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Surgery and imagery question and answers.
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lOMoARcPSD|18207238SURGERY AND IMAGING EXAM
ANSWERS
2019
1. Theatre Practice and Design
There are FOUR (4) major sources of contamination in theatre. List all
four sources AND for each source, give one example of how this risk of
contamination can be mitigated.
A. The environment – can be mitigated by reducing the traffic
flow
B. The equipment – can be mitigated by ensuring the
sterilisation protocols are followed
C. The patient – Making sure the patient is clipped properly
with the correct margins and the surgical area been
scrubbed correctly.
D. The personnel – ensuring that all those that come into
contact or are in the same room as the patient are wearing
adequate attire for surgery.
2. Patient Preparation & Asepsis
You are the veterinary technologist in charge of preparing a 12kg
crossbreed bitch for spay surgery. The patient has been induced and
placed under general anaesthesia.
a) What will you need to confirm prior to starting the surgical preparation
of this patient?
Confirm patient details, confirm consent form is signed, type of
surgery, the surgery site, the correct drugs and doses are
recorded and ready to be drawn up, the equipment for surgery
is sterile and all the equipment is all present and in good
working order.
b) List THREE (3) precautions you need to take when clipping a site on a
patient. Provide a brief reason for each precaution.
, lOMoARcPSD|18207238
Ensure the clippers don’t overheat – can cause clipper burns/
clipper rash
Make sure the clippers are sharp and not broken – this
prevents the chance of cutting the skin
Make sure to be careful of open wounds, mucous membranes
and nipples when clipping – These areas can be easily cut and
cause harm to the patient
c) Previously, this patient has had a reaction to chlorhexidine 4%. List
another skin preparation solution that could be used as an alternative
to chlorhexidine for this patient. Iodine
3. Surgical Instrument Sterilisation
List THREE (3) methods of surgical instrument/equipment sterilisation.
For each method listed, provide an example of an instrument/piece of
equipment which would be sterilised using this method.
Moist heat – Scalpel
Dry heat – Glassware
Irradiation – Heat sensitive equipment
4. Wound Healing, Infection, & Surgical Epidemiology
a) The inflammatory stage of wound healing can be divided into a
vascular and cellular response. Briefly explain the main events that
occur during the cellular phase.
White blood cells are attracted to chemicals in the interstitial
fluid
The white blood cells then adhere and roll along the wall of the
vessels (Diapedesis – outward flow of blood cells)
Neutrophils and other leukocytes begin to phagocytose
foreign material Neutrophils start to die off releasing
enzymes to further promote inflammatory process
b) There are many factors which influence wound healing. Briefly explain
FOUR (4) of these factors.
Temperature – hypothermia causes vasoconstriction which
prevents blood flow to the area of that needs to heal.
Desiccation – Excessive drying of wound
, lOMoARcPSD|18207238
Maceration – Excessive moistness of wound, promotes
infection
Obesity – Reduced blood supply to adipose tissue, nutritional
deficiencies
Reduced blood supply – Blood supplies nutrients and O2 that
are crucial for healing
Age
Systemic disease
Medications
5. Haemorrhage & Haemostatic Methods
a) Surgical haemostatic methods can be divided into four main
categories. List TWO (2) of these categories and provide an example of
each. Mechanical – Pressure (Digital pressure with gauze)
Thermal – Electrocautery, cryogenic haemostasis
Chemical – Epinephrine (causes
vasoconstriction) Physical – Bone wax
(purified bees wax)
b) During the second stage of natural haemostasis, the protein fibrin is
produced. What is the primary role of fibrin during the coagulation
phase? Stabilise and strengthen the clot
6. Surgical Equipment
a) List the FOUR (4) main differences between monopolar and bipolar
diathermy. Monopolar – Flow of current from hand piece from
hand piece, through tissue to the ground plate, can cut tissue,
is not as precise as bipolar, no ground plate = burnt patient,
hand piece (1 tip)
Bipolar – hand piece (2 tips), flow of current between the two
tips as the tissue is grasped, no ground plate required, Precise
coagulation, can’t cut tissue
b) List TWO (2) benefits of placing an active drain.
Closed system – decreased risk of infection
Prevents skin maceration by drain fluid
, lOMoARcPSD|18207238
Easy monitoring of draining fluid
No static fluid column for bacteria to grow.
7. Physiotherapy
Choose ONE (1) correct answer for questions a- e.
a) Cryotherapy reduces pain and inflammation by: Increasing
vasoconstriction to reduce bleeding and inflammation (1 mark)
b) Warm compresses can: Increase blood flow to distal limbs
c) Which of the following statements is true? Massage enhances
excitement to improve blood flow to the healed tissue
d) Neuromuscular stimulation is indicated when: The patient has a
history of seizures
e) Therapeutic ultrasound is absorbed at which rate by the tissues: 3%
blood, 24% muscle, 59% tendon, 96% bone
8. Small Animal Soft Tissue Procedures
a) List THREE (3) techniques used to isolate a viscus (e.g. loop of bowel)
prior to incising it.
Pack off with abdominal swabs
Empty the segment by milking it
Stay sutures to hold viscus up and out so it doesn’t deflate and
leak contents into
abdomen
b) List TWO (2) injuries/conditions that commonly result in a ruptured
bladder in cats and dogs.
RTA
Blocked bladder
c) What TWO (2) diagnostics are performed to confirm a ruptured
bladder?
X-ray
Ultrasound
d) What is the difference between a TRUE hernia and a FALSE hernia?
True hernias have a hernial sac
False hernias do not have a hernial sac
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