Home
Explore
Exams
Search for anything
Login
Get started
Home
Science
Medicine
Surgical Semiology
5.0
(1)
Rate it
Studied by 17 people
Learn
Practice Test
Spaced Repetition
Match
Flashcards
Card Sorting
1/242
Earn XP
Description and Tags
Medicine
University/Undergrad
Add tags
Study Analytics
All
Learn
Practice Test
Matching
Spaced Repetition
Name
Mastery
Learn
Test
Matching
Spaced
No study sessions yet.
243 Terms
View all (243)
Star these 243
1
New cards
asepsis
measures that prevent germ contact with patient, status free of germs
2
New cards
antisepsis
curative measure to destroy germs in wound or enviro
3
New cards
status of asepsis is produced by
sterilization
4
New cards
antiseptic principle
applying carbolic acid and wound dressing to prevent infection, by Pasteur
5
New cards
methods of asepsis in OR
washing hands
disinfecting operating field
sterilization of materials
6
New cards
humid heat sterilization is called
autoclave
7
New cards
sterilization by dry heat is called
poupinel (double wall chamber, for metal instruments)
8
New cards
sterilization by irradation
by gama rays, highly efficient but expensive, for packaged materials
9
New cards
ethylene oxide sterilization is for which equipment
special equipment, soft materials
10
New cards
diff bw formaldehyde and glutaraldehyde solution sterilization
both for bio materials
glutha is more stable
11
New cards
__________ methods use changing of colour of test
chemical
12
New cards
_________ methods use bacteriological cultures from samples
biological
13
New cards
desinfectant vs antiseptic
fluid which removes microbes from inanimate objects
antiseptic - on tissue
14
New cards
prep before operation
patient washes with antiseptic, hair removed by clipping
15
New cards
prep in operating room
cleaning with antiseptics, skin prep w/ iodine, draping of operative field
16
New cards
antisepsis of hands of surgeons
dressing, surgical scrubbing
17
New cards
method of performing antisepsis
desinfection
18
New cards
antiseptics
bactericidal chemical products
19
New cards
chlorhexidine
organic compounds - antiseptics
20
New cards
role of OR circulators
verifies equipment, charts etc
21
New cards
scrub technicians vs surgical assistants
scrub technicians - deal w/ tools
surgical assistants help them
22
New cards
bowel prep
fasting liquids 2 hrs, solids 6 hrs
23
New cards
patient prep involves
bowel prep, atb use, cessation/administration meds (anticoags)
24
New cards
Postoperative Pathway - recovery area for complex surgeries is called
ICU
25
New cards
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
26
New cards
objectives for patient preop
1. establish diagnosis
2. diagnose other comorbidities
3. screening common disorders
27
New cards
sensitivity
ability of clinical test to identify patient with abnormality
28
New cards
specificity
ability of test to identify healthy patient who doesn’t have abnormality
29
New cards
\+/- predictive value
probability that individual who tested pos/neg does/not have abnormality
30
New cards
patient flow: patient handed to ____ __staff to confirm identity → theatre trolley →__ _____ __→__ ______operating table
theatre
anesthetic room
31
New cards
methods of infection control
* sterilization equipment
* skin prep + draping
* prep of operating team
32
New cards
effects of ventilation control and sterilization
infection control
33
New cards
__________ must be divided, stable, highly adjustable w/ rubber padding
operating table
34
New cards
most used position for patient on operating room
supine
35
New cards
Trendelenburg position
patient on operating table supine but head down (reverse in up)
36
New cards
prone position of patient on operating room is for
spinal surgeries
37
New cards
jackknife position is used for
access to anus/rectum
38
New cards
complications of patient position in surgery
ischemia, pressure ulcers, n injury, compartment syndrome
39
New cards
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
40
New cards
what must be used for a patient in reverse trendelenburg
compression stockings
41
New cards
lateral position - requirements
cushions, secure fastening
42
New cards
precautions when positioning patients on operating table
unintentional contact w/ metal, padding around pressure points, legs down positions preferred (to avoid compartment syndrome)
43
New cards
common nerves at risk during surgery
brachial plexus, ulnar nerve, radial nerve, common peroneal nerve
44
New cards
routine cases - vascular access
one peripheral IV line
45
New cards
vascular access in more complex cases
2+ large-bore IVs, central v catheters (for patients w/ comorbidities)
46
New cards
fxns arterial lines
monitoring BP & ABG
47
New cards
if regional anesthesia, what airway management is used?
nasal/facial canule
48
New cards
if general anesthesia, what airway management is used?
endotracheal tube
49
New cards
when is bag-mask ventilation used?
