Minor Sx cards from a quizlet Flashcards Preview

Minor Sx/Proct Study Set 1 > Minor Sx cards from a quizlet > Flashcards

Flashcards in Minor Sx cards from a quizlet Deck (219):
1

define Surgery

Branch of medical care which treats injuries, deformities by manual or operative methods.

2

define laceration

The act of tearing OR a torn, ragged wound

3

define superficial

Pertaining to tissue situated near the surface.

4

define abrasion

Wearing away of a substance/structure through some unusual or abnormal mechanical process.

5

define benign

Not malignant, not recurrent; favorable for recovery

6

define lesion

Any pathological or traumatic discontinuity of tissue or loss of function of a part.

7

define foreign body

Any material lodged in human tissue that is foreign (wood, metal, glass, etc.)

8

define excise

cut off

9

define incise

cut into

10

define ligate

tie off

11

sound (surgical)

to probe deeply with a blunt instrument

12

debride

to clean away damaged or necrotic tissue

13

- tome (suffix)

to cut" as in episiotome

14

-ectomy

to remove" cut out completely as in appendectomy.

15

Antiseptic

A substance that inhibits growth and development of microorganisms without necessarily destroying them

16

Local anesthetic

Agent whose primary affect is to bring about a temporary loss of localized sensory nerve function.

17

Number 1 Cause of Minor Surgery Complications

Patient Anxiety

18

3 Most common complications from DC Minor Surgery

1) Pt. anxiety
2) Adverse reaction to anesthetic.
3) Pre- or Post-operative bleeding.

19

best age range for minor sx

15-65

20

Body type that is slowest to heal (hint: one of 3 types)

Endomorph

21

Three basic labs required before minor surgery

CBC, UA, prothrombin

22

After minor surgery rest for ___ hours (range)

2-3

23

Follow-up with patient within ___ hours

24

24

Most effective means of instrument sterilization killing both bacteria and spores. Boiling water under pressure (13 mins at 120*C and 750 mmHg pressure). blunts instruments.

steam autoclaving

25

Ethylene oxide used to kill both bacteria and spores but dangerous and expensive.

Gas autoclaving

26

sterilization in oven at 170*C for 1 hour. Kills most bacteria BUT not spores. Emergency sterilization technique.

Dry sterilization

27

Least effective method sterilization but emergency method. Iodine bath (providyne, beta dyne).

Cold sterilization

28

True/false: Shaving hair off patient considered Std Of Care in minor surgery

false

29

Minimum # of times surgical area cleansed with antiseptic (e.g. beta dyne).

5

30

Germicide

Material that actually kills bacteria

31

- Strength/effectiveness of an antiseptic is measured by this scale

Phenol coefficient

32

- Powerful antiseptic. Caustic to skin; used to cleanse counters and floors. AKA carbolic acid. Used in concn's of 2-20% for bacteriostasis.

Phenol

33

Ingredient in lotion of calamine (used for dermatitis).

Phenol

34

Camphorated Phenol

A cream consisting of 30% phenol, 60% camphor, and 10% liquid petroleum.

35

- Coal tar antiseptic. Has phenol coefficient 3X, brown liquid with tarry odor. Impregnates telephone poles and railroad ties to prevent decay

-Coal tar antiseptic in 50% concn linseed oil soap making it more soluble. Used to disinfect rooms and equipment. Very dilute concn (.25-0.5%) used as vaginal douche or bladder irrigation.

Cresol

36

AKA Creolin, Cresolin, Lysol

cresol

37

Coal tar antiseptic that is colorless, odorless crystal. Turns pink in light. Phenol coefficient of -1X.

Resorcinol

38

Coal tar antiseptic. Very soluble in water, alcohol, and glycerine. Primarily used as ointment 5-10% concn treating psoriasis, eczema, erysipelas.

Resorcinol

39

Coal tar antiseptic. Colorless, aromatic crystalline solid. Very soluble in alcohol. Primary use as mouth wash/astringent gargle. Useful as fungal antiseptic and hook worm treatment.

Thymol

40

Coal tar antiseptic. AKA picric acid

Trinitrophenol

41

- Coal tar antiseptic
Yellow crystalline powder with bitter taste and odorless. Stains skin. Phenol coefficient 7X!

