Flashcards in Clinical Skills Deck (167)
Where would you feel for a pulse when assessing circulation prior to CPR?
Where should chest compressions be applied during CPR in narrow-chested dogs?
Directly over the heart
In which recumbency should chest compressions be performed during CPR in barrel-chested dogs?
In which recumbency should chest compressions be performed during CPR in small dogs win compliant chests and most cats?
How do you achieve the cardiac pump theory in small dogs with compliant chests/most cats? (2)
1. Wrap fingers of one hand around sternum at level of heart
2. Both hands- one under cat and one around sternum at level of heart
How many chest compressions should be performed during CPR?
100-120 per minute
How should ventilation be applied during CPR?
10ml/kg tidal volume
Use pure oxygen and a reservoir bag from a breathing circuit
When is the only time you use the thoracic pump theory?
In which recumbency should chest compressions be performed during CPR in round and narrow-chested dogs?
What are the 4 methods of taking a cytological sample?
Fine needle (aspirate) biopsy
When taking a fine-needly biopsy, when would you use aspiration?
For tissues with more structure, eg soft tissue sarcoma
When taking a biopsy, when would you not use aspiration?
Vascular or soft tissues eg spleen, lymph node
What are some advantages of using fine-needle biopsy technique?
Often no sedation required for superficial tissues
What gauge needle would you use when doing a fine needle biopsy?
Why no bigger?
May cause haemorrhage
When might aseptic preparation of the patient be used?
When wouldnt it?
Would=fine needle aspiration of eg liver
Wouldn't=surface cytologies eg impression smear of skin, as you would be destroying the changes you wish to examine
What are fine needle biopsies used to obtain?
When might they be inappropriate?
Small samples of cells from inside organs or masses. Can be done 'blind' or with ultrasound guidance (more accurate).
If the patient has a coagulation defect, or in highly vascular masses.
When would you take an impression smear?
Ulcerated masses, burst pustules or from the cut surface of a mass
Most useful for highly exfoliative tissues (eg lymph nodes) rather than ones with rigid architecture eg tumours of fibrous tissues (fibromas)
How would you do an impression smear?
Gently blot surface of mass to remove blood contamination
Press the cut surface of the sample on to the face of a clean slide
Allow to air-dry
When doing a tape strip examination, how long should the tape be?
2cm longer than microscope slide
When staining a tape strip, which stains do you use?
Red and blue components of the Diff-Quik stain, as the fixing solution will melt the glue in the tape
What is the optimal body condition score for a dog?
4/5 on a 9 point scale.
Ribs easily palpable with minimal fat covering. Waist observed behind ribs when viewed from above.
Abdominal tuck evident
What is the optimal body condition score for a cat?
5 on a 9 point scale
Ribs palpable with slight fat covering.
Can observe waist behind ribs.
Abdominal fat pad minimal.
When performing a clinical exam, what should you look at regarding the head?
Check musculature, palpate submandibular lymph nodes. Examine oral cavity (mucous membrane colour, capillary refill time, teeth, tongue, tonsils). Check nose (discharge, condition, airflow in each nostril). Eyes (ophthalmoscopy). Examine ears (otoscopy)
Why should you perform heart auscultation in a dog when its standing as opposed to in lateral or dorsal recumbency?
Thoracic structures may displace due to gravity when in dorsal/lateral recumbency
Where is the heart located?
Close to the sternum between ribs 3 and 6 (count ribs backwards as it is difficult to identify rib 1 and count forwards due to the thoracic limb and pectoral muscle mass). LHS.
Can also use position of the olecranon-when animal is standing square, the olecranon is at the level of the 5th costo-chondral junction
In order to listen to all areas of the heart, the thoracic limb should be drawn forward to pull the triceps muscle mass out of the way
Where are the heart valves located?
Pulmonary: LHS ribspace 3
Aortic: LHS ribspace 4
Left atrio-ventricular (mitral valve): LHS ribspace 5
Right atrio-ventricular (tricuspid valve): RHS ribspace 4
What are the 2 parts of a stethoscope?
What can be heard with each part?
Bell (head): low frequency sounds
Diaphragm: high frequency sounds
What is percussion?
What should it sound like over the heart and lungs?
The technique of placing one finger on the thoracic wall and tapping with another finger to identify areas of dullness, either with or without the stethoscope
Percussing over the lungs will sounds slightly hollow (tympanic) as they are air-filled, but percussing over the heart will sound slightly dull as it is fluid-filled (area of cardiac dullness).
What can percussion be used for?
Over the lungs to identify solid masses (tumours or abscesses) and fluid lines in the case of pneumonia and pleural effusions