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Minor Surgery > Midterm > Flashcards

Midterm Flashcards

1
Q

How long should sutures stay in: the face, the thigh

A

Face: 3-5 days
High tension areas, eg Thigh: 10-14
Low tension areas: 6-10 days
Trunk: 6-12 days

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2
Q

What suture materials are used internally?

A

Vicryl or Gut

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3
Q

What sutures are absorbable? Non absorbable?

A

Absorbable: vicryl, gut
Nonabsorbably: silk, nylon, cotton, etc

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4
Q

What are the different types of nerve blocks? What might they be used for?

A

Field block, digital block, IV anesthesia, Spinal/ Epidural anesthesia…

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5
Q

When might we use a digital block? What kind of anesthetic would we use?

A

Toenail removal; Lidocaine with Marcaine (longer lasting anesthetic effect)

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6
Q

What type of anesthetic are marcaine and lidocaine?

A

amides

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7
Q

When would we use a vertical mattress suture?

A

closing deep dead spaces (eg. after lipoma/cyst removal)

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8
Q

When would we use other stitches?

A

Subcutaneous: close deep dead spaces
Vertical mattress: as a stay, and to close dead spaces
Horizontal mattress: as a stay for wounds under tension

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9
Q

What is the most common cause of anaphylaxis during minor surgery procedures?

A

Accidental injection of anesthetic into central circulation (vein/artery)

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10
Q

What are signs/Sxs of an adverse reaction to anesthetic?

A

coma, convulsions, syncope, LOC, bradycardia, hypotension etc

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11
Q

Nerve block vs. Field block vs. Infiltration

A

Field block: uses less anesthesia to get effect, surrounds the area of use
Nerve Block: inject into peripheral nerve roots directly
Infiltration: Inject underneath the area of interest (causes distortion of area and may require more anesthesia to gain desired effect)

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12
Q

What is infiltration? What might it be used for?

A

Injection at or underneath a lesion to be removed.

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13
Q

What are the major solutions we use for sterile prep?

A

Betadine, Provoiodine, Hebiclense

NOTE: alcohol not effective, as sterility doesn’t last very long

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14
Q

What is the most important step in creating a sterile field/environment?

A

GLOVES!

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15
Q

What medications are contraindicated in minor surgery?

A

MAOI

use caution with antidepressants

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16
Q

What are the best tools for undermining?

A

dull (iris) scissors, hemostat, use care/caution with pointed scissors

17
Q

How far do we undermine around a wound?

A

1/2 the distance of the wound

18
Q

At what temperature and how long at that temperature is required to sterilize tools?

A

Autoclaving: 250degF at 15lb/sq.in. for 30 minutes

Dry Sterilization: 450degF for 30 minutes

19
Q

What kills spores on tools?

A

quick release/snap (sudden decompression)

20
Q

What is the progression of pain/numbness with anesthetic?

A
  1. pain sensation lost
  2. cold/warmth sensation
  3. sense of touch lost
  4. deep pressure sense lost
  5. motor fxn lost
21
Q

What are the pros/cons of using betadine?

A

Betadine: requires 2 minutes contact to be effective. Some patients may be allergic to components of the product

22
Q

Is it better to have wound closure with inversion or eversion?

A

EVERSION

23
Q

What channel does lidocaine block?

A

sodium channels

24
Q

What instruments are in a suture pack?

A 
curved iris or dull scissors
needle holder/hemostat
forceps (toothed and flat)
gauze
may have a scalpel handle
25
Q

Which forcep is best to grab tissue?

A

toothed

26
Q

1:100,000 epinephrine is used in:

A

when mixed with lidocaine for topical anesthesia

27
Q

1:1000 epinephrine is used in:

A

Epipens
Adults dose: 0.3ml
Ped. dose: 0.15ml

28
Q

1:10,000 epinephrine is used in:

A

in an IM injection for MI

29
Q

What size needles do we use for drawing up lidocaine?

A

18g

30
Q

What size needles do we use for injection of lidocaine?

A

25g

31
Q

In what order would you want to draw up anesthetic materials?

A

Bicarb 1cc, Lidocaine, then Epinephrine 9-10cc

Bicarb, then Lido+Epi, if they’re already mixed

32
Q

What size scalpel would we want to use most often? (eg: for cutting elliptical areas around a biopsy)

A

15 blade

33
Q

What size scalpel would we want to use for lancing boils?

A

11 scalpel

34
Q

What size scalpel would we want to use for a shave biopsy?

A

10

35
Q

What are the pros/cons of using topical anesthetics?

A

CONS: can’t apply to deep wounds- may be absorbed systemically

36
Q

Who (what type of pt) is more prone to infection and why?

A

Immunocompromised

37
Q

Does injection do long term damage to the nervous system?

A

No- there is no evidence to support this

38
Q

How long does it take Lidocaine and Marcaine to take effect? How long do the effects last?

A

Lidocaine: onset 1 minute, lasts 45-60 minutes
with Epi: lasts 2-6 hours
Marcaine: onset 5 minutes, lasts 2-4 hours

Minor Surgery (4 decks)

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