Surgical skills Exam 3

How should you properly clip a patient's hair for an ovariohysterectomy?

xiphoid process to pubis

What is the correct patient position for an ovariohysterectomy?

dorsal recumbency

How is suture size determined?

the strength of the tissue is proportionate to the size of the suture

Why would an early spay be done?

neoplasia of reproductive tract

What is dystocia?

difficulty giving birth

What breeds are more likely to go through dystocia?

boxers

bulldogs

pekingese

pugs

What drugs should be administered to neonate for a C section due to dystocia?

naloxone

doxapram

epinephrine

Which stage of labor is the nesting stage, it is several hours, and ends with dilation of the cervix?

stage 1

Which stage of labor is the dilation of the cervix where the fetus enters the birth canal and ruptures the fetal membranes, it can last up to 4 hours for the first fetus and up to two hours between each fetus?

stage 2

What stage of labor is the passage of the placenta?

stage 3

What is an exploratory laparotomy?

an abdominal exploratory surgery

What would indicate an exploratory laparotomy?

surgical biopsy

removal of abdominal masses

GI obstruction

traumatic injury

What would indicate a gastrotomy?

foreign body removal

biopsy of mass

mass removal

pyloric outflow obstruction

What is a gastrotomy?

incision into stomach

What is an enterotomy?

incision in the small intestine

What are the indications for an enterotomy?

foreign body removal

biopsy of small bowel

What special instrument is needed for an enterotomy?

doyen intestinal clamps

What is an excision of a segment of bowel followed by reestablishment of the two remaining segments?

intestinal resection and anastomosis

What is a GDV?

distended stomach that has rotated on its axis

What breeds are predisposed to GDV?

deep-chested, large breeds

What is the first step to treating a GDV?

IV catheters to stabilize and reduce shock

What is the second step to treating a GDV?

decompress stomach

What is the third step to treating GDV?

surgically correct

What is a cystotomy?

incision of the bladder

What method of evaluating masses is done by pressing a glass slide against an open lesion or cut edge of an excised lesion?

impression smear

What gauge needle is used for a FNA?

20-22

What size syringe is used for a FNA?

3-5 cc

Which FNA technique is done by quickly stabbing the mass repeatedly with a needle?

woodpecker

Which FNA technique is done by placing a needle in the mass and pulling back the plunger multiple times in one spot?

suction

What biopsy would be done if there was no diagnosis with FNA or the impression smear or you need more tissue for characterization?

needle core biopsy

What masses are needle core biopsies used for?

palpable masses

masses on organs visible by ultrasound or CT

What biopsy method requires sedation or anesthesia, sterile prep, and uses a large needle that cuts a core of tissue from the mass?

tru-cut biopsy

What biopsy would be used to diagnose proliferative or lytic bony lesions or evaluate bone marrow?

bone biopsy

What is the preferred needle for bone biopsy?

jamshidi

Where are bone biopsies done?

proximal humerus

ilial wing

proximal femur

proximal tibia (young dogs only)

Should you go all the way through the bone for a bone biopsy?

no (that creates a pathologic fracture)

What biopsy would be used for cutaneous masses, focal organ masses (liver, pancreas, spleen), and intestinal biopsies?

punch biopsy

What instrument is used for a punch biopsy?

baker skin biopsy punch

Where should the punch biopsy be taken?

edge of lesion with some normal tissue

What biopsy would be used for large, superficial lesions, ulcerated lesions, or if the lesion is located in an area where achieving margins and closure might be difficult?

incisional biopsy

What biopsy would be used when the treatment choice would be unchanged by the tumor type (usually benign tumors and lesions), it is considered both diagnosis and treatment?

excisional biopsy

What is the best chance to cure cancer with surgical excision?

getting it all the first time

What is the amount of normal tissue removed with the tumor?

margin

What is the margin for cutaneous carcinomas?

1 cm

What are the margins for mast cell tumors?

2-3 cm and 1 fascial plane deep

What are the margins for cutaneous sarcomas?

