Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
63 Cards in this Set
- Front
- Back
|
What is aseptic technique & why is it important
|
-describes all precautions taken to prevent contamination & infection of surgical wounds
-improper sanitation, sterilization & disinfection can lead to microbial resistance & increase the risk of nosocomial infection |
|
|
nosocomial infection
|
hospital acquired infections
|
|
|
3 most common types of sterilization
|
-steam
-gas -cold chemical |
|
|
steam sterilization
|
-most effective & common in clinics
-steam destroys microbes by cellular protein denaturation by correlating temperature, time & pressure -autoclaves |
|
|
autoclave types
|
-gravity displacement
-pre-vacuum |
|
|
pre-vacuum autoclave
|
larger & more costly; has a boiler to generate steam & a vacuum system; air is forced out of loaded chamber by vacuum pump; 250 F steam is put into chamber, filling it & eliminating vacuum; takes 9-15 mins exposure with complete steam sterilization
|
|
|
gravity displacement autoclave
|
water is heated in chamber which increases pressure which in turn increases temperature as long as the volume stays the same; most common in clinics
|
|
|
gas sterilization
|
-ethylene oxide is most common gas used: flammable & explosive; is mixed with CO2 or Freon
-for equipment that cant handle steam or pressure -must be aerated: porous material used for implants must be aerated for 24 h before using -clean & dry before gasing: moisture & organic material will bond with gas causing toxic residue |
|
|
cold chemical sterilization
|
-must not be corrosive to items being sterilized
-glutaraldehyde for delicate lens instruments OR for equipment that can be safely immersed in water use 3% glutaraldehyde -clean & dry first because organic residue may prevent saturation into crevices & joints -immerse in 3% glutaraldehyde 20-25 degrees C for 10 h to sterilize OR 10 mins at 20-25 degrees C for disinfection -after immersion, rinse with sterile water & dry with sterile towel |
|
|
how to maintain surgical instruments
|
-keep moist after use or wash immediately to prevent residue for drying
-clean with distilled water & approved cleaner *tap water can leave mineral deposits * approved cleaner needs pH 9.2-11 to prevent spotting & corrosion * scrub with instrument brush -ultrasonic cleaner is 16x more effective manual cleaning -can use surgical milk solution -inspect instruments before packing & sterilizing |
|
|
surgical milk solution
|
-lubricates & prevents rust
-can be used on any instrument that can be cleaned ultrasonically -use fresh surgical milk each time -also comes as a spray |
|
|
What to look for when examing surgical instruments?
|
-are they clean
-boxlocks work smoothly & are not loose -tips close tightly & loosely |
|
|
Mayo scissors
|
-cutting & dissecting dense tissue
-blunt tipped -straight & curved blade |
|
|
Metzenbaum scissors
|
-dissecting delicate tissue
-fine tipped, blunt or pointed -long handles -blades straight or curved |
|
|
Iris scissors
|
-small, sharp, delicate
-intraocular surgery |
|
|
wire cutting scissors
|
-short, thick jaws with serrated edges for cutting wire sutures
|
|
|
Littauer & Spencer scissors
|
-suture removal scissors post-op
-blunt tip -one blade ends into thin curved hook -Spencer's are smaller than Littauer |
|
|
Lister bandage scissors
|
-cuts under bandages without puncturing the skin
-one blade is flat thick edge with blunt tip -various sizes |
|
|
types of thumb forceps & their uses
|
*hold like a pencil
-Rat tooth: has large intermeshed teeth tograsp skin & used for doing sutures -Adson: good tissue grip with minimal tissue damage; fine teeth for delicate tissue -Brown-Adson: multiple fine intermeshing teeth at edge of tips for delicate tissue; sides of blades are wider for easier handling -Dressing: serrate but no teeth; good for handling bandages -Russian tissue forceps: rounded tips for holding hollow viscera |
|
|
