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What is the most common scalpel blade size?
15
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What type of blade is common for nail procedures/tenotomy?
Beaver blade
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What forceps are used for skin closure?
adson rat-tooth
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What forceps are utilized for deep tissue handling?
Adson brown
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What retractors are self-retaining?
Weitland retractor
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What retractor is good for gripping bone?
Hohman retractor
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What retractor is used for ankle surgery?
Army/Navy retractor
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What forceps are similar to hemostats and have teeth on the end?
Kocher traction forceps
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What saw RPM is common for podiatry?
20,00 rpm
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How long should a patient abstain from food before entering the OR?
8 hours
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Which is a better antiseptic for scrubbing: Iodine or Chloraprep?
Chloraprep
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What is an egg crate used for in surgery?
Reduce pressure around patient's bony prominences during surgery
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Which patient position is the best for surgery: Supine, lateral, prone, or trendelenberg
Supine
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What is the Trendelenberg position during surgery?
table tilted so head is down
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Do incisions heal end-to-end or side-to-side?
Side-to-side
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What does RSTL stand for?
Relaxed skin tension lines
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Should you be parallel or perpendicular to the RSTLs?
Parallel
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What should be the length of a skin bridge to reduce necrosis possibilities?
>1cm (never less than 1cm)
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When is a DuVries incision made?
Plantar fasciotomy
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What are the five hemostat methods? ((MCATT)
- Mechanical
- Chemical
- Anatomical
- Thermal
- Tourniquet
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What is the diff b/t bipolar and monopolar thermal hemostasis?
- Bipolar: current between tips of forceps
- Monopolar: current through body, requires grounding
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What is the max time to have a patient in a tourniquet?
1.5-2 hrs
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How long should a tourniquet be reperfused before acivating again?
10 minutes
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What is the formula for limb occlusion pressure in adults and infants?
- adult: Systolic pressure + 100 mmHg
- infant: Sys pressure + 50mmHg
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What is the max tourniquet pressure for the thigh and calf?
- thigh: 300mmHg
- calf: 250mmHg
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What is the max tourniquet pressure for the ankle and thigh of an infant?
-
T/F: You should not use a tourniquet in a sickle cell case?
False
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What is the chemical diff b/t an amide and an ester?
- Amide: NH group
- Ester: COOH group
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What organ metabolizes amides?
Liver
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Which is safer, amides or esters?
Amides
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What are the two most common amides used for anesthetics?
-
What channel does the anesthetic block?
Na channels so deploarization cannot occur
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Do charged or uncharged ions diffuse through tissue?
uncharged (charge ions are repelled)
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Once an uncharged ion enters the tissue does it remain uncharged?
No, it becomes charged
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T/F: Increased acidity increases uncharged ions in solution
F: Acidity decreases uncharged ions in solution
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What is normal physiological pH?
7.4
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What happens to pH during infection?
- decreases, more acidic
- means less uncharged anesthetic
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Should you inject distal or proximal to an infection?
Proximal
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What is the order of sensory loss after anesthetic?
- pain-light touch-temperature
- (motor and pressure conserved)
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What is the most common % of lidocaine?
1%
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What is the most common % of bipuvicaine?
.25%
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What is the toxic dose of lidocaine and bipuvicaine?
- Lidocaine = 300
- Bipuvicaine (Marcaine)= 175
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Which anesthetic is more common for a post-op block?
Bipuvicaine
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What is the common pre-op anesthetic mix?
1% lidocaine and .25% bipuvicaine 1:1 mix
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What is the function of Epinephrine?
vasoconstriction
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What chemical is formed from esters that causes allergic rxns?
PABA
-
What happens to needle size as guage increases?
- Inversely proportional
- **As guage increases, size decreases
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When do you do a digital block?
Hallux/digit problem
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When do you do a mayo block?
Bunion
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What three injections make a full ankle ring block?
- Posterior Tibial
- Deep Fibular
- Sural
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What are five characteristics of sutures?
- Strength/tension
- Volume
- Elongation
- Flexibility
- Monofilament/braided
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Why is a monofilament used?
- Smaller
- less friction
- good for contaminated wounds
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Why is a braided suture used?
Strength
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What is a bad side of braided sutures?
- Capillarity: binding of bacteria due to size
- high rubbing friction due to size
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What are four characteristics of a good suture for infection?
- Monofilament
- uncoated
- synthetic
- non-absorbable
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What is the most common, braided, absorbable suture?
Polyglactin 910
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What absorbable/synthetic suture is most commonly used for tendon repair?
Poliglecaprone (monocryl)
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What is the day diff for absorbable/non-absorbable?
- Absorbable = 60 days
- Non-absorbable = >60 days
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What is the most common non-absorbable suture?
nylon
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What is the most common suture needle in podiatry?
Reverse cutting
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What is an autograft, allograft and xenograft?
- Autograft: same person
- Allograft: same species
- Xenograft: diff species
-
What is the diff b/t a split thickness and full thickness skin graft?
- split: epidermis and part of dermis
- full: epidermis and all of dermis
-
What are four common sites to take skin from for STSG?
-
What are two common graft bacteria?
- B-hemolytic streptococci
- Pseudomonas aeruginosa
-
What are donor sites for FTSG?
- flexor creases
- pinch grafts
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Which do you mesh, STSG or FTSG?
STSG
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What are the three stages of graft healing and their time?
- 1) Plasmatic: 24-48 hours
- 2) Inosculation: 48 hrs - 2 wks
- 3) reorganization: 1 year
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What is the most common complication of grafts?
Seroma: Swelling b/c the lymph and capillaries don't enter until the inosculation stage (48hrs - 2 wks.)
-
What type of flap is used for mucoid cysts?
Unilobed flap
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What sizes should the two flap be of the bilobed flap when compared to the debridment?
- 1st: 75%
- 2nd: 50% (90 degrees from first)
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What are the four History and Physical areas?
- Neurology
- Dermatology
- Vascular
- Musculoskeletal
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What does the PARQ method of H&P for surgery stand for?
- Procedure
- Alternative
- Risks
- Questions
-
What are the 5 ws of Post-op fever?
- Wind:12-24 hrs
- Water: dehydration
- wound: 5-7 days, infection
- Walk: 3 days, DVT
- wonder: drugs
-
What is the most commoon antibiotic?
Keflex
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