VTNE Prep Surgical Nursing
What is the typical length of time that an incision should be monitored after an uncomplicated surgery? 21 days 48 hours 2 weeks 5 days
2 weeks Most incisions will heal in approximately 10-14 days. Although the skin has not fully returned to its pre-surgical strength, this is enough time that an incisional complication is extremely unlikely. Incisions should be carefully monitored for excessive pain, swelling, discharge, or bleeding for the first 10-14 days after surgery or until suture/staple removal.
A 10 kg Miniature Schnauzer is to receive 22mg/kg cefazolin intravenously following a laceration repair. If the concentration of the cefazolin is 50mg/ml, how many milliliters should be administered? 3.2 4.4 6.0 2.2 1.5
4.4 The answer is 4.4 mL. 10kg x 22mg/kg = 220mg cefazolin. 220mg/ 50mg/ml = 4.4 mL to be administered.
The attending veterinarian would like you to administer a 22 mg/kg dosage of Cefazolin to a 67 pound dog that is about to have surgery. You find that the vial that has been reconstituted is empty and you need to make a new bottle. How much sterile water will you add to a 1 gram vial if you want the concentration to be 200 mg/ml? 5 ml 50 mls 1 gram of powder can not be reconstituted to 200 mg/ml 200 mls
5 ml First convert grams to milligrams 1 gram = 1000 mg. 1000 mg divided by 200 mg/ml = 5 mls Note that in this question the body weight and dose are not needed to solve.
A dog has recently obtained a fresh superficial linear wound after lacerating its flank on a fence. Within what time period can this wound be optimally repaired by primary closure? 8 hours 12-24 hours 3-5 days 2 hours
8 hours After 8 hours pass, the wound tissue starts to become increasingly compromised, and risk of infection and necrosis increase. Primary closure is used when a wound is classified as clean or clean-contaminated. Closure of these involves immediate lavaging, suturing, and closure of the wound. Delayed primary closure is used in clean-contaminated wounds or contaminated wounds and is performed 2-5 days later. The wound is lavaged and debrided. Closure of the wound takes place before the development of granulation tissue. Secondary closure is wound management consisting of lavage and debridement until granulation tissue develops (3-5 days). Then, the edges of the wound are excised, and the skin edges are sutured over the granulation tissue. Second-intention healing is when a wound is allowed to heal by granulating in, wound contraction, and epithelialization; no surgical closure is performed.
Which of the following types of wounds would most benefit from a wet-to-dry bandage? A dog with a clean cut on its side from a fence A dog that has a lick granuloma on its forelimb that is severely inflamed A dog that has a scrape on its hock with a large surface area A dog hit by a car that has an open wound with gravel debris and macerated tissues
A dog hit by a car that has an open wound with gravel debris and macerated tissues Wet-to-dry bandages best serve the purpose for debriding necrotic tissue, especially in the cases of trauma where the wounds are dirty and have the potential of having tissue necrosis around the insult. The goal is to treat these wounds with wet-to-dry bandages until the tissues have healthy granulation tissue and can be adequately debrided and closed. Also, these bandages are beneficial in trauma cases when primary closures are not possible due to more significant internal injuries that need to be addressed first.
Which animal might receive a perineal urethrostomy? A dog with a pus-filled uterus A male cat with a urethral obstruction A female dog with a large bladder stone A dog that has a puppy stuck in the birth canal
A male cat with a urethral obstruction Perineal urethrostomies are performed in male cats with a urethral blockage. The procedure is performed when a cat has had multiple episodes of obstruction or when the obstruction cannot be relieved manually. The procedure entails making a new opening in the urethra in the perineal area and removing the penis.
In which situation would a post-operative sponge count be necessary following an abdominal exploratory? Sponge counts are not necessary since they are radiopaque Sponge counts only need to be performed for mass removals A sponge count should always be performed regardless of the nature of the abdominal surgery Sponge counts are performed only when there is excessive bleeding
A sponge count should always be performed regardless of the nature of the abdominal surgery Inadvertently leaving a sponge in the abdomen is a completely avoidable complication which unfortunately still occurs. Sponge counts should always be performed at the beginning of surgery and then again at the end of surgery to ensure that no sponge was left behind. If a sponge cannot be located, a radiograph of the patient should be performed. The sponge will only show up on the radiograph if it had a radiopaque marker.
When is the appropriate time to immerse surgical instruments in surgical milk? Immediately after surgery After a preliminary rinsing of the instruments After being cleaned in the ultrasonic cleaner Just prior to placing them in the ultrasonic cleaner
After being cleaned in the ultrasonic cleaner Surgical instruments should be placed in surgical milk after being cleaned in the ultrasonic cleaner. Surgical milk is used to help lubricate instruments and protect them from rust. Placing an instrument in an ultrasonic cleaner after being in the surgical milk will result in removal of the surgical milk. For highly specialized instruments such as drills, it is recommended that the technician follow the recommendations of the manufacturer for the best cleaning and sterilization practices.
