic/cardiogenic shock (but not septic shock), even though their use is controversial?

Back 9

steriods

Front 10

how long does it take for a surgical incision to be strong enough to hold the wound edges together without sutures?

Back 10

10 days

Front 11

how much additional time does it take a wound to be at full strength after the incision is strong enough to hold the wound edges together?

Back 11

2-4 weeks

Front 12

what is meant by the term "first intention healing"?

Back 12

healing a wound without infection or excessive granulation.

Front 13

what is meant by the term "second intention healing"?

Back 13

open healing of a wound that contains 2 granulated surfaces and some degree of suppuration

Front 14

when should skin sutures be removed?

Back 14

10-14 days after insertion

Front 15

what should be noted about a skin incision at the time of suture removal?

Back 15

date of removal and condition of incision.

Front 16

what type of retractors (sharp-tipped or blunt) are most appropriate for use on muscle and skin?

Back 16

sharp tipped so tissue does not slip.

Front 17

why should unnecessary handling of skin be avoided during surgery?

Back 17

to reduce possibility of contamination

Front 18

what type of cutting method results in the least trauma and most rapid healing of skin?

Back 18

with a scalpel

Front 19

why is it important to preserve soft tissue attachment to bone when repairing fractures?

Back 19

because blood supply from tissue is important to bone healing.

Front 20

what is a potential complication that can arise when performing surgery on the hollow organs in the body?

Back 20

contamination of surgical site from contents of organ.

Front 21

describe the appropriate use of surgical sponges to achieve heamostasis.

Back 21

pressure with cauze can stop low pressure bleeding from small vessels.

Front 22

what complication will ocur if surgical sponges are left in the abdomen during a surgical procedure and how can you keep this from happening?

Back 22

it can cause peritonitis and pleuritis, and you can stopo it by counting sponges before and after surgery.

Front 23

why should alcohol be avoided when using electrocautery?

Back 23

because alcohol can be flammable.

Front 24

why should surgical glove be worn when using electrocautery?

Back 24

to avoid shock.

Front 25

what will happen to the patient of good contact between the patient and the ground plate is not achieved with a conductive gel or fluid when using electrocautery?

Back 25

it can burn the patient

Front 26

which type of electrocautery unit (monopolar or bipolar) requires a dry surgical field to function?

Back 26

monopolar

Front 27

on what type of tissue would use of Gelfoam by appropriate?

Back 27

tissues that tend to ooze, like the liver.

Front 28

what are the two primary purposes of tissue lavage?

Back 28

keep tissues soft and remove bacteria.

Front 29

list three characteristics of all fluids that are routinely used for tissue lavage.

Back 29

isotonic, physiological neutral and same pH as serum

Front 30

what is the difference in route of passage of fluid in a passive drain versus and active drain?

Back 30

passive allow fluid to pass through outside of train, active allows drainage to flow through the middle of the drain.

Front 31

when should a drain normally be removed?

Back 31

2-5 days

Front 32

what should all animals with a drain in place wear?

Back 32

e-collar

Front 33

why is the routine prophylactic use of antibiotics for all surgical procedures not recommended?

Back 33

it contributes to the development of resistant strains of bacteria that are difficult to treat.

Front 34

list five situations in which the routine prophylactic use of antibiotics in indicated.

Back 34

1. patient is immunosuppressed
2. hollow viscus has entered surgical site
3. orthopedic implant is placed
4. long joint procedures
5. consequences of infection would be very severe.

Front 35

what is the time frame in whcih antibiotics should be started pre-op when the antibiotics are for prophylactic purposes (not to treat an already exhisting infection)?

Back 35

3+ hrs pre-op, and 6-24 hrs post

Front 36

what is the most common cause of abscesses?

Back 36

bite wound

Front 37

what is the most common systemic clinical sign of abcesses?

Back 37

fever

Front 38

where in the hoospital should surgery for an abcess be performed?

Back 38

dirty surgical area or treatment area.

Front 39

what instructions should be given toa client when discharging a routine abcess surgery?

Back 39

how to clean the drain and what is normal or abnormal for healing.

Front 40

how is further contamintation of the wound minimized when clipping a laceration for surgery?

Back 40

because fur carries debris and bacteria, and it can irritate the healing skin.

Front 41

what procedure should be performed to characterize a cutaneous mass prior to its removal?

Back 41

FNA Bx

Front 42

is malignancy and metastasis more common with mammary neoplasia of dogs or cats?

Back 42

cats

Front 43

describe the effect of Ovariohysterectomy on the incidence of mammary neoplasia in dogs

Back 43

risk of neoplasia significantly increases as the animal gets older.

Front 44

what should be done to screen for metastasis before a mastectomy is performed in dogs and cats?

Back 44

pre-op chest and abdominal radiographs to check for metastasis in lungs and lymph nodes, because if present, doing mastectomy will be of no clinical use anymore.

Front 45

what are the most frequent potential complications following radical mastectomy

Back 45

bruising

Front 46

what anatomical structures are removed during a feline onychectomy?

Back 46

the entire nail and the 3rd phalanx of the paws

Front 47

should a cats nails be trimmed as part of prepping the feet prior to performing a declaw?

