Animal Nursing medicine fall 2021

Choose a typical SID used in veterinary radiology. 40 in 40 cm 30 cm 30 in

40 in

Which syringe has 30 units of blue liquid? A B

A

Premedication

-Main objective is to calm down the patient and prepare for induction. -Different combinations of medications are used to achieve desired effects -Commonly used agents for premedication are: -Tranquilizers - Acepromazine, Diazepam, Midazolam, -Opioids - Torbugesic (Butorphenol) -Anticholinergic Drugs - Glycopyrrolate or Atropine uThe sedatives can also be used as premedication/ induction in some animals especially fractious pets. uAlpha2 agonist - Dexmedetomidine (dexdomitor) uDissociative agents - Telazol uThe above mentioned agents can be used in combination with opioids (Butorphanol) uWhen using sedatives as premedication/induction, if possible, intubation should be done under sedation

Later in the week, the cat needs a blood transfusion of 40 ml. The doctor wants if given over 3 hours. What is the drip rate if you use a standard set of 20 drops/ml? 1 drop @ 5 seconds 1 drop @ 13-14 seconds 1 drop @ 10 seconds 1 drop @ 7 seconds

1 drop @ 13-14 seconds

Someone else needs the infusion pump!!What is his drip rate if you use a standard drip set ( 15 gtt/ml)? 1 drop @ second 1 drop @ 3 seconds 1 drop @ 4 seconds 1 gtt @ 13 seconds

1 drop @ 3 seconds

What is the drip rate for this cat if you use a microdrip or pediatric drip set? a little faster than 1 gtt@sec 1 gtt @ 1 second 1 gtt @ 2 seconds 1 drop @ 8 seconds

1 gtt @ 1 second

Close time on Friday night and a Chihuahua is brought in HBC. He has a head injury and the orders are to flow Mannitol solution over 1 hour. The total volume to be delivered is 150 ml. What is your drip rate? (use a standard set) 1 gtt@ 10 seconds 1 gtt @ 5 seconds 1 gtt @ 1-2 seconds faster than 1 drop per second

1 gtt @ 1-2 seconds

Pre-anesthetic Agents

1. Tranquilizers and Sedatives •Phenothiazines - Acepromazine •Benzodiazepines - Diazepam and Midazolam •Alpha2-agonists - Dexmedetomidine (Dexdomitor) 2. Opiods •Butorphenol (Torbugesic) •Buprenorphine •Hydromorphone •Morphine 3. Anticholinergic (parasympatholytic, cholinergic blockers) •Glycopyrrolate (Robinul V) •Atropine

Put the following in order describing the proper recovery phase: Turn flowmeter to 0 Empty and fill bag 3-5 times with 100% oxygen turn vaporizer off continue oxygen for 5 minutes disconnect patient from circuit deflate ET cuff and untie gauze

1. Turn vaporizer off 2. Empty and fill bag 3-5 times with 100% oxygen 3. continue oxygen for 5 minutes 4. Turn flowmeter to 0 5. disconnect patient from circuit 6. deflate ET cuff and untie gauze

Anesthesia Machine Shutdown

1.Turn O2 Tank Off 2.Open Flowmeter until it zeros 3.Check O2 Pressure Gauge (@ zero) 4.Close Flowmeter 5.Check O2 Pressure Gauge (stays @ zero) 6.Ensure Vaporizer is Off 7.Check Isoflurane Level 8.Check Soda Lime Color 9.Check Charcoal (50 grams gain) 10.Check POV Open?

Recovery Procedure

1.Turn Vaporizer off 2.Empty and fill bag 3-5 times with 100% O2 3.Continue O2 five minutes (reduce WAGs) 4.Turn Flowmeter to 0 5.Turn Respiratory Monitor Off 6.Disconnect patient from circuit (patient breathes room air) 8. Deflate ET Cuff 9. Untie ET string gauze (position gauze and cuff pilot tube on midline) 10. Wait for gag reflex- Swallow 3 times 11. Extubate in sternal recumbency or lateral recumbency and monitor breathing ***remember to rotate patient if recovery in lateral recumbency 12. Continue monitoring until sternal and alert

The milliamperage-seconds (mAs) for 1000 mA and 1/10 sec is: 10 mAs 10,000 mAs 100 mAs 1mAs

100 mAs

Riley, a 17 kg Wheaton Terrier is presented with garbage can enteritis. He is 6% dehydrated and is vomiting around 200 ml daily. How much does he need to correct his dehydration only? (don't include maintenance in this.. just rehydration) 300 ml 1700 ml 1020 ml 850 ml

1020 ml

Any body part exceeding this measurement requires the use of a grid to reduce fog-producing scatter radiation 20cm 10cm 2.5cm 30cm

10cm

You are to induce a 50 pound female Poodle with Propofole. The Veterinarian has asked you to calculate the dose based on his recommendation for a dosage of 5mg/kg. The concentration of Propofol is 10mg/ml. How many mls should you draw up in the syringe 11.4 mLs 2.5 mLs 22.7 mLs 5 mLs

11.4 mLs

What is the maximum allowable pressure in the breathing circuit, as measured on the manometer? 15 psi 50 cm H2O 15-20 cm H2O 45 psi 65 cm H2O

15-20 cm H2O

Flow 2 times maintenance to a 4 kg cat. Calculate the fluid rate? 17 ml/hr 22 ml/hr 13 ml/hr 14 ml/hr

17 ml/hr

Flow 2 times maintenance to the above cat. What will the ml/hr amount to? 22 ml/hr 17 ml/hr 14 ml/hr 13 ml/hr

17 ml/hr

Although each patient and situation is different, pick the best choice in catheter size for each animal listed. Adult greyhound 18 gauge, 1.5 in 24 gauge, 3/4 in 22 gauge, 1 in 20 gauge, 1 in

18 gauge, 1.5 in

What is the total amount of fluids that Riley needs on day one? 1500 ml 1140 ml 1920 ml 2990 ml

1920 ml

How many views are standard for each anatomical part? 1 2 3 4

2

How many views are standard for each anatomical part? 1 2 3 4

2

A canine urinary catheter is advanced Until resistance is met at the os penis Until resistance is met at the urethral flexure around the pelvis 2-4 cm past the point where urine initially flows 15 cm past the point where urine initially flows

2-4 cm past the point where urine initially flows

How many drops per minute is equivalent to 20mL/hr using a 60 drops/mL drip set? 10 20 60 120

20

Although each patient and situation is different, pick the best choice in catheter size for each animal listed. Adult Beagle 18 gauge, 1.5 in 24 gauge, 3/4 in 22 gauge, 1 in 20 gauge, 1 in

20 gauge, 1 in

Normal fluid losses and hence maintenance fluid requirements for most domestic species is: 5-15 mL/kg/day 20-40 mL/kg/day 40-60 mL/kg/day 80-100 mL/kg/day

20-40 mL/kg/day

Daily fluid maintenance needs for a 8.8# cat. 200 ml @ day 150 ml/day 1500 ml/day 60 ml/day

200 ml @ day

Daily fluid maintenance needs for a 8.8# cat. 60 ml/day 1500 ml/day 200 ml/day 150 ml/day

200 ml/day

Although each patient and situation is different, pick the best choice in catheter size for each animal listed. Adult cat 18 gauge, 1.5 in 24 gauge, 3/4 in 22 gauge, 1 in 20 gauge, 1 in

22 gauge, 1 in

What reading should you expect from a full O2 tank? 5000psi 4500psi 2200psi 1000psi

2200psi

Although each patient and situation is different, pick the best choice in catheter size for each animal listed. Kitten 18 gauge, 1.5 in 24 gauge, 3/4 in 22 gauge, 1 in 20 gauge, 1 in

24 gauge, 3/4 in

A persistent skin tent (considerable loss of skin turgor) and extremetly dry mucous membranes indicate a dehydration of: < 5% 5% 8% >10%

>10%

How many ml/hr do you flow this cat AFTER it has recieved an initial bolus of 200 ml? 45 ml/hr 36 ml/hr 28 ml/hr 15 ml/hr

28 ml/hr

The amount of Normasol-R replacement fluids for a 36.5 kg dog estimated at 8% dehydrated would be calculated as: 1825 mL 2920 mL 292 mL 365 mL

2920 mL

The amount of Normasol-R replacement fluids for a 36.5 kg dog who is estimated to be 8% dehydrated would be calculated as: 2920 mL 292 mL 1825 mL 365 mL

2920 mL

According to the body condition score five-level system, what number indicates an ideal weight? 1 2 3 4 5

3

What is the correct formula for calculating rebreathing bag size? After this calculation we round up to the next higher Liter size bag. 10 ml/Kg 60 ml/# 30 ml/# or 60ml/Kg 22 ml/Kg 10 ml/#

30 ml/# or 60ml/Kg

A 7 year old Golden is admitted for a routine dentistry and some small skin mass removals. He weighs 67 pounds. The surgery/anesthetic fluid rate is 10 ml/kg/hr. What is his hourly rate? What is his drip rate? (use standard drip set: 15gtt/ml)Hint: 1 kg = 2.2 pounds 300 ml/hr and a little faster than 1 drop per second 150 ml/hr and 1 drop @ 2 seconds 300 ml/hr and 1 drop @ 5 seconds 83 ml/hr and 1 drop per second

300 ml/hr and a little faster than 1 drop per second

The acceptable crystalloid IV infusion rates for a cat in shock would be: 3 to 10 mL/kg. 12 to 20 mL/kg. 25 to 30 mL/kg. 40 to 60 mL/kg.

40 to 60 mL/kg.

what is A

4th Metacarpal

What is normal Tidal Volume for dogs and cats? 300 ml/# 5-7 ml/# or 10-15 ml/Kg 600 ml/Kg/hour 25 Gallons per hour

5-7 ml/# or 10-15 ml/Kg

A feline patient (13#) with mild cardiac and renal deficits is hospitalized for IV fluids. The doctor has order 1/2 maintenance fluids. What will the flow rate be? 6 mL/hr 12 mL/hr 27 mL/hr 37 mL/hr

6 mL/hr

Tiki, a 6 kg Siamese, with mild cardiac and renal deficits is hospitalized for IV fluids. The doctor has order 1/2 maintenance fluids. What will the fluid rate be? 37 mL/hr 6 mL/hr 12 mL/hr 27 mL/hr

6 mL/hr

With the exception of cats, most animals have a total blood volume equivalent to ________ of their body weight. 7% 15% 25% 40%

7%

A 4 kg feline is scheduled for surgery tomorrow. The doctor has ordered maintenance fluids for her until surgery. What is her flow rate? 32 mL/hr 16 mL/hr 8 mL/hr 4 mL/hr

8 mL/hr

What will you set the IV pump at for total ml/hr? 15 ml/hr 55 ml/hr 80 ml/hr 220 ml/hr

80 ml/hr

Daily fluid maintenance for a 16.8 kg border collie is: 840 ml/day 18,503 L/day 1680 ml/day 504 ml /day

840 ml/day

Daily maintenance for a 37 pound border collie is: 504 ml / day 840 ml/day 1680 ml/day 18503 liters a day

840 ml/day

Riley, a Wheaton Terrier is presented with garbage can enteritis. He is 5% dehydrated and is vomiting around 200 ml daily. He weighs 38 pounds. You will use this history for the next 3 questions. First one: How much does he need to correct his dehydration only? (don't include maintenance in this.. just rehydration) 860 ml 500 ml 300 ml 1100 ml

860 ml

A cat is presented after being lost for a week. He is 10% dehydrated and there are no continuing losses from vomit/diarrhea. He originally weighed 20 pounds but today weighs 13#. The doctor instructs you to run 200 ml quickly as a bolus and flow the remaining total over the 1st day. The next 3 questions will pertain to this cat. First what is the total amount of fluids to be flowed today?Use his current weight for your fluid calculations. 390 ml 885 ml 1040 ml 1500 ml

885 ml

Which of the following scenarios would lead to the highest level of waste gas contamination? A bottle of isoflurane is dropped and broken while refilling the vaporizer. A fractious cat is "boxed down" in an induction chamber. A dog is sedated using an anesthesia mask and isoflurane. A dog is intubated and the endotracheal tube is not inflated prior to the use of isoflurane.

