surgery

Question 1

Which parameters are monitored during surgery?

Answer 1

• ECG
• urine
• arterial/central venous pressure
• body core temperature
• pO2/pCO2
• HKT

Question 2

Which parameters are monitored after surgery?

Answer 2

• ECG
• urine
• temperature
• central venous/arterial pressure

Question 3

Name sterilization procedures and their problems.

Answer 3

• gas sterilization by means of ETO
• material has to fumigate
• polyurethane absorbs ETO

Question 4

What is meant by cleaning?

Answer 4

• desinfection of the surface
• cleaning with a mob without applying pressure

for heart surgery that is:

neck -> thorax -> groin -> legs

Question 5

Explain the use of transparent foil on the patients skin.

Answer 5

• reducing the risk of infection
• desinfection only on surface -> bacteria can get to the top from deeper regions -> foil prevents that

Question 6

What kinds of admissions are placed?

Answer 6

• central venous catheter
• intubator
• bladder catheter

Question 7

Explain the cutting of the sternum and how is the blood stilled?

Answer 7

• soft tissues are pushed away
• cut from top to bottom:

menubrium sternii -> corpus s. -> pr. xypho.

bleeding stopped mainly by means of cauterization (hf surgery) of smaller vessels or ligation of bigger vessels

Question 8

How is the heart accessed after sternotomy?

Answer 8

• retractor is used to separate the opened thorax
• thymus dissected and ligated
• reaching the pericardial membrane

Question 9

What is the thymus and which function does it have for children and adults?

Answer 9

• a gland situated dorsal to the sternum bones top part
• it works as site for T cell differentiation in children
• starts to shrink through adulthood
• no clear function for adults

Question 10

Meaning of the thymus for the cannulation?

Answer 10

• located over the base of the heart
• has to be clamped, cut in half, ligated and pushed away to allow aortal cannulation and general acces to the heart

Question 11

What is needed for high frequency surgery?

Answer 11

• neutral electrode on the back of the patient

Question 12

How will narcotic gases be administered during surgery?

Answer 12

• central venous catheter
• if heart and lung are out of function, they can be administered through the heart lung machine, because the membrane oxygenator is permeable for narcotic gases

Question 13

What is the meaning of the ductus aortus botelli?

Answer 13

• short cut between pulmonary artery and aorta in embryonic phase, which should be closed after birth in normal case.
• if this ductus is not closed, the high pressure blood in aorta will go to lungs through pulmonary artery causing over-fill if lungs and later fibrousis.

Question 14

Describe the surgical process of cannulation.

Answer 14

• purse string suture
• threads through rubber tube
• clamp
• incision
• apply cannula
• fasten suture and clamp

Question 15

What is ACVB?

Answer 15

aorto-coronary venous bypass.

• vene etched out of leg as bypass
• applied behind stenosis (distal anastomosis)
• then behind aorta (proximal anastomosis)

blood flow:

aorta -> venous bypass -> coronary vessel behind stenosis