Student handout 2014

DEPARTMENT AND CLINIC OF SURGERY AND OPHTHALMOLOGY Address: 1078 Budapest, István u. 2. Phone: +36-1-478-4195, Fax: +36-1-478-41-96 www.kisallatsebeszet.hu, www.univet.hu Student handout 2014 Department and Clinic of Surgery and Ophthalmology Faculty of Veterinary Science Szent István University Edited by T. NÉMETH,,, DipECVS Associate Professor and Head of Surgery

2 Department and Clinic of Surgery and Ophthalmology Address: H-1078. Budapest, István u. 2. Mailing address: H-1400 Budapest, P.O. Box 2. Phone: (+36-1) 478-4195, 478-4197 Fax: (+36-1) 478-4196 Homepage: www.kisallatsebeszet.hu, www.univet.hu Short history of the department Department of Veterinary Medicine was funded in 1786 as part of the University of Pest established by King Josef II, which institution already dealt actively with the education of. Students for human medicine of the University compulsorily studied surgical aetiology and operative accompanied by subject of veterinary medicine performed by S. Tolnay on the basis of surgical textbook edited by Prof. Wolstein from Vienna (1785). At that time veterinary remained at second level behind the human medicine. Remarkable progress in the education of veterinary was achieved under V. Zlamal (1803-1886) recognising the importance of as an independent subject completing it with other related disciplines. The first teacher of was F. Varga, a medical doctor, who was an assistant of Prof. Balassa, the founder of Hungarian operative. In 1870 the Special Surgical and Operative Department was established and moved into present-day buildings in Rottenbiller Street. B. Plósz, at the time of his heading, completely reconstructed and reorganised the department, introduced conditions of surgical asepsis and operative. He was outstanding in orthopaedics and abdominal of the horse. Following head of the department, M. Berrár (1884-1929) was an internationally accepted expert of veterinary and ophthalmology. Radiological unit was established by E.Gy. Guoth after 1929. Gy. Kómár, then A.B. Kovács took part in the foundation of hoof and abdominal of the horse and cattle. L. Tamás headed the department between 1981 and 1989 contributing to the progress of equine followed by J. Tóth, who renewed the department developing the institution onto a reasonable European level both in large and small animal with regard to both instrumentation and special work. After years under supervision by Prof. Tamás and Ferenc Felkai as curators, Tibor Németh has been the Assoc. Professor and Head of Surgery since 2005. Surgery and Ophthalmology currently works in the framework of the new small animal hospital in István Street.

3 Register of the academic staff Staff DEGREE POSITION SPECIALITY E-MAIL Tibor NÉMETH DipECVS Associate Professor Head of Department Small animal soft tissue Attila ARANY TÓTH Péter CSÉBI Zoltán DIÓSZEGI Miklós Pál DUNAY Tamás IPOLYI Assistant Professor Radiology Cytology Lecturer Radiology Neurology Senior Lecturer Assistant Professor Small animal orthopaedics and neurology Anaesthology Dentistry Intensive care Lecturer Small animal orthopaedics and neurology Nemeth.Tibor@aotk.szie.hu aaranytoth@yahoo.c om pcsebi@freemail.hu zdiosz@yahoo.com Dunay.Miklos.Pal@ aotk.szie.hu ipolyit@freemail.hu Péter MOLNÁR Lecturer Aneszteziológia ptrmol@hotmail.co m Anna NÓGRÁDI Clinician Kisállat-sebészet anna.nogradi@gmai l.com Csilla SIMON Clinician Kisállat-sebészet kissimcsi@freemail. hu Zsolt SZENTGÁLI Senior Lecturer Ophthalmology szentgal@freemail.c 3.hu Gábor BODÓ DipECVS Large Animal Surgery Section Associate Professor Head of Equine Department and Clinic General Large animal Bodo.Gabor@aotk.s zie.hu Péter TÓTH Simon IZING Zita MAKRA Pál TUSKA Kata WIRTH Assistant Professor Chief of Section Large animal Assist.Professor Large animal Assist. Professor Ophthalmology Anesthesiology klinikai állatorvos Large animal klinikai állatorvos Anesthesiology Large animal Toth.Peter@aotk.szi e.hu Izing.Simon@aotk.s zie.hu Makra.Zita@aotk.sz ie.hu Tuska.Pal@aotk.szi e.hu Wirth.Kata@aotk.sz ie.hu Credits of Surgery and Ophthalmology Radiology Anesthesiology General Surgery: 6th semester 3 credits Detailed Surgery I.: 7th semester 2 credits Ophthalmology: 8th semester 6 credits