A bottle of isoflurane is dropped and broken while refilling the vaporizer.

Which statesment(s) below is/are true pertaining to IV catherization. A)Choose an IV catheter of sufficient length to minimize risk of dislodgement B) Choose a location that will not interfere with the procedure C) Choose a catheter of the smallest diameter D) Use saline flush/heparin flush following IV injection of a drug

A)Choose an IV catheter of sufficient length to minimize risk of dislodgement B) Choose a location that will not interfere with the procedure D) Use saline flush/heparin flush following IV injection of a drug

Granulation tissue, the red tissue underlying a scab, is made up of: New capillaries Fibroblasts Fibrous tissue A,B, and C None of the above

A,B, and C

dry mm, slightly prolonged CRT A. 6-8% B. 10-12% dehydrated C. >12% dehydrated D. <5% dehydrated E. 5-6% dehydrated

A. 6-8%

When positioning for a lateral shoulder, how can you assure the chest on a deep chested dog is not superimposed over the area of interest? Pull both front legs caudally Pull the down leg caudally Abduct the top leg and pull caudally Pull the top leg caudally

Abduct the top leg and pull caudally

What is C

Accessory carpal bone

Phenothiazines

Acepromazine: -Can be given SQ, IV, IM, Oral -Onset of action is 15 min when given IM and peak effect occurs within 30-60 min -Minimize anxiety -No analgesia -Anti-arrhythmic effect -Anti emetic - helps prevent vomiting -HYPOTENSION - due to peripheral vasodilatation - can be treated by using IV fluids -Should be avoided in patient with systemic diseases and geriatric patients. -Greyhounds and Boxers sensitive to ace and may cause severe hypotension and bradycardia -Penile Prolapse in HORSES

This noncontrolled anesthetic adjunct is used to provide sedation, decrease general anesthetic and ease induction/recovery via depression of the RAS system and CNS. Although it can cause hypotension, this drug is also an antiemetic and antiarrhythmic Propofol Pentobarbital Glycopyrrolate Acepromazne

Acepromazne

Clipping the hair and performing a surgical prep prior to intravenous catheterization is necessary for what reason? All answers pertain Aids in visualization of the vein Aid in the adherance of bandaging Helps prevent infection Help prevent further contamination - easier to clean

All answers pertain

Clipping the hair and performing a surgical prep prior to intravenous catheterization is necessary for what reason? All answers pertain Aids in visualization of the vein Help prevent further contamination - easier to clean Helps prevent infection Aid in the adherance of bandaging

All answers pertain

Which statement is true of carpal bones, metacarpal bones and phalanges? All are numbered in lowest to highest starting medially. All are numbered in lowest to highest starting laterally.

All are numbered in lowest to highest starting medially.

A craniocaudal view of the radius ulna: Means the beam enters the cranial side of the front first Means the beam exists the back of the front leg Requires the animal to be in sternal recumbency 2 of the above All of the above

All of the above

Anesthesia safety can be improved by: Taking a good history. Performing a thorough physical examination. Performing appropriate preanesthetic laboratory tests, X-Rays, and tests like EKG, Blood Pressure, etc. Using IV Fluids during anesthesia, and monitoring the anesthesia closely. All of the above

All of the above

Why do we use IV Fluids during anesthesia? To maintain excellent hydration. To prevent hypovolemia. To have an open vein in case emergency drugs need to be given IV. To enhance kidney, liver, and other organ function. All of the above

All of the above

Why is the skin wiped with 70% isopropyl alcohol before venipuncture? All of the above. It improves visualization of the vein It removes some superficial skin contaminants. It causes vasodilation.

All of the above.

Why is the skin wiped with 70% isopropyl alcohol before venipuncture? It causes vasodilation. It improves visualization of the vein It removes some superficial skin contaminants. All of the above.

All of the above.

Which if the following are inhalation anesthetic agents? Methoxyflurane Halothane Isoflurane Sevoflurane All the Above

All the Above

Granulation tissue, the red tissue underlying a scab, is made up of: Fibrous tissue Fibroblasts New capillaries none of the above All the above

All the above

If an animal goes home with a bandage, the client should observe the bandage daily and alert the hospital if the following occurs If skin irritation occurs at the edge of the bandage If the position of the bandage has shifted If the bandage is wet All the above

All the above

When discharging a patient wearing a cast, client education is essencial and should include instructing the client to Check animal toes daily for warmth, discoloration, and swelling Check the cast daily for foul odor Observe areas of skin chafing from cast Keep the cast covered with plastic or other water proff matertia when the animal is outside All the above

All the above

When discharging a patient wearing a cast, client education is essential and should include instructing the client to: observe areas of skin chafing from the cast check the cast daily for foul odor check the animals toes daily for warmth, discoloration, and swelling Keep the cast covered with plastic or other waterproof material when the animals is outside All the above

All the above

Which of the following is NOT a sign that the CO2 granules need to be changed? Hard, brittle granules that are purple in color More that 6-8 hours of use Greater than 30 days A CO2 level greater than 0 during peak inspiration as measured with a capnograph All the above are correct

All the above are correct

Which statement is false? All wounds are contaminated; however, a contaminated wound elicits no immune response from the host body A surgical wound is considered contaminated by microbes on the tissue and surrounding area Infection if the term used for a wound where microorganisms are invading tissue and therefore eliciting an immune response from the host body A wound is considered infected if the patient is presented for treatment more than 48 hours postinjury

All wounds are contaminated; however, a contaminated wound elicits no immune response from the host body

The patient

Always think about the comfort and welfare of the animal, they can be easily frightened by the machine and environment of the radiology room. use a slow quiet manner to minimize anxiety. So as much as you can before positioning your animal

Sandbags

Always use sandbags, tape, and boxes to position and hold animals for the radiograph People should not hold animals for a radiograph until all other possibilities have been explored If manual restraint is necessary, the technician should make sure they have taken all steps necessary to ensure their own as well as the patient's safety.

Collimation

Always use the smallest field size possible for the area of interest. Without collimation you increase scatter and decreases contrast This image shows lack of collimation.

A loss of sensitivity to pain. Analgesia Sedation Narcosis Hypnosis

Analgesia

Stages and Planes of Anesthesia DepthVeterinary Anesthesia & Analgesia, McKelvey & Hollingshead, Mosby

Anesthesia Stages 1.Disoriented 2.Excitement 3.Anesthesia Planes 1.Light: RR 12-20, HR>90 2.Medium: (Surgical Anesthesia) RR 12-16, HR>90 3.Deep: RR Shallow <12, HR 60-90, CRT+, Pulse- 4."Too Deep": HR<60, CRT>2sec, Hypopnea, Pale mm. 4.Moribund: Apnea

Stages and Planes of Anesthesia Depth

Anesthesia Stages: Stage 1 - Disoriented Stage 2 - Excitement Stage 3 - Anesthesia Planes Plane 1 - Light: RR 12-20, HR>90 Plane 2 - Medium: (Surgical Anesthesia) RR 12-16, HR>90 Plane 3 - Deep: RR Shallow <12, HR 60-90, CRT+, Plane 4 - "Too Deep": HR<60, CRT>2sec, Hypopnea, Pale mm. Stage 4 - Moribund: Apnea

During administration of dexmedetomidine, bradycardia is noted. When taking treatment options into consideration, the most appropriate is administration of: Acepromazine Atropine Antisedan Ketamine

Antisedan

High doses and rapid administration of propofol are known to cause: Diarrhea Heinz bodies Apnea Anorexia

Apnea

A large Rottweiler comes in with a fractured tibia at 6pm. Surgical repair is scheduled for 9am the following morning. The most appropriate way to manage the fractured leg overnight is to Apply Robert jones bandage Apply an ehmer sling Apply a valpeau sling Apply hobbles to the rear leg

Apply Robert jones bandage

When should an enema be given for a view of the abdomen? At least 1 hour before radiology at least 12 hours before radiology at least 10 minutes before radiology 24 hours before radiology

At least 1 hour before radiology

Effects including arrhythmias and tachycardia, thickening of secretions, bronchodilation, and mydriasis are most likely to be seen with the use of which drug? Acepromazine Antisedan Atropine Atipamezole

Atropine

Signs of discomfort by a patient receiving medications through an intravenous catheter are: abnormal and may indicate leakage of the drug out of the vein. abnormal and injection should be stopped immediately. B and C normal, as most intravenous medications are slightly irritating.

B and C

Early shock, marked slow CRT D. <5% dehydrated B. 10% dehydrated C. >12% dehydrated E. 5-6% dehydrated A. 6-8%

B. 10% dehydrated

Early shock, marked slow CRT A. 6-8% B. 10-12% dehydrated C. >12% dehydrated D. <5% dehydrated E. 5-6% dehydrated

B. 10-12% dehydrated

Shock, death is eminent A. 6-8% B. 10-12% dehydrated C. >12% dehydrated D. <5% dehydrated E. 5-6% dehydrated

B. 10-12% dehydrated

Shock, death is eminent C. >12% dehydrated E. 5-6% dehydrated B. 10-12% dehydrated D. <5% dehydrated A. 6-8%

B. 10-12% dehydrated

What level of consciousness (LOC) is a fully conscious, alert, and engaged patient that is interested in his/her environoment? B/A/R= Bright, alert, responsive Q/A/R= Quiet, alert, responsive Obtunded Comatose

B/A/R= Bright, alert, responsive

Administration of multiple drugs to the same patient during one anesthetic event Regional Anesthesia Balance Anesthesia Local Anesthesia Topical Anesthesia

Balance Anesthesia

Along with being minor tranquilizers, this drug class also provides good muscle relaxation: Dissociatives Barbiturates Opioids Benzodiazepines Alpha2-Agonists

Benzodiazepines

Which of the following groups of drugs, also referred to as minor tranquilizers, are commonly used for their sedative, muscle relaxant, and anticonvulsant properties? Alpha2-agonists Phenothiazines Opioids Benzodiazepines

Benzodiazepines

What is A

Body of radius

How do we calculate the O2 flow rate during the maintenance period for a rebreathing system? Body weight x 10-20 ml/#/min Body weight x 300-400ml/#/min Body weight x 100-600 ml/#/hr Body weight x 20-40 ml/#/hr

Body weight x 10-20 ml/#/min

Which of the following tissues is least sensitive to ionizing radiation? Lymphoid tissue Lens of the eye Skin Bone

Bone

Choose which of the following are used to evaluate the cardiovascular system: Choose all that apply. CRT Hydration Abdominal Palpation Pulse Pupillary Light Reflex