Trinitrophenol

42

. Primary use in burn treatment and superficial wounds. Soaked dressing applied directly to burn. Caustic substance generally. Max allowable surface area ~one extremity of entire body.

Trinitrophenol

43

Groups of antiseptics which often contain mercury and most effective as antiseptic or chemotherapeutic agents.

Dye Group

44

Dye antiseptic no longer commonly used. Used in isotonic saline soln with concn 1:1000. Used prior to antibiotics.

Proflavine dihydrochloride

45

Dye antiseptic used frequently prior to antibiotics to saturate gauze, for conjunctival gonorrhea, otitis media, and pack wound cavities. Used for furunculosis and carbunculosis.

Proflavine dihydrochloride

46

Dye antiseptic AKA gentian violet, deep purple soln in 3% water/alcohol concn. Used to treat RING WORM; very effective against gram + bacteria (Staph.). Used as jelly for cystitis, fungus, and burns

Methylrosaniline

47

Dye antiseptic AKA methylene blue. Dark green powder that forms blue solns. Urinary antiseptic, also used diagnostically to locate ano-vaginal fistulas.

Methylthionine chloride

48

Dye antiseptic AKA thymerol and thmersol. Contains up to 50% mercury. Very effective general antiseptic - even spores. Useful for lacerations/abrasions. Antiseptic of choice for final scrub in preoperative skin preparation in 1:2000 concon

Merthiolate

49

Antiseptic group containing chlorine, iodine, or bromine

halogen group

50

Halogen antiseptic. Yellowish irritant gas. Widely used as disinfectant in drinking water.

Chlorine

51

- Sodium hypochlorite. Dilute chlorine solution contain .45-.5% sodium. Freshly mixed and kept in light-resistant bottle for up to 48 hours. Effective antiseptic for open wounds of all sizes. Dissolves bacteria, pus, necrotic tissue without disturbing clots. Coat unprotected normal skin with petroleum jelly

Dakin Solution

52

Halogen antiseptic. Blue-black crystal with metallic odor. Soluble with potassium in water. Popular surgical scrub/skin prep. Used in wound lavage.

Iodine

53

Halogen antiseptic. AKA beta dyne or providyne in 10% concn. Used for skin prep and cold sterilization methods. 7% used open wounds, 5% external mucosa lining (vaginal packs).

Iodine

54

% iodine vaginal pack is called...

Logol solution

55

Antiseptic. Solid form on wooden stick applicator. Used for warts, excess tissue, ulcers, canker sores, and cauterization. Fast acting and may cause burns.

Silver nitrate

56

Antiseptic. Historically used in .25-1.0% concn for mucus membranes, sinuses, throats, conjunctiva gonorrhea.

Silver nitrate

57

An old school treatment. Silver nitrate placed in eyes of newborns to kill off conjunctival gonorrhea.

Crede treatment

58

Silver antiseptic. Protein precipitate used for chronic/acute sinusitis. Cotton-tipped applicator placed into nasal passages for one hour. Repeated for three consecutive days. Used in many DC offices.

Argyrol

59

- Poor Antiseptic. Mostly used in 20-70% concns. >80% concn hardens protein coats of bacteria but <80% tends to dehydrate bacteria. NOT recommended as sterilization technique.

Alcohol

60

Antiseptic. Oxidizes bacterial proteins. A gas soluble in water at 40% concn. Extremely powerful; never used on living patients. Commonly used 10% soln for biopsy transfer.

Formaldehyde

61

- Brand name is formalin. Used to transfer biopsy samples.

Formaldehyde

62

Weak antiseptic. MOA liberates oxygen. On open wounds bubbles and forces debris to surface. Found in 3% solns at most stores. Wash/lavage wound/ulcer. Debrides tissue and removes dirt. Damages tissue while killing bacteria. Used in 1:5 dilution for gingivitis.

Hydrogen peroxide

63

Astringent antiseptic. Mild, soothing antiseptic reduces mucous membrane swelling. 2% soln for conjunctivitis and open wounds and vaginitis. 10% concn for skin irritation.

Boric acid

64

Astringent AKA alum. Skin lotion for irritation treatment. 0.5-1% concn used in solid stick form as hemostatic. Septic pencil for shaving nicks in men.

Potassium aluminum sulfate

65

Astringent soluble salt. Sulfate form strong astringent and topical antiseptic. Oxide form ointment effective burns/skin diseases. Used in sunscreen.

Zinc

66

Wound lavaging agent. 1/4 grain tablets (1 tab per oz water). Good antiseptic and fungicide. Used in cuts, abrasions, animal scratches, insect bites, athlete's foot. DC's use this for irrigating ears.

Hydroxyquinoline sulfate

67

General purpose antiseptic and fungicide. From Australian tree. Must be diluted in mineral oil. useful in Staph infections. DO NOT take internally.

Tea tree oil

68

Topical antibiotic/antibacterial ointment of neomycin polymycin. Over-counter topical used post-operative dressing.

Bacitracin

69

Antibiotic ointment. Over-counter purchase w/ neomycin polymycin. Most frequently used topically post-operatively.

Neosporin

70

A Complex of halogen antiseptic w/ carrier molecule. Effective wound lavaging agent for gram +/- bacteria, fungi, and viruses. Stains clothing. AKA Betadine, Operand, Acu-Dyne, Clonidine.

Providone-Iodine

71

Wound lavage agent. Effective gram + bactericidal. Used for hand scrubbing primarily; direct wound contact discouraged. AKA Hibiclens, STERIS tat.

Chlorhexidine

72

Wound lavage agent with hyphenated chemical name. Non-ionic detergent. May be used directly on wounds but has no antibacterial activity. Best for facial wound cleansing. AKA Shur-Clens.

Pluronic-F-68

73

Wound lavage agent. Bacteriostatic agent effective for gram + bacteria. Potential toxicity & teratogenicity. AKA PHisoHex.

hexachlorophene

74

Interruption of sensory nerve conduction without subjecting the patient to unconsciousness.

Anesthesia

75

T/F: All anesthetics are toxic.

True

76

This type of medication interferes with neural depolarization and transmission of impulses along axons.

anesthetic

77

T/F: Anesthesia inhibits nociception before pressure/touch sensation.

True

78

Properties of ___ to consider before application in minor surgery.
1) onset of action
2) effectiveness
3) duration

anesthetics

79

- Maximum allowable dose of anesthetic used by DC's is ___ cc's. (there is one exception

30

80

Maximum allowable dose of 1% lidocaine with epinephrine in adult is ___ cc's

50

81

T/F: Pregnant females should be given local anesthetics

False

82

T/F: Higher concn anesthetic MORE toxic than increased volume anesthetic

True

83

T/F: Anything greater than 2% anesthetic concn is WRONG for injectable local anesthetic.

True

84

Average dose of Epi-enhanced lidocaine, (___ cc's).

35

85

- Lidocaine enhanced with ___

epinephrine

86

Advantage of epi with lidocaine

Advantage: vasoconstrictive and decreases bleeding.

87

Cons of epi with lidocaine

Con's: Increased % infection, cannot use on distal or end organs d/t decrease bloodflow

88

Always use (larger/smaller) syringe than required for amount anesthetic needed

Larger

89

A ___ gauge needle used for venipuncture

21

90

An ___ gauge needle is used for joint aspiration.

18

91

Needle gauges used for introducing local anesthetic range from ____-____.

25-27

92

Superficial topical anesthetic used as refrigerant pre-injectable for squeamish patients. Comes in pressurized bottle and applied by inverting and spraying in area of injection for 5 seconds. Anesthetic effect lasts 15-30 seconds.

Ethyl Chloride

93

T/F: Never inject patient in an upright position.

True

94

T/F: Acceptable injection positions include supine or prone.

True

95

T/F: It is acceptable to perform minor surgery on patients who do not speak your language, have great fear of needles, their own blood, or the elderly

False

96

T/F: After placing syringe needle in chosen tissue site, pull back on plunger to test for bloodflow.

True

97

T/F: Best to introduce anesthetic 'on the move.'

