Deck 11: Hemostatis, Wound Healing, and Wound Closure

Question 1

When a blood vessel is incised during surgery, the first response is _____________ , which can sometimes make it difficult to find the bleeder.

Answer 1

Vasoconstriction

Question 2

________ is the most common congenital bleeding disorder; other bleeding disorders include liver disease, anticoagulant therapy, and aplastic anemia.

Answer 2

Hemophilia

Question 3

________means of hemostasis include the hemostat clamp, ligatures, clips, sponges, suction, pledgets, bone wax, drains, and tourniquets.

Answer 3

Mechanical

Question 4

_________means of hemostasis include the ESU, laser, argon plasma coagulator, harmonic scalpel,and cryotherapy.

Question 5

________ means of hemostasis include absorbable gelatin (Gelfoam), collagen (Avitene),oxidized cellulose (Surgicel), silver nitrate, epinephrine, and thrombin.

Question 6

Match the term to the appropriate description.

-A, B, AB, O

A) From patient; either stored or Cell Saver. autotransfusion
B) Donated from another; requires type and cross-match.
C) Four main blood type groups.
D) Universal donor.
E) Universal recipient.
F) Occurs when mismatched blood is given (mild to anaphylactic shock).
G) Antigen found in RBCs of most people.
H) Specific type of reaction; occurs with Rh mismatch.

Question 7

Match the term to the appropriate description.

-Autologous

A) From patient; either stored or Cell Saver. autotransfusion
B) Donated from another; requires type and cross-match.
C) Four main blood type groups.
D) Universal donor.
E) Universal recipient.
F) Occurs when mismatched blood is given (mild to anaphylactic shock).
G) Antigen found in RBCs of most people.
H) Specific type of reaction; occurs with Rh mismatch.

Question 8

Match the term to the appropriate description.

-Hemolysis

A) From patient; either stored or Cell Saver. autotransfusion
B) Donated from another; requires type and cross-match.
C) Four main blood type groups.
D) Universal donor.
E) Universal recipient.
F) Occurs when mismatched blood is given (mild to anaphylactic shock).
G) Antigen found in RBCs of most people.
H) Specific type of reaction; occurs with Rh mismatch.

Question 9

Match the term to the appropriate description.

-Homologous

A) From patient; either stored or Cell Saver. autotransfusion
B) Donated from another; requires type and cross-match.
C) Four main blood type groups.
D) Universal donor.
E) Universal recipient.
F) Occurs when mismatched blood is given (mild to anaphylactic shock).
G) Antigen found in RBCs of most people.
H) Specific type of reaction; occurs with Rh mismatch.

Question 10

Match the term to the appropriate description.

-Rh factor

A) From patient; either stored or Cell Saver. autotransfusion
B) Donated from another; requires type and cross-match.
C) Four main blood type groups.
D) Universal donor.
E) Universal recipient.
F) Occurs when mismatched blood is given (mild to anaphylactic shock).
G) Antigen found in RBCs of most people.
H) Specific type of reaction; occurs with Rh mismatch.

Question 11

Match the term to the appropriate description.

-Transfusion reaction

A) From patient; either stored or Cell Saver. autotransfusion
B) Donated from another; requires type and cross-match.
C) Four main blood type groups.
D) Universal donor.
E) Universal recipient.
F) Occurs when mismatched blood is given (mild to anaphylactic shock).
G) Antigen found in RBCs of most people.
H) Specific type of reaction; occurs with Rh mismatch.

Question 12

Match the term to the appropriate description.

-Type AB

A) From patient; either stored or Cell Saver. autotransfusion
B) Donated from another; requires type and cross-match.
C) Four main blood type groups.
D) Universal donor.
E) Universal recipient.
F) Occurs when mismatched blood is given (mild to anaphylactic shock).
G) Antigen found in RBCs of most people.
H) Specific type of reaction; occurs with Rh mismatch.

Question 13

Match the term to the appropriate description.

-Type O

A) From patient; either stored or Cell Saver. autotransfusion
B) Donated from another; requires type and cross-match.
C) Four main blood type groups.
D) Universal donor.
E) Universal recipient.
F) Occurs when mismatched blood is given (mild to anaphylactic shock).
G) Antigen found in RBCs of most people.
H) Specific type of reaction; occurs with Rh mismatch.

Question 14

Match the type of emergency with the relevant description.

