Abomasal Fistula and Abomasal Volvulus, Fractures of the Skull Flashcards
Surgical options for Left Displaced Abomasum:
1.
2.
3.
4.
- Right flank omentopexy
- Left flank abomasopexy
- Right paramedian abomasopexy
- Closed suture or bar techniques
How does a fistula prevent wound healing?
enzymes in the fistula
First thing to do when treating an abomasal fistula?
do a CBC to identify potential electrolyte issues, and treat them.
T/F: Repair of abomasal fistulas are difficult to treat in the field?
T. Usually refer them because of the labor and equipment required
Closure after removal of abomasal fistula removal:
- Suture size to use?
- Can also place additional sutures after closure, using what material? Why that material?
- large sizes like 2-3-4
2. Steel, because it is the least tissue reactive suture
What is the most likely cause of a simple abomasal displacement?
gas accumulation causes the abomasum to rise dorsally within the abdomen, and it begins to twist and turn
Abomasal volvulus twists (clockwise/counterclockwise) from behind, and (clockwise/counterclockwise) from the right side?
counterclockwise
counterclockwise
Surgical Options for Treatment of Abomasal Volvulus:
- _____ = preferred
2.
- Right flank omentopexy
2. Right paramedian abomasopexy
When using a right flank omentopexy approach for abomasal volvulus, what should you find on the serosa of the abomasum?
descending duodenum and omentum congestion
In what direction is the liver displaced during abomasal volvulus?
It is displaced medially
Before placing a stomach the in the abomasum for fluid decompresssion, you should….
preplace a purse string suture in the seromuscular layer of the abomasum
Describe the technique for correcting the abomasal volvlus manually:
place left forearm medial to the abomasum and push laterally-ventrally-caudally, to free the duodenum from its site of entrapment ventral to the abo-omaso junction
What do you do once the volvulus has been manually corrected?
pull the omentum until you see the pylorus to confirm correction
Good prongostic indicators after abomasal volvulus surgery:
1.
2.
3.
- Sternal
- good appetitie
- Feces on wall
Cecal dilatiation, cecal displacement, and cecal volvulus all share what clinical symptom?
ping on the right paralumbar fossa
What will a rectal exam in a cecal dilatation or volvulus reveal?
distended viscus 4 inchs in diameter at the brim of the pelvis
When decompressing a cecal dilatation, you (do/do not) want to put the needle in at an angle?
do, so when you remove the needle you avoid contamination
1 cause of fractures in the skull?
Trauma
4 Aspects of the skull fracture emergency protocol in order of most important to least important:
- 2.
3.
4.
- A - Airway
- B - Breathing, Bleeding
- C - CV, circulation
- D - Drugs
T/F: In patients with suspected head trauma and increased intracranial pressure, the use of ketamine is CONTRAindicated
True
T/F: Clipping for an emergency tracheostomy is ALWAYS required
False
Anesthetic for a tracheostomy?
Local infiltration
T/F: It is easier to remove a tracheal ring in an older horse due to the decreased calcification
F, it’s harder due to increased calcification
How often should you clean a tracheostomy tube?
What should you clean it with?
twice a day
rinse with water and parahydroxide
Calvaria fractures are (easy/difficult) to diagnose with radiographs
Difficult.
Hyphaema definition
Blood in the eye
What imaging technique provides a radiographic contrast evaluation of the nasolacrimal duct?
Dacryocysto-rhinography
Equine:
What is the name of the opening to the nasolacrimal duct, and where do you find it?
Nasal punctum
at the edge of the pigmented/non-pigmented mucosa
Three BROAD steps to surgically repair a facial fracture in a foal:
1.
2.
3.
- Elevate the bone depression using periosteal elevator
- Drill holes for cerclage fixation
- Tighten cerclage wire
Technique to drain a sinus in a horse:
place a foley catheter into the sinus.
Treatment options for a fracture in the incisive region in a horse:
1. 2. 3. 4. 5
- Conservative
2 Cerclage
- Screws
- Plates
- Fixateur extern
What is the best way to anchor the cerclage wire when using the cerclage technique to repair an incisive fracture in a horse?
cut a small grove with a saw into a nearby tooth
What would you add if you wanted to create additional compressive forces during the surgical repair of a fracture in the inter-dental space of a horse?
A tension band. It transforms tension forces into compression forces. Has better fracture healing.
T/F: Wires, screws, and plates are one time use only, but you can use them twice with minimal loss of efficiency
FALSE. ONLY USE THEM ONCE. they have micro-fractures!
You can re-use clamps and bars though
What type of external fixator for the equine skull has sharp tips that clamp onto the bone?
Pinless External Fixator System
The prognosis of using Cerclage wire to repair the upper incisive region in a horse is (poor/good)?
good! GREAT even
What is the regarded tool to cut bone during an osteotomy of the equine skull?
Oscillating Saw
what kind of screws do you use to attach a fixator to the bone in a equine “parrot mouth” repair?
distraction screws
One complete turn of a distraction screw (used in equine skull fracture repair) inserts the screw by how much?
1mm per turn
Two most common cause of vertebrae fractures in a horse?
Trauma and Electrocution
In a horse with suspected vertebrae fracture, what diagnostic imaging method is contraindicated? Why?
Myelogram - may increase deficits
4 Broad treatment options for equine vertebrae fracture:
1.
2.
3.
4.
- Conservative
- Screws
- Plates
- Fixateur extern
How would you repair a fracture of the dens of the axis in a horse?
Lag-Screw fixation
How to treat a communuted fracture of C5 in a recumbent horse?
Stabilization with a plate + basket
What is the cause of static compressive spinal cord lesions in horses?
Degenerative joint disease of diarthrodial articulations of caudal cervical vertebrae
What qualifies a lesion found in a myelogram as a “clinically relevant compressive lesion”?
If BOTH dorsal and ventral contrast columns narrow at the same level
What are the three options to treat a static compressive spinal cord lesion in horses
- Rest
- Dorsal laminectomy
- Cervical ventral interbody fusion
Laminectomy for static compressive SC lesion in horses:
- What position should horse be in?
lateral recumbancy, “hanging” over the surgery table
Laminectomy for static compressive SC lesion in horses:
Incision length and location? consider use of what other tool for incision?
30-40 cm incision on dorsal midline, consider using large self-retaining retractors
Cervical ventral interbody fusion for static compressive SC lesion in horses:
What position should the horse be in?
Dorsal recumbancy, with an “over-stretching” of the neck
Cervical ventral interbody fusion for static compressive SC lesion in horses:
After identifying the vertebrae, what do you do? How?
Remove the ventral spinous process, than use 16 mm pilot hole + overdrilled with 25 mm core saw
Cervical ventral interbody fusion for static compressive SC lesion in horses:
After drilling hole, do what?
Insert basket, smooth hole with osteotome
Cervical ventral interbody fusion for static compressive SC lesion in horses:
What is the goal of placing a basket?
arthrodesis of joint
