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Equine final practical exam - Surgery > 2. Describe the wound, clinical examination of the injured equine patient > Flashcards

2. Describe the wound, clinical examination of the injured equine patient Flashcards

1
Q

What is a wound?

A

Loss of continuity in the skin, mucous membrane or in an organ or witout underlying tissue damage

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2
Q

Name causes/etiology of wounds:

A
  1. Mechanical caused trauma
  2. Chemicals:
    - Acids = coagulation necrosis
    - Alkalis = Colliquation necrosis
  3. Thermal effects
    - Burn
    - Frostbite
  4. Radioactive injuries
  5. Electricity caused injuries
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3
Q

How would you classify a wound?

A

By:
1. Localisation
2. Shape and size
3. deep or superficial
4. Origin
5. Age
6. Healing stadium
7. What type of wound is it:

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4
Q

What do we mean by localisation in classification of a wound?

A

Which anatomical region or which organ is affected (head, neck, skin, mucous membrane, muscle)

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5
Q

What do we mean by Shape and size in classification of a wound?

A

point like
lime like
lobed
cavernous
loss of materia
loss of body part
regular edges
irregular edges

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6
Q

What do we mean by superficial or deep in classification of a wound?

A

If its superficial = denuding of epidermis, minimal bleeding, some serum exudation

Deep = Several strucutres are affected

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7
Q

What do we mean by Origin in classification of a wound?

A

Surgical or traumatical

Surgical = aseptic

Traumatical = Always contaminated

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8
Q

What do we mean by age in classification of a wound?

A

If its fresh or old

Old = granulation tissue is deep, epithelisation - no primary closure indicated

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9
Q

What do we mean by healing stadium in classification of a wound?

A

Regular healing
Irregular healing
Infected or with compulsion

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10
Q

What do we mean by type in classification of a wound?

A

We have 6 type of wounds:
1. Incised
2. Laceratged
3. Contused
4. Punture
5. Gunshot
6. Bite

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11
Q

Latin name for incised wound:

A

Vulnus scissum et caesum

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12
Q

Latin name for lacerated wound:

A

Vulnus lacerum s. ruptum

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13
Q

Latin name for contused wound:

A

Vulnus contusum

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14
Q

Latin name for puncture wound:

A

Vulnus punctum

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15
Q

Latin name for Gunshot wound:

A

Vulnus sclopetarium

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16
Q

Latin name for bite wound:

A

Vulnus morsum

17
Q

Which type of wound is this?

A

Vulnus scissum et caesum

18
Q

What type of wound is this?

A

Vulnus lacerum s ruptum

19
Q

What type of wound is this?

A

Vulnus contusum

20
Q

Vulnus scissum et caesum.
Cause, edges, tissue damage, painful?, prognosis

A

Produced by sharp objects

Wound edges: linear, smooth

Minimal tissue damage
Underlying tissue may be damaged only in the line

Minimal pain

Prognosis: in general good

21
Q

Vulnus lacerum s ruptum
Cause, edges, tissue damage, painful?, prognosis

A

Produced by irregular objects

Wound edges: Smooth-lacerated

Extensive tissue damage, loss of materia
Extensive damage of the underlying tissue

Painful

Prognosis: Depends on the individual case

22
Q

Vulnus contusum
Cause, edges, tissue damage, painful?, prognosis

A

Produced by dull objects

Wound edges: irregular

Extensive tissue damage
Extensive damage to underlying tissue
-> check for synovial cavity involvement; fill the joint with aspetic fluid, check for leakage

Very painful, initially block

Prognosis: unfavourable, anaerobic wound infections are common

23
Q

Vulnus punctum
Cause, edges, tissue damage, painful?, prognosis

A

Produced by sharp objects

Have both penetration and perforation
Penetration: Into tissue byt does not go through, only the entrance of the wound
Perforation: Both entrance and exit wound

Prognosis: Highly depends on presence of anaerobic infections

24
Q

Vulnus morsum
Cause, edges, tissue damage, painful?, prognosis

A

Caused by teeth

Carnivores: produce puncture wounds, risk of anaerobic infections

Herbivores: Produce contused wound

Prognosis: Depends on the level of tissue damage and presence of anaerobic infections

25
Q

Vulnus sclopetarium
Cause, edges, tissue damage, painful?, prognosis

A

Cause: gunshot wound, arrow, ball, bullet, splinter, shrapnel

Inlet: primer necrotical zone
Channel: Necrobiotical zone
Outlet: Molecular commotional zone

Possibilities of a bullet:
- Can wonder within the tissue
- Can produce a capsule around it

26
Q

Which steps would you do for the clinical examination of the injured horse?

A
  1. Emergency help and stabilization for transport to clinic
  2. Relief anxiety and pain
  3. Clinical examination
  4. Rule out the risks in case of wounds
  5. Examination of wounds
27
Q

Emergency help and stabilization for transport to clinic, which measures do we do?

A
  1. check circulatory and mental stata briefly
  2. Stop bleedings
  3. Prevent further injury
  4. Wounds: sterile coverage, gauze bandage, self-aticky gauze
  5. Allow safe transport
28
Q

What to use for anxiety and pain relief?

A

Seadtion -> Alpha-2 agonists
- Xylazine
- Detomidine
- Butorphanol
NOT ACE = hypotensive effects

Orthopaedic painkillers:
- COX-2: firocoxib
- be carefull in severe hydration/shock

29
Q

Which parameters do we check in clinical examination?

A

We check the circulatory system and mental state.

Heart rate: Normal=28-42

Respiratory rate: Normal 10-18

MucousMembrane, CRT: Normal: light pink, CRT=below 2

Temperature: Normal: 37-38

Check for hydration: check for skin turgor

Take blood sample: biochemistry, electrolyte

30
Q

Name some risks in case of wound injuries:

A
  1. Shock
  2. Pneumothorax
  3. Internal bleedings
  4. Perforation of internal organs

Especially important to assess the risks if the wound is above the chest

31
Q

How would you examine the wound?

A
  1. Take a swab for microbiology before cleaning
  2. Pre-OP antibiotics
  3. Aseptic preparation of the wound
  4. Wound debridement
  5. Lavage
  6. Check for involvement of underlying strucutre: joints, tendon sheaths, tendons, bones
  7. check for presence of foreign material
  8. Primary wound healing: closure
  9. Secondary wound healing in case of: high contamination, lack of tissue, huge loss of materia, location with huge moveability = results in formation of granulation tissue
32
Q

Steps for aseptic preparation of the wound:

A
  1. Clipping hair
  2. Disinfection of the skin: Povidine iodine, chlorhexidine
33
Q

What is lavage, and precasionally steps:

A

Cleans the wound of debris and bacteria, and stimulates the microcirculation.

Precautions:
- Avoid too much pressure
- Solution: Sterile isotonic, normothermic, non-toxic (NaCl, Lavanid solutions

34
Q

What is meant by wound debridement?

A

Remove injured and necrotic tissue to get fresh, intact wound margins for primary wound closure.

Equine final practical exam - Surgery (12 decks)

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