True

98

Method of introducing anesthetic where a portal of entry has already been established (into a laceration to avoid second puncture of skin).

Direct infiltration

99

AKA parallel margin infiltration (method of anesthetic application).

Field Block

100

Most frequently used method of anesthesia application. Preferred method when wound is dirty or contaminated. Decreases risk of spreading infection.

Field Block

101

This type of conduction anesthesia used for sebacous cystectomy, lipomectomy excision, and foreign body removal.

Field Block

102

- Method of anesthesia whereby sensory nerves are anesthetized by injecting into nerve plexus.

nerve block

103

Nerve block uses ___-___ cc's anesthesia per side.

1-2

104

Most common nerve blocks are ___ (AKA volar blocks).

digital

105

T/F: Epinephrine is acceptable in digital nerve blocks (fingers).

False

106

Facial anesthesia utilizes nerve blocks in the supr/infraorbital and ___ foramen.

Mental

107

AKA novocaine

Procaine

108

Anesthetic soln used for all methods. comes w/ and w/o epinephrine. Ester-based soln packaged in concn's of 0.5, 1.0, 1.5, and 2.0%. In minor surgery highest concn needed is 1.0%. Commonly used in dentist offices.

novocaine

109

AKA pontocaine

Tetracaine

110

Potent and toxic anesthetic. 10X more potent than procaine. Limited to few procedures like spinal blocks. Not used in DC offices.

Pontocaine

111

AKA Xylocaine

lidocaine

112

Most popular and frequently used local anesthetic. Comes in 0.5, 1.0, 1.5, 2.0% concn w/ and w/o Epi. Has low toxicity compared to novocaine, rapid diffuses, topical activity and chemical stability. Very good stuff.

Xylocaine

113

AKA Carbocaine

mepivacaine

114

Amide-base anesthetic soln widely used in minor surgery that ISN'T Lidocaine. Used for procedures with longer time frames. Possesses slightly vasoconstrictive properties and CAUTION indicated in distal end organs.

carbocaine

115

AKA Marcaine

Bupivacaine

116

- A newer amide-based anesthetic soln. Not widely used in minor surgery but getting there. Con's: Slow onset of action. Pro's: Duration of action surpasses lidocaine and mepivacaine.

Marcaine

117

Non-injectable topical anesthetic. Useful in pediatric patients for simple lacerations/wound care. Mixture 0.5% tetracaine, Epi 1:2000 concn, 11.8% cocaine. Applied directly via soaked gauze sponge 5-10 mins. No needle stick required!

TAC

118

T/F: Can TAC be used on distal organs?

False

119

- AKA proparacaine hydrochloride

Ophthaine

120

0.5% soln anesthetic with glycerine for topical eye application. Suitable for foreign body removal of ocular pressure testing. One drop in eye achieves complete anesthesia in 13 seonds and lasts 15-20 minutes.

Ophthaine

121

T/F: Ophthaine contraindicated in hyperthyroidism.

True

122

AKA Rostra Spray

Cetacaine

123

___ spray: Topical anesthetic effective on mucous membranes but not conjunctiva. Anesthesia takes ~1 minute. Useful for overriding gag reflex. Contains tetracaine and benzocaine.

Rostra

124

Flammable topical skin refrigerant used as pre-injectable. Useful for lancing furuncles and carbuncles. Anesthesia lasts 15-30 seconds.

Ethyl chloride

125

- T/F: Redness, itching, swelling at inoculation site usually resolves.

True

126

Cardiovascular reactions to inoculation include hypotension and ___

bradycardia

127

CNS rxn's to anesthesia can include excitatory phenomena and ___.

seizures

128

The most common rxn to anesthetic injection is ___ AKA passing out

vasovagal syncope

129

Anesthesia S/E most common because injecting into a ___.

vein

130

Supplement with ___ to increase clotting factor ability

vitamin K

131

T/F: Acceptable to bring up surgical options with patients, (i.e. I can get that mole removed for you?).

False

132

If you expect a procedure to take 15 minutes, tell the patient it will take ___.

45

133

T/F: Acceptable to use a bactericide on patient tissue?

