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small animal surgery > abdominal cavity > Flashcards

abdominal cavity Flashcards

1
Q

surgicasl incison into the abdominal cavity

A

celiotomy

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2
Q

flank approach incision to the abdominal cavity

A

laparatomy

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3
Q

incision through the linea alba

A

ventral midline approach

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4
Q

what are the advantages of ventral incision

A
  • most commonly used in small animals
  • easiest and quickest approach and closure
  • minimal bleeding
  • exposure of all abdominal organs
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5
Q

ventral abdominal incision parallel; to the midline

A

paramedian

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6
Q

discuss exposure of organs in paramedian incision

A

increase exposure to organs on one side of the abdominal cavity

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7
Q

what are the disadvantages of paramedian incision

A
  • increased bleeding
  • increased closure time
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8
Q

describe flank incision

A

lateral incision between last rib and tube rcoxae

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9
Q

what are the advantages of flank approach

A
  • excellent exposure of the kidney,one adrenal gland,one ovary
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10
Q

what are the disadvantages of flank incision

A

limited excess to entire abdomen

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11
Q

how is the paracostal incision made

A

caudal and parallel to the last rib

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12
Q

what are the disadvantages of paracostal incision

A
  • very limited exposure
  • rarely used alone
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13
Q

what are the advantages of combining ventral midline and paracostal incision

A

increased exposure, espercially of gall bladder and liver lobes(right)

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14
Q

what are the disadvantages of combining ventral midline and paracostal incision

A
  • increased bleeding
  • prolonged closure
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15
Q

what are the advantages of combining ventral midline and median sternotomy

A
  • increeased exposure of cranial abdomen (liver and abdomen)
    *
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16
Q

what are the disadvantages of combining ventral midline and median sternotomy

A
  • opens pleural cavity–assisted ventilation is required
  • sternum must be closed
  • thoracic drainage is required
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17
Q

explain the margins of opening the abdomen in exploratory celiotomy using the ventral midline approach

A
  • from the xyphoid to the pubis
  • the umblicus should be included in the surgical field as a landmark.
  • the skin incision should be extended 1 cm cranial and caudal to the anticipated body wall incision
  • the subQ layer is incised in the same line as the skin
  • the linea alba is identified,tented and incised.
18
Q

discuss the ventral midline approach in male dogs

A
  • the preputial orifice is draped out of the field
  • the skin incision detours lateral (right or left) to the prepuse
  • the preputialis mm. must be severed in half,ends are tagged for later reattachement
  • the incision returns to midline after branches of caudal superficial epigastric vessels are ligated
19
Q

which layer is required for closing the abdomen with ventral midline approach

A
  • the external rectus fascia
  • the internal sheath is not usually closed
  • suturing the rectus mm. layer should be avoided because it doesnot add streng of closure and
  • also increases inflamation
20
Q

explain suturing of midline incision vs when the muscles are exposed

A
  • if the incision is in the midline,full thickness bites may be placed
  • if muscle is exposed, sutures are places in the rectus sheath(fascia) only
  • sutures are placed 5-10 mm apart and incooperate 5-10 mm of tissue
21
Q

explain the type of suture and needle used in simple interupted closure of ventral midline

A
  • monofilament absobable or non absobable suture
  • dogs= size 3/0 to 0
  • cats=3/0 or 4/0
22
Q

explain the type of suture and needle used in simple continuous closure of ventral midline

A
  • monofilament synthetic absobable or non absobable suture
  • dogs=3/0 to 0
  • cats=3/0 or 4/0
  • do not use chronic gut or stainless steel suture in continuous pattern in linear alba
  • stsart at one end and close at the other end of the incision or
  • start at each end and close towards the centre of the incision. tie 2 sutures together at centre of incision
23
Q

discuss how the subQ and skin are closed (suture pattern,size of needle)

A
  • subQ tissue= simple continuous or simple interupted pattern, using 2/0 to 4/0 synthetic absobable suture
  • in the male dog the preputialis mm. mustrbe accurately apposed
  • skin=closed with 3/0 or 4/0 nylon
24
Q

indications for exploratory celiotomy biopsy

A
  • fluid accumulation–ascites
  • organ dysruption
  • biopsy
  • non responsive pain
  • non responsive dystocia
  • abnormal discharge
  • content evaluation by inspection or palpation
  • microbiological sampling
25
Q

what should you tell your anesthetian when using the trendelemburg positioning

A

the patient breathing is going to be impaired due to abdominal organs pressing on the diaphragm.

26
Q

list the equipment required for celiotomy

A
  • balfour or gosst retractors
  • gelpi retractors
  • lap sponges
  • sunction
  • doyen interstinal forceps wlwctroscapel
  • delicate thumb forceps
27
Q

discuss the surgical technique for celiotomy

A
  • essentially the same
  • after entering the peritoneal cavity,obtain sample of free fluid
  • ignore the obvious lesions unless they are life threatening eg haemorrhagesor leakage
  • thorough exploration, evaluate color,size,shape location,consistency
  • begin cranially with diaphragm
  • four quadrants
  • always use the same technique,be consistent, effecient
  • use anatomical retractors
28
Q

which type of biopsy takes the whole of the mass

A

excisional

29
Q

type of biopsy which makes a wedge of the mass and include the part of the healthy tissue

A

incisional biopsy

30
Q

organs commonly biopsied

A
  • liver
  • prostate
  • interstine
  • lnn
  • kidney
31
Q

organs less commonly biopsied

A
  • stomach
  • spleen
  • pancreas
  • urinary blader
  • greater omentum
32
Q

list all the techniques you can perform for biopsying the liver

A
  • finger crushing–be careful with bleeding and bile peritonitis
  • ligature fracture technique (guillotine)
  • instrument fragmentation
  • wedge resection
  • biopsy punch
  • tru-cut
  • hemostasis is achieved with surgicel,vetspon or omentum
    *
33
Q

how much of the intestine can be biopsied and which closure suture technique should be deployed

A
  • do not exceed 20% of interstinal circumference
    *
34
Q

which lnn are commonly biopsied

A
  • mesenteric
  • external iliac
  • colic
    *
35
Q

why is excisional biopsy of lnn prefered over FNA

A
  • provides morphological info
  • preserve regional blood supply
  • minimal handling
  • ligate blood supply
36
Q

which method is used to biopse the kidney

A

needle aspiration

37
Q

which suturing techniques are used to suture kidneys after biopsy

A

mattress or continuous pattern using omentum or oxidized cellulose

38
Q

methods of biopsy of stomach

A
  • endoscopy
  • exploratory cellotomy allows full thickness biopsy
    *
39
Q

methods of biopsy in spleen

A
  • partial spleenoctomyor wedge resection
    *
40
Q

methods of biopsy in pancrease

A

partial pancreactomy,distal aspect

41
Q

method of biopsy of UB

A
  • full thickness
  • one or two layer closure
42
Q
A

small animal surgery (3 decks)

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