Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Surgery > abdominal surgery > Flashcards

abdominal surgery Flashcards

1
Q

what is a laparotomy?

A
  • Surgical incision into the abdominal
    cavity
  • Technically refers to a flank incision
  • Rarely if every performed
  • Used synonymously with celiotomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is a celiotomy

A
  • Correct terminology
  • Routinely along the midline
  • “Ex lap” = Exploratory Celiotomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

“ACUTE ABDOMEN” means:

A

Acute clinical signs referable to the abdominal cavity :

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how to clip to prep for ex lap

A
  • Wide clip!!
  • Few cm’s cranial to xiphoid
  • Few cm’s caudal to inguinal region
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how long should our incision be to explore the abdomen?

A
  • Exploring the entire abdomen – incision xiphoid to pubis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what number blade should we incise with for our first cut into the abdomen? how far do we go?

A
  • Incise (xiphoid to pubis) with #10 (for big) or #15 (for small) skin blade
    -incise subcutaneous tissue down to external rectus fascia > 15 blade or metzenbaum scissor
    -identify the linea alba
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

how do we get through the linea alba?

A

Tent the abdominal wall at the linea alba and make a stab incision (#15 blade) facing upwards
* Palpate for adhesions
* Mayo scissors to extend cranially and caudally along the linea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what should we do with the falciform ligament?

A

can either:
* Leave in abdomen
* Excise (remove) it for better view

  • Clamp and ligate the cranial attachment (blood supply enters)
  • Amputate distal to the suture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

when should we count our gauzes/ sponges?

A

-before and after surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what do we want to do with the prepuce of male dogs to prep

A

-clip and prepare
-lateralize with towel clamp
-drape over tip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what tool can we use to help us see into the abdomen?

A

balfour retractor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

when closing the abdomen, we have layers of skin, fascia, muscle, fat, and peritoneum. What are the strongest parts? weakest? which heals fastest but does not contribute to wound healing?

A
  • Skin and Fascia:
  • Strong
  • Muscle and Fat:
  • Weak
  • Peritoneum:
  • Heals fast
  • Does not contribute to wound healing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what type of suture pattern should a less experienced surgeon use on the linea? what are the advantages and disadvantages?

A

simple interuppted

  • Advantages:
  • More secure when learning
  • Disadvantages:
  • More foreign material in wound
  • Longer Surgical Time
  • Use more suture (cost?)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what type of suture pattern should a more experienced surgeon use to close the linea alba? how many knots? how long should tags be?

A
  • Simple Continuous
  • No increased risk dehiscence when properly performed
  • Secure knots (5-6 start, 7-8 end)
  • Appropriate suture material
  • Appropriate suture size
  • Good bites
  • Suture tags ~0.5cm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

should we use a surgeons knot on the skin layer?

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

advantages and disadvantages of continuous pattern closure of linea alba

A

Advantages:
* Rapid closure
* Less foreign material in the wound
* Use less suture (cost?)

Disadvantages:
* Catastrophic failure

17
Q

what suture materials should we never use for linea closure?

A

DO NOT USE CATGUT OR STEEL FOR LINEA ALBA CLOSURE

NON ABSORBABLE BRAIDED SUTURE MAY CAUSE SINUS FORMATION (NOT RECOMMENDED)

18
Q

how big should our bites be when closing the linea? what layer should we be focusing on, and what should we not include? how far apart should sutures be?

A
  • Full thickness bites (linea) – 4-10mm bites
  • External rectus sheath – 10 mm bites
  • Do not include falciform or subcutaneous fat (delay healing)
  • Place sutures 5-7mm apart (animal size dependent)
  • Tighten but do not strangulate (ischemia)
19
Q

when closing the first layer of the abdomen, if we are off the linea, what should we include in our bites?

A

-if not on the linea alba, include the external fascia only, not the rectus muscle

20
Q

what is the most major cause of dehiscence? how to we minimize risk?

A

weakness of the tissue caught in bites
> take large bites of the external leaf of the fascia

21
Q

what types of suture materials should we use to close the linea alba?

A

PDS, Biosyn, Maxon

22
Q

what size of suture should we use to close the linea alba with a simple interrupted pattern? what about with continuous?

A

depends on size of dog:

2-12kg: 3-0 (2-0 for simple continuous)
12-30kg: 2-0 (2-0 to 0 for simple continuous)
>30kg: 0 (0 for simple continuous)

23
Q

keys to success when closing the linea alba

A
  • Full thickness bites
  • Wide bites
  • Good distance between suture bites
  • Long enough suture tags
24
Q

what suture pattern and material should we use to close the subcutaneous layer? what size?

A
  • Simple continuous pattern to close
  • Monocryl
  • Vicryl
  • Absorbable suture (4-0, 3-0, 2-0 depending on size of animal)
25
Q

knots must be ___ in subcutaneous closure

A

buried

26
Q

subcutaneous skin sutures will be more ___ than functional

A

aesthetic

27
Q

how do we close the subcutaneous tissue in male dogs, with regards to the prepuce?

A
    1. Close subcutaneous tissue in sub-preputial area
    1. Re-appose the preputial muscle to realign prepuce
    1. Close subcutaneous tissue in a simple continuous pattern
28
Q

when complications can arise in male dogs, relating to subcutaneous closure around the prepuce?

A
  • Paraphimosis
  • Seroma formation
  • Crooked urination
29
Q

what pattern, size, and general material of suture should we use for skin?

A
  • Simple interrupted or cruciate pattern (4-0 or 3-0)
  • Non absorbable suture
30
Q

what surgeries do not warrant antibiotics?

A
  • Surgeries <1.5-2h with no entry into a hollow viscous or contamination do not warrant prophylactic antibiotics (clean surgery)
31
Q

what does perioperative antibiotics mean? what is the general protocol?

A
  • Perioperative means to start within 1⁄2 hour of cutting skin and stop once the procedure is done or within 24 hours
32
Q

post-operatively, check twice daily for:

A
  • Redness
  • Swelling
  • Discharge
  • Pain
  • Dehiscence
33
Q

at what point do we remove skin sutures?

A

10-14 days

Surgery (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions