Clinical Skills Year 1 Flashcards
(110 cards)
1
Q
What is the weakest part of any suture line?
A
The knot
2
Q
What is a throw?
A
Wrapping ends of suture around each other and tightening each end
3
Q
What is a square knot?
A
2 throws, will unwrap if tension applied
4
Q
What is a secure square knot?
A
minimum of 4 throws
5
Q
What is a tail or end?
A
the cut ends of suture
6
Q
What is a surgeons knot?
A
A surgeon’s throw with secure square knot on top
7
Q
What is a surgeons throw?
A
long strand of suture is wrapped around needle holder TWICE in the first throw
8
Q
When is a surgeon’s knot used?
A
When 1st throw loosens before the second throw can be placed to secure knot
9
Q
Why is an additional throw required with surgeons knot?
A
because it is more difficult to tighten the knot with the double wrap
10
Q
What is a granny knot?
A
when knot is finished, its ends form cross to the suture bite (BAD)
11
Q
What is a half hitch?
A
Square knot where 1 strand stands straight up & the other is flat
12
Q
What causes half hitching?
A
1 end is pulled harder or in higher direction than the other
13
Q
How to avoid granny knots?
A
place needle holders on incision & wrap suture around them
14
Q
How to avoid half hitching?
A
keep hands close to tissue & apply equal tension to each end when tightening
15
Q
What causes a granny knot?
A
Wrapping suture from outside center of knot or not alternating steps when performing hand ties
16
Q
Why do we not use a surgeon’s knot all the time?
A
It causes an increased tissue reaction due to being a bigger knot
17
Q
When do we use a simple interrupted suture pattern?
A
Used for skin closure or in various tissues when careful apposition of incision edges are desired
18
Q
What is the cruciate suture pattern used for?
A
Commonly used for skin closure
19
Q
Which suture patterns are used infrequently on skin when tension is present?
A
Horizontal mattress pattern, vertical mattress pattern, Ford interlocking
20
Q
Which suture patterns do you start in backhand position?
A
Vertical mattress, Utrecht
21
Q
What are the near bites in near far patterns for?
A
They improve skin apposition
22
Q
What are the far bites for in near far patterns?
A
They manage tension present in the skin
23
Q
Why is handwashing important?
A
To prevent spread of microorganisms to patient & prevent acquiring an infection from your patient
24
Q
What is the number 1 factor in preventing hospital acquired infections?
A
Washing your hands
25
When do we wash our hands?
1. When hands are visibly dirty
2. Before patient contact
3. After patient contact
4. After handling pet food/treats, animal wastes, contaminated surfaces
5. Before donning gloves for an invasive procedure (ex: IV catheters)
6. After removing gloves
26
When do we use handrubs instead of handwashing?
When handwashing isn't an option or when you want to avoid excess drying of skin from soap
27
Why is healthy skin important?
Prevents colonization with microorganisms that are not normal residents of your skin
28
How long should handwashing take?
At least 20 seconds
29
What is the recommended alcoholic volume of a handrub solution?
At least 60% alcohol
30
Why do we don non-sterile gloves?
To reduce risk of spreading microorganisms from your hands to the patient & to reduce risk of acquiring and infection from your patient
31
When do we don non-sterile gloves?
If there is risk of contact with blood, wounds, bodily fluids, or invasive devices (IV catheter)
32
When do we don sterile gloves?
Invasive procedures like catheters/tubes, open wound management, & minor surgeries
33
What does K mean?
Kilo (1000)
34
What does h mean?
Hecto (100)
35
What does dk mean?
Deka (10)
36
What does d mean?
Deci (0.1)
37
What does c mean?
Centi (0.01)
38
What does m mean?
Milli (0.001)
39
What does µ mean?
Micro (0.000001)
40
What should you do while performing all rapid emergency panel tests?
Wear non-sterile gloves
41
What is PCV?
Packed cell volume; rapid estimate of the red cell component of blood
42
How full do you fill microhematocrit tubes?
3/4 full
43
How long do you spin microhematocrit/PCV tubes for?
3-5 mins
44
How do you line up a PCV tube?
Top of clay plug with bottom line (0), then move it until the top of the plasma line lines up with the 100 line, then read top of red fluid line (this is the PCV)
45
What does total solids tell you?
Estimate of the total protein (measured by refractometer)
46
What do different plasma colours mean? Clear with slight yellow? red? yellow? white?
Normal. Hemolysis. Icterus. Hyperlipidemia.
47
What does the TS line stand for?
Total solids
48
What does the BUN quick test measure?
Renal function & hydration
49
How to do BUN quick test?
1. Take reagent test strip out
2. Make sure not expired
3. Apply large drop of fresh venous blood onto reagent pad at the end of the strip (make sure entire reagent pad is covered)
4. Wait 60 secs
5. Rinse off with wash bottle or tap water
6. Read immediately
50
How to do total solids?
1. Score microhematocrit tube above buffy coat & then break it at this line
2. Open glass cover of refractometer to see if it is clean
3. Place unbroken end of tube on underlying glass surface, allowing fluid to drain onto surface by capillary action
4. Close the cover (or do this step before if there is draining spot with lid closed)
5. Look through viewer
51
What do you do if BUN strip is between two values?
Assign the higher value
52
How to use glucometer?
1. Turn on
2. Insert glucose test strip (ensure it matches reading on glucometer)
3. Place test strip up against blood drop & allow it to draw up the blood by capillary action
4. Blood glucose value will appear on glucometer window after required period of time has elapsed
53
How many additional throws do you need in a continuous suture pattern?
At least one additional on the beginning knot and two additional on the end knot
54
What is the difference between Cushing and Connell suture patterns?