3-5 cm and 1 fascial plane deep for soft tissue, 2 fascial planes deep for vaccine associated

What tumors need no margins?

benign tumors with low risk of recurrence (lipoma)

masses in body cavities

What indicates removal from within capsule or pseudocapsule (debulking)?

intracapsular

What indicates removal at the margin of the tumor?

marginal

What indicates removal with margin of normal tissue surrounding tumor?

wide excision

What indicates removal of entire affected tissue compartment?

radical excision

What is done to remove a majority of the mass and is intended to follow up with other therapy?

debulking surgery

What is done to improve quality of life and not meant to cure or to extend life?

palliative surgery

What should always be assessed for tumor staging?

regional lymph nodes

What can reduce the incidence of mammary tumors?

spaying

What stage of decubital ulcer shows with red skin and can go away shortly after pressure is relieved?

stage I

What stage of decubital ulcer shows with partial dermal skin loss?

stage II

What stage of decubital ulcer shows with full skin loss and is a deep crater-like wound?

stage III

What stage of decubital ulcer shows with a large scale loss of skin with damage to muscle, bone may be exposed, it is the most serious and can be fatal due to infection?

stage IV

How long does it take for a decubital ulcer to show signs of healing?

2-4 weeks

What are the areas that are likely to develop decubital ulcers?

hocks

knees

capris

How can lung atelectasis be prevented?

flip sides

put in sternal recumbency

listen to the lungs

copage

walk

How can urine scalding (bladder overflow) be prevented?

urinary catheter

diaper

bathe frequently

spot cleaning

powder

What can be done to help prevent fecal incontinence?

diaper

high quality, low waste food

walk outside after eating meals

fiber

What is accomplished with a wet-to-dry or dry-to dry bandage?

lets tissue declare itself before attempting surgical closure

What bandage layer is sterile, conforms to the body contour, allows drainage to pass to secondary layer, nontoxic and nonirritating, and helps to minimize layer?

contact or primary layer

What primary layer is used for loose necrotic debris and low-viscosity exudate?

dry adherent (gauze)

What contact or primary layer is used for necrotic tissue and/or viscous exudate?

wet adherent (wet gauze or water preparation)

What contact or primary layer is used when there is no necrotic debris and it protects granulation tissue and migrating epithelium?

nonadherent

What layer of the bandage is the bulk of the bandage, it holds drainage, provides support and immobilization, decreases dead space, and reduces edema?

intermediate or second layer

What layer of the bandage holds the first two layers in place?

outer or tertiary layer

What are examples of a secondary layer of a bandage?

absorbent cotton

combine roll

cast paddine

What are examples of a third layer of a bandage?

stretch gauze

stockinette

adhesive tape

vetrap

What is a main guideline for bandaging the thorax or abdomen?

may need to cross bandage in front of the forelimbs to prevent slippage

What are the main guidelines for bandaging the head and neck?

always mark where the ears are

you should be able to insert fingers underneath the bandage

What drain depends on gravity and should be covered sterily?

passive drain

What drain depends on a vacuum, is used to drain deeper tissues, and has a lower risk of infection?

active drain

What is the dilution ratio for povidone iodine?

1:10

What is the dilution ratio for chlorhexidine?

1:40

What wound closure is for immediate closure of wounds and used for clean wounds and clean-contaminated wounds?

primary

What wound closure is left open for 2-5 days and is closed prior to granulation tissue formation?

delayed primary

What wound closure allows granulation tissue to form in wound prior to closure?

secondary

What wound closure is used for dirty or infected wounds and allows for granulation, epithelialization, and contracture?

second intention

How is a chest tube cared for?

check every hour then taper

How is a urinary catheter cared for?

check bag regularly to assure urine output

weigh bag hourly (1 gram = 1 ml of urine)

empty bag only when full to avoid environmental contamination

What is the normal output for a urinary catheter?

> 1-2 ml/kg/hour average