Back 47

no

Front 48

where should a tourniquet be placed to minimize the possibility of damage to the radial nerve when performing a declaw?

Back 48

distal to elbow

Front 49

what particular precautions should be taken when utilizing a laser to perform a feline onychectomy?

Back 49

use moitened gauze on the cats feet, instruments and surgens fingers to keep from burning.

Front 50

what restriction should be in place on the life style of any cat on which declaq surgery has been performed?

Back 50

do not put cat outside

Front 51

describe typical post-op care for a cat on which a declaw surgery has been performed/

Back 51

analgesic for at least 4-5 days, and use "yesterdays news" as litter intil paws heal, and keep bandages clean and dry

Front 52

what combination of analgesics is frequently used post-op after feline onychectomy?

Back 52

opioid and NSAIDs

Front 53

what is the most common complication in the short-term after feline onychectomy?

Back 53

bandages come off too soon and cause hemorrhage

Front 54

what are the two most common complications in the long-term after feline onychectomy?

Back 54

regrowth of nail due to incomplete removal of germinal layer, or lameness due to a cut pad.

Front 55

at what age should tail docking and dewclaw removal in puppies be done?

Back 55

3-5 days old

Front 56

how do the anesthetic and analgesic protocols used when tail docking and dewclaw removal in puppies are performed differ from those used when these procedures are performed in adult dogs?

Back 56

no anesthesia or analgesia for puppies, and adults are put under general anesthesia and analgesia use used.

Front 57

what structures are removed during an ovariohysterectomy?

Back 57

both ovaries and uterus

Front 58

list three reasons why early ovariohysterectomy is recommended in dogs and cats.

Back 58

decreased risk of mammary tumors, increased risk of complications if OHE done during heat cycles, and decreased pet overpopulation

Front 59

what is the primary undesirable potential side effect that can occur in some dogs after ovariohysterectomy?

Back 59

urinary incontinance

Front 60

what two things should you check specifically on an animal that is being admitted for an ovariohysterectomy?

Back 60

animal is female and has not had any other reproductive surgeries, and that the animal is not in heat.

Front 61

what is the difference between an open and closed pyometra?

Back 61

open has leaked into abdominal cavity and should be operated on immediately.

Front 62

what is the mother at increased risk for as the neonates are removed during a C-section?

Back 62

increased blood loss

Front 63

what six things should the person receiving the neonates do for them during a C-section?

Back 63

remove membranes from mouth and nose, tie umbilical cord 1cm from body, remove fluids from mouth and nose, doxapram and O2 if not breathing, dry and rub briskly, place in a warm area.

Front 64

what must be taken into consideration regarding administration of systemic analgesics to a patient after C-section

Back 64

should be low doses because it is transfered to the babies through the milk.

Front 65

what instructions should be given to a client regarding bloody vaginal discharge from animal that has undergone a C-section?

Back 65

Unless there is excessive bleeding, it is usually normal.

Front 66

list three social behaviors that occur less commonly in dogs and cats that are neutered.

Back 66

less aggressive
less urinary marking
less of a problem if they come in contact with female in heat

Front 67

describe the difference in prepping of the scrotum for castration in dogs versus cats

Back 67

you do not clip the hair of the scrotum in the dogs, while you remove all hair from the scrotum of the cat.

Front 68

describe the difference in location of the surgical incision for castration in dogs versus cats.

Back 68

dogs have a pre-scrotal incision, while cats have a scrotal incision.

Front 69

whta two things should you check specifically on an animal that is being admitted for castration?

Back 69

verify animal is male, and that both testicles are in scrotum.

Front 70

what instructions should be given to a client upon discharge of a dog that has undergone a routine OHE?

Back 70

return for skin suture removal, observe for licking, and restrict activity

Front 71

what is a cystotomy?

Back 71

incision into lumen of urinary bladder

Front 72

what is the most common indication for a cystotomy?

Back 72

remove cystic calculi

Front 73

what should be placed pre-op in cats and female dogs, and intra-op in male dogs so that the surgical team can ascertain that all uroliths are removed?

Back 73

urethral catheter

Front 74

what instructions should be given to a client upon discharge of a dog that has undergone a routine cystotomy regarding the animal urination?

Back 74

monitor closely for blood, and make sure animal is urinating

Front 75

what is a perineal urethrostomy?

Back 75

opening made in urethra in perineal area in male cats

Front 76

what is the most common indication for performing a perineal urethrostomy?

Back 76

cats with chronic or recurrent idiopathic LUTD (FUS) that repeatedly obstruct.

Front 77

in what position should a cat be placed for a perineal urethrostomy surgery?

Back 77

ventral recombancy

Front 78

what must the surgical team remember to remove following perineal urethrostomy surgery?

Back 78

the purse string suture in anus

Front 79

what MUST be placed on a cat following perineal urethrostomy surgery?

Back 79

e-collar

Front 80

what is the routine care of a surgical site following a perineal urethrostomy surgery?

Back 80

leave area alone as much as possible.