CRT PULSE

Measurement

Calipers are used to measure the animals and is usually done in centimeters; however, can be done in inches if technique is set up for that. Usually inches are used primarily in large animals Typically you measure over the thickest area however if a large difference in the thickness of the area of interest exists take 2 radiographs

Red rubber Useful in radiology contract studies Non sterile, accepts reg syringe tip Can leave in longer, flexable

Can leave in longer, flexable

These red rubber urinary catheters are Open-ended Close ended

Close ended

Wound is not able to be closed due to its large size. This results in secondary intention healing primary closure using sutures delayed primary closure Contraction and epilelialization secondary closure

Contraction and epilelialization

Landmarks

Cranial border of collimation (front edge of the light) should be 1/2 way bewteen the caudal border of the scapula and the xiphod process (roughly 2/3 way down the chest) Caudal border of collimations (back edge of the light) should be on the greater trochanter of the femur measure over the thickest part which is cranial abdomen

Oscillometric

Cuff size 30-50% of extremity circumference

The preferred method of urine collection for bacterial examination and/or culture is: Midstream voided catch Urethral catheterization- midstream Manual expression- midstream Cystocentesis

Cystocentesis

no evident physical signs, history of V/D A. 6-8% B. 10-12% dehydrated C. >12% dehydrated D. <5% dehydrated E. 5-6% dehydrated

D. <5% dehydrated

no evident physical signs, history of V/D A. 6-8% E. 5-6% dehydrated C. >12% dehydrated B. 10-12% dehydrated D. <5% dehydrated

D. <5% dehydrated

Which finding on a physical examination could put a patient at increased risk of anesthetic complications including hypotension, poor tissue perfusion, and kidney damage? Bruising lesions Anemia Dehydration Respiratory abnormalities

Dehydration

Which of the following is not a controlled substance? Diazepam Thiopental Ketamine Dexdomitor Butorphanol

Dexdomitor

Atipamezole is used to reverse the effects of which agent Ketamine Telazol Diazepam Propofol Dexmedetomidine

Dexmedetomidine

When evaluating the pupillary light reflex below, what can you determine: Direct and consensual reflex (normal) Consensual but no direct Direct but no consensual Normal Pupils

Direct but no consensual

What is B

Distal Phalanx

While all patients should be screened for a coagulation problem, which of the following breeds may be commonly affected? Golden Retriever Dachshund Doberman English bulldog

Doberman

What are your options when you run out of Kv stops when formulating your chart? Start over Double your mAs and decrease your KV by 10-15% Double only your mAs Decrease your KV by 10% only

Double your mAs and decrease your KV by 10-15%

A patient presents with vomiting. The technician must collect which of the four points to aid the doctor in diagnosing a problem? Duration, volume or severity, frequency, and appearance Duration, times of day, volume, and appearance Times of day, volume, appearance, and location Duration, severity, frequency, and location

Duration, volume or severity, frequency, and appearance

Which of the following is true? During expiration the diaphragm is more cranial than during inspiration During inspiration the diaphragm is more cranial than during expiration During expiration the diaphragm is more caudal than during inspiration Any view of the abdomen should be taken at inspiration

During expiration the diaphragm is more cranial than during inspiration

Slight signs of dehydration, still BAR A. 6-8% B. 10-12% dehydrated C. >12% dehydrated D. <5% dehydrated E. 5-6% dehydrated

E. 5-6% dehydrated

Slight signs of dehydration, still BAR C. >12% dehydrated A. 8% E. 5-6% dehydrated B. 10-12% dehydrated D. <5% dehydrated

E. 5-6% dehydrated

Heart Rhythm

ECG •Graphic reading of electrical potentials produced by heart muscle during the different phases of the cardiac cycle • Esophageal Stethoscope •Permits auscultation of the heart from a distance

In which of the following species is it acceptable to estimate weight based on the measurement of the girth and length of the animal prior to administering anesthesia? Feline Canine Equine Rodent

Equine

Which of the following inexpensive, simple, and reliable monitoring devices allows for auscultation of the heart from a distance when conventional auscultation is difficult? Stethoscope Electrocardiograph Esophageal stethoscope Ultrasound

Esophageal stethoscope

Evaluate Film technique

Evaluate the exposure technique by the following parameters: Density- the degree of blackness Contrast- density difference between two areas of a finished radiograph If technique modifications are required follow the following rules: Too dark- over penetration: --observe contrast between bone and surrounding soft tissue. --if bone is gray without much contrast- lower the kVp by 10-15% -- If bone is white compared with surrounding soft tissue- Lower the mAs by 30-50% Too Light -Adequate penetration- silhouettes of internal organs are visible. Increase the mAs 30-50% -Inadequate penetration- outline of abdominal structures not visible. Increase the kVp by 15%

Post administration of alfaxalone, it is important to monitor the patient for: Excitement during recovery hypertension muscle rigidity Excitement during induction

Excitement during recovery

A laceration in a healthy, robust animal will heal at the same rate as one in a sick, old, or debilitated animal True False

False

A person in the radiology suite wearing lead goggles, thyroid shield, apron, gloves and a dosimeter is as safe as a person outside the radiology suite. True False

False

Activated charcoal cartridges need to be replaced after 12 hours of use OR after a weight gain of 25 grams. True False

False

For heavily contaminated wounds treated more that 12 hours after injury immediate surgical closure is critical to achieving adequate healing True False

False

In normal healthy animals, total body water is equivalent to 40% body weight. True False

False

It is acceptable to re-direct the needle a few times if urine is not immediately abtained during cystocentesis True False

False

It is easier to see radiographic density in tissues that are similar in thickness and mass. True False

False

T/F In the United states, the Controlled Substances Act (CSA) is enforced by the AVMA

False

T/F Intubation is more difficult in brachycephalic breeds due to laryngospasm,

False

T/F Most anesthetics are analgensics

False

T/F Triangular and rectangular foam blocks are commonly used positioning aids and it is 100% radiolucent even it is covered with some protective material.

False

The best way to check your safety equipment is to radiograph them to check for leaks in the lead. Leaks would show as white area on the film. True False

False

The lateral positioning image is labeled (either R or L) according to the side the beam is entered. True False

False

The veterinary technicians role during the pre-anesthetic period is to diagnose and develop a treatment plan. True False

False

True or false? Anesthesia is not required when performing skull radiographs.

False

True or false? If your hand is outside the primary beam, you do not need to wear leaded gloves.

False

True or false? The right side of the pelvis on the ventrodorsal view is narrower than the left

False

X-rays only travel downward in a straight line. True False

False

an indwelling urinary catheter should stay in place for at least 72 hours true false

False

In the Classification of Patient Physical Status, how many Classes of Risk are there? Five Ten Twelve Three

Five

Which of the following devices reduces the pressure of the gas from about 50 to 15 psi, the optimal pressure for entry into the breathing circuit? Pressure reducing valve Flowmeter Line pressure gauge Vaporizer

Flowmeter

What is this item (catheter)

Foley urinary catheter

Maintenance

General anesthesia is maintained with inhalant agent delivered using anesthesia machine. Isoflurane - maintained at 1.5% to 2.5% Sevoflurane - maintained at 2.5% to 4.0%

The veterinarian has ordered 0.9% NaCl given SC to a 5 kg cat. Using the standard maintenance dose (50ml/kg/day)for fluids. What would be the best way to deliver this fluid order? Give 250 ml in one location once daily Give 125 ml every 12 hours SC in divided sites as needed. Give 250 ml every 12 hours SC in divided sites as needed. Give 50 ml SC.

Give 125 ml every 12 hours SC in divided sites as needed.

What is C

Glenoid Cavity

What is B

Greater tubercle of humerus

What is D

Humerus

Drug-induced sleeplike state from which the patient can be aroused with sufficient stimulation. Analgesia Sedation Narcosis Hypnosis

Hypnosis

Which lead of the standard ECG machine is most commonly used by itself to evaluate heart rhythm I II aVR avL

II

The correct route of administration for drugs that are given "to effect" is: IM PO SQ IV

IV

What statement about bandages are true? A dry-dry bandage has as its primary layer an adherent material soaked in saline An occlusive tape tertiary layer allows to penetrate the wound The tertiary bandage layer contacts the wound surface and may be adherent or non-adherent and occlusive or semi-occlusive If a wound is exudative, a semi-occlusive primary layer is indicated

If a wound is exudative, a semi-occlusive primary layer is indicated

Concerning subcutaneous administration of fluids and medications, which statement is most accurate? Aspiration to check for needle placement into a vein is not necessary before administering agents subcutaneously. All of the above If multiple vaccinations or medications are to be administered, space injection sites several centimeters apart SC injections should only be administered between the shoulder blades.

If multiple vaccinations or medications are to be administered, space injection sites several centimeters apart

how soon after ab injury does the wound healing begin Immediately 30 min 2-4 hour 6-8 hour 10-12 hour

Immediately

When out technique chart starts using 5:1 grid, what should we do to our mAs when using this grid? Increase by 2x Decrease by 2x Increase by 4x Increase by 3x

Increase by 2x

If a radiograph is too light after taking a view of the lateral abdomen, what change may be recommended? decrease kVp by 10% to 15% Increase mAs 30% to 50% increase the kVp by 30% to 50% decrease the mAs by 30%-50%

Increase mAs 30% to 50%

Abnormal Sinus

Irregular sinus rhythm, alternating periods of slower and more rapid heart beat related to respiration Increasing with inspiration Decreasing with expiration

Which of the following is believed to be the least toxic inhalation agent? Sevoflurane Isoflurane Methoxyflurane Halothane

Isoflurane

What is the most appropriate wound flushing solution Hydrogen peroxide Isotonic saline Providone iodine solution Tap water

Isotonic saline

Concerning urinary catheterization, which statement is least accurate? Mucosal damage in the urethra and bladder can occur with any type of catheter It is not necessary to maintain a closed system of urine collection because ascending infection is prevented by continued urine outflow The distance from the tip of the penis or vulva to the bladder neck should be measured before selecting or placing a catheter Most dogs require only physical restraint for catheterization, whereas most cats require sedation or anesthesia

It is not necessary to maintain a closed system of urine collection because ascending infection is prevented by continued urine outflow

The easiest vein from which to draw 10 ml of blood from an 11 kg dog is the: Cephalic vein Jugular vein Lateral saphenous vein Marginal ear vein

Jugular vein

Thoughtful IV catheter placement would dictate that a _________________________ catheter would best be placed in a patient with severe vomiting. Lateral saphenous Jugular Cephalic

Lateral saphenous

In addition to the lateral and dorsoventral view, what two views are recommended to assess the tympanic bulla? Open mouth oblique and ventrodorsal view Left and right lateral oblique views and open mouth rostrocaudal view Rostrocaudal skyline view and open mouth ventrodorsal view Left and right lateral views

Left and right lateral oblique views and open mouth rostrocaudal view

A canine patient is being held in right lateral recumbency for venipuncture. which of the following veins are most accessible? Left lateral saphenous right lateral saphenous left medial saphenous right jugular

Left lateral saphenous

Loss of sensation in a small area of the body produced by administration of a local anesthetic agent in proximity to the area of interest. Regional Anesthesia Balance Anesthesia Local Anesthesia Topical Anesthesia

Local Anesthesia

The act of forced delivery of oxygen and anesthetic gases by squeezing the reservoir bag is: Spontaneous ventilation Mechanical ventilation Controlled ventilation Manual ventilation

Manual ventilation

Drug-induce sleep from which the patient is not easily aroused. Analgesia Sedation Narcosis Hypnosis

Narcosis

Both sand and beans (polyester beads) are radiolucent. Therefore sandbags and bean bags do not interfere with the image even it is in the field of interest. True, both sands and polyester beads are radiolucent Only sandbags are radiolucent Only bean bags made with polyester beads are radiolucent Neither should be in the field interest (both sands and polyester beads are radiopaque).