One of the most common incisional complications encountered in veterinary surgery is the formation of a seroma. Which of the following is a poor treatment choice for an incision diagnosed with a seroma? Warm compress Exercise restriction Placement of a drain Antibiotics
Antibiotics Seromas are not infections and do not need to be treated with antibiotics. They consist of serous fluid, which is usually secondary to excessive dissection or "dead-space" that was created during surgery. Excessive activity and motion at the surgical site may predispose to the formation of a seroma. A warm compress will help increase blood flow to the region and thus help the body reabsorb the fluid. Nonetheless, it may take days to weeks for a seroma to completely resolve. Placing a drain at the site of a seroma may help speed up its resolution, as this helps keep the tissues adhered to each other.
A patient who has stopped breathing after administration of a short-acting anesthetic can be described as being which of the following? Apneic Atelectic Eupneic Dyspneic
Apneic This patient would be apneic, which means the patient is not breathing. Dyspnea implies difficulty breathing. Eupnea is normal respiration. Atelectasis is the description given to collapsed lungs.
In which situation would perioperative antibiotics be strongly indicated? Arthroscopy Ovariohysterectomy Orchidectomy 3.5 cm lipoma excision
Arthroscopy Procedures that are considered uncomplicated and clean typically do not require perioperative antibiotic therapy unless there is a break in sterility. Performing arthroscopy carries a very low likelihood of infection; however, because an infection of the joint can be catastrophic, it is recommended that perioperative antibiotics be administered.
The skin of a prepped surgical site is considered: Aseptic Sterile Bacteria-free Contaminated
Aseptic Aseptic means the number of bacteria has been reduced below the level that would overwhelm the body's defenses. It is not possible to completely sterilize the skin. Note that "aseptic" and "aseptic technique" have slightly different meanings than the term "asepsis" which is the state of being free from disease-causing contaminants (such as bacteria, viruses, fungi, and parasites).
Which of the following appropriately describes a surgical preparation of an incision site? Alternate chlorhexidine and iodine scrubs for a total of 6 scrubs Scrub from cranial to caudal starting at the hairline Scrub and rinse the area a minimum of 6 times Begin where the incision will be made and scrub in outward circles, not returning to the central area
Begin where the incision will be made and scrub in outward circles, not returning to the central area Either chlorhexidine or betadine can be used, but not both together. Scrubbing is started near the center of the incision site in a circular scrubbing motion, moving from the center to the periphery without returning from the periphery to the center. Frequently, the site is scrubbed alternately with alcohol or saline although the benefit of this practice is controversial.
This instrument is commonly used in surgery for grasping tissues. vWhat is the name of this instrument? Debakey forceps Brown-Adson forceps Allis tissue forceps Kelly forceps
Brown-Adson forceps The Brown-Adson tissue forceps are thumb forceps used for grasping tissue without causing excessive trauma. Note the multiple tiny teeth on each tip. Debakey thumb forceps are even less traumatic in that they don't have tiny teeth at the tip. Allis tissue forceps as well as Kelly forceps are different primarily in that they have a "scissor-type" handle. These can be very traumatic to delicate structures.
A 1-year old pregnant female bulldog presents with a history of unproductive labor. The dog has not had contractions in several hours, and the veterinarian has requested a chemistry panel. What value would be most important on this panel? Calcium Albumin Potassium Phosphorous Sodium
Calcium Low ionized calcium levels are an indication of eclampsia. Changes in sodium, potassium and albumin, while important in the overall assessment of the patient, do not give information as to the ability of the patient to produce uterine contractions.
Why is nitrous oxide contraindicated in gastrointestinal surgeries? Causes hypersegmentation of the bowel Causes vomiting Longer recovery due to delayed GI emptying Causes nitrous build up in the GI tract Causes flatulence
Causes nitrous build up in the GI tract Nitrous oxide moves into closed gas spaces such as the intestines. As such, its use is contraindicated in bowel surgeries. You should also be aware that nitrous oxide decreases fractional inspired oxygen levels, although this can be managed and monitored in most instances. Nitrous oxide is also contraindicated when pathology such as pulmonary bullae are present.
Novalsan is also known as which of the following? Betadine Isopropyl alcohol Phenol Chlorhexidine
Chlorhexidine Novalsan and Hibiclens are both names of chlorhexidine solutions or scrub.
A very young puppy presents with a history of milk coming from his nose and seems to cough and gurgle when he eats. What deformity commonly results in this presentation? Esophageal stricture Stenotic nares Cleft palate Persistent right aortic arch Occluded sinus
Cleft palate A common presentation for cleft palate is milk coming from a puppy's (or kitten's) nose after or during eating. It is a defect that affects the upper lip and/or the roof of the mouth. Cleft palate can involve only the soft tissue in the back of the mouth (soft palate) or extend forward through the front of the mouth (hard palate). If there is a hole in the roof of the mouth, milk can travel out the nose while the puppy is drinking.
Which type of gloving method would result in the least chance for contamination? Closed gloving Double open gloving Assisted gloving Open gloving
Closed gloving Closed gloving results in the least chance of contamination and is the preferred method for surgical preparation. In closed gloving, the skin never contacts the outside part of the glove. The arms are still inside the gown sleeves, the glove is placed on the sleeve, and then the hand is pushed through the sleeve and into the glove.
Which of the following is NOT a component of an incisional dehiscence secondary to infection? Cold to the touch Pain Purulent discharge Swelling
Cold to the touch Incisional dehiscences are very serious, and the sooner they are identified the better. When dealing with an abdominal or thoracic incision, it is that much more important to recognize a problem early before there are life-threatening consequences as a result of incision failure. An infection is characterized by all the cardinal signs of inflammation (redness, pain, swelling, heat) as well as purulent discharge.
An animal is hit by a car and has a broken leg in which the bone is sticking out through the skin. This is an example of which fracture type? Spiral Greenstick Compound Comminuted
Compound Fracture types: Oblique - a fracture which goes at an angle to the axis Comminuted - a fracture of many relatively small fragments Spiral - a fracture which runs around the axis of the bone Compound - a fracture which breaks the skin Greenstick - a fracture of soft bone where the bone can bend and be partially broken, seen in young animals
A subtotal colectomy in which a small amount of colonic contents spills into the abdomen in a cat is an example of which of the following? Contaminated surgery Clean surgery Infected (dirty) surgery Clean-contaminated surgery
Contaminated surgery In order from cleanest to most at risk from infection, surgery can be categorized by the following system: Clean, clean-contaminated, contaminated, and infected surgery. These can also be referred to as category I, II, III, or IV surgeries respectively. A clean surgery is one where the surgical wound is made under aseptic conditions, no contaminated viscous is entered, and no breaks in sterile technique occur. Examples include castration, splenectomy, and hernia repair. A clean-contaminated surgery is one made under aseptic conditions that enter the oropharynx, respiratory, alimentary, or urogenital tracts, but there is no other source of contamination (i.e. no spillage of contents). Examples include lung lobectomy and gastrotomy. A contaminated surgery is one where there is either a spill of contaminated material, a break in sterile technique, or entry into a region with a high bacterial load such as the oral cavity or colon. An infected or dirty surgery is a procedure involving a site with known infection. Examples include ear canal ablation or removal of abscessed or necrotic tissue.
The hip joint is known as which of the following? Glenohumeral Coxofemoral joint Femorotibial Ileocecal
Coxofemoral joint This is the joint where the coxae (pelvis bone) meets the femur (leg bone). The joint is where the head of the femur meets the acetabulum of the pelvis to form the ball and socket joint. Ileocecal does not refer to a joint at all, but refers to the area where the Ileum (distal part of the small intestine) meets up with the colon (the cecum specifically). Remember that the ileum is part of the small intestine, and the ilium is uppermost and largest bone of the pelvis. The glenohumeral joint is the shoulder. Femorotibial refers to the joint at the area of the stifle.
You are assisting in radiographing a four-year-old German Shepherd. The dog has been limping on his left hindlimb. The veterinarian elicits a "drawer motion" in the limb during physical exam, and the doctor's suspicion is confirmed by the radiographs. What diagnosis is supported by these findings? Osteosarcoma Hip dysplasia Luxating Patella Cranial cruciate ligament rupture
Cranial cruciate ligament rupture Cranial cruciate ligament injuries are the most common orthopedic problem seen in dogs. Based on the radiographic finding of stifle effusion of the left stifle noted by the displacement of the infrapatellar fat pad, this patient likely has a cranial cruciate ligament rupture. The clue in this question is the veterinarian palpating "drawer motion." This is most commonly associated with a cranial cruciate rupture. (You would not be expected to diagnose this patient, but you should know the general fact that drawer motion is usually caused by a ruptured cranial cruciate ligament.)
Which of the following terms describes an incision into the bladder? Cystotomy Cystectomy Dystocia Cystocentesis
Cystotomy When a word ends with "-otomy" it means an incision or to cut into organ. For example, an enterotomy is an incision into the intestine just as a cystotomy is an incision into the bladder. Words that end in "-ectomy" mean that they are being removed. So a cystectomy would be the removal of the bladder. Words that end in "-centesis" imply the removal of fluid. A cystocentesis is what would be performed to obtain a urine sample via a needle and syringe inserted into the bladder. Dystocia is a general term used to describe an abnormal or difficult labor. There can be many different causes of dystocia.
A tibial fracture needs to be repaired. The surgeon is intending to place a bone plate on the medial aspect of the tibia. How should the patient be positioned and prepped? Dorsal recumbency with leg tied to the table Lateral recumbency with affected side down Lateral recumbency with affected side up Dorsal recumbency with affected leg temporarily hung until the patient is draped
Dorsal recumbency with affected leg temporarily hung until the patient is draped The best positioning is that which will allow the surgeon good access to the proposed surgical site while ideally keeping the patient comfortable. Any time surgery is being performed on the tibia, the leg should be hung while it is being prepped for surgery. Sometimes the surgeon will prefer the leg to stay hung while performing the repair. Such an approach helps maintain retraction on the bone fragments and thus reduce the fracture. This is common practice when placing external fixators. When placing bone plates, the surgeon will usually opt to "cut" the leg down and lay it such that the lateral side is against the surgery table. This will allow for an incision into the medial aspect of the tibia. This is the preferred location as there is not nearly as much musculature on this side. This allows an easier approach and dissection, and reduces morbidity. Therefore the best answer is to have the patient in dorsal recumbency with the limb temporarily hung until the patient is draped.
Which instrument is specifically designed for atraumatically clamping across the intestine? Doyen forceps Kelly forceps Halted mosquito forceps Rochester-Carmalt Crile forceps
Doyen forceps Doyen forceps are the only forceps used in veterinary medicine for atraumatically occluding a loop of bowel. All the other forceps mentioned will result in trauma to the intestine and are not recommended for use on either the intestine or any other delicate structure that the surgeon is trying to preserve.
Which describes the proper order of intestinal segments? Ileum, duodenum, jejunum, colon Jejunum, ileum, duodenum, colon Jejunum, duodenum, ileum, colon Duodenum, jejunum, ileum, colon
Duodenum, jejunum, ileum, colon The proper order of the GI tract is: esophagus, stomach, duodenum, jejunum, ileum, cecum, colon. The duodenum, jejunum, and ileum make up the small intestine. The cecum is the pouch that connects the small intestine to the colon (the large intestine).
A client's dog has been diagnosed with a splenic mass that requires surgical removal. The dog has also been previously diagnosed with liver disease. The owner has pet insurance and is submitting a claim for the laparotomy. She is afraid the insurance company will deny the claim because of the liver disease and asks you to omit that from the medical record until the claim is approved. Of the following, which would be the most appropriate action to take? By law you must report attempted fraud to the insurance company. Explain to the owner that by law you can not change the medical record. Explain to the owner that the medical record can not be altered but you can omit the liver disease from the claim form. Let the owner fill out the claim form by herself and you will be absolved of any responsibility of committing insurance fraud.
Explain to the owner that by law you can not change the medical record. Explaining to the owner that you can not change the medical record by law is the appropriate response.
You are scrubbing in to assist in a surgery. The scrub should occur in which order? Forearms, wrists, hands, fingers Fingertips, hands, wrists, forearms Elbows, forearms, hands, fingers Between fingers, wrists, forearms, fingertips
Fingertips, hands, wrists, forearms The scrub should start at the fingertips and work up towards the forearms. The scrub should not go back in the reverse direction. The elbows are not typically included in the scrub at all.
A Great Dane is presented for her ovariohysterectomy. The owner would also like to have a procedure done at the same time to secure her stomach to the body wall to prevent her from a gastric dilatation volvulus in the future. What is this procedure called? Gastrectomy Gastropexy Gastric bypass Gastrotomy
Gastropexy Pexy" is the term for surgical fixation. A gastropexy is attachment of the stomach to the abdominal wall to prevent the stomach from torsion or malposition. Gastrotomy is an incision into the stomach. Gastrectomy is the removal of the stomach. Gastric bypass procedure typically reduces the size of the stomach and allows food to bypass part of the small intestine. (This is mostly performed in people as a weight loss procedure.)
In order for oxygen to diffuse from the alveoli into the capillaries, the partial pressure of the oxygen in the alveoli in the lungs must be: Higher in the capillaries than in the lungs Oxygen cannot diffuse through the alveoli The same pressure between both the lungs and the capillaries Higher in the lungs than in the capillaries
Higher in the lungs than in the capillaries Partial pressure of oxygen in the alveoli is ~100mmHg, and is ~45mmHg in the capillaries. Gas diffuses from an area of higher concentration to an area of lower concentration.
Which of the following species is unable to vomit? Cows Birds Dogs Horses Cats
Horses The correct answer is horses. Horses are unable to regurgitate or vomit; they are less likely to develop aspiration pneumonia secondary to vomiting or regurgitation while under anesthesia. Regardless, horses are kept off food for approximately 12 hours prior to surgery to allow the stomach to empty. Taking this precaution may help the horse achieve better ventilation while under anesthesia.
Which of the following correctly describes a "surgeon's knot" which may be used to close tissues where tension makes it difficult to apply a regular square knot? It involves passing one strand through the loop twice on the first throw When applied correctly, it results in moderate inversion of the tissue It is an alternative term used to describe a half-hitch knot It is a continuous pattern
It involves passing one strand through the loop twice on the first throw A surgeon's knot is produced by passing one strand through the loop twice on the first throw of a square knot. It is for closure of tissues where tension on the tissues makes it difficult to apply a regular square knot. A surgeons knot can be used with many different suture patterns including interrupted sutures or the first or last knot of a continuous pattern. It can also be used with inverting or everting patterns, but the knot itself does not cause inversion or eversion. A half-hitch is a different type of knot that can be used to slide a knot down a suture line (i.e. toward a pedicle).
In which part of the intestinal tract is nutrient absorption the greatest? Jejunum Duodenum Colon Ileum
Jejunum The jejunum is the longest portion of the small intestine and is the site of the most nutrient absorption.
When assisting with a forelimb declaw, it is helpful to place a tourniquet to help control hemorrhage. Where should the tourniquet be placed? Directly around the digit upon which the surgeon is working Just distal to the elbow Over the proximal humerus Just proximal to the elbow
Just distal to the elbow The optimal placement of the tourniquet is just below or distal to the elbow. Placing the tourniquet above the elbow can result in damage to the radial nerve, which will result in an inability for the patient to use the limb if the damage is permanent. Placing the tourniquet around the digit is unpractical and cumbersome.
The adrenal glands are closest to what other structure? Brain Bladder Kidneys Pancreas Liver
Kidneys The adrenal glands are located right above the kidneys. The bladder sits in the caudal abdomen ventral to the colon. The liver is just caudal to the diaphragm and is the most cranial organ in the abdomen. The right limb of the pancreas runs parallel with the duodenum while the left limb runs along the body of the stomach.
Castration is a common procedure performed in horses. How is a horse commonly positioned for the procedure? Dorsal recumbency with legs spread wide Dorsal recumbency with legs "hog" tied Lateral recumbency with upper rear leg tied around neck Dorsal recumbency with rear legs positioned cranially
Lateral recumbency with upper rear leg tied around neck The most common position for a horse castration is lateral recumbency with the upper rear leg tied around the neck. It is extremely important to confirm that both testicles are descended prior to heavily sedating the patient for the procedure.
When using the ultrasonic cleaner, it is important to do which of the following? Run the clean cycle for at least 27 minutes Scrub the instruments while the ultrasonic cleaner is running Lay the instruments in an open position Add surgical milk to the solution
Lay the instruments in an open position Laying the instruments in an open position will help ensure ultrasonic waves reach all areas of the instrument. Surgical milk should not be mixed in with the cleaner solution. The 10 minute run cycle is typically sufficient to clean the instruments. Scrubbing the instruments while in the ultrasonic cleaner is not necessary. Ideally, the instruments should be rinsed off of any major debris and residue or pre-cleaned prior to being placed in the ultrasonic cleaner.
Which of the following is not a potential job responsibility of the technician during colic surgery? Making the initial incision into the abdomen Opening surgical packs Administering anesthesia Placing a jugular catheter
Making the initial incision into the abdomen Making the incision into the abdomen is the surgeon's responsibility. A technician is neither legally permitted nor adequately trained to perform surgery, including the initial incision. That being said, a technician may be asked to scrub into surgery to help assist with the surgery. Assisting in surgery includes such tasks as passing instruments, dabbing, retracting, and cutting suture. Administering anesthesia, placing catheters, and opening sterile surgical packs are all tasks the technician should know how to perform.
Which of the following scissors are the most heavy duty and should be used for cutting through dense or thick tissues and fascia? Mayo Metzenbaum Iris Olsen-Hegar
Mayo Mayo scissors are heavy duty scissors compared to the other options. Metzenbaum and iris scissors have thinner blades and should be used for thin, delicate tissues only. Olsen-Hegar is a type of needle driver which includes a scissor for cutting suture material and should not be used for tissue due to potential to damage the tissue with the needle holder tip.
Which of the following blades is the most commonly used when incising the skin of an animal? No. 11 No. 12 No. 10 No. 20
No. 10 The No. 10 blade is the most commonly used blade, and the technician needs to be familiar with this blade size. The No. 15 blade is also commonly used. This blade is smaller and will be used for more delicate incisions. The No. 11 blade is pointed at the tip and will be used to transect structures such as ligaments. The No. 12 blade is not commonly used but some may use it to lance abscesses.
Bone is made by which type of cell? Osteoclasts Osteoblasts Chondrocytes Osteocytes
Osteoblasts Osteoblasts are mononucleate cells that are responsible for bone formation and come from the bone marrow. Osteocytes are actually cells inside of the bone. Osteoclasts are large cells that dissolve the bone. Chondrocytes are cartilage cells.
A dog owner is considering having a scheduled cesarean section for her dog and would like some more information regarding the risks associated with the procedure. Which of the following statements is TRUE? Performing a cesarean delivery will result in the dog being unable to have another pregnancy Performing a spay at the time of surgery is not recommended as there is a risk that the female will not display maternal instincts Performing a spay at the time of surgery does not affect milk production Performing a cesarean delivery will result in decreased milk production
Performing a spay at the time of surgery does not affect milk production It is important to be aware that performing a spay at the time of surgery does not have a detrimental effect on the female. There are no adverse effects on milk production or predictable unwanted behaviors. Similarly, there are no long-term negative effects of performing a cesarean delivery; however, there is a possibility of development of scar tissue at the site of a cesarean which may hinder the ability of a future embryo to attach at that specific location.
A purse-string suture would be been placed for which of the following surgeries? Enucleation Enterotomy Cystotomy Perianal mass excision
Perianal mass excision A purse-string suture is a surgical suture passed as a running stitch in and out along the edge of a circular region (as seen with the anus), so that when the ends of the suture are drawn tight the region is closed like a purse. This is often done around the anus prior to initiating surgery to prevent fecal contamination within your surgical site.
Which of the following instruments would be LEAST effective at cutting or removing bone from a patient? Michel trephine Curette Osteotome Periosteal elevator Gigli wire
Periosteal elevator Periosteal elevators are good for elevating muscle attachments from bone or periosteum. They would not be effective at actually cutting or removing bone. Curettes are great for removing small amounts of bone such as when obtaining a bone graft. Gigli wire is still used for cutting through bone. With an osteotome and mallet, precise bone cuts can be made by the experienced surgeon. Alternatively, a battery powered bone saw can be used. A Michel trephine is used to obtain core samples of bone. It is commonly used to help diagnose neoplasia involving the bone.
Which vessel transports blood from the intestines to the liver? Portal vein Renal artery Hepatic duct Vena cava
Portal vein The portal vein is responsible for transporting the nutrient-dense blood from the intestines to the liver.
Which of the following scenarios describes the proper care of surgical instruments? Pre-rinse the instruments immediately after surgery to remove residues. Place in ultrasonic cleaner for approximately 10 minutes. Place in surgical milk. Remove from surgical milk and let instruments dry. Place instruments in ultrasonic cleaner for approximately 10 minutes. Rinse instruments with distilled water and scrub as necessary. Place instruments in surgical milk. Remove from surgical milk and let instruments dry. Place instruments in surgical milk. Remove from surgical milk and rinse to remove and debris and residue. Place instruments in ultrasonic cleaner for 10 minutes. Let instruments dry. Rinse the instruments to remove the debris and residue. Place in an ultrasonic cleaner for 30 minutes. Then place the instruments in surgical milk. After removing instruments from the surgical milk rinse them again.
Pre-rinse the instruments immediately after surgery to remove residues. Place in ultrasonic cleaner for approximately 10 minutes. Place in surgical milk. Remove from surgical milk and let instruments dry. The correct answer is to pre-rinse the instruments (using distilled water) immediately after surgery to remove residues. Place in ultrasonic cleaner for approximately 10 minutes. Place in surgical milk. Remove from surgical milk and let instruments dry.
A 10-year old male intact Rottweiler is currently undergoing surgery for removal of a prostatic mass. Which term best describes the procedure? Prostatitis Prostatectomy Cholecystectomy Onychectomy Orchidectomy
Prostatectomy There are a few basic rules that will allow you to comprehend a majority of the medical terms. Any term that ends with "-ectomy" infers to removal of that organ. Onychectomy is another word declawing or removal of the distal phalanx. Orchidectomy is the removal of a testicle. A cholecystectomy is removal of the gall bladder. The ending "-itis" means inflammation. In this case, prostatitis would be inflammation of the prostate.
The sacculus rotundus is part of the intestinal anatomy of which species? Horse Psittacine bird Camel Rabbit
Rabbit Just proximal to the cecum is a gastrointestinal structure containing a large amount of lymphoid tissue called the sacculus rotundus which has some immune function. It is present only in lagomorphs.
The shoulder joint links which two bones? Humerus and ulna Radius and ulna Scapula and humerus Humerus and radius
Scapula and humerus The shoulder joint connects the scapula and the humerus. The head of the humerus sits at glenoid cavity of the scapula to form the shoulder joint.
A fracture has just been repaired with a 3.5 mm screws. What is the 3.5 mm in reference to? Screw diameter Screw length Pitch Thread type
Screw diameter The number is in reference to the screw diameter. The pitch of a screw describes the number or distance between each thread. The two main types of thread used are cortical and cancellous. Cortical screws are designed for dense bone; cancellous screws are made for softer bone. The screw length is also measured in millimeters. The most common sizes used in small animal surgery are 2.0, 2.7, and 3.5 mm screws. In large animal surgery 4.5, 5.5, and 6.5 mm diameter screws are used.
A suture pack with a cutting needle would be used on which of the following? Gall bladder Skin Intestine Urinary bladder
Skin A cutting needle is ideal for skin. Cutting edge needles are not typically used when an airtight or watertight suture line is needed (like the bladder, intestines, etc.)
You are assisting with an exploratory surgery, and the dog has a septic peritonitis from a perforated bowel. Before closure, the veterinarian lavages the abdomen with what? Sterile physiologic saline Sterile physiologic saline with betadine Sterile physiologic saline infused with antibiotics Sterile Lactated Ringer's solution
Sterile physiologic saline Copious lavage of the abdomen with sterile physiologic saline solution is performed prior to closure of the abdomen.
After finishing a routine enterotomy, the surgeon prepares to perform a leak check of the site. What instruments should you hand the surgeon? Sterile syringe, needle, and saline Sterile suction tip and gauze Sterile saline and the appropriate sized suture Sterile red rubber catheter and saline
Sterile syringe, needle, and saline A leak check is performed by occluding both sides of intestine several centimeters from the enterotomy and then injecting sterile intraluminal saline, with a syringe. As the intestine fills with saline the incision site is evaluated for obvious leakage. Ligatures are then placed as necessary to seal any leak sites. A sterile red rubber catheter may be used for leak checks in male dogs that have had a cystotomy. The red rubber catheter is introduced via the penis, and saline is then infused into the bladder to perform the leak check.
A dog has torn his cranial cruciate ligament and is having surgery. What area should you clip and aseptically prep? Shoulder Stifle Abdomen Elbow Hip
Stifle The correct answer is stifle. An extracapsular repair involves placing a synthetic suture material like heavy gauge fishing line spanning in a similar orientation as the cranial cruciate ligament, except the material is outside the joint. This is a very common surgery performed in small breed dogs with ruptured cranial cruciate ligaments.
How are bladder stone types identified? Gross examination Submit to lab for analysis Look for crystals on the urinalysis Check the urine pH
Submit to lab for analysis The only way to know what a bladder stone is composed of is through lab analysis of its composition. Sometimes we can make an educated guess based on the appearance of the stones grossly, on a radiograph, crystals in urine, or based on urine pH, but none of these things are definitive and can be unreliable.
Which of the following suture/needle combination is most commonly used in veterinary medicine? Swaged, straight needle Eyed, straight needle Swaged, curved needle Eyed, curved needle
Swaged, curved needle A swaged needle is one that has the suture connected to the needle. It is essentially "eye-less". Curved needles are preferentially used to suture all anatomic structures such as fascia, subcutaneous tissue, dermis, and skin. Eyed needles have a hole at the end through which suture is fed. These types of needles are more traumatic to the tissues and not as commonly used.
Bandages are commonly placed on the legs of animals after surgical procedures to help prevent swelling and protect the incision. They can also be used to help stabilize fractures or protect wounds. Which of the following is NOT a sign of a potential bandage complication when monitoring the bandage of a forelimb bandage? Swelling of the neck Soiling of the bandage Slipping of the bandage Swelling of the toes
Swelling of the neck Swelling of the neck would definitely be alarming but would not be associated with a bandage complication. Bandage complications are usually seen as a result of slippage, wetting, or soiling, which result in bandage sores. Additionally, slippage or improper placement can result in constriction and subsequent problems with circulation. If circulation is interrupted, a tourniquet effect may occur; this can be a very serious complication resulting in loss of the limb if gone unchecked.
A puppy presents for his caudectomy procedure. What is being performed? Soft palate repair Tail removal Dewclaw removal Testicle removal
Tail removal Caudectomy is the removal of an animal's tail. Tail "docking" and tail amputation are caudectomy procedures.
Which of the following statements is LEAST correct regarding dystocias and Cesarean sections? The gravid female may have difficulty breathing when anesthetized The fetuses are not affected by the anesthetics delivered, as they do not cross the placenta Metabolic alterations such as hypocalcemia should be corrected Not all dystocias can be treated medically
The fetuses are not affected by the anesthetics delivered, as they do not cross the placenta When performing anesthesia for a cesarean delivery, it is of absolute importance to consider the anesthetic protocol since the fetuses will be affected by the anesthetics delivered to the female. It is best to keep anesthesia time to a minimum to reduce anesthetic exposure to the fetuses. Any gravid female placed on her back may have additional difficulty fully expanding her lungs when anesthetized; it is therefore recommended to monitor respiration carefully to ensure adequate ventilation is achieved. She may need to be intermittently bagged or placed on a ventilator. It is very important to determine the cause of a dystocia prior to administration of medications such as oxytocin, which can bring about uterine contraction. For example, if the birth canal is obviously obstructed, giving oxytocin will only cause additional contraction and predispose the animal to uterine rupture or hypocalcemia.
A patient has sustained a burn to the skin corresponding to the area where the electrocautery ground plate had been placed. What is the most likely reason this occurred? The ground plate had poor contact with the patient's skin The power level was too high The electrocautery unit was inadvertently switched to bipolar mode The surgeon used the cut mode for over 30 seconds
The ground plate had poor contact with the patient's skin Poor contact between the ground plate and the skin can result in a burn to the patient. To reduce this risk, conductive gel is spread along the ground plate to help improve the level of contact with the patient's skin. Switching to bipolar mode by accident will result in an inability to use the monopolar hand piece but should not cause a burn. Setting the power level too high may cause excessive tissue trauma to the region where the electrocautery is being used, but this will not affect the interface between the skin and the ground plate. Keeping the cut mode activated for more than the given period of time has no impact on the ground plate-skin interface.
A client has called your hospital to schedule a castration to be performed on her rabbit. The owner says she remembers that she had to fast her dog when he got neutered and asks if she should do the same for the rabbit. What is the correct response? The rabbit should not be fasted. The rabbit should be fasted for 6 hours prior to being dropped off at the hospital. The rabbit should be fasted for 12 hours prior to being dropped off at the hospital. The rabbit should fasted for 24 hours prior to being dropped off at the hospital.
The rabbit should not be fasted. Small rodents and rabbits do not vomit, therefore, there is generally no reason to withhold food or water prior to anesthesia. Withholding food from rabbits can trigger digestive disturbances that can be fatal.