-Malignant hyperthermia

A) During surgery, causes blood loss and lowered oxygen saturation due to mismatched blood.
B) Triggered by gas anesthetics and succinylcholine agents
C) Epinephrine; be alert to allergies.
D) CAB sequence: Push hard, push fast rate 100 per minute, change every two minutes or five cycles, 30:2, early defibrillation.
E) Treatment includes fresh frozen plasma (FFP) and cryoprecipitate, along with heparin and blood replacement; poor prognosis.
F) Most likely cause is exsanguination; restore blood circulation/ transfusions.

Question 15

Match the type of emergency with the relevant description.

-Sudden cardiac arrest (SCA)

A) During surgery, causes blood loss and lowered oxygen saturation due to mismatched blood.
B) Triggered by gas anesthetics and succinylcholine agents
C) Epinephrine; be alert to allergies.
D) CAB sequence: Push hard, push fast rate 100 per minute, change every two minutes or five cycles, 30:2, early defibrillation.
E) Treatment includes fresh frozen plasma (FFP) and cryoprecipitate, along with heparin and blood replacement; poor prognosis.
F) Most likely cause is exsanguination; restore blood circulation/ transfusions.

Question 16

Match the type of emergency with the relevant description.

-Trauma and cardiac arrest

A) During surgery, causes blood loss and lowered oxygen saturation due to mismatched blood.
B) Triggered by gas anesthetics and succinylcholine agents
C) Epinephrine; be alert to allergies.
D) CAB sequence: Push hard, push fast rate 100 per minute, change every two minutes or five cycles, 30:2, early defibrillation.
E) Treatment includes fresh frozen plasma (FFP) and cryoprecipitate, along with heparin and blood replacement; poor prognosis.
F) Most likely cause is exsanguination; restore blood circulation/ transfusions.

Question 17

Match the type of emergency with the relevant description.

-DIC

A) During surgery, causes blood loss and lowered oxygen saturation due to mismatched blood.
B) Triggered by gas anesthetics and succinylcholine agents
C) Epinephrine; be alert to allergies.
D) CAB sequence: Push hard, push fast rate 100 per minute, change every two minutes or five cycles, 30:2, early defibrillation.
E) Treatment includes fresh frozen plasma (FFP) and cryoprecipitate, along with heparin and blood replacement; poor prognosis.
F) Most likely cause is exsanguination; restore blood circulation/ transfusions.

Question 18

Match the type of emergency with the relevant description.

-Hemolytic transfusion reaction

A) During surgery, causes blood loss and lowered oxygen saturation due to mismatched blood.
B) Triggered by gas anesthetics and succinylcholine agents
C) Epinephrine; be alert to allergies.
D) CAB sequence: Push hard, push fast rate 100 per minute, change every two minutes or five cycles, 30:2, early defibrillation.
E) Treatment includes fresh frozen plasma (FFP) and cryoprecipitate, along with heparin and blood replacement; poor prognosis.
F) Most likely cause is exsanguination; restore blood circulation/ transfusions.

Question 19

Match the type of emergency with the relevant description.

-Anaphylactic reaction

A) During surgery, causes blood loss and lowered oxygen saturation due to mismatched blood.
B) Triggered by gas anesthetics and succinylcholine agents
C) Epinephrine; be alert to allergies.
D) CAB sequence: Push hard, push fast rate 100 per minute, change every two minutes or five cycles, 30:2, early defibrillation.
E) Treatment includes fresh frozen plasma (FFP) and cryoprecipitate, along with heparin and blood replacement; poor prognosis.
F) Most likely cause is exsanguination; restore blood circulation/ transfusions.

Question 20

Describe how the EBL is tracked during surgery.

Question 21

Describe the role of the surgical technologist during a cardiac arrest in surgery.

Question 22

Describe how suture is cut when second assisting in surgery.
Braided multifilament is cut ________ .
Monofilament suture is cut ________ .

Question 23

Describe how blood products are carefully identified prior to administration.

Question 24

Sometimes the surgical technologist must wash the laps during surgery to recover the red blood cells from blood sponges. Describe the factors that may prevent an autotransfusion utilizing the Cell Saver machine during surgery.

Question 25

The most commonly used needle for friable tissue or parenchymal organs (liver, kidney, prostate) is the ________ needle.

Question 26

The professor who recommended gentle tissue handling, strict hemostasis, matching suture to the type of tissue, and elimination of dead space, and also invented the hemostat, is ________.

Question 27

The biopsy needle used for a liver biopsy is most likely to be the Tru-Cut or ________needle.

Question 28

The straight needle is also called the________ needle.

Question 29

The ________needle is most likely to be used for bowel or vessel anastomosis.

Question 30

Match the classification with the appropriate description and/or procedure. (Note: Questions 1-4 may have more than one correct answer.)