Front 81

define laparotomy

Back 81

surgical incision into abdominal cavities

Front 82

define gastrotomy

Back 82

incision into stomach

Front 83

define enterotomy

Back 83

incision into intestine

Front 84

define intestinal resection and anastomosis

Back 84

portion of intestine removed and two remaining portions are joined together

Front 85

what is the most common indication for gastrotomy or enterotomy in dogs and cats?

Back 85

to remove foreign body or tumor or to obtain a biopsy

Front 86

why is efficient endotracheal intubation and cuff inflation particulry important in most animals that are to undergo surgery of the GI tract?

Back 86

to avoid aspiration if animal vomits.

Front 87

what is different about instrument packs to be used for GI surgery compared to instrument packs used in routine elective surgeries?

Back 87

there are extra instruments and some will be designated clean and dirty.

Front 88

what is the most common complication following surgery of GI tract?

Back 88

Infection

Front 89

list for things that we can do to minimize likelihood of infection after GI tract surgery

Back 89

pack off any intestine exposed outside, irrigate before closing, injectable antibiotics, and use abdominal drains.

Front 90

why is intestinal resection and anastomosis performed?

Back 90

when a section of intestine is damaged and can no longer function.

Front 91

list three characteristics of devitalized intestine.

Back 91

black green or gray color, lack of motility, not bleeding or doppler blood flow reading and no vital stain uptake

Front 92

what is the expectation regarding vomiting post-op in an animal that has undergone GI surgery?

Back 92

may occur 1-2 times without a problem, but repeated vomiting is a bad sign.

Front 93

discuss appropriate post-op feeding of an animal that has undergone GI surgery.

Back 93

begin as soon as animal has appetite (unless vomiting). with frequent, small amounts of highly digestible, bland food

Front 94

define articular fracture

Back 94

a fracture involving a joint surface

Front 95

define comminuted fracture

Back 95

bone fracture into a number of fragments

Front 96

define compound fracture

Back 96

one or more fragments have penetrated into soft tissue and through skin exposing to air.

Front 97

define epiphyseal fracture

Back 97

fracture of a growth plate

Front 98

define green stick fracture

Back 98

incomplete, does not penetrate both cortices

Front 99

define oblique fracture

Back 99

angle is between horizontal and verticle

Front 100

define spiral fracture

Back 100

fracture curves or winds around bone

Front 101

define transverse fracture

Back 101

right angle to long axis of bone

Front 102

what serious complication can occur following repair of fracture be internal fixation?

Back 102

osteomyelitis.

Front 103

which joint is most commonly luxated in dogs and cats?

Back 103

hip

Front 104

what surfaces should be avoided when retracting tissues during surgery?

Back 104

articular cartilage in joint

Front 105

what instructions should be given to a client upon discharge of an animal that has undergone orthopedic surgery?

Back 105

prevent thrashing, do passive range of motion exercises 2-3x/day, and keep bandages clean and dry

Front 106

it is incumbent upon us ethically to provide effective control of pain in our patients. list five reasons why control of post-operative pain is medically advantageous as well.

Back 106

increased cardiovascular function
increased appetite
speeds up wound healing
decreased risk of infection
decreased fead and anxiety

Front 107

give three examples of procedures that typically result in irritating or mildly painful situations.

Back 107

dental prophylaxis, IV, Urinary catheter.

Front 108

give three examples of procedures that typically result in mildly to moderately painful situations.

Back 108

castration, OHE, dental extraction

Front 109

give three examples of procedures that typically result in moderately to severely painful situations.

Back 109

fractures, mastectomy, declaws

Front 110

give three examples of procedures that typically result in severely painful situations

Back 110

limb amputation, ear ablation, thoroctomy

Front 111

list five physiologic changes that may be observed in painful animals.

Back 111

increased blood pressure
increased heart rate
increased respiratory rate
pale mucous membranes (prolonged CRT)
decreased tital volume

Front 112

what type of opioids are appropriate for control of moderate to severe pain in animals? give 4 examples.

Back 112

Morphine, Oxymorphone, hydromorphone, fentanyl

Front 113

what type of opioids are appropriate for control of mild to moderate pain in animals? give 2 examples

Back 113

butorphanol, buprenorphine

Front 114

how long after fentanyl patch is applied does it take to achieve therapeutic blood levels in cats and dogs?

Back 114

cats- 4-12 hours, dogs 12-24 hours

Front 115

how long does fentanyl remain in therapeutic levels when using a transdermal patch in cats and dogs?

Back 115

cats- 5 days
dogs- 3 days

Front 116

why should fentanyl patches not be cut?

Back 116

it interferes with the rate of release and it exposes people to the drug

Front 117

what instructions should be given to a client upon discharge of an animal that is going home with a fentanyl patch in place?

Back 117

bring animal in to have it removed and disposed of, and if it falls off at home, do not let children or pets play with it, and do not touch it if you are pregnant or breastfeeding. Then pick it up, fold it in half onto itself, and flush it down the toilet.

Front 118

what is tramadol and what is its mechanism of action?

Back 118

its an analgesic that is a mu Opioid binding drug

Front 119

what are the three primary potential side effects associated with the use of NSAIDs

Back 119

GI ulceration, renal toxicity and bleeding