Neither should be in the field interest (both sands and polyester beads are radiopaque).

Polyethylene Useful in radiology contract studies Non sterile, accepts reg syringe tip Can leave in longer, flexable

Non sterile, accepts reg syringe tip

Normal Sinus

Normal rhythm of the heart 60-150 bpm dog 120-180 bpm cat

Place the anethesia machine parts below in the order that an O2 molecule would flow through the machine. Fresh Gas Inlet O2 Tank Vaporizer O2 Pressure Gauge O2 Flowmeter O2 Pressure Reduction Valve

O2 Tank O2 Pressure Gauge O2 Pressure Reduction Valve O2 Flowmeter Vaporizer Fresh Gas Inlet

What is B

Olecranon

What is B

Olecranon (ulna)

In addition to the lateral and dorsoventral view, choose two views that are recommended to assess the nasal cavity. Open mouth ventrodorsal view and skyline rostrocaudal view Open mouth obliqued view and skyline rostrocaudal view Skyline rostrocaudal view and open mouth rostrocaudal view

Open mouth ventrodorsal view and skyline rostrocaudal view

Radiation Safety Principal #1: Distance

Our first method of reducing the radiation exposure we receive is by keeping our distance The goal is to put as much distance between you and primary x-ray beam as possible. Get out of the room is the best way to accomplish this. If the animal is anesthetized there is no reason to be in the room. if the animal is awake, restraint and positional devices should be used to help everyone in the room move away from the primary bean as much as possible. At the very least, anyone performing physical restraint on an animal should extend their arms fully to increase the distance between them and the x-ray beam as much as possible

You have an adult cat that presents for a dental cleaning. On your routine diagnostics TP = 6. PCV=15%. Which of the following are true? PCV is low, TP is normal PCV and TP are normal PCV is normal, TP is low PCV and TP are low

PCV is low, TP is normal

DV

Patient is laying on its abdomen

VD

Patient is laying on its back

Select the reasons why proper radiographic positioning is important? Pattern recognition Visualization of desired anatomy Symmetry

Pattern recognition Visualization of desired anatomy Symmetry

Too Dark

Penetration evaluation of a radiograph that is too dark Anytime your film is too dark some factor needs to be decreased if bone and tissue contrast is gray you have to much penetration and you should lower the kVp, if bone is white and tissue is black you would decrease the mAs

Too Light

Penetration evaluation of a radiograph that is too light adequate penetration is when you can see the edges of the anatomy if you decide penetration is adequate increase the mAs by 30-50%, if penetration is inadequate increase the kVp by 10-14%

The three classes of tranquilizers and sedatives that are often used in veterinary medicine include: Phenothiazines, benzodiazepines, and alfaxalone agonists Phenothiazines, barbiturates, and alpha2-adrenoceptor agonists Phenothiazines, benzodiazepines, and alpha2-adrenoceptor agonists Phenothiazines, barbiturates, and alfaxalone agonists

Phenothiazines, benzodiazepines, and alpha2-adrenoceptor agonists

The Pop Off Valve: Keeps the unidirectional valves from popping off Prevents excess gas from building up in the breathing circuit so pressure never exceeds 15 cm H2O Prevents waste gases from re-entering the vaporizer Prevents the CO2 absorber from turning blue

Prevents excess gas from building up in the breathing circuit so pressure never exceeds 15 cm H2O

Which of the following choices characterizes the skin turgor in a dehydrated dog or cat? Prolonged Normal Shortened Skin turgor test is not a reliable indicator of hydration

Prolonged

what is C

Proximal Phalanx

Which of the following breeds of dog is more difficult to intubate and demands close supervision to ensure a patent airway before, during, and after any anesthetic procedure? Golden Retriever Greyhound Beagle Pug

Pug

What is A

Radius

What is a common problem that occurs when performing thoracic radiographs on anesthetized patients? Excess gridlines Under exposure Recumbent atelectasis Excessive anesthesia exposure to personnel Excessive radiation exposure

Recumbent atelectasis

Which urinary catheter is most appropriate for long-term placement Red rubber Tom cat polypropylene Polypropylene

Red rubber

Loss of sensation in a limited area of the body produced by administration of a local anesthetic or other agent in the proximity of sensory nerves. Regional Anesthesia Balance Anesthesia Local Anesthesia Topical Anesthesia

Regional Anesthesia

Which films (views) are taken in a "routine" study of the abdomen? Right lateral and left lateral Right lateral and VD Cranial abdomen and VD Left abdomen and caudal abdomen

Right lateral and VD

What is the most common issue associated with cervical spinal radiographs? Double exposure Over exposure Sagging artifact Being bitten by the patient

Sagging artifact

What is A

Scapular Spine

Protective equipment protects you from: Primary beam so your body is protected from radiation Both primary beam and scatter radiation Scatter radiation and none of your body part should be in the primary beam

Scatter radiation and none of your body part should be in the primary beam

Drug-induced CNS depression in which a patient is minimally aware or unaware of it surroundings but can be aroused by noxious stimulation. Analgesia Sedation Narcosis Hypnosis

Sedation

Radiation Safety Principal #2: Time

Short exposure time Fewest retakes possible -is the machine set properly -is the film in place -is the marker on the film -are you centered over the are you want to radiograph -any other item you may find you forget to do that is a detriment to the radiograph can also be added to this list important to make sure the film is not lost to developing or handling errors such as bad chemicals, improper labeling or improper filing

Which arrhythmia is also normal in the dog? Second degree AV block Sinus arrhythmia First degree AV block Atrial fibrillation

Sinus arrhythmia

What are the two main electrolytes found primarily in the extracellular space? Sodium and chloride Sodium and potassium Potassium and magnesium Chloride and potassium

Sodium and chloride

What stage and plane of anesthesia would you like the patient to be maintained in when performing an ovariohysterectomy? Stage II plane 3 Stage III plane 1 Stage IV plane 2 Stage III plane 2

Stage III plane 2

Optimum Depth for SX

Stage III, Plane II (Medium Surgical Anesthesia) §Patient does not move §Patient is not aware §Patient does not feel pain §Patient has no memory of the procedure afterward §There is no dangerous depression of the cardiovascular and respiratory systems

How do you maintain IV catheter and fluid line sterility when taking your patient for a walk? take bag of fluids with you on walk hang fluid line up and clamp off IV catheter just disconnect IV catheter from line and go for walk Stop fluid pump, disconnect fluid line and cap; clamp IV catheter line and cap

Stop fluid pump, disconnect fluid line and cap; clamp IV catheter line and cap

Which device is used to maintain an open airway in an anesthetized patient by connecting with the opening of the epiglottis without invading the tracheal lumen? Laryngoscope Supraglottic airway device (SAD) Anesthetic mask Induction chamber

Supraglottic airway device (SAD)

An anesthetic with eyes in the ventromedial position and no jaw tone is considered to be at which anesthetic level? Ventromedial eye position happens in all levels of anesthesia Too light Too deep Surgical

Surgical

A parvo puppy is admitted to the hospital at 8 AM. He weighs 15 kg. The fluids orders are double maintenance. When his owners pick him up at 6 PM - he would have received 625 ml of fluids. True False

TRUE

What is the advantage of taking a ventrodorsal view of the thorax as opposed to a dorsoventral view? The VD view allows better visualization of the caudal mediatinum and accessory lung The VD allows better visualization of the heart The VD view is more comfortable for a patient in respiratory distress all of the above

The VD view allows better visualization of the caudal mediatinum and accessory lung

An anesthetic patient is swallowing and has an elevated heart rate. This is indicative of: The anesthetic level being too deep The anesthetic level being too light That patient being at a surgical stage of anesthesia A normal reaction to anesthesia

The anesthetic level being too light

The most common place for a leak to occur during anethesia is: In the endotracheal cuff The bag The O2 tank The vaporizer The modulator

The bag

Flutter Valves help to control: Fluttering, so the machine won't flutter when started The direction of the flow of gas in the breathing circuit The hypendophenator The temperature of the gas

The direction of the flow of gas in the breathing circuit

Left lateral recumbency

The patient is laying on its left side down

Right lateral recumbency

The patient is laying on its right side down

What is the purpose of the balloon (3cc in this catheter !) in this catheter? To retain the catheter in the bladder To move aside cystic calculi in the urethra To help guide the catheter in more smoothly For use when sterility is needed

To retain the catheter in the bladder

The Negative Pressure Relief Valve is helpful when: There is failure of O2 to flow thru the machine The manometer reads > 75 psi The POV is closed all the way The Vaporizer is at 5 %

There is failure of O2 to flow thru the machine

Which of the descriptions below best explains how this urinary catheter would be used? This urethral catheter is used for a difficult placement in a male dog. This urethral catheter is a good choice for an indwelling catheter that requires no suturing. This catheter is best used for unblocking an obstruction in a dog.

This catheter is best used for unblocking an obstruction in a dog.

Film #1

This film #1 looks too white and is considered as "too light" - underexposed Next step is to evaluate if there is enough/proper penetration or not. The outline of the abdominal organs are visible in this view and there is not area which is completely white. Therefore we evaluate the penetration of this film as "adequate". You will need to increase mAs by 30-50% for a better exposure.

How can the collimator light be helpful other than seeing the region exposed? To assess for unwanted superimposition To evaluate the amount of scatter radiation To illuminate the region of interest To read your favorite magazine

To assess for unwanted superimposition

What is the main purpose of the pre-anesthetic period. To have an extra charge for the client. To see if the client was paying attention during the drop-off procedure. To assess the risk of anesthesia for the patient, and to insure maximum safety for the patient. To make sure the pet has had a Bowel movement and urinated prior to surgery.

To assess the risk of anesthesia for the patient, and to insure maximum safety for the patient.

When radiographing a joint why is it important to center the primary beam on the joint? To decrease scatter radiation To decrease exposure To maximize joint space and minimize false narrowing To minimize the joint space and maximize false narrowing

To maximize joint space and minimize false narrowing

Loss of sensation of a localized area produced by administration of a local anesthetic directly to a body surface or to a surgical or traumatic wound. Regional Anesthesia Balance Anesthesia Local Anesthesia Topical Anesthesia

Topical Anesthesia

Cranial toward lower aspect of animal farther away from the point of origin Toward upper aspect of animal toward the head from any given point toward the tail from any given point forelimb from carpal joint distally (caudal side)

Toward upper aspect of animal

dorsal toward the nares from any given point on the head toward lower aspect of animal farther away from the point of origin Toward upper aspect of animal toward the head from any given point hind limb from tarsal joint distally (causal side) toward the tail from any given point Nearer to the point of origin x-ray enters through medial side and exits through lateral side of a limb forelimb from carpal joint distally (caudal side)

Toward upper aspect of animal

A parvo puppy is admitted to the hospital at 8 AM. He weighs 34 pounds. The fluids orders are double maintenance. When his owners pick him up at 6 PM - he would have received 640 ml of fluids. True False

True

Collimation for a dorsopalmar paw radiograph includes the tip of the phalanges to 1 inch of the radius and ulna. True False

True

Collimation for an AP (dorsopalmar)paw you should include from the tip of the phalanges to 1 inch of the radius and ulna. True False

True

T/F Instruments cannot replace a skilled and conscientious anesthetist.