Which is true regarding umbilical hernias? They usually consist of a small piece of fat protruding through the body wall and are not life-threatening They usually progress until a loop of bowel is strangulated through the defect and should be repaired as an emergency procedure The best treatment for all umbilical hernias is benign neglect They should not be repaired at the same time as a spay or neuter procedure
They usually consist of a small piece of fat protruding through the body wall and are not life-threatening MOST umbilical hernias are stable and consist of a small piece of fat protruding through a body wall defect. Many small dogs with stable hernias do not require repair since they are not life-threatening. Larger dogs with hernias require repair more often since the weight of their abdominal contents on the defect can enlarge it and increase the risk that abdominal contents (such as intestine) could protrude through. The best time to repair these is when they are already under anesthesia for their spay or neuter. The course of action for repair or monitoring depends upon the risk factors (size of hernia, size of dog, etc.).
What is the best method for handling tissues during abdominal surgery when they must be placed outside of the peritoneal cavity? Tissues and organs outside the abdomen should be covered with saline-moistened sponges Tissues and organs outside the abdomen should be covered in an antibiotic-impregnated solution and sponges Tissues and organs should never be exteriorized from the abdomen Tissues and organs outside the abdomen should be wrapped in a dry gauze or sponge
Tissues and organs outside the abdomen should be covered with saline-moistened sponges Tissues and organs should always be handled with exceptional care. To avoid desiccation, all tissues/organs should be intermittently moistened with sterile saline or wrapped in saline-impregnated gauze or lap sponges. Antibiotic-impregnated solutions are not necessary, can be irritating, and may select for resistant organisms. Allowing the tissues/organs to dry will cause damage to their surfaces and result in subsequent inflammation.
When applying a bone plate to fix a fracture, which of the following instruments would be least useful? Drill guide Screw driver Point-to-point forceps Trocar Tap
Trocar Trocars are typically used for penetrating into a space for arthroscopy, thoracoscopy, or laparoscopy. Once the trocar has been inserted, it is replaced by a cannula, which allows for insertion of an instrument or scoping device into the desired space, such as the knee joint. A drill with the appropriately sized drill bit is used to drill holes into bone. A drill guide is used to help protect the surrounding soft tissues and assist in aiming. A tap is then used to put a thread into the hole so that the screw can be placed securely. The screw is inserted with the aid of a screwdriver. Point-to-point forceps will help keep the fracture properly reduced while the bone plate is being applied.
The placenta supplies the fetus with oxygen via which structure? Umbilical vein Foramen ovale Ductus venosus Umbilical arteries Left portal vein
Umbilical vein The umbilical vein carries oxygenated blood from the placenta to the growing fetus. The umbilical arteries carry deoxygenated blood from the fetus to the placenta. The foramen ovale is an opening in the septum between the atria in the heart of the fetus with allows blood to bypass the lungs. The ductus venosus shunts a large portion of blood flow in the fetus from the umbilical vein to the inferior vena cava such that oxygenated blood from the placenta can bypass the liver. The left portal vein connects umbilical circulation with portal (liver) circulation.
Which of the following is NOT a good recommendation to make to an owner after having had a declaw performed on their cat? Monitor the bandages for slippage Restrict his activity as much as possible Use clay based litter in the litter box Discourage licking or chewing of the toes
Use clay based litter in the litter box Typical "gravel-type" clay litter will stick to the incisions and may perpetuate complications with healing and subsequent osteomyelitis. Therefore, it is important to confirm that owners are using approved litter such as torn paper towels or newspaper to help prevent small particles from embedding into the healing incisions. The other answer choices are good recommendations to make.
An incision made from xyphoid to pubis would be found where? Over the dorsal hip region Ventral midline Ventral chest over the sternum Ventral cervical region
Ventral midline The xyphoid is the lowest part of the sternum. The pubis is one of the bones that makes up the hip. An incision from xyphoid to pubis implies a ventral midline incision as is customarily performed during abdominal exploratories.
In a horse, what is the most common surgical approach to the abdominal cavity? Ventral midline incision Flank incision Transverse incision Parasaggital incision
Ventral midline incision Similar to small animals, the most common approach performed is a ventral midline incision. This provides excellent exposure of abdominal organs. A flank incision may be preferred in special circumstances but is not performed as routinely. A parasaggital incision is not ideal as it results in trauma to the abdominal musculature. A transverse incision would not provide good visualization as compared to a ventral midline incision.
The dog's abdominal region may also be referred to as which of the following? Dorsal region Proximal region Anterior region Ventral region
Ventral region
A horse is presented for a surgical procedure. What is the best time to administer perioperative antibiotics to the patient? 1 hour post-operatively When the incision is being closed Within 1 hour of cut time When the surgeon makes the first cut
Within 1 hour of cut time The best time to administer antibiotics for a surgical patient is within 1 hour of cut time. Antibiotics are most effective and can provide therapeutic levels to the patient when they are given within 60 minutes of cut time (when the incision is made). Subsequent doses may be needed if the surgical procedure is more than 1-2 times the half-life of the chosen antibiotic.
Which structure is NOT a part of the equine large intestine? Right Dorsal Colon Left Dorsal Colon leum Cecum Pelvic Flexure
leum The ileum is part of the small intestine. The large intestine of the horse starts with the cecum and continues with the right ventral colon, sternal flexure, left ventral colon, pelvic flexure, left dorsal colon, diaphragmatic flexure, right dorsal colon, transverse colon, and small colon.
