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Y6 Senior Surgery > Instruments 2 > Flashcards

Instruments 2 Flashcards

1
Q

What are the benefits of a definitive airway

A
  • prevent ASPIRATION of gastric contents
  • control of bventilation
  • higher delivery of oxigen
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2
Q

benefit of non definitive airway

A

temporarily maintain aiirway patency

easy to insert

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3
Q

types of non definitive airway

A

LMA
OPA
NPA

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4
Q

types of definitive airway

A

endotracheal tube

tracheostomy

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5
Q

what is the function of a guedel

A

prevents tongue and pharynx soft tissues from obstructing the airway

– use if suspected airway compromise / snoring

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6
Q

complication of guedel airway

A 
gagging 
vomiting 
laryngospasm if gag reflex intact 
trauma to local structure 
biting down may injure teeth
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7
Q

when is an NPA indicated

A

to provide an airway in people with suspected airway compromise or decreased levels of consciousness

or if mouth is diffiduclt to open e.g. seizure

or if laryngeal trayma

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8
Q

contraiindiczayions for NPA

A

basal skull fracture (CSF leak othorroea orr rhinorrhoea, haemotymnpanum, Battle sign, Racoon eyes)

facial /nasal fracture

nasal deformitiy

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9
Q

complications of NPA insertion

A

epistaxis
ulceration
insertion through criibiform plate into brain

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10
Q

indications for LMA

A
  • elective procedure, low risk (alternative to endotracheal airway)
  • cardiac arrest to secutre airway
  • prrehospital management
  • rescue of failed intubation
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11
Q

benefits of LMA

A
  • reduced trauma to oropharynx
  • reduced hospital stay
  • does not require laryngeal visualisation
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12
Q

contraaindication for LMA

A
  • poor mouth opening
  • pharyngeal or laryngeal obstruction
  • intact gag reflex
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13
Q

complication of LMA

A 
malposition 
dislodgement 
laryngospasm 
ciugh 
trauma to upper airway
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14
Q

indication for ET tube

A

trauma case
GCS <=8
surgery with GA
status epileptcus, rappuid sequence

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15
Q

when is miller blade (straight blade) of a laryngoscope used

A

in paediatrics

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16
Q

how long can a long term catheter be put in for

A

up to 3 months

17
Q

indications for a surgicaal drain

A

drainage of a potential space post-surgery
removal of harmful fluid e.g. blood, bile, pus
detection of bleeding or leakage e.g. anastamosis

used in GI, ortho, plastics, cardiothoracics, breast, head and neck

18
Q

how do you classify surgical drains

A

ACTIVE or PASSIVE

active drain - maintained under negative pressure, improves wound closure

passive drain - uses gravity, preferred in abdomen due to reduced risk of perforation

19
Q

complications of surgcakl drains

A

Ascending infection (more common with open
or passive systems)
Foreign body reaction (fibrosis/granulation)
Migration
Obstruction/kinking
Fistulation

20
Q

what materials can catheters be made up of and what is the difference

A

YELLOW = latex, short term

CLEAR = silicone, better for long term use

21
Q

indications for urinary catheters

A 
Urinary retention (acute or chronic)
Measurement of urine output in acute illness
During abdominal/pelvic surgery
Neurogenic bladder
Immobility (e.g. stroke)
End of life care
Urinary incontinence
Sacral or perineal ulceration
22
Q

indications for absorbable vs non absorbable sutures

A

Absorbable: deep or rapid healing tissues e.g. bowel/biliary/urinary anastomoses

Non-absorbable: for permanent support and slower healing tissues e.g. vascular anastomoses,
tendon, fascia

23
Q

what is a LAPAROSCOPIC TROCAR used for

A

used to create entry ports in laparoscopic procedures

INITIAL ENTRY CARRIES HIGHEST RISK OF PERFORATION

24
Q

what is the gas of choice for laparoscopy and why

A

Carbon dioxide is the gas of choice

Inert, highly soluble in blood and tissues, rapidly cleared by expiration

25
Q

what is the scale of airway management

A
  1. Airway maneuvres
  2. Airway adjunct (OPA, NPA)
  3. Supraglottic device
  4. Definitive airway
26
Q

indications for intubation

A
  • Decreased consciousness and loss of airway reflexes (GCS <8) – Failure to protect against aspiration
    Failure to oxygenate (T1RF) e.g. Respiratory pathology, ARDS, pulmonary oedema
    Failure to ventilate (T2RF) e.g. Tiring patient (life threatening asthma)
    Failure to maintain airway patency (upper airway obstruction, Angioedema, Facial/upper airway trauma)
27
Q

what colour is a Hickmann

A

WHITE - two ports usually

28
Q

what colour is a Tesio line

A

clear, shorter than Hickmann - TWO ports

29
Q

whhich instrument is the only one that allows to measure central venous pressures

A

CENTRAL VENOUS CATHETER

30
Q

difference between needle holder and haemostatic clamp

A

needle holder = shorter grasping arms

haemostat = longer grasping arms, used in ssurgery to clamp small blood vessels and control bleeding

31
Q

what does the tensile strength of sutures rely on

A

the diameter of the thread

Y6 Senior Surgery (10 decks)

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