True

T/F Stage 2 is characterized by excitement

True

T/F Stage 3 of anesthesia is subdivided into three planes: light, medium (surgical), and Deep

True

T/F The most appropriate route of administration for alpha2-adrenoceptor agonists is Intramuscular (IM) or intravenous (IV)

True

T/F The most common cardiac changes associated with administration of dissociative anesthetics are increased heart rate and output.

True

T/F intubating too far can cause only one lung to oxygenate because the ETT enters one of the main stem bronchi.

True

The best way to avoid scatter radiation is by putting distance between you and the primary beam. True False

True

The urethral opening on the female dog is located on the ventral surface of the vagina, about 1 and ½ "-2" inches from the opening of the vulva True False

True

When catheterizing a male cat, the penis is extruded and pulled parallel to the vertebral column True False

True

When positioning an animal using a v-trough for an abdominal radiograph, the abdomen should be completely in the trough or completely out of the trough. True False

True

You can reduce your exposure to radiation by increasing your distance from the primary beam. True False

True

Required views

Two views at right angles to each other. The are of interest should be closest to the cassette as to avoid geometric distortion in that area When radiographing limbs the good limb may also be radiographed for comparison however not on the same film The film can be split to do this or separate cassettes could be used

What is an orthogonal view? A skyline view A lateral view Comparison view of two limbs Two views of the same region performed at right angles to each other A nice view of the ocean

Two views of the same region performed at right angles to each other

Insulin Syringes should match the correct insulin being administered, and are supplied in the following units: (choose all that apply) U-80 U-40 4U U-100

U-40 U-100

Barbiturates

Used to induce anesthesia- seldom anymore Egs: Thiopental, Methoxital, Pentobarbital Vary greatly in terms of speed of onset, duration, distribution, etc.

Foley Useful in radiology contract studies Non sterile, accepts reg syringe tip Can leave in longer, flexable

Useful in radiology contract studies

FILM #3

Was taken with the same kVp as film #1 and #2. Film #1 was taken with 2.5 mAs (300 mA with 1/120 sec) and Film #2 was taken with 10 mAs (300 mA with 1/30 sec). An mAs was adjusted to 5 (300 mA with 1/60)- 50% decrease from film #3 In this view you will be able to evaluate the entire liver, spleen, and bladder better compared to #2 film (entire liver is visible on the viewer- digital image makes it hard to see)

Proper splint and bandage care includes all of the following except Washing the splint or bandage daily Preventing the bandage from becoming wet Inspecting the bandage daily for any change such as swelling above or below Inspecting the bandage or splint for any shifting or change in position on the limb

Washing the splint or bandage daily

The term WAG refers to: Waste analgesia gas Waste anesthetic gas Waste agents and gas Water agents and gas

Waste anesthetic gas

Apart from obvious complications, an outpatient wearing a cast should generally be rechecked at least: every other day Weekly 2 weeks 4 weeks

Weekly

When might the lateral saphenous be preferred to the cephalic vein for canine venipuncture? When a large amount of blood is needed. When an animal is especially sensitive to pain. When a dog is very aggressive. All of the above

When a dog is very aggressive.

When is a lateral horizontal beam view of the thorax indicated? When fluid or free air is suspected in the abdomen When the patient cannot be properly positioned in lateral recumbency on the table When fluid or free air is suspected in the thorax when spinal cord injury is suspected

When fluid or free air is suspected in the thorax

Radiation Safety Principal #3: Shielding

When getting out of the room is not possible, it is still our responsibility to ourselves to be as safe as we can be. Lead lined items to help cover our most susceptible body parts are a necessity and a requirement by law. Lead blocks radiation and therefore does not allow it to pass through into our bodies Gowns- the standard for most state requirements is a lead gown of 0.5mm lead equivalent. No exceptions to this rule Gloves- worn at all times while in the radiology room during exposure. Worn on the hands not over the hands. Since scatter radiation can be coming from any direction, lead mitts that have finger holes but not lead protection on the palm said of the hand are not safe Thyroid Shield- highly recommended. They are a strip of leaded material which Velcro around your neck thus covering the thyroid gland. The Thyroid gland is one of the tissues of the body most susceptible to radiation damage. Lead glasses- contrary to popular belief, squinting your eyes and turning your head offer little to no protection in most cases. Lead glasses help block radiation to the eyes when facing the x-ray beam during the exposure interval. Glasses and thyroid shields should be worn whenever possible and are two radiation devices that are greatly underutilized in veterinary medicine. None of these items are made to withstand a full direct hit from the primary x-ray beam. Keep all body parts out of the primary x-ray beam even if covered by radiation shielding devices. Always face the source of radiation exposure during the exposure and make sure all your body parts are outside of the primary beam even if they are covered by lead.

When blood flows into the syringe when cystocentesis is attempted Continue filling the syringe with as much sample as is desired Re position the needle without withdrawing it and aspirate Withdraw the needle immediately and try again with a clean needle and syringe.

Withdraw the needle immediately and try again with a clean needle and syringe.

You are drawing blood from a cat's medial saphenous vein using a 23 gauge needle on a 3 ml syringe. The blood begins to fill the syringe then stops flowing. One likely cause of this problem is: The needle is too large. The syringe is too large. The needle is too small. You have applied too much suction, causing the vein to collapse.

You have applied too much suction, causing the vein to collapse.

Intubating the pet: secures airway decreases risk of aspiration decreases risk of waste gas exposure provides oxygen support all the above

all the above

Small animal thorax

all views of the thorax should be taken at the peak of inspiration this will show fully expanded lung field, pulling the diaphragm away from the heart in its caudal-most position

Choose the best response. How does radiographic density affect radiographic quality? allows a range of blackness related to the rate at which x-rays are absorbed influences the beam angle in relation to the subject matter causes high contrast between tissue types reduces flim fog

allows a range of blackness related to the rate at which x-rays are absorbed

Yohimbine, tolazoline, and atipamezole are best categorized as: Opioid agonists opioid antagonists alpha2-agonists alpha2-antagonists

alpha2-antagonists

Radiology goal/responsibility

animals to be restrained properly by mechanical or chemical means in order to allow the technician student to leave the room during the radiation exposure. In this way the danger to the student is minimalized responsible to make sure no one is in danger of being exposed to radiation when the radiograph is being taken

Thoracic films should be measured: over the last rib over the thickest part caudal border of the scapula any of the above

any of the above

An antagonist: binds to and stimulates receptors binds to but does not stimulate receptors binds to and partially stimulates receptors binds to more than one receptor and simultaneously stimulates at least one and blocks at least one

binds to but does not stimulate receptors

Identify the organ labeled B Kidney bladder stomach liver

bladder

Identify the organ labeled D liver stomach right kidney left kidney bowel loops

bowel loops

It is best practice to remove air bubbles from a syringe containing medication because: Pick all that apply. you will not know if you are in the vein or not when administering the medication. by displacing medication you are causing dosage inaccuracy. you are wasting medication. it can cause an air embolism.

by displacing medication you are causing dosage inaccuracy. it can cause an air embolism.

In regard to the control of WAGs, a scavenging system: reduces the escape of waste anesthetic gas by leak testing. leads to less waste pollution by the control of flow rate carrier gas controls the waste gas concentration by anesthetic time. captures waste anesthetic gases by attaching to a machine and discharging them outside the clinic.

captures waste anesthetic gases by attaching to a machine and discharging them outside the clinic.

What does the presence of subcutaneous fluid around an IV catheter site indicate? catheter site infection catheter leakage normal insertion site catheter occlusion

catheter leakage

The positional term used to describe the part of the pelvis limb found toward the tail and proximal to the hock is: caudal plantar rostral palmar

caudal

Thorax landmarks

center the vertical part of the cross-hatch to the caudal edge of the scapula open the collimator light until the light is on the cranial border of the scapula (or manubrium, thoracic inlet, 1st rib) The back edge of the collimator light should be on or just cranial to the last rib (to ensure the inclusion of the diaphragm) Measure over the thickest part (caudal thorax)

kVp mainly controls the radiograph's ______________________. contrast contrast and density density scatter collimation

contrast and density

Tube Voltage

controls the "quality" or penetrating ability of the radiation

Tube Current (mA)

controls the amount of intensity of radiation

kVp

controls the penetrating power of the x-rays High kVp = long scale of contrast (many shades of gray) or labeled low contrast. Good for soft tissue examinations. Low kVp = short scale of contrast (blacks and whites) or high contrast. Good for bone studies

Alarms on infusion pumps will alert the technician to all of the following except? air in the line occlusion somewhere from the bag to the catheter correct flow rate for the particular patient fluid has run out

correct flow rate for the particular patient

Alarms on infusion pumps will alert the technician to all of the following except? correct flow rate for the particular patient air in the line occlusion somewhere from the bag to the catheter fluid has run out

correct flow rate for the particular patient

When you decrease SID you _____________________ image sharpness. decrease increase do not affect

decrease

Wound is moderately contaminated but requires closing before 3-5 days for optimal results. primary closure using sutures delayed primary closure Contraction and epilelialization secondary closure

delayed primary closure

radiographic contrast

differences between the appearances of adjacent tissue on a radiograph

subject contrast

differences in thickness and mass of adjacent anatomical structures

Where should the measurement for the radius/ulna in craniocaudal view be taken? distal humerus distal radius proximal radius elbow joint

distal humerus

The IV catheter is placed as __________________ as possible on the leg. distally proximally

distally

U and V shaped troughs are useful to position patient for: lateral recumbency positioning dorsal recumbency ventral recumbency

dorsal recumbency

Should abdominal films be taken on inspiration or expiration? inspiration expiration

expiration

Swelling proximal to the IV catheter usually means: extravascular infiltration infection tight bandage sensitivity to tape

extravascular infiltration

A laceration in a healthy robust animal will heal at the same rate as one in a sick, old or debilitated animal. true false

false

An AP view (dorsopalmar view) means you have taken a shot from the rear of the animal's leg to the front of the leg. True False

false

For heavily contaminated wounds treated more than 12 hours after injury, immediate surgical closure is critical to achieving adequate healing. true false

false

Placing an indwelling catheter is not concerdered a sterile procedure true false

false

Radiographs of the abdomen are taken on inspiration to avoid motion. True False

false

T/F Your lateral abdomen radiograph should include from the last rib to the greater trochanter.

false

T/F The lateral positioning image is labeled (either R or L) according to the side the beam is entered.

false

T/F Thoracic films are taken at expiration to limit motion

false

a non-adherent primary layer is used for nonselective debridement? true false

false

Distal

farther away from the point of origin

When setting up an IV fluid line to be used without an infusion pump, the drip chamber should be: filled completely to the top filled to the halfway line on the chamber left empty allowed to fill by gravity

filled to the halfway line on the chamber

Palmar toward lower aspect of animal hind limb from tarsal joint distally (causal side) toward the tail from any given point Nearer to the point of origin x-ray enters through medial side and exits through lateral side of a limb forelimb from carpal joint distally (caudal side)

forelimb from carpal joint distally (caudal side)

a primary closure using sutures

fresh, clean wound with very little contamination or trauma

When radiographing a dorsopalmar view of an animal limb, the primary beam enters the ____________ of the paw and exits through the _____________. cranial aspect; caudal aspect front ; back back ; front lateral aspect ; medial aspect

front ; back

Thorax anatomy

heart spine trachea vena cava sternum lungs aorta **note that a normal esophagus CANNOT be seen on a radiograph

