Surgical Semiology

studied byStudied by 17 people
5.0(1)
Get a hint
Hint

asepsis

1 / 242

flashcard set

Earn XP

Description and Tags

243 Terms

1

asepsis

measures that prevent germ contact with patient, status free of germs

New cards
2

antisepsis

curative measure to destroy germs in wound or enviro

New cards
3

status of asepsis is produced by

sterilization

New cards
4

antiseptic principle

applying carbolic acid and wound dressing to prevent infection, by Pasteur

New cards
5

methods of asepsis in OR

washing hands disinfecting operating field sterilization of materials

New cards
6

humid heat sterilization is called

autoclave

New cards
7

sterilization by dry heat is called

poupinel (double wall chamber, for metal instruments)

New cards
8

sterilization by irradation

by gama rays, highly efficient but expensive, for packaged materials

New cards
9

ethylene oxide sterilization is for which equipment

special equipment, soft materials

New cards
10

diff bw formaldehyde and glutaraldehyde solution sterilization

both for bio materials glutha is more stable

New cards
11

__________ methods use changing of colour of test

chemical

New cards
12

_________ methods use bacteriological cultures from samples

biological

New cards
13

desinfectant vs antiseptic

fluid which removes microbes from inanimate objects

antiseptic - on tissue

New cards
14

prep before operation

patient washes with antiseptic, hair removed by clipping

New cards
15

prep in operating room

cleaning with antiseptics, skin prep w/ iodine, draping of operative field

New cards
16

antisepsis of hands of surgeons

dressing, surgical scrubbing

New cards
17

method of performing antisepsis

desinfection

New cards
18

antiseptics

bactericidal chemical products

New cards
19

chlorhexidine

organic compounds - antiseptics

New cards
20

role of OR circulators

verifies equipment, charts etc

New cards
21

scrub technicians vs surgical assistants

scrub technicians - deal w/ tools

surgical assistants help them

New cards
22

bowel prep

fasting liquids 2 hrs, solids 6 hrs

New cards
23

patient prep involves

bowel prep, atb use, cessation/administration meds (anticoags)

New cards
24

Postoperative Pathway - recovery area for complex surgeries is called

ICU

New cards
25

screening done before surgery

  1. Full blood count - Hb, coagulation screen, leukocytes

  2. Biochem - urea, creatinine, electrolytes

  3. Urinalysis

  4. Microbio

  5. Cardiac - ECG

  6. Lung fxn

  7. cross matching blood

New cards
26

objectives for patient preop

  1. establish diagnosis

  2. diagnose other comorbidities

  3. screening common disorders

New cards
27

sensitivity

ability of clinical test to identify patient with abnormality

New cards
28

specificity

ability of test to identify healthy patient who doesn’t have abnormality

New cards
29

+/- predictive value

probability that individual who tested pos/neg does/not have abnormality

New cards
30

patient flow: patient handed to ____ staff to confirm identity → theatre trolley → _____ ______operating table

theatre

anesthetic room

New cards
31

methods of infection control

  • sterilization equipment

  • skin prep + draping

    • prep of operating team

New cards
32

effects of ventilation control and sterilization

infection control

New cards
33

__________ must be divided, stable, highly adjustable w/ rubber padding

operating table

New cards
34

most used position for patient on operating room

supine

New cards
35

Trendelenburg position

patient on operating table supine but head down (reverse in up)

New cards
36

prone position of patient on operating room is for

spinal surgeries

New cards
37

jackknife position is used for

access to anus/rectum

New cards
38

complications of patient position in surgery

ischemia, pressure ulcers, n injury, compartment syndrome

New cards
39

why is trendelenburg position used

organs go towards head - better view for lower gi surgeries

increased v return, intracranial + ocular p, pul compliance, myocardial work

New cards
40

what must be used for a patient in reverse trendelenburg

compression stockings

New cards
41

lateral position - requirements

cushions, secure fastening

New cards
42

precautions when positioning patients on operating table

unintentional contact w/ metal, padding around pressure points, legs down positions preferred (to avoid compartment syndrome)

New cards
43

common nerves at risk during surgery

brachial plexus, ulnar nerve, radial nerve, common peroneal nerve

New cards
44

routine cases - vascular access

one peripheral IV line

New cards
45

vascular access in more complex cases

2+ large-bore IVs, central v catheters (for patients w/ comorbidities)

New cards
46

fxns arterial lines

monitoring BP & ABG

New cards
47

if regional anesthesia, what airway management is used?

nasal/facial canule

New cards
48

if general anesthesia, what airway management is used?

endotracheal tube

New cards
49

when is bag-mask ventilation used?

short procedures

New cards
50

lines of langer

cleavage lines of skin in parallel with fibers, indications for incisions → nicer scar

New cards
51

median sternotomy

exposure for thoracic surgeries, from sternal notch to xiphoid process

New cards
52

thoracotomy

incision for open thoracic surgeries, into pleural space

New cards
53

thoracoabdominal incision

good exposure but increases postop complications

New cards
54

upper midline incisions

from xiphoid process to umbilicus

New cards
55

lower midline

from umbilicus to pubic symphysis, good exposure

New cards
56

paramedian incision

2cm either side of midline depending on organ to be operated on, avoiding linea alba

New cards
57

chevron incision

exposes upper abd, from midaxillary line under ribs

New cards
58

flank incision

for retroperitoneum access, from rib to anterior midline, risk flank bulge postop