Cushing doesn't enter the lumen ('sh' = shallow) while Connell does ('l' = lumen)
55
Where to start Cushing/ Connell pattern?
Just beyond right end of the incision
56
What is the Cushing/Connell pattern used for?
Inverting pattern for hollow organs like the stomach or bladder
57
What is Ford Interlocking used for?
Occasionally used for skin closure in areas where the animal cannot reach the incision
58
What is the Lembert pattern for?
Inverting pattern commonly used for closing hollow organs
59
Where do you start a Lembert pattern?
Just to the right of the incision
60
When and Why would you use the Utrecht suture pattern?
It is commonly used in large animal c-sections to close the uterus. It minimizes exposed suture.
61
When are knots buried?
When closing the subcutaneous tissue layer or when placing an intradermal pattern
62
Why are knots buried?
to keep them from protruding through the skin incision after it is closed
63
Why are exposed knots bad?
Exposed knots can allow bacteria to access deeper tissue planes, can irritate the patient, & can predispose the suture to damage by the patient
64
When are knots not buried?
When closing the abdominal wall to minimized abdominal inflammation, adhesions, & trauma to the organs
65
What is the intradermal pattern used for?
Skin closure in small animals
66
What is 1st nerve block?
Palmar digital nerve block
67
How do you perform the Palmar Digital Nerve block?
Hold the limb, Insert needle directly over the palpable neurovascular bundle (1 cm proximal to hoof cartilage), direct needle distally, inject 1.5 mL
68
What does the Palmar Digital Nerve Block block?
- medial & lateral palmar nerves (just above the heel bulbs @ back of pastern)
- skin, entire sole, navicular apparatus, soft tissues of the heel, coffin joint, distal part of DDFT, some of distal sesamoidean ligaments
- may block part of the pastern joint in some horses (esp if large volume of anesthetic is used)
69
What is the 2nd nerve block?
The abaxial sesamoid nerve block
70
How do you perform the abaxial sesamoid nerve block?
Feel for the vein, artery, and nerve bundle on abaxial area of proximal sesamoid bone and inject caudal to it.
71
What does the abaxial sesamoid nerve block block?
The whole foot and pastern area except for some skin on the dorsal aspect of the proximal pastern, palmar aspect of fetlock joint is sometimes desensitized
72
What is the 3rd nerve block?
Low palmar nerve block
73
How do you perform the low palmar nerve block?
Four point block; 2 medial & 2 lateral, (1 directly below buttons and 1 caudal to that between the suspensory ligament & the DDFT)
74
What nerves does the low palmar nerve block block?
- palmar digital nerve and distal part of medial & lateral palmar metacarpal nerve
75
What does the low palmar nerve block block?
blocks the distal cannon bone, proximal sesamoid bones, fetlock joint, and all structures distal to it; some cutaneous sensation is retained over dorsal aspect of fetlock joint
76
Horse resp rate
8-16 breaths per min
77
Horse HR
32-44 bpm
78
What is S3 heart sound sometimes heard in horses?
Filling of ventricle
79
What are the points of maximal intensity?
Pulmonic valve (intercostal space 3 at level of elbow), Aortic valve (intercostal space 4, higher), Mitral valve (intercostal space 5), on R side Tricuspid valve (intercostal space 4 just above level of elbow)
80
What is a thrill?
vibration felt when laying fingers on ribs
81
What could you hear in the cranioventral lung field?
Pneumonia. (be aware of no ventral sounds with an easy to find heartbeat - pleuropneumonia (pleural cavity infected as well))
82
What could you hear in the caudodorsal lung field of a horse?
Allergic lung disease
83
Horse teeth facts
Up to 44 teeth; most males have 42 (2 upper wolf teeth, rarely lower wolf teeth); most females have 38 (typically no canine teeth)
84
Eye exam
Position and movement, not sunken, not bulging, able to be compressed, normal mucous membrane colour, no discharge or staining, palpebral, menace, dazzle, PLR, prolapse 3rd eyelid, sclera should be white, cornea should be clear, smooth, no vessels, normal pupil size, lens is clear
85
Auscultating abdomen of horse
Should hear nearly constant borborygmi; L dorsal will be quieter due to spleen; R dorsal should hear cecal flush that will happen at least every 90 secs
86
Why would you ping the R dorsal abdomen of horse?
suspect cecal tympani
87
Horse with back pains signs?
Pressing down on dorsal spinous processes will brace or dip; pressing up on sternum, if it doesn't flex its back, significant back pain
88
Temp of horse?
37.5-38.5
89
Size of needle when doing jugular venipuncture in horse?
1.5 inch 18G vacutainer needle
90
What angle do you use for equine jugular venipuncture/IV meds administration?
45 degrees
91
Most common site for IV drug administration in horse?
Jugular vein
92
Resp rate cows?
10-30 breaths per min
93
HR of cow
48-84 bpm
94
Where should you spend significant time listening to cow lungs?
Cranioventral; pneumonia
95
Rumen contractions in adult cow
3 contractions / 2 mins
96
Cow temp
38-39.3
97
Cow Sub Q inj needle?
16 or 14 G 1" needle
98
How much can you inj in cow (sub Q or IM) before redirecting?
10-15 mL
99
Cow IM inj needle?
16 or 14 G 1.5 " needle
100
Cow Coccygeal venipuncture needle?
18G 1" vacutainer needle
101
Cow jugular venipuncture needle?
18 G 1.5 " vacutainer needle
102
Cow jugular vein drug administration needle?
14 G 2 "
103
Dog temp
38-39.5
104
Cat temp
38.5-39.5
105
HR in dogs
60-140 bpm
106
HR in cats
120-200 bpm
107
Resp rate dogs
15-35
108
resp rate cats
20-30
109
What needle gauge in dogs & cats?
22 G (or 25 G)
110