What may help to achieve a long scale of contrast for an abdominal view? low kVp and high mAs high kVp and high mAs high kVp and low mAs contrast media

high kVp and low mAs

Is the percentage of body weight represented by water higher or lower in neonates than in adults? higher lower

higher

How soon after injury is wound healing initiated? 10-12 hours 6-8 hours 2-4 hours 30 minutes immediately

immediately

what will interfere with the normal healing of a surgical wound

inadequate blood supply to the incision

which of the following will have the greatest impact on normal healing of a surgical wound? inadequate blood supply to the incision use of a sharp blade for incision no movement of the skin margins after closure bacterial contamination and infection of the incision exact alignment of incision margins during closure

inadequate blood supply to the incision

When radiographing long bones it is important to: include as much of the abdomen as possible include the joints proximal and the joint distal measure over the thinnest area for the kilovoltage peak including the long bones only not the joints

include the joints proximal and the joints distal

X-Ray Production (Tube Voltage)

increase electron velocity -> decrease minimum wavelength -> increase radiation intensity -> decrease filament temperature -> decrease supply of electronics -> increase radiation intensity

X-Ray Production (Tube Currant)

increase filament temperature -> increase supply of electronics -> increase radiation intensity -> decrease filament temperature -> decrease supply of electrons -> increase radiation intensity

Total protein levels are ________________________ in a dehydrated patient. unaffected decreased increased variable

increased

Which of the following increases radiographic density? thicker body parts increased mAs increased density of the body part being radiographed decreased kVp

increased mAs

The above fluid total is pretty high. What signs do you need to watch for in volume overload? vomiting and diarrhea oliguria and anuria decreased HR and respiration increased respiration and nasal discharge

increased respiration and nasal discharge

A higher kVp setting affects scatter radiation in what way? increases scatter decreases scatter does not affect scatter directly increases scatter above the table only

increases scatter

Evaluating of the radiographic technique

is the film too dark or too light? Overexposed is too dark and underexposed is too light, if too light the options are to increase kVp or mAs, if too dark the options are to decrease kVp or mAs. To decide which change to make you need to assess the penetration of your film. Remember penetration refers to the kVp setting. If penetration is adequate then change the mAs, if penetration is not adequate then change the kVp.

What is the most appropriate wound flushing solution? tap water providone iodine solution hydrogen peroxide isotonic saline

isotonic saline

The effects of Kilo Volts

kV's increased -electron flow increases -wave length shortens -increase in penetration -reduction in contrast kV's decreased -Electron Flow reduces -wave length increases -reduction in penetration -increase in contrast

Vaccum

lack of molecules allow electrons to travel across the x-ray tube unencumbered

kV Controls

large amount of electricity (kilovoltage) makes anode more positive draws electrons across vacuum in tube

In general, when compared to the IV dose, the dose of the induction drug for IM use is: smaller equal larger given 1/2 IM and 1/2 IV

larger

In general, when performing a venipuncture, use the _________ needle possible for the vein chosen and direct the bevel __________. smallest downward smallest, upward largest, upward largest downward

largest, upward

Lateral abdomen

lay animao on its right right tape and pull front legs cranial and rear legs caudal place a sponge under the sternum to make the animal truly lateral

Lateral Thorax

lay the animal on its right side tape and pull the front legs forward tape and pull the rear legs back place a sponge under the elbows and abdomen to make truly lateral

X-rays can not penetrate: bone interior walls of most animal hospitals lead b and c

lead

Identify the organ labeled C liver stomach left kidney right kidney bowel loops

left kidney

Identify the organ labeled A liver stomach right kidney left kidney bowel loops

liver

Anatomy

liver diaphragm kidneys small intestine Stomach spleen urinary bladder colon **note** that the normal pancreas, gall bladder, and uterus cannot be seen on a radiograph

Film #2

looks a little too dark- overexposed. Lower part of abdomen (edges of liver, spleen and bladder are hard to see in this film) Next step is to evaluate penetration (kVp). is there too much penetration power of the x-rays? you need to check the contrast of the image in the film to evaluate over penetrated film. Although this film looks darker, it does not give an impression of "gray radiographs" like film #4 There is decent contrast exist between bone (spine) and soft tissue (abdomen) since the spine is relatively white compared to the soft tissue, we will alter mAs instead of kVp. We will try to decrease mAs by 30-50%

Film #4

looks too dark- overexposed. Extremities film which does not involve soft tissue is little hard to evaluate because you will not be able to evaluate "contrast" as easy as abdominal x-ray which shows both soft tissue and bone. The bone is very gray in this film so there is little too much penetration in this film

A higher kVp setting allows for a __________mAs and ______________exposure time. higher, lower lower, higher lower, lower higher, higher

lower, lower

Filament

mA heats it up using electricity; electrons leave the atoms on the filament creating an electron cloud

the layers of a wound bandage are: non-adherent primary, secondary, and then tertiary layer Primary layer, tertiary layer, and then secondary layer tertiary layer, primary dry-to-dry and then 3rd layer or final bandage adherent primary layer, tertiary layer, and the outer layer

non-adherent primary, secondary, and then tertiary layer

The layers of a wound bandage are: nonadherent primary, secondary, and then outside layer or tertiary layer. adherent primary layer, tertiary layer, and the outer layer. primary layer, tertiary layer, and then secondary layer tertiary layer, primary dry-to-dry layer and then 3rd layer or final bandage

nonadherent primary, secondary, and then outside layer or tertiary layer.

The most common heart rhythm in healthy dogs and cats is: sinus arrhythmia normal sinus rhythm first degree block second degree block

normal sinus rhythm

When should a dorsal ventral view of the thorax be taken? One at peak of inspiration and one at peak of expiration one at peak of inspiration one at peak of expiration one at peak of inspiration and one any time during expiration

one at peak of inspiration

When collecting information from a client regarding a patient's history, it is best to ask: simple, direct questions. questions that can be answered with yes or no. leading questions. open-ended questions.

open-ended questions.

If a film is too dark would it be considered: overexposed underexposed underdeveloped none of the above

overexposed

The minimum database consists of the following: patient history and signalment, patient's name, complete physical examination findings, and the results of the preanesthetic diagnostic workups. patient history and signalment, owner's income, and complete physical examination findings. patient history and signalment, complete physical examination findings, and results of the preanesthetic diagnostic workups. patient name, gender, and complete physical examination findings.

patient history and signalment, complete physical examination findings, and results of the preanesthetic diagnostic workups.

What should be done to eliminate the animal tilting toward the table on a lateral abdominal radiograph? Choose the best answer. pull rear legs caudally and tape pull front legs cranially and tape place a foam wedge under the sternum and sponge between femurs sandbags over the pelvis

place a foam wedge under the sternum and sponge between femurs

Ventral Dorsal Thorax

place animal on its back in a position box make sure all of the thorax is inside of the box pull and tape front leg cranial put animals nose between the front legs pull and tape rear legs caudal put sternum directly over the spine for a true VD

Ventral dorsal abdomen

place animal on its back in positioning box make sure abdomen is all the way in the box pull front legs cranial and rear legs caudal, tape both Place animals nose between front legs put sternum directly over spine for a true VD

Poor Processing

poor radiographic quality with film imaging is many times caused by improper darkroom technique or poor quality chemicals. Automatic processors provide a consistent processing procedure, fast film through out and maintain proper chemical concentration however; processors must be used on a regular basis to ensure proper performance Many low volume veterinary clinics do not perform an adequate volume of radiographs to warrant the investment of a digital radiology so still use analog with automatic processing. Processing factors that may affect the quality of the finished radiographs -concentration of processing chemicals -Age of chemicals -Degree of chemistry agitation during development -chemical temperature -development time -non-agitiated chemicals -chemical contamination

Fresh, clean wound with very little contamination or trauma? primary closure using sutures delayed primary closure Contraction and epilelialization secondary closure

primary closure using sutures

Where should the measurement for the lateral shoulder view be taken? distal humerus proximal humerus caudal aspect of scapula elbow joint

proximal humerus

Which of the following choices characterizes the pulse rate and quality in a moderately dehydrated dog? pulse rate increased pulse rate decreased pulse rate inconsistent pulses not palpable

pulse rate increased

Which of the following choices characterizes the pulse rate in a moderately dehydrated dog? pulses not palpable pulse rate decreased pulse rate inconsistent pulse rate increased

pulse rate increased

The anatomic area of interest should be as close to the film as possible in order to: reduce distortion increase magnification enlarge the area of interest as much as possible keep the structure as far from the cathode as possible

reduce distortion

The anatomic area of interest should be as close to the film as possible in order to: reduce distortion increase magnification enlarge the area of interest as much as possible keep the structure as far from the cathode as possible

reduce distortion

Identify the organ labeled B liver right kidney left kidney bowel loops

right kidney

Which of the following statements are true? Veterinary personnel who restrains animals for radiology are often exposed to the primary beam scatter radiation can be reduced by collimation Aluminum filtration helps to increase soft, less penetrating x-rays thus increasing quality of the radiograph scatter radiation is produced by the primary beam interacting with the anode

scatter radiation can be reduced by collimation

Wounds that allowed to remain open are said to heal by: primary closure third intention first intention second intention

second intention

third intention healing of a wound that was severely contaminated or traumatized and has started to heal primary closure using sutures delayed primary closure Contraction and epilelialization secondary closure

secondary closure

wounds allowed to remain open are said to heal by first intention secondary intension third intension primary closure

secondary intension

Small Animal abdomen

should be taken at expiration this will minimize the chance of motion showing up on the film.

