EXAM I Basic Surgical Principles Flashcards

1
Q

developing a surgical diagnosis is a culmination of what 6 diagnostic steps?

A
  1. signs
  2. symptoms
  3. relevant history
  4. patient data
  5. scientific data
  6. logical reasoning and experience
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2
Q

you should never accept a diagnosis in which 3 cases?

A
  • diagnosis made by another individual
  • diganosis made using poor radiographs
  • diagnosis made with inaccurate information
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3
Q

what are 7 basic necessities for surgery?

A
  • adequate lighting
  • adequate access
  • adequate visibility
  • appropriate patient positioning
  • assistance
  • surgical field free from blood
  • aseptic technique
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4
Q

when making an incision, what kind of stroke should you use?

A

firm, continuous stroke, with the blade held perpendicular to the epithelial surface

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5
Q

when making an incision, what should you avoid?

A

injuring vital strucures, such as nerves, vessels, lips, adjacent tissues, etc.

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6
Q

what are halstead’s principles (7)?

A
  1. gentle handling of tissue
  2. meticulous hemostasis
  3. preservation of blood supply
  4. strict aseptic technique
  5. minimum tension on tissues
  6. accurate tissue apposition
  7. obliteration of dead-space
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7
Q

to avoid flap necrosis, the apex of the flap should never be ___ than the base. what are the exceptions?

A
  • wider
  • unless a major artery or other major structure is present
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8
Q

a flap should always converge from the ___ to the ___, or parallel if required due to ___

A
  • base to the apex
  • major structures
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9
Q

to prevent flap necrosis, the ___ should be no more than twice the ___ of the base

A

length, width

ideally, the base is greater than the lengh

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10
Q

is axial blood at the apex or the base of the flap?

A

base

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11
Q

because axial blood supply is at the base of the flap, the base should be handled with care to avoid what?

A

twisting, stretching, or injury to the blood supply

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12
Q

what is a possible complication with button hole flaps?

A

you can get an area of necrosis coronal to the flap, in the area where blood supply has been cut off by the button hole

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13
Q

to avoid flap dehiscence, incisions must be made over ___

A

intact bone

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14
Q

to avoid flap dehiscence, if the pathological condition has eroded the buccocortical plate, the incision must be ___mm away from it

A

6-8

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15
Q

to avoid flap dehiscence, the incision must be ___mm away from the bony defect created by surgery

A

6-8mm

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16
Q

gentle handling of flap edges and avoiding placing flap under tension can help avoid flap ___

A

dehiscence

17
Q

to avoid flap dehiscence, you should never cross ___ if possible

A

bony prominences (like the canine eminence)

18
Q

T or F:

short incisions heal faster than long incisions

A

false

if properly repaired, a long incision will heal just as quickly as a short one

19
Q

what can you do at the beginning of surgery to avoid flap tearing?

A

create a flap at the onset of the surgery that is large enough for the surgeon to avoid tearing it or interrupting surgery to lengthen it

20
Q

what are the 3 main types of mucoperiosteal flaps?

A
  • envelope/sulcular incision
  • envelope with one releasing incision (3-corner flap)
  • envelope with two releasing incisions (4-corner flap)
21
Q

in creating a standard envelope flap with no releasing incisions, how many teeth should be anterior and posterior to the tooth being worked on? where is it placed in an edentulous arch?

A
  • 1 tooth posterior and 2 teeth anterior to the one being worked on
  • in an edentulous arch, it should be placed at the crest of the ridge
22
Q

in creating an envelope flap with 1 vertical releasing incision, how many teeth should be anterior and posterior to the tooth being worked on?

A

1 tooth anterior and 1 posterior

23
Q

in creating an envelope flap with 2 releasing incisions, how many teeth should be anterior and posterior to the tooth being worked on?

A

1 anterior and 1 posterior

24
Q

it is important to handle tissue carefully during surgical procedures. what are some things that can damage tissues?

A

excessive pulling, crushing, extremes of temperature, desiccation, or chemicals

25
Q

what type of tissue forceps are good for delicate manipulation of tissues?

A

toothed forceps or tissue hooks

26
Q

to avoid tissue damage, you should use copious irrigation when ___

A

cutting bone

27
Q

patients whose tissue has been handled gently and physiologically will experience wounds that heal with less frequenty ___

A

complications

28
Q

what are some issues caused by uncontrolled bleeding?

A
  • decreased visibility
  • hematomas
    • decreased vascularity
    • wound dehiscence
    • infection
29
Q

what are some things you can do to promote wound hemostasis?

A
  • natural hemostatic methods
    • gauze (dab) and pressure
  • heat
    • electrocautery
  • suture ligation
  • hemostatic agents
  • vasoconstrictive substance
30
Q

what is a concern with dead space?

A

it will usually fill with blood, resulting in a hematoma

31
Q

what are some ways to prevent dead space?

A
  • suture tissue planes together
  • direct pressure
  • packing the surgical site
  • drains
32
Q

when assessing a patient for oral surgery, what are some important general health concerns that can affect the surgery?

A
  • conditions that establish a catabolic state of metabolism, that impeded oxygen or nutrient delivery to tissues, or that require administration of drugs or physical agents that interfere with immunologic or wound-healing cells
  • uncontrolled diabetes
  • end-stage renal or hepatic disease
  • malignant diseases
  • severe COPD
  • poorly compensated congestive heart failure
  • drug addictions such as ethanolism (alcoholism)
  • medications
  • long-term corticosteroid therapy, malignancies, cytotoxic agents, and irradiation