Exam 1

history taking should include this of the patient signalment

* age
* gender/repro status
* breed

other criteria for history taking

* concise and chronological
* reason for visit
* specific history for presenting complaint
* any treatments
* current mediations, vitamins, supplements

if the animal is not aggressive, you can allow them to roam the exam room to assess:

* temperament
* attitude
* body condition

consent form should include:

* identity of patient
* name, age, breed, sex, color, and weight
* specific procedures to be performed
* preop bloodwork
* general anesthesia
* neuter
* potential risks
* vet name
* estimate
* signature of owner of patient
* owner contact info

most common source of surgical infection

patient’s endogenous flora

your scrub should start:

after the animal has been clipped, prepped, moved to surgery room, and positioned

surgical hand scrub is designed to:

decrease microbial load on hands; skin is NEVER made sterile

this type of gloving is NOT used for routine surgical gloving

* used for minor procedures, bone marrow biopsy, and catherizations

open gloving

this type of gloving provides assurance against contamination because bare skin is not exposed

* preferred method for surgical procedures

closed gloving

this type of gloving requires 2 people and is only used if a gloce is contaminated during surgery

assisted gloving

responsibility of vet tech in surgery room

* maintain sterile environment
* monitoring patient
* managing instrument table
* passing proper instruments
* maintain tissues (restraction/moistened)
* maintain hemostasis

as you are arranging the instruments on the surgery table, you should count them when?

before opening AND before closing body cavity

gossypiboma is

retained surgical sponge

instrument handling

* orderly arrangement
* ring handles closest to surgeon
* know what you need before
* know what instrument does
* pass instrument with purpose

when using sponges, you should

blot DON’T rub

3x3 sponges absorb

6 mls of blood

4x4 sponges absorb

10 mls of blood

laparotomy sponges absorb

100 mls of blood

* ground plate - placed under patient
* current passes through patient toward grown plate
* sufficient contact
* use saline NOT alcohol

monopolar cautery

* current passes from one tip to another
* no grounding plate

bipolar cautery

suction is used in these procedures:

* abdominal
* orthopedic
* neurologic

used to remove large volumes of liquid/fluid

poole suction

used mostly in ortho and neuro surgeries

frasier suction

general purpose suction tip

yankauer

ideal suture properties

* easy to handle
* minimal reactivity with tissue
* inhibits bacterial growth
* holds knot securely
* resists shrinking in tissue
* absorbed with minimal reaction
* non-capillary
* non-allergenic
* non-carcinogenic
* non-ferromagnetic
* inexpensive

suture characteristics to consider

* size
* flexibility/memory
* surface/coating
* capillarity
* knot tensile strength
* relative know security

patient factors to consider when choosing a suture

* type of tissue
* healing time
* presence/absence of infection, neoplasia, medications prescribed, and endocrine disorders
* patient nutritional status
* size of patient

smallest suture size

12-0

largest suture size

7

inherent capability of suture to return to, or maintain, its original gross shape

memory

two aspects that play a part in flexibility of suture

torsional stiffness and diameter

least flexible suture

steel

most flexible suture

silk

amount of friction created as suture is pulled through the tissue

drag

this suture drags more in general that monofilament

braided

degree to which absorbed fluid is transferred along a suture

capillarity

monofilament sutures are considered

non-capillary

this reduces capillarity of sutures

coating

a measurement of the ability of a material (or tissue) to resist deformation and breakage; diminishes over time as suture is absorbed, stretches, and/or has constant load on it

tensile strength

strength required to break or untie a tied knot'; holding capacity of suture

relative knot security

this type of material has better knot security

braided material

degree to which suture will deform under stress or load and return to its original form when the load is removed

elasticity

degree to which suture will deform without breaking and will maintain its shape after removal of the deforming force

plasticity

ease of handling and the ability of the suture to change shape

pliability

tendency of a suture to slowly and permanently deform under constant stress

creep

* suture that loses most of its tensile strength within 60-90 days in living mammalian tissue
* promotes inflammatory reaction in tissue
* natural and composite fibers

absorbable

* does NOT degrade; becomes walled-off by body
* promotes inflammatory reaction in tissue
* natural and composite fibers

non-absorbable

non-absorbably but does degrade after 2 years

silk suture

manufactured from small intestine submucosa of sheep

catgut suture

absorbable suture materials

* dexon
* vicryl
* monocryl
* PDS
* maxon

non-absorbable suture materials

* nylon
* prolene
* stainless steel

most sutures degrade by:

hydrolysis

* cleavage of chemical bonds by addition of water

catgut degrades by

proteolysis

* breakdown of proteins into peptides and amino acids