4 Detailed Surgery II.: 9 th semester 2 credits Curriculum 6th semester: - Radiology (Dr. Arany Tóth - Dr. Csébi Dr. Tóth) - Anaesthesiology (Dr. Dunay Dr. Makra) 7 th semester: 8th semester: - General Surgery, Surgical Diagnostics (Dr. Németh Dr. Izing) - Detailed Soft Tissue Surgery I. (Dr. Németh - Dr. Csébi Dr. Molnár Dr. Tóth Dr. Izing) - Detailed Soft Tissue Surgery II. (Dr. Németh - Dr. Tóth Dr. Izing) - General and detailed orthopaedics (Dr. Diószegi- Dr. Ipolyi Dr. Izing Dr. Tóth) - Neuro (Dr. Diószegi - Dr. Csébi Dr. Ipolyi) 9th semester: - Ophthalmology (Dr. Szentgáli Dr. Makra) Short description of subjects Radiology: - principles of Radiology - radiographic diagnostics of different regions in large and small animals Anesthesiology: - principles of anaesthesiology - anaesthesiology of premedication - general anaesthesiology - local anaesthesiology - analgesia - anaesthesia of different species General Surgery: - animal handling - surgical basic and supplementary diagnostics - classification, forms and treatments of wounds - shock - anti-inflammatory agents, antibiotics Soft Tissue Surgery: - general operative - of the head and neck - of the upper airways and thorax - of hernias - abdominal Orthopaedics and Neurology: - surgical diseases of the bones and joints - diseases of tendons, tendon sheaths and bursae - lameness diagnostics in large and small animals

5 - limb diseases in the horse - limb diseases of the cattle and sheep - principles in bone and joint - principles of veterinary neurology (diseases of the spine, diagnostics, therapy) Ophthalmology: - ophthalmologic basic and supplementary examinations - anatomy and physiology of the eye - congenital and acquired ophthalmologic conditions in large and small animals Educational and Examination Requirements Attendance the lectures is compulsory, the examinations are based on the topics mentioned during lectures and practicals. The attendance each practical is the prerequisite of obtaining the semester certification signature. White coat and stethoscope are necessary for practicals. The 6 th semester is followed by a written Semi-final examination, which covers radiology and anaesthesiology. The dates of the written examination are assigned according to the agreement with sudents.. The written Final examination of is being held at the end of the 8th semester. The Surgical Positive Educational Encouraging System (SPEES) will be introduced for your class from 2013/2014: certain number of points will be approved for students who show up at the Surgery lecture at the random check events (3 events/semester) during the 7th and 8th semester according to the following order: 1 event=3, 2 events=8 and all the 3 events=15 points per semester. These points will be added to the overall points achieved at Surgery Final Test (maximum test point number is 90), thus one can collect 1/3 of the maximum points of the final test attending lectures regularly (which is otherwise compulsory). The written Semi-final examination of ophthalmology is at the end of the 9th semester Any further detailed and current information (including lecture notes) are available on the department s website (www.kisallatsebeszet.hu, www.univet.hu) and the information board at the entrance of the Surgery Lecture Hall. The students are kindly asked to follow these information regularly. Making appointment at the secreteriat is possible on personal or objective purpose. Elective courses managed by the department - Specific operative techniques in small animal soft tissue (lecturer: Dr. Németh) - Operation techniques: hand-on practice on cadavers (soft tissue ) (lecturers: Dr. Szalay Dr. Németh) - Operation techniques: hand-on practice on cadavers (orthopaedics) (lecturers: Dr. Szalay Dr. Ipolyi)

6 Learning sources, suggested readings The material of the examination is based on the topics of the lectures and practicals! The lecture notes are provided by lecturers and are available constantly on the website. The suggested readings helping the preparation for examination are the followings: AUER&SICK: Equine Surgery 4th Ed. St. Louis: Elsevier-Saunders, 2012. BAXTER: Adams and Stashak's Lameness in Horses 6th Ed. Wiley-Blackwell, 2011. BRINKER, PIERMATTEI and FLO: Handbook of Small Animal Orthopedics and Fracture Repair 4th edition Saunders Elsevier 2006 BUTLER DYSON, POULUS ET AL.: Clinical Radiology of the Horse 3rd Ed. Oxford: Wiley, John&Sons, 2008. DENOIX: The Equine Distal Limb. London: Manson Publishing, 2005. DIK&GUNSSER: Atlas of Diagnostic Radiology of the Horse 2nd Ed. Hannover: Schlütersche, 2002. FOSSUM, T.W.: Small Animal Surgery, 4th Edition, Elsevier 2012. FUBINI&DUCHARME: Farm Animal Surgery, Saunders, 2004. GAYNOR J.S., MUIR W.W.: Handbook of Veterinary Pain Management, 2nd ed, Mosby 2008 LAVIN, L.M.: Radiography in Veterinary Technology 3rd ed., 2002., Saunders PIERMATTEI D., JOHNSON A.K. An atlas of surgical approaches to the bones and joints of the dog and cat. 4th edition Saunders 2004 REEF: Equine Diagnostic Ultrasound. Philadelphia: Saunders, 1998. ROSS&DYSON: Diagnosis and Management of Lameness in the Horse 2nd ed. Saunders, 2011. SALLY M. TURNER: Small Animal Ophtalmology, Saunders, Elsevier 2008. SEYMOUR C., DUKE-NOVAKOVSKI T.: BSAVA Manual of Canine and Feline Anaesthesia and Analgesia 2nd ed., 2007. SLATTER, D.H.: Fundamentals of veterinary ophthalmology. Philadelphia, Saunders, 4th. edition, 2002. SLOVIS: Atlas of Equine Endoscopy. Mosby, 2003. STASHAK&THEORET: Equine Wound Management 2nd Ed. Wiley-Blackwell, 2008. STASHAK, T. S.: Adams' lameness in horses. Philadelphia: Lea & Febiger, 2002. THRALL, D.E.: Textbook of Veterinary Diagnostic Radiology. 6th ed London: W.B. Saunders, 2012. TOBIAS, K.M.-JOHNSTON, S.A.: Veterinary Surgery Small animal. 1st ed. Elsevier 2012. TRANQUILLI W. J., THURMON J. C., GRIMM K. A.: Lumb & Jones' Veterinary Anesthesia and Analgesia 4th ed., 2007.