-Type I wound Classification

A) Shotgun wound to abdomen with bowel perforation
B) Perforated appendix
C) Cholecystectomy
D) Breast biopsy
E) Incision and drainage
F) Uninfected, enters alimentary tract (GI tract)
G) Hernia repair with minor break in technique
H) Open (compound) fracture
I) Craniotomy with major break in technique (instruments used not sterile)
J) Clostridium perfringens

Question 31

Match the classification with the appropriate description and/or procedure. (Note: Questions 1-4 may have more than one correct answer.)

-Type II wound Classification

A) Shotgun wound to abdomen with bowel perforation
B) Perforated appendix
C) Cholecystectomy
D) Breast biopsy
E) Incision and drainage
F) Uninfected, enters alimentary tract (GI tract)
G) Hernia repair with minor break in technique
H) Open (compound) fracture
I) Craniotomy with major break in technique (instruments used not sterile)
J) Clostridium perfringens

Question 32

Match the classification with the appropriate description and/or procedure. (Note: Questions 1-4 may have more than one correct answer.)

-Type III wound Classification

A) Shotgun wound to abdomen with bowel perforation
B) Perforated appendix
C) Cholecystectomy
D) Breast biopsy
E) Incision and drainage
F) Uninfected, enters alimentary tract (GI tract)
G) Hernia repair with minor break in technique
H) Open (compound) fracture
I) Craniotomy with major break in technique (instruments used not sterile)
J) Clostridium perfringens

Question 33

Match the classification with the appropriate description and/or procedure. (Note: Questions 1-4 may have more than one correct answer.)

-Type IV wound Classification

A) Shotgun wound to abdomen with bowel perforation
B) Perforated appendix
C) Cholecystectomy
D) Breast biopsy
E) Incision and drainage
F) Uninfected, enters alimentary tract (GI tract)
G) Hernia repair with minor break in technique
H) Open (compound) fracture
I) Craniotomy with major break in technique (instruments used not sterile)
J) Clostridium perfringens

Question 34

Match the description.

-First intention or primary intention

A) Characterized by granulation tissue; heals from the bottom up.
B) A small, white, mature surface scar, called a cicatrix, appears.
C) Type of ideal healing characterized by the formation of collagen, with healing from side to side.
D) Fibroblasts lay down collagen, capillaries extend; occurs days 3-20, with wound gaining 25-30 percent of former strength.
E) Characterized by presence of infection; also known as delayed healing.

Question 35

Match the description.

-Second intention

A) Characterized by granulation tissue; heals from the bottom up.
B) A small, white, mature surface scar, called a cicatrix, appears.
C) Type of ideal healing characterized by the formation of collagen, with healing from side to side.
D) Fibroblasts lay down collagen, capillaries extend; occurs days 3-20, with wound gaining 25-30 percent of former strength.
E) Characterized by presence of infection; also known as delayed healing.

Question 36

Match the description.

-Third intention

A) Characterized by granulation tissue; heals from the bottom up.
B) A small, white, mature surface scar, called a cicatrix, appears.
C) Type of ideal healing characterized by the formation of collagen, with healing from side to side.
D) Fibroblasts lay down collagen, capillaries extend; occurs days 3-20, with wound gaining 25-30 percent of former strength.
E) Characterized by presence of infection; also known as delayed healing.

Question 37

Match the description.

-Maturation phase

A) Characterized by granulation tissue; heals from the bottom up.
B) A small, white, mature surface scar, called a cicatrix, appears.
C) Type of ideal healing characterized by the formation of collagen, with healing from side to side.
D) Fibroblasts lay down collagen, capillaries extend; occurs days 3-20, with wound gaining 25-30 percent of former strength.
E) Characterized by presence of infection; also known as delayed healing.

Question 38

Match the description.

-Proliferation phase

A) Characterized by granulation tissue; heals from the bottom up.
B) A small, white, mature surface scar, called a cicatrix, appears.
C) Type of ideal healing characterized by the formation of collagen, with healing from side to side.
D) Fibroblasts lay down collagen, capillaries extend; occurs days 3-20, with wound gaining 25-30 percent of former strength.
E) Characterized by presence of infection; also known as delayed healing.

Question 39

Describe the five classic signs and symptoms of the lag or inflammatory phase of healing caused by the release of histamine.

Question 40

Name and describe three nonabsorbable sutures (multifilament or monofilament and natural or synthetic).

Question 41

Which nonabsorbable is the most inert? What do we mean by inert?

Question 42

Name and describe the advantages or uses of three absorbable sutures (multifilament or monofilament and natural or synthetic).

Question 43

What is the difference between hydrolysis and enzyme action?