New cards
59

transverse abd incision - why is it unnatural

must cut muscle

New cards
60

phannenstiel incision

1-2cm above pubic symphysis, for c section

New cards
61

right subcostal Kocher incision

from xiphoid process → costal inf margin, for liver/gallbladder access

New cards
62

thoracoscopy vs laparoscopy

thoracoscopy has free passage of air into the chest & for pleural space, laparoscopy has peritoneal cavity is distended with a gas

New cards
63

invasive monitoring

to maintain adequate hemodynamic status in an anesthetized patient

New cards
64

After the induction of general anesthesia, the patient’s ability to ___________ is lost

maintain the airway

New cards
65

how is stomach aspiration prevented under anesthesia

fasting, endotracheal tube

New cards
66

indications nasogastric tube

vomiting, gastric dilatation, prevent gastro-esophageal reflux/damage

New cards
67

indications urethral catheterisation

before any surgery or to assess urinary output (retention), incontinence

New cards
68

how to help male catheterisation

pull penis upwards first, then down

New cards
69

Allen test

ulnar collateral supply checked before getting access to radial artery, ask patient to make tight fist

New cards
70

seldinger technique

for central venous catheterisation, needle placed in vessel and guide wire inserted into veie first,

New cards
71

int jugular, femoral and median basilic veins are sites of choice for

central venous catheterisation

New cards
72

central venous pressure

measure of p in vena cava, assessment hemodynamic statush

New cards
73

high vs low CVP levels (normal 8-12mmHg)

  • high is hypervolemia, RV failure, tamponade

  • low is hypovelemia, decreased v return

New cards
74

swan-ganz catheter

pulmonary artery flotation catheter to measure wedge p, bp, cvp, co

New cards
75

low vs high levels paco2 associated w/ low pao2

low is hyperventilation, high is RF

New cards
76

low vs high values paco2

low is hyperventilation, metabolic acidosis/resp alkalosis

high is hypoventilation, RF

New cards
77

local host factors causing an infection

foreign body, necrosis, ischemia (reduces phagocytes + increases anaerobes), hematoma, DM (hyperglycemia, vasc + neuro pathies)

New cards
78

host defense system of skin

mechanical, acidic sebum

New cards
79

why is the proximal small bowel mostly sterile

stomach acid + peristaltic movement

New cards
80

how do skin + GI flora prevent infection

prevents adherence and chemical barrier

New cards
81

___________ are responsible for high morbidity + mortality and prolonged stay in hospital

postop infections

New cards
82

what surgeries have high infection risk

perforated bowel, pus at site (perforated appendicitis)

New cards
83

disinfectants

substances that kill most pathogens (not spores or slow viruses), cleans instruments + surfaces

New cards
84

antiseptics

disinfectants used on living tissue

New cards
85

sterilization

complete destruction of all organisms, for surgical instruments

New cards
86

personal protective equipment for staff

double gloving if HIV, HCV, gowns during operation

New cards
87

maintaining normothermia and hemostasis prevents what

postop infection

New cards
88

aim of prophylactic use of antibiotics

high conc of drug at the surgical site at the time of incision

New cards
89

doses of prophylactic atb

single IV (same as multiple doses), if surgery >4h → 2nd dose

New cards
90

which types of infections are in early postop period (<48h)

resp or urinary

New cards
91

when do wound infections clinically manifest postop

48h

New cards
92

how many days postop of GI anastomosis leakage pccur

5-6

New cards
93

when do implant-related infections manifest postop?

weeks or months

New cards
94

signs of postop infection

cough, dysuria, abd pain, tachycardia, shock, wound tenderness

New cards
95

blood count if postop infection

raised WBC, low + anemia if severe infection

New cards
96

general measures for postop infection management

resuscitation, analgesia, anti-emetics, antipyretics

New cards
97

specific measures for postop infection management

atb, drainage

New cards
98

management of infected wounds

open wound, debride necrosis, take swab + mark cellulitis, dress + antiseptic gauze, secondary closure

New cards
99

when are stoma wound bags and vacuum dressing used

complex/large infected wound

New cards
100

methods of drainage of infected wounds

needle aspiration (leaves no scar), guided drainage, surgical drainage

New cards

Explore top notes

note Note
studied byStudied by 8 people
... ago
5.0(1)
note Note
studied byStudied by 56 people
... ago
5.0(1)
note Note
studied byStudied by 169 people
... ago
5.0(1)
note Note
studied byStudied by 6 people
... ago
5.0(1)
note Note
studied byStudied by 15 people
... ago
5.0(2)
note Note
studied byStudied by 1 person
... ago
5.0(1)
note Note
studied byStudied by 20 people
... ago
5.0(2)
note Note
studied byStudied by 73 people
... ago
5.0(1)

Explore top flashcards

flashcards Flashcard (20)
studied byStudied by 3 people
... ago
5.0(2)
flashcards Flashcard (25)
studied byStudied by 10 people
... ago
5.0(2)
flashcards Flashcard (70)
studied byStudied by 11 people
... ago
5.0(1)
flashcards Flashcard (45)
studied byStudied by 5 people
... ago
5.0(1)
flashcards Flashcard (50)
studied byStudied by 1 person
... ago
5.0(1)
flashcards Flashcard (37)
studied byStudied by 264 people
... ago
4.0(5)
flashcards Flashcard (60)
studied byStudied by 32 people
... ago
5.0(1)
flashcards Flashcard (174)
studied byStudied by 4 people
... ago
5.0(1)
robot