7 Rules for students working at the surgical hospital Duties of students attending the morning treatment of surgical patients. Students assigned for compulsory or voluntary shift are to show up at 8 a.m. Walking the patients: 1. inspect the medical record. Check if the patient is allowed to walk and data on patient cooperation, as some patients may pose a risk to personnel and other animals. 2. approach the patient in a friendly way, and put on a leash. 3. walk the patient shortly (5 to 10 mins.) Support debilitated and paretic patients with a towel placed under the groin. 4. note and record urination, defecation and any noteworthy observations. Examination of the patient is performed immediately after walk. Mark in the record for each patient: 1. mental status: alert, apathic, recumbent, unconscious, (seizures!), etc. 2. mark food and water consumption, urination and defecation 3. take the rectal temperature, colour of mucous membranes and capillary refill time 4. perform specific examinations according to disease condition or surgical procedure: check the condition of the surgical wound, observe respiration pattern, palpate the abdomen, inspect the operated limb, etc. Approved abbrevations: Ny.h. mucous membrane, Hrv.-pink, CRT.-Capillary Refill Time, Inj-Injection, Inf-Infusion Treatment: 1. Follow the instructions of the attending veterinarian or assistant when performing treatment. Special care must be taken regarding drug dosage and the route of administration (i.v., i.m., s.c., p.o.). 2. All drugs administered must be marked in the patient record following application. Selective disposal of waste material: 1. sharp waste (such as metal, glass vials, syringes and needles) in the plastic bucket 2. hazardous waste (waste that has contacted body fluids, discharge or excretion) in the yellow bag 3. communal waste (i.e. anything not specified in the above) in the black bag

8 Rules for students attending surgical procedures Students are required to participate in the work in the anesthesia and preparation room. Preanesthetic and anesthetic procedures: physical patient examination, intravenous cannulation, premedication, induction of anesthesia and endotracheal intubation. The instructions of the anesthetist or assistant must always be followed. Preparation of the surgical site: mechanical hair clipping and thorough cleansing of the surgical site with Betadine soap. Before entering the operating room: wash and disinfect your hands thoroughly! make sure to wear appropriate clothing, a surgical mask, hair covering and shoe covers. no more than 5 students may be present in the operating room at a time. When in the operating room: always keep away (at least half a metre of safety distance) from sterile instruments, the surgeon and the patient. refrain from impetuous actions and movements, do not point, reach or lean over aseptically prepared areas. avoid frequently changing your position or walking in and out of the operating room without a particular reason. do not stand between the patient table and the instrument tray. waste is collected selectively sharp waste (such as metal, glass vials, syringes and needles) in the plastic bucket hazardous waste (waste that has contacted body fluids, discharge or excretion) in the yellow bag communal waste (i.e. anything not specified in the above) in the black bag students are to assist in patient transport and opening of sterile packs during. it is always allowed to ask questions. Please try to use adequate anatomical and medical terms whenever possible. After surgical procedures: students attending surgical procedures are to monitor patients during recovery from anesthesia. Any abnormalities should be reported to the anesthetist. students actively participating in surgical procedures are requested to help prepare and transport specimens procured during to the lab (histopath., internal med, etc).

9 Hogyan mosakodjunk be? 1. lépés: (szappanoldat): 3x1 perces kézmosás az ujjak hegyétől a könyökig, meleg folyóvizes öblítésekkel elválasztva; 2. lépés: a bőr szárazra törlése tiszta textil - vagy papírtörölközővel; 3. lépés: (70%-os alkohol-oldat): 5x1 perces fertőtlenítés, filmréteg-képzés. How to scrub in? 1. step (soap solution): 3 x 1-minute brushing your hand and lower arm with warm tap water rinsing in between; 2. step: skin drying with towel; 3. step: (Alcohol 70%): spread the solution on your skin for 5 x 1 minute