False

134

Six steps in healing process. Step 1 is

Immediate response to injury

135

Six steps in healing process. Step 2 is

Inflammatory phase

136

Six steps in healing process. Step 3 is

Epithelialization , scab forms

137

Six steps in healing process. Step 4 is

Neovascularization

138

Six steps in healing process. Step 5 is

Collagen synthesis

139

Six steps in healing process. Step 6 is

Wound contraction

140

T/F: Sew them up if wound is primary union.

True

141

T/F: Sew them up if wound is secondary union.

False

142

Most common cause of primary union wounds (clean with minimal tissue loss).

knife

143

Primary union wounds have a 'golden period' in which they can be closed with sutures or skin tapes. This period lasts ___ hours

6

144

- T/F: You can sew up a tertiary union wound after observation and lavage greater than 12 hours.

True

145

T/F: Antibiotic ointment required in tertiary union wounds.

True

146

- A wound into the muscle tissue that does NOT involve nerve rupture is a (superficial/deep) wound...

superficial

147

A wound that involves tendon and vasculature is a (superficial/deep) wound

deep

148

A 2nd degree burn is a (simple/complex) wound...

complex

149

A puncture wound is a (simple/complex) wound...

simple

150

if a wound will probably become infected if closed is considered a ___ wound

dirty

151

wounds older than ___ hours are considered 'dirty' wounds...

5

152

Erythema extending beyond ___ cm from the wound margin is suggestive of infection

1

153

Wound redness accompanied by palpable induration greater than ___cm suggests infection

0.5

154

- critical mass of ___ organisms per gram tissue to be considered 'infection'

100,000

155

most common organism to be active in infection

staph

156

Other common infective organisms include E coli, Proteus, Enterobacter, Klebsiella, and ___

strep

157

___X increase in infection rate with 20% weight loss in chronically ill patient

3

158

When required, give tetanus booster shots every ___ hours.

5

159

Minimum # dozes tetanus toxoid to be considered 'fully immunized'.

3

160

___x___ size gauze sponge helps 'maintain hemostasis in wound closures

4x4

161

amount of tissue taken when placing a suture needle in skin or fascia.

bite

162

Each knot of a suture consists of a series of ___(s).

knot

163

___ suture: placed on surface of skin for final closure using nonabsorbable materials.

superficial

164

___ suture: made from absorbable material placed in superficail fascia or deris with knot buried in wound.

deep

165

- ___ suture: single sutures tied separately.

interrupted

166

- ___ suture: wound closure effected by taking several bites the full length of the wound without tying individual knots. AKA 'running' suture

continuous

167

Number __ scalpel used for debriding devitalized (dead/dying) damaged tissue from a wound.

15

168

Most common surgical knot technique for clean wounds without complications.

simple interrupted

169

Surgical knot technique that uses a shallow first loop, a deep second loop and then ties off. Used in flexed areas or places under regular stress.

vertical mattress

170

Surgical knot technique. Used for cuts that have 'flaps'. Apex of cut must be pointing toward heart.

apical suture

171

Suture material. AKA PGA - synthetic polymer, less reactive and resists infection. Primary for superficial and deep fascia and ligatures.

Polyglycolic acid

172

PG 910 suture material. Workable but not the best for tight knots. Preferred for deep wound support for prolonged periods

Polyglycan-910

173

Suture material. Make from animal tissues. Treated with chromic acid to delay absorption

gut

174

Suture material - AKA ethilon - Used for minor wounds/lacerations, resists infections, good tensile strength.

monofilament

175

- Intradermal subcuticular 'pull out' sutures are used because they decrease ___.

scarring

176

Sutured wounds are vulnerable to infection up to ___ hours post application.