short procedures
50
New cards
lines of langer
cleavage lines of skin in parallel with fibers, indications for incisions → nicer scar
51
New cards
median sternotomy
exposure for thoracic surgeries, from sternal notch to xiphoid process
52
New cards
thoracotomy
incision for open thoracic surgeries, into pleural space
53
New cards
thoracoabdominal incision
good exposure but increases postop complications
54
New cards
upper midline incisions
from xiphoid process to umbilicus
55
New cards
lower midline
from umbilicus to pubic symphysis, good exposure
56
New cards
paramedian incision
2cm either side of midline depending on organ to be operated on, avoiding linea alba
57
New cards
chevron incision
exposes upper abd, from midaxillary line under ribs
58
New cards
flank incision
for retroperitoneum access, from rib to anterior midline, risk flank bulge postop
59
New cards
transverse abd incision - why is it unnatural
must cut muscle
60
New cards
phannenstiel incision
1-2cm above pubic symphysis, for c section
61
New cards
right subcostal Kocher incision
from xiphoid process → costal inf margin, for liver/gallbladder access
62
New cards
thoracoscopy vs laparoscopy
thoracoscopy has free passage of air into the chest & for pleural space, laparoscopy has peritoneal cavity is distended with a gas
63
New cards
invasive monitoring
to maintain adequate hemodynamic status in an anesthetized patient
64
New cards
\
After the induction of general anesthesia, the patient’s ability to ___________ is lost
maintain the airway
65
New cards
how is stomach aspiration prevented under anesthesia
fasting, endotracheal tube
66
New cards
indications nasogastric tube
vomiting, gastric dilatation, prevent gastro-esophageal reflux/damage
67
New cards
indications urethral catheterisation
before any surgery or to assess urinary output (retention), incontinence
68
New cards
how to help male catheterisation
pull penis upwards first, then down
69
New cards
Allen test
ulnar collateral supply checked before getting access to radial artery, ask patient to make tight fist
70
New cards
seldinger technique
for central venous catheterisation, needle placed in vessel and guide wire inserted into veie first,
71
New cards
int jugular, femoral and median basilic veins are sites of choice for
central venous catheterisation
72
New cards
central venous pressure
measure of p in vena cava, assessment hemodynamic statush
73
New cards
high vs low CVP levels (normal 8-12mmHg)
* high is hypervolemia, RV failure, tamponade
* low is hypovelemia, decreased v return
74
New cards
swan-ganz catheter
pulmonary artery flotation catheter to measure wedge p, bp, cvp, co
75
New cards
low vs high levels paco2 associated w/ low pao2
low is hyperventilation, high is RF
76
New cards
low vs high values paco2
low is hyperventilation, metabolic acidosis/resp alkalosis
high is hypoventilation, RF
77
New cards
local host factors causing an infection
foreign body, necrosis, ischemia (reduces phagocytes + increases anaerobes), hematoma, DM (hyperglycemia, vasc + neuro pathies)
78
New cards
host defense system of skin
mechanical, acidic sebum
79
New cards
why is the proximal small bowel mostly sterile
stomach acid + peristaltic movement
80
New cards
how do skin + GI flora prevent infection
prevents adherence and chemical barrier
81
New cards
___________ are responsible for high morbidity + mortality and prolonged stay in hospital
postop infections
82
New cards
what surgeries have high infection risk
perforated bowel, pus at site (perforated appendicitis)
83
New cards
disinfectants
substances that kill most pathogens (not spores or slow viruses), cleans instruments + surfaces
84
New cards
antiseptics
disinfectants used on living tissue
85
New cards
sterilization
complete destruction of all organisms, for surgical instruments
86
New cards
personal protective equipment for staff
double gloving if HIV, HCV, gowns during operation
87
New cards
maintaining normothermia and hemostasis prevents what
postop infection
88
New cards
aim of prophylactic use of antibiotics
high conc of drug at the surgical site at the time of incision
89
New cards
doses of prophylactic atb
single IV (same as multiple doses), if surgery >4h → 2nd dose
90
New cards
which types of infections are in early postop period (
resp or urinary
91
New cards
when do wound infections clinically manifest postop
>48h
92
New cards
how many days postop of GI anastomosis leakage pccur
5-6
93
New cards
when do implant-related infections manifest postop?
weeks or months
94
New cards
signs of postop infection
cough, dysuria, abd pain, tachycardia, shock, wound tenderness
95
New cards
blood count if postop infection
raised WBC, low + anemia if severe infection
96
New cards
general measures for postop infection management
resuscitation, analgesia, anti-emetics, antipyretics
97
New cards
specific measures for postop infection management
atb, drainage
98
New cards
management of infected wounds
open wound, debride necrosis, take swab + mark cellulitis, dress + antiseptic gauze, secondary closure
99
New cards
when are stoma wound bags and vacuum dressing used
complex/large infected wound
100
New cards
methods of drainage of infected wounds
needle aspiration (leaves no scar), guided drainage, surgical drainage
Load more