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EXAM 3 FINAL > C Section Ruminant > Flashcards

C Section Ruminant Flashcards

1
Q

What are the 2 Paravertebral Nerve blocks?

A

1) Proximal

2) Distal

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2
Q

How can you block the paralumbar fossa in cattle?

A

1) infiltration anesthesia
- Line block
- inverted L block

2) Paravertebral Nerve block
- Proximal
- Distal* (what we did in lab)

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3
Q

What are the 2 infiltration anestheia blocks used to block the paralumbar fossa?

A

1) inverted L

2) line block

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4
Q

Why is infiltration anesthesia more risky than para vertebral, in ruminants?

A

Because you will be approaching the lidocaine toxic dose.

5mg/kg
-goats more sensitive dilute to 1%

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5
Q

What is the toxic dose of lidocaine for ruminants?

A

5mg/kg

-goats more sensitive dilute to 1%

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6
Q

Describe the parameters for line block/ inverted L

A
  • 1cm deep (SQ)
  • 2-7cm deep (Muscle
  • 1-2 Mls per site
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7
Q

How do you do the inverted L block

A
  • Parallel to the last rib
  • under the transverse process of the lumbar vertebrae
  • all the way to the tuber coaxe
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8
Q

What are the advantages of infiltration anesthesia?

A

EASY to perform

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9
Q

What are the disadvantages of infiltration anesthesia?

A
  • large amounts of lidocaine required (easy to reach toxic dose)
  • anesthesia may be inadequate
  • more block required to enlarge incision
  • Lidocaine in incision site (delays healing)
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10
Q

What are the parameters of the Proximal paravertebral nerve block

A

Blocks: T13, L1, L2

-dorsal and ventral roots

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11
Q

What nerves provide sensation to the paralumbar fossa?

A

T13, L1,L2

-dorsal and ventral roots

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12
Q

What are the advantages of the Proximal paravertebral block

A

1) less lidocaine than infiltration
2) excellent anesthesia of ENTIRE FLANK
3) No lidocaine in incision

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13
Q

What are the disadvantages of Proximal paravertebral block?

A

1) more difficult to perform
2) scoliosis to side of block
3) Ataxia ( if migration of lidocaine to L3)
4) Risk of penetrating major vessels/ spinal chord

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14
Q

What Nerves does the distal paravertebral nerve block block?

A

Same nerves

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15
Q

What are the advantages of performing the DISTAL paravertebral nerve block over the proximal?

A

1) easier to perform/ regular size needle
2) no scoliosis
3) less risk of ataxia
4) less risk of damaging vessels/ spinal chord

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16
Q

What are the disadvantages of the Distal paravertebral nerve block?

A

*variable position of the nerves = potential failure

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17
Q

What are the indications for performing a C section?

A

To relieve or prevent dystocia :

1) maternal indication:
- small pelvis
- abnormal pelvic conformation
- uterine inertia/torision/rupture
- hydrops (amnion, Allantosis)
- Vaginal constriction

2) fetal indication:
- oversized fetus
- fetal malposition
- fetal monsters/emphysematous fetuses

18
Q

What does a reproductive examination for dystocia involve?

A

1) vaginal examination
- cervix dilation
- calf Presentation, Postion, Posture
- Dead/Alive, monster/emphysematous

2) Transrectal palpation

19
Q

When performing a C section from which side do you approach?

A

LEFT
-easier to manipulate rumen than SI

  • Standing = most common
20
Q

What is the standard approach to C section in cattle?

A

Standing PL fossa celiotomy (LEFT side)

21
Q

Where do you make the incision for C section in cattle?

A

Caudal 1/3 of the left paralumbar fossa

  • 10cm ventral to the transverse process
  • extend incision ventrally (40cm)
22
Q

What are the muscle layers that are cut during a C-section?

A
  • Skin
  • EAO
  • IAO
  • transverse abdominal
  • Peritoneum
23
Q

Why make the C-section incision in the caudal 1/3 of the PL fossa?

A

Ease exteriorization of uterus

24
Q

T/F: you should attempt lifting the uterus out during a C- Section in cattle?

A

FASE
-Do not attempt lifting uterus

*grasp limb (MT3/MC3) and rock uterus towards incision

25
Q

How would you close the uterus following C-section in a cow?

A

1) Single layer
- ONLY if live calf and no IU contamination (closed cervix—> elective C-section)
- continuous inverting
- avoid mucosal penetration

Or

2) Double layer
-simple continuous + and inverting sutuer:
——>Lemberg
——>Utrecht
——>Cushing

(DO not penetrate the mucosa)

26
Q

The closure of the uterus following C-section is dependent on What?

A
  • calf alive or not

- IU contamination

27
Q

WHat suture pattern has been associated with better fertility following C-section?

A

Utrecht suture patter

28