Focusing cup

slight negative charge; repels electrons

mA Controls

small amount of electricity (mil amperes) heat up filament

If a pregnant woman is in the radiology suite and her baby's cells are damaged by radiation what type of damage is this? genetic somatic generational reproductive electromagnetic

somatic

What is the ideal stage and plane for surgical anesthesia? stage 1, plane 1 stage 6, plane 9 stage 3, plane 2 stage 2, plane 1

stage 3, plane 2

Identify the organ labeled A kidney stomach bladder liver

stomach

Which of the following is the least effective method of delivering fluids to a 10% dehydrated patient? central venous catheter intraosseous peripheral intravenous subcutaneous

subcutaneous

How does marked dehydration affect an animal's eye? lateral nystagmus pinpoint pupils rotated ventrally sunken in the socket

sunken in the socket

If a body part to be radiographed has a significant difference in density between its thickest and thinnest parts: measure and radiograph the thickest part measure and radiograph the thinnest part use the average measurement to determine the area over which to center the x-ray beam take two separate exposures with different measurements

take two separate exposures with different measurements

A radiograph of the metacarpus-phalanges requires that: the patient be in dorsal recumbency the elbow be included the beam centered over the carpus the beam centered over the middle of the metacarpal bones

the beam centered over the middle of the metacarpal bones

A radiograph of the metacarpus-phalanges requires that: the patient be in dorsal recumbency the elbow be included the beam centered over the carpus the beam centered over the middle of the metacarpal bones

the beam centered over the middle of the metacarpal bones

Beam Direction

the first letter is where the beam enters the body and the second is where it leaves. For example VD= ventral dorsal so the beam enters the ventral side and exits the dorsal side

Focal Spot

the location where electrons hit the anode producing a reaction creating the x-ray bean (1%) and heat (99%)

The lateral view of the elbow requires that: the unaffected limb be pulled cranidorsally the scapulohumeral joint and carpus be included the carpus be supinated the unaffected limb be pulled caudodorsally

the unaffected limb be pulled caudodorsally

The lateral view of the elbow requires that: the unaffected limb be pulled cranidorsally the scapulohumeral joint and carpus be included the carpus be supinated the unaffected limb be pulled caudodorsally

the unaffected limb be pulled caudodorsally

Window

the x-ray beam exits the x-ray tube through this glass window

Cooling Fins

these pieces of metal attach to the anode outside of the x-ray tube to help with cooling

What should one consider when anesthetizing sight hounds? They have an increased sensitivity to barbiturates They require more oxygen because they do a lot of aerobic exercise They need extra lubrication in their eyes They need more anesthetic than other breeds

they have an increased sensitivity to barbiturates

Secondary closure

third intention healing of an old wound that has started to heal and is severely contamianted or traumatized

Anode

this anode acts like a magnet. the side of the anode where the kV enters has a negative charge while the side of the anode containing the target has a positive charge. adding a large amount of electricity to the negatively charged side creates a correspondingly strong positibe charge on the other side (the target side). this strong positive charge pulls the negatively charged electrons towards the target

Aluminum Filter

this filter is located directly below the window. the x-ray beam travels through the aluminum filter. this filter removes long waves of x-rays, which tend to cause sxatter radiation.

Oil

this oil is outside the x-ray tube vacuum but inside the x-ray tube helps to dissipate the heat created during the reaction creating the x-ray beam.

Which of the following complications associated with intravenous catheters is the term used to describe the formation of a blood clot resulting from an impeded blood flow? air embolism septicemia thrombus thrombophlebitis

thrombus

Swelling distal to the catheter usually indicates tight bandage infection sensitivity to tape extravascular infiltration

tight bandage

Why is a right lateral view of the abdomen preferred over a left lateral view? To allow visualization of the descending colon to allow better separation of the kidneys so that the fundus of the stomach is closer to the cassette so that the pylorus is as far away from the cassette as possible

to allow better separation of the kidneys

What is the purpose of using an induction agent? To keep the patient asleep longer to allow smooth, safe and rapid intubation To keep the IV catheter patent To provide analgesia

to allow smooth, safe and rapid intubation

When radiographing a dorsopalmar view of an animal limb, the primary beam enters the ____________ of the paw and exits through the _____________. dorsal aspect, ventral aspect top, bottom back; front lateral aspect; medial aspect

top, bottom

Ventral toward the nares from any given point on the head toward lower aspect of animal farther away from the point of origin Toward upper aspect of animal toward the head from any given point hind limb from tarsal joint distally (causal side) toward the tail from any given point Nearer to the point of origin x-ray enters through medial side and exits through lateral side of a limb forelimb from carpal joint distally (caudal side)

toward lower aspect of animal

Cranial toward the nares from any given point on the head toward lower aspect of animal farther away from the point of origin Toward upper aspect of animal toward the head from any given point hind limb from tarsal joint distally (causal side) toward the tail from any given point Nearer to the point of origin x-ray enters through medial side and exits through lateral side of a limb forelimb from carpal joint distally (caudal side)

toward the head from any given point

cranial

toward the head from any given point

Rostral toward the nares from any given point on the head farther away from the point of origin Toward upper aspect of animal toward the head from any given point Nearer to the point of origin

toward the nares from any given point on the head

Caudal

toward the tail from any given point

Preanesthetics categories include: tranquilizers anticholinergics opioids tranquilizers and anticholinergics only tranquilizers, anticholinergics and opioids

tranquilizers, anticholinergics and opioids

Dextrose should never be administered SC True False

true

Jugular venipuncture would be contraindicated in a patient with a potential bleeding disorder. True False

true

Peripheral catheters may stay in longer than 72 hours as long as they are functional and the patient shows no signs of discomfort. True False

true

Positioning for a lateral shoulder requires that the shoulder of interest is closest to the film. True False

true

Radiographic projections are named according to the direction in which the central beam anatomically enters the body part, followed by the area of exit of the x-ray beam. True False

true

T/F Collimation landmarks for the chest are: thoracic inlet to the last rib

true

T/F Plastic or acrylic made V- trough is radiolucent.

true

T/F Radiographic projections are named according to the direction in which the central beam anatomically enters the body part, followed by the area of exit of the x-ray beam.

true

T/F Stage 1 is characterized by disorienting

true

The maximum volume that should be injected intramuscularly at any site is 2 ml in the cat and 5 ml in the dog. True False

true

To reduce the accidental removal of the catheter, the IV line is looped and taped off. True False

true

if a wound is exudative a semiocclusive primary layer is indicated true false

true

Classification of Patient Physical Status to Assess Anesthetic Risk

u"What is special about this anesthesia case?" uClass 1: Minimal Risk, >6 mos. <6 years, PA normal uClass 2: Slight Risk, <6mos. >6 years, or mild disease uClass 3: Moderate Risk, Moderate systemic disease uClass 4: High Risk, Severe systemic disease uClass 5: Extreme Risk, Advanced systemic disease

Mask Induction

uAttach Mask to Y-piece uGive 100% oxygen for 2-3 min uGive 0.5% Iso and 4L/min Oxygen and gradually increase conc. of anesthetic until 4% (Start 1% sevo and incr to 6%) uMay take 5-10 minutes uOnly possible with anesthetic agents like iso and sevo, because rapid induction is needed uUseful in patients, when IV is not indicated for some critically ill patients. Might be safer as easily discontinued if problems arise. uProper restraint needed as patient may struggle

Box Induction

uAttach tank to anesthesia machine uGive Isoflurane 4% (or 8% Sevo) and high flow rate oxygen (3-5 L/min) used uMonitor behavior. Remove when loses ability to stand. uPlace on mask. uMay take 5-10 minutes uIntubate after removing.

Intubation- Why not

uCan be difficult in certain breeds and species uMay stimulate sympathetic tone uAttempts to intubate may damage larynx or pharynx. uTrachea may tear with movement uPressure necrosis of trachea may occur

Induction Routes

uIV Route: uPropofol uKetamine - Diazepam (Valium) uTelazol uDexmedetomidine (dexdomitor) uIM Route: uUseful for animals, when IV injection is difficult uDose for IM is almost twice than IV dose uSlow onset of sedation as compared to IV route uTelazol uDexmedetomidine (dexdomitor) uInhalant Induction: uMask Induction uChamber Induction uIsoflurane - 3% to 5% by mask or chamber uSevoflurane - 4% to % by mask or chamber

Anesthetic Induction

uPatient loses consciousness uInduction Routes: uIntravenous uIntramuscular uOral - practically not possible uInhalant uIntubate patient safely and effectively

Steps to Anesthesia

uPre-anesthesia uInduction uMaintenance uRecovery

Intubation- Why

uSecure airway uEfficient delivery of gas uProviding oxygen support uDecreased risk of aspiration uDecreased risk of WAG exposure Image A: Canine ready for intubation; S - soft palate; E - epiglottis; Arrows pointing at open trachea for intubation Image B: Tube being passed between laryngeal cartilages (arytenoids) and into the trachea

General Anesthesia

uState of controlled and reversible unconsciousness. uUse injectable or inhaled drugs. uCharacterized by absence of pain perception, motor, memory.

Viewing the radiograph

view the radiograph in an evenly lit, clean view box in a semi-dark room. animals head should be at the top of the radiographs when viewing, and the animals right side is on your left When viewing a lateral, head should be facing the left with the spine on top.

Film #5

was taken with decreased kVp from the film #4 technique Lowered kVp (by 10%) brought up more contrast for this stifle film

Proper splint and bandage care includes all of the following except: inspecting the bandage or splint for any shifting or change in position on the limb preventing the bandage from becoming wet inspecting the bandage daily for any change such as swelling above or below washing the splint or bandage daily

washing the splint or bandage daily

Apart from obvious complications, an outpatient wearing a cast should generally be rechecked at least: every other day weekly every 2 weeks every 3 days

weekly

What is the most appropriate method to separate a digit from the others in order to radiograph it separately while the limb is positioned laterally? with lead lined gloves with tape the technician can hold none of the above

with tape

If the skin surrounding a wound is very tight and under tension <blank> will be limited? wound contraction epithelialization Fibroblast migration granulation tissue formation none of the above

wound contraction

if the skin surrounding a wound is very tight and under tension, what will be limited wound contraction epithelialization fibroblast tissue formation granulation tissue formation none of the above

wound contraction

a delayed primary closure

wound that is moderately contaminated but requires closing before 3-5 days for optimal results

a contraction and ephilieliazation

wound that is not able to be closed due to its large size, this results in second intention healing

Mediolateral toward the nares from any given point on the head toward lower aspect of animal farther away from the point of origin Toward upper aspect of animal toward the head from any given point hind limb from tarsal joint distally (causal side) toward the tail from any given point Nearer to the point of origin x-ray enters through medial side and exits through lateral side of a limb forelimb from carpal joint distally (caudal side)

x-ray enters through medial side and exits through lateral side of a limb

X-Ray Generation

x-rays are generated in an x-ray tube consisting of a cathode (negative charge) and an anode )positive charge) The cathode consists of a wire filament that emits electrons when heated The filament temperature is controlled by the milliamp (mA) setting. As mA increases, the temperature of the filament is increased producing more electrons The period allowed for electrons to leave the x-ray tube is divided into fractions of a second (s) and determines how many x-rays are available. The number of electrons and perios set for release determine how many x-rays are available (mA x s). mAs= (mA)(seconds) = total # of x-ray's produced. The electron speed necessary to creat a high-energy impact is achieved by applying thousands of volts (kilovoltage-kV or kilovoltage peak-kvp) across the anode and cathode field. Increased voltages produce x-rays with greater penetrating power and intensity resulting in more x-rays reaching the film.

Remember the inverse square law

x-rays coming from the x-ray beam follow a rule called the inverse square law This means that every time we double your distance away from the x-ray beam, we cut our radiation exposure to one quarter of what it was.