Types of self-retaining forceps & their uses
|
*rachet locking to grasp & retract tissue
-Allis tissue: intermeshing teeth to ensure secure grip; an traumatize delicate tissues -Babcock intestinal: similar to Allis but no gripping teeth so it can be used on delicate tissues -Doyen intestinal: for holding the bowels -Ferguson angiotribe: for holding large bundles of tissue -Sponge: hole in center of circular tips to hold gauze & provie hemostasis during surgery or patient prep -Backhaus towel clamp: forceps to secure drapes to patient's skin -Roeder towel clamp: similar to Backhaus but have metal bead on each tip so it doesn't puncture the skin as deep but keeps towels from sliding |
|
|
Types of hemostatic forceps (hemostats) & their uses
|
*straight or curved
*for ligating vessels & tissues -Halsted mosquito: to control capillary blleding; can be up to 10 cm long; transverse serrations over entire jaw length -Kelly & Crile: grasp intermediate size vessels; 12.5cm long; distal transverse grooves on Kellys; complete transverse grooves on Crile; -Rochester-Pean & Rochester-Carmalt: to clamp large tissue bundles with blood vessels-common in stump or pedicle ligations; 20 cm long; Carmalts have longitudinal grooves & distal transverse grooves; Peans have transverse grooves -Rochester-Oschner: similar to Pean's; 1:2 tooth ratio; teeth allow for better grip on tissue |
|
|
Types of needle holders & their uses
|
* holds needle to do sutures & surgical preference determines type used
-Mayo-Hegar & Olsen-Hegar: most common used in clinics; Olsen-Hegar has scissors to cut sutures without changing tools; both have criss-cross grooves -Mathier: no rings for fingers, open/close with finger pressure |
|
|
types of retractors & uses
|
-Senn rake: double ended to retract skin & superficial muscles; one end has 3 prong point that curves resembling a rake
-Meyerding, Hohmann & US Army: for larger muscle masses; Army's come in a set of 2, one end is paddled shaped to open wound easily -Malleable: made of soft material that can be bent for hard to retract areas -Selfretaining: have a locking mechanism -OVH/spay hook: the Snook has broad flat handle with flat curved tip; Covault has octagon handle with button tip |
|
|
What are the different types of self-retaining retractors & their uses?
|
-Gelpi: single tip extending outward to retract muscles; common in ortho & neuro surgeries
-Weitlander: similar to Gelpi but have multiple prongs at tip; same surgeries as Gelpi -Balfour: many sizes & holds abdomen open -Finochetto: used during thoracic surgery |
|
|
Orthopedic forceps
|
-Kern & Richards forceps: strong gripping teeth; some lock to manipulate bone fractures to reduction
-Verbrugge & reduction forceps: holds bone fractures in place while inserting plates & pins -Liston bone cutting forceps: double handled to increase power to cut bone |
|
|
Other orthopedic instruments
|
-wire twisters: resembles large needle holders
-Jacobs chucks: advances pin placement -Rongeurs or Lempert's: breaks & removes bone -Osteotomes: cuts bones -Mallets: to strike osteotomes or other instruments during surgery -bone curette: sharp edge to remove bone; cupped at one end; commonly used to scrape out osteochondritis dissecan lesions -bone rasps: smooths rough bone edges -periosteal elevators: removes muscle from bone by releasing periosteum -intramedullary pins: stabilizes fractures |
|
|
Types of suction tips & uses
|
-Poole: removes abdominal fluid without getting plugged by the omentum
-Frazier-Ferguson: variable suction strength to remove blood -Yankauer: removes fluids but not blood |
|
|
Scalpel handle sizes & uses
|
*Bard-Parker handle with detachable blade
-#3 with #10-12, 15 blade most common in small animal surgery -#10 basic blade, skin incisions -#11 severe ligaments -#12 lance abcesses -#15 precise, small or curved incisions *#4 handle with #20 blade most common for large animal surgery |
|
|
Suture needles
|