72

177

Used during healing to absorb exudates from wound. Small section surgical rubber inserted into inferior aspect of wound

penrose drain

178

Occlusive wound dressing type. Transparent polyurethane. Transmits water, O2, and CO2. Can pull up scab once epithelialization begins.

flim

179

Occlusive wound dressing type. Nonadherent material taped in place over a wound

foam

180

Occlusive wound dressing type. This is an opaque, gas IMpermeable, absorbant material. Over time fluid leaving wound separates dressing from wound itself.

hydrocolloids

181

Occlusive wound dressing type. Semitransparent, nonadhesive, absorbent material

hydrogel

182

Occlusive wound dressing type. AKA "Doctor Spenko's Second Skin"

hydrogel

183

Coating for dressings used in burns and skin grafts.

petrolatum

184

Controlled cell proliferation; ie adapting to stresses (callus).

hyperplasia

185

- Adaptive substitution of cell type (e.g. squamous) for another type. Used in inflammation.

metaplasia

186

'Pre-cancerous' cell substitution. These cells exhibit pelomorphism (change in nucleus materials).

dysplasia

187

__% of all head/neck cancers begin in the oral cavity.

75

188

Basal cell carcinomas are caused by exposure to ___.

UV light

189

Squamous cell carcinomas are caused by exposure to ___. These are rapid metastasizers.

UV light

190

Jet black, most dangerous type of skin cancer (most rare). If it invades Clark's level 4, prognosis grim.

Melanoma

191

T/F: Fractures are often overlooked in open wounds or bleeding injuries.

True

192

Used instead of iodine if Pt is allergic to it. AKA Zephiran in a 1:750 concn soln.

benzalkonium chloride

193

Patients who have had three Tetanus boosters but none in ___ years still need a booster for preventative care.

10

194

Benign skin tumor. Scar hypertrophy d/t collagen deposition. Usually result of improper surgical technique done against natural tension lines in the fascia.

keloid

195

Benign skin tumor. Encapsulated fat tissue often d/t blunt force trauma. If there are multiple lesion it's typicaly from familial predisposition.

lipoma

196

- Benign skin tumor. Caused by duct blockage of oil gland adjacent to hair follicle. DDX from lipoma via small central well @ middle of raised lump (hair follicle).

sebaceous cyst

197

Benign skin tumor. AKA verrucae vulgaris. Benign papillae growth. Often on hands and feet; surgical removal rapid and effective.

wart

198

Benign skin tumor. AKA skin tag. These have vascular and neurological supply.

papilloma

199

- Benign skin tumor. Hornlike projection extending above skin level. About 12% are MALIGNANT

cutaneous horn

200

Benign skin tumor. These are hard, movable, non-inflammatory lesion within the skin layers..

fibroma

201

Benign skin tumor. Cystic swelling surrounded by fibrous tissue that occur within vicinity of joint capsules.

ganglia

202

Skin lesion treatment. Liquid nitrogen typically used. Minimal scarring, often more than 1 treatment needed.

cryosurgery

203

skin lesion treatment. A small cordless instrument with local anesthesia is used.

electrocautery

204

Skin lesion treatment type. Great for superficial skin lesion but may cause scars. Requires sterilization

hyfrecator

205

Skin lesion treatment type. Minimal thermal damage caused, best for cosmetic treatments, self-sterilizing.

radiosurgery

206

Skin lesion treatment. Electrical energy is converted into light energy (used in many DC offices for purposes other than minor surgery).

laser

207

Infected sebaceous gland with central necrotic induration most commonly caused by staph infection.

pustule

208

A singular furuncle in a large bulbous presentation.

boil

209

Takes ___-___ days for a carbuncle to become 'fully ripened.'

4-6

210

Distal phalanx infection that appears along base of nail from Staph. aureus.

Paronychia

211

- Most common organism to infect bite wound from human bite injury. REFER OUT

eikenella corrodens

212

Anti-venom used for black widow spider bites.

lyovac

213

___% of animal bites presenting at minor surgical offices are from dogs.

90

214

Brown spiders with particularly strong venom. Symptoms include anorexia, dehyrdation, apathy. Tissue will begin to necrose within a week of bite.

loxoscles

215

Frostbite. Heat loss caused by wet clothing in contact with metal.

conduction

216

Frostbite. Heat loss caused by wind chill.

convection

217

Which degree burn? Redness, epidermis only. No blisters. Recovers in 1-2 days.

1st

218

Which degree burn? Redness and blister. Capillary wall destruction with edema.

2nd

219

Which degree burn? Redness, blister, tissue damage. Subsequent scarring; refer to hospital.

3rd