Patient positioning and basic thought

you may need sedation or general anesthesia along with positioning devices. Manual restraint should be used only when chemical restraint is contraindicated. Think of the following items: -welfare of the animal -restraint and immobilization -minimal trauma to area of interest -least risk to assistants

Hypotension Prevention

•Avoid excessive anesthetic depth •Provide adequate analgesia •Use preanesthetic medications to decrease amount of anesthetic required •Administer drugs that decrease cardiac output, induce bradycardia or cause vasodilation cautiously •Administer IV fluids at a rate sufficient to maintain blood pressure •Some patients may require medication to maintain blood pressure •eg ephedrine, dobutamine, dopamine

OPIOIDS

•Derivative of opium •Controlled Substances •Can be given SQ, IM, IV, Oral, Transdermal •Safely used in healthy and sick pets •ANALGESIC (degree of analgesia depends on agents used) •Examples: •Butorphanol (Torbugesic) - duration of action (2 to 4 hours) •Buprenorphine - longer duration of action (6 to 8 hours) •Hydromorphone •Morphine •Fentanyl •May cause bradycardia •Can cause miosis in dogs and mydriasis in cats •Increased responsiveness to noise •Reversal agent for opioid - NALOXONE - Used only in case of overdosage

Alpha2 - Agonists

•Dexmedetomidine (Dexdomitor) •Xyalzine (Rompun)

Benzodiazepines

•Diazepam, Midazolam and Zolazepam •Controlled substances •Can be given IM or IV •Onset of action - 15 min after IM injection •Diazepam is not water-soluble, so should not be mixed with water-soluble drugs EXCEPT ketamine •Anti anxiety and Calming effect •Anticonvulsant activity •Skeletal Muscle Relaxant •Appetite stimulant in cats •Diazepam may cause pain on IM injection •Midazolam is less irritating when given IM and can be mixed with other water soluble agents •Zolazepam is only available in combination with tiletamine in TELAZOL

Blood Pressure Monitoring

•Direct •Catheter inserted into an artery and attached to a sensor • •Indirect (via an external sensor and cuff) • •Doppler • •Oscillometric

Monitors

•Electrocardiograph •BP monitor •Capnograph •Pulse Oximeter •Temperature And LOOK at your patient!

Pulse Oximeter

•Estimates saturation of hemoglobin (SO2) expressed as a percentage of the total binding site

Cyclohexamines

•Examples - Ketamine and Tiletamine •Dissociative agents - Animal appears awake but immobile and unaware of surroundings •Exaggerated reflexes (palpebral and laryngeal) •Occular effect - eyes remain open •Increased muscle tone - makes cat stiff •Anesthesia to skin and limbs, but poor visceral analgesia. •Liver or renal excretion.

Blood Pressure

•Force exerted by flowing blood on arterial walls •Affected by: •HR •Stroke Volume •Amount of blood ejected by heart on each beat •Vascular Resistance •Diameter of vessels •Arterial Compliance •Elasticity •Blood Volume Systolic- Produced by contraction of the left ventricle as it propels blood through systemic arteries Diastolic-Pressure that remains in the arteries when the heart is in its resting phase, between contractions Mean Arterial Pressure (MAP)-Average pressure through the cardiac cycle Best Indicator of Blood Perfusion

Why Glycopyrrolate preferred over Atropine

•Glycopyrrolate lasts longer •Less arrythmias •Less Ileus

Indicators of Circulation

•HR •Dog: 60-150 •Cat: 120-180 •Heart Rhythm •Dog: NSR or SA •Cat: NSR •CRT •Dog & Cat: < 2seconds •BP •Dog & Cat: MAP>60, Systolic >90

Cycloheximines in practice

•IM or IV routes •Tachycardia and vasoconstriction •Can cause apneustic respiration •Tissue irritation •Increased salivation •Increased intracranial and intraocular pressure •Exaggerated responses to stimuli •Recovery can be rough

Monitoring

•Keep patient SAFE •Regulate Anesthetic Depth •PARAMETERS •Vital Signs •HR, RR, MM color, CRT, Pulse Strength, BP, Temperature •Reflexes •Palpebral, Corneal, Pedal, Swallowing, Laryngeal, PLR •Other Indicators of Anesthetic Depth •Spontaneous Movement, Eye Position, Pupil Size, Muscle Tone, Nystagmus, Salivary/Lacrimal Secretions, Response to Surgical Stimulation

Ketamine Combinations

•Ketamine-diazepam •Ketamine-xylazine •Ketamine-medetomidine •Ketamine-acepromazine

Indicators of Oxygenation

•MM color •Bubblegum Pink • •Pulse Oximeter •>95% • •Blood Gas Analysis •paco2: 45-60 mmHg •pa02: 500 mmHg under 100% oxygen; concern if <80 mmHg

Capnograph

•Measures amount of CO2 in the air that is breathed in and out by the patient • •Noninvasive, continuous and practical • •End tidal CO2 closely mirrors arterial CO2 • •Levels determined by: •Rate of production/Cellular metabolism •Rate of transport to lungs •Rate of elimination from the lungs

Inhalants

•Minimal toxicity •No unwanted side effects •Pleasant smell •Rapid induction. Smooth recovery •Easily controlled depth •No liver or kidney metabolism •Analgesia •Cheap $$$ •Potent •Safe •No equipment •Low rubber solubility •Examples: •Ether •Halothane - is a halogenated hydrocarbon •Halogenated Ethers - Isoflurane and Sevo •WE USE- Halothane, Isoflurane and Sevo

Propofol

•Neutral pH, therefore NO tissue irritation •Oil-in-water emulsion •IV only •Give slowly and to effect •Can be used for anesth maintenance •Recovery is FABULOUS! •Transient excitement can be seen •Transient hypotension •Depress respiration •Rapid metabolism •Decreased ICP and IOP •Safe in sighthounds •No analgesia

Temperature

•Normal 97-100 F • •Anesthetics decrease body temperature •Depressing hypothalamus •Reducing muscular activity •Slowing metabolic rate •Loss is greatest in the first 20 minutes • •Hypothermia •Prolonged anesthetic recovery •Predisposes to overdose if rate not decreased •Decreases doses of anesthetic required •Shivering during recovery increases pet's oxygen demand 6x •<89.6 results in dangerous CNS depression and heart function

Mucus Membranes

•Pale-Anemia from any cause. Poor capillary perfusion •Cyanosis- Low blood oxygen concentration - respiratory arrest - oxygen deprivation - pulmonary disease

Hypothermia TX

•Place towel between patient and tabletop •Warm water blanket •Warm air blankets •Caution with electric heating pads! •Usually not temperature regulated •Often exceed 107.6F and can cause severe burns •Warm water bottles ~100 F next to patient •Infrared heating lamps, 30 inches away from pet •Warm IV fluids ~100 F

Injectable Anesthetics

•Rapid onset and recovery •Lack of tissue toxicity, cardio, respiratory •Rapid metabolism •Analgesic •Muscle relaxant •Examples: •Barbiturates •Cyclohexamines •Propofol

Halothane

•Rarely use •Cheap •Moderately low solubility •Moderate MAC •High rubber solubility •Smells bad

Inhalant vs Injectable Anesthetics

•Readily alter depth •Lung elimination •Delivers O2 •Intubated •Anesth mach necessary •Slow induction •WAGS •Needs reversal or metabolism •Redistributed to liver or kidneys •Room air (20% O2)

Indicators of Ventilation

•Respiratory Rate (RR) •Dog and Cat: 8-20 •Tidal Volume •10-15 ml/kg •Respiratory Character •Smooth and Regular •Apnea Monitor •Alarm when no breath is taken over a preset time period •Capnograph (End Tidal CO2) •CO2:40 mmHg •Blood Gas Analysis •paco2: 45-60 mmHg •pa02: 500 mmHg under 100% oxygen; concern if <80 mmHg

Effects of Barbiturates

•Respiratory depression •Cardiac depression •Protein Binding- Have tendency to bind with proteins. In animals with hypoproteinemia, less protein available to bind, and more free form available to enter brain, so its potency increases in these patients •Acidotic- greater effect if acidotic •Sighthounds- increased potency •Tissue Irritation- can be severe •Excitement •Loss of Potency- reconstituted •Drug Interactions- decrease efficacy of some other drugs

Other Indicators of Anesthetic Depth

•Spontaneous Movement •Indicates light plane of anesthesia •Some drugs such as opioids and propofol can cause focal muscle twitching •Muscle tone (Jaw Tone, Anal Tone) •Muscle relaxation increases with increasing anesthetic depth •Eye Position •Central during light and deep anesthesia •Ventromedial during medium anesthesia •Pupil Size •Mydriatic during Stage II •Miotic during light anesthesia/Stage III Plane I •Progressively dilate during deep anesthesia •Response to surgical stimulation •Increase in HR, RR or BP in response to sx stimulation does not usually reflect a conscious perception to pain. Look at other signs to determine if depth is inadequate.

Neuroleptanalgesia

•State of profound sedation •Combination of opioid and tranquilizing agent •May have a profound effect in high-risk or debilitated dogs •Use for sedation in patient under going minor procedures like radiographs, minor wound repair, endoscopy

Reflexes

•Swallowing •Pet should not swallow under surgical anesthesia. •Return of this reflex during recovery is main indicator used to determine when it is safe to remove ET tube. •Laryngeal •Often seen during intubation. Laryngospasm often seen in cats making intubation difficult. •Palpebral •Should be absent in small animals under surgical anesthesia. •Pedal •Should be absent under surgical anesthesia. •Corneal •Used more in large animals to determine depth •PLR •Present in light and medium planes, but lost during deep surgical anesthesia

Tranquilizer vs. Sedative

•Tranquilizer - reduces anxiety but pet is still awake and aware about surroundings •Sedative - Not aware about surroundings

Dexmedetomidine (Dexdomitor)

•Uncontrolled substance •Used as sedatives, for minor procedures like radiographs, minor wound repair, ear cleaning, fractious pet. •Can be used alone or in combination with other agents •Can be given IM or IV •Sedative and analgesic - if combined with other analgesic agents, may provide moderate analgesia •Onset of action within 5 to 10 min with IV injection and 10 to 20 min with IM injection. •Must leave animal in cage and quiet conditions to allow drug take effect. •Adverse Effects of Dexdomitor •BE CAREFUL, DOG MAY STILL BITE •Dog and Cat may vomit after administering dexdomitor •Severe Bradycardia (down to 40-50 bpm) - can only be treated using antagonist Antisedan Glycopyrrolate will not work to treat bradycardia caused by dexdomitor, if given after admininstration of drug. It is only useful if glycopyrrolate is given, at least 15 min. before giving dexdomitor to counteract the bradycardia caused by the drug •ANTAGNOIST of Dexdomitor (Reversal Agent) - To reverse the effects of dexdomitor use ATIPAMEZOLE (ANTISEDAN)

Tiletamine

•Used as Telazol- •Tiletamine + zolazepam •Adverse Effects: •Excessive salivation •Tachycardia

Anticholinergic Agents

•Used to treat bradycardia •To decrease salivation •To decrease GI activity (vomiting and diarrhea) •Examples: •Glycopyrrolate •Atropine •Can be given SQ, IM, IV

Properties of Inhalants

•Vapor pressure - measures the tendency of a liquid to evaporate •Halothane, Isoflurane and Sevoflurane have high vapor pressure and evaporate easily. •Need precision Vaporizer •Solubility coefficient- low means faster induction and recovery •MAC (Minimum Alveolar Conc.) - means the lowest concentration in alveoli at which patient will show no response to painful stimuli •low means more potent

Sevoflurane

•Very low solubility •MAC greater than others •Greater heart effects than iso •Depress resp more than iso •No increase in cerebral blood flow •Muscle relaxant •No analgesia

Isoflurane

•Veterinary standard •Volatile •Solubility is low •MAC is moderate- higher than Halothane •Rubber solubility low •Stable without preservatives •Few adverse effects •Maintains cardiac performance •Depresses respiration •Minimal increase cerebral blood flow •Quick exhalation of gas •Good muscle relaxation •No analgesia

Heart Rate

♡ Apical pulse through thoracic wall ♡ Peripheral pulse ♡ Stethoscope ♡ Esophageal stethoscope