-straight, curved, half curved, half circle
-described by its size -point is either cutting or tapered -cutting tips are for the skin, cartilage, tendons -tapered tips are for delicate tissues that may tear easily -eyeless with suture material attached OR has an eye to thread own suture material |
|
|
Absorbable suture material surgical gut
|
-most common nonsynthetic
- aka cat gut -made from the submucosa layer of sheep intestines - phagocytosis breaks it down |
|
|
absorbable synthetic sutures
|
-polyglycotic acid: synthetic polyester from hydroxyacetic acid
-polyglactin acid: copolymer of lactic & glycolic acids -polydioxanone & polyglyconate: synthetic polyester -monofilament (less tissue drag) |
|
|
Natural nonabsorbable suture materials
|
-silk: loses tensile strength after 6 months; braided or twisted to multifilament strands; for cardio surgeries; allows migration of contamination
-cotton -linen -stainless steel: difficult to work with as its inflexible |
|
|
Synthetic nonabsorbable suture material
|
*retains tensile strength 60+ days
-polypropylene: synthetic plastic -polyamide/nylon: polymerized plastic -polymerized caprolactrum: coated synthetic fiber; common for closing skin |
|
|
suture material sizing
|
-the larger the number to the right after ought (0) the diameter is thicker: 3 is thicker than 2
-increase to the left of ought (0) diameter is thinner: 2-0 larger than 3-0 -wire sutures: 18-40 gauge; lower the number the thicker the wire |
|
|
Preparing instruments & linens to be packed
|
-instruments need to be cleaned & lubricated (if needed)
-instruments need to be thoroughly dried -linens to be sterilized need to be washed separately from other laundry *minimal detergent *extra rinse cycle *dry completely *fold gown inside out with ties & sleeves on inside; fold accordion style to fit into pack -perforated tray or pan -leave boxlocks & rachets open -heavy instruments on bottom with items used first on top |
|
|
What sizes to cut disposable drapes/wraps & how to fold
|
-small 38"x38"
-large 38"x44" -wrap 19"x19" -International drape 38"x44" -fold accordion style side to side about 4 inches wide, then accordion fold in 1/4s opposite side *finished size should be 4x8 for small & 5x9 for large |
|
|
How to wrap surgical pack
|
-place contents in the middle of two wraps laid in a diamond shape
-take corner nearest you of the inner wrap & fold over top of pack, folding a small part of the corner back over to leave a tab -repeat this with each of the 3 remaining corners of the inner wrap -then repeat the whole process with the outer wrap -place a piece of indicator tape to hold tab down: write type of pack, date & initials |
|
|
Contents of K9/Feline & pediatric spay pack
|
-4 towel clamps
-scalpel handle -needle driver -rat tooth thumb forceps -Brown-Adsen thumb forceps -Mayo scissors -metzenbaum scissors (feline) -4 mosquitos hemostats -2 Carmalts (k9) -2 Kelly (feline) -spay hook -15 gauze pads -1 drape -indicator strip *pediatric spay pack is the same except its a pediatric spay hook |
|
|
contents k9 neuter pack
|
-4 towel clamps
-scalpel handle -needle driver -rat tooth thumb forceps -Brown Adsen thumb forceps -mayo scissors -2 curved criles -2 curved mosquito hemostats -15 gauze pads -drapes -indicator |
|
|
feline neuter pack
|
-2 curved hemostats
-scalpel handle -gauze pads -indicator |
|
|
Common soft tissue surgeries
|
-spays/OVH
-C-section: ventral or flank midline -orchiectomy (neuter) -lateral ear resection -laparotomy/celiotomy -cystotomy -gastrotomy -rumenotomy -gastroplexy -splenectomy -thoracotomy -herniorrhaphy -enterotomy -intestinal anastomosis -perineal urethrostomy -urethrotomy |
|
|
common orthopedic surgeries
|
-onychectomy
-intervertebral disk fenestration -intramedullary bone pining -joint stabilization via lateral suture technique -tibial tuberosity advancement -femoral head ostectomy |
|
|
lateral ear resection
|
removes lateral ear wall for vertical portion of external ear canal to improve ventilation & allow drainage; for chronic ear infections
|
|
|
perineal urethrostomy
|
incision into urethra & suturing edges to the skin to make a larger urethral orifice; usually in male cats with reoccurring urethral obstructions
|
|
|
laparotomy or celiotomy
|
incision into the abdomen
|
|
|
cystotomy
|
removing urinary calculi from the bladder
|
|
|
gastrotomy
|
incision into the simple stomach
|
|
|
gastropexy
|
suturing the stomach to the abdominal wall to hold it in place; usually for gastric torsion
|
|
|
herniorrhaphy
|
repairing a hernia by suturing the abdominal opening closed
|
|
|
enterotomy
|
incision into the intestine
|
|
|
intestinal anastomosis
|
removing a section of the intestine & suturing the ends to restore continuity of the intestinal tube
|
|
|
urethrotomy
|
incision into the urethra, usually to remove bladder stones
|
|
|
onychectomy
|
declawing
|
|
|
intervertebral disk fenestration
|
removing prolapsed intervertebral disk material
|
|
|
intramedullary bone pinning
|
placing a bone pin into medullary cavity of a long bone to fix a fracture in place
|
|
|
joint stabilization via lateral suture technique OR tibial tuberosity advancement
|
performed when the cranial cruciate ligament in the stifle joint ruptures; stabilizes the joint
|
|
|
femoral head ostectomy
|
amputating the femur head
|
|
|
proper surgical scrubbing technique
|
*use the same method each time
-get water to a warm temperature that is comfortable -wash hands, arms & nails normally -then with a sterile scrub brush scrub as follows *fingertips & nails: 30 strokes * dividing each finger into four planes, scrub each plane of each finger 20 strokes *20 strokes each on palm & back of the hand *divide the wrist into four planes & scrub each plane 20 strokes *scrub arm 20 strokes stopping about 2 inches proximal to the elbow KEEP HANDS POINTED DOWNWARD IN SINK WITHOUT TOUCHING THE SINK -repeat with the other hand & arm -dry hands & arms with a sterile towel: one side for each hand/arm |
|
|
Proper technique for gowning & gloving
|
-sterile person pick up sterile gown by inside shoulder seams up & away from counter; due to accordion folding, gown will unfold & open naturally
-slide one arm into gown at a time, holding the cuff partially down on the hand -UNSTERILE person ties the gown shut -remove a glove from sterile package one at a time -hold glove & allow surgeon to place hand into glove, then pull glove up over the cuff of the gown |
|
|
How to prepare the surgeon for surgery
|
-set out sterile scrub brushes, packs & any other equipment needed for procedure
-put on cap & mask -remove jewelry & ensure fingernails are no longer than fingertip length: no artificial nails -perform sterile scrub of hands, wrists & arms -immediately put on sterile gown & gloves |
|
|
How to prepare the operating room
|
-get all equipment & surgical packs needed for surgery: don't open sterile packs
-get mayo stand ready -once the patient is in the room & on the table, sterile packs can be opened & instruments arranged in surgeons preferred order *unsterile personnel should not reach over instruments |
|
|
How to drape the patient
|
-prepare skin at surgical site
-personnel needs to be gloved & gowned to drape patient -place one drape at a time at the periphery of prepared area: secure corners with Backhaus towel clamps: these are the field towels -place final drape over the patient & entire table to maintain a continuous sterile field |
|
|
opening sterile packs
|
-unfold one corner at a time using nondominant hand & hold each corner in your hand as you open them
-with dominant hand, open final corner -the pack is now fully exposed & handed to sterile personnel or placed on sterile table -individually wrapped items are opened by separating opening flaps so the sterile item doesn't touch an unsterile area; place on sterile table or have sterile personnel remove it from the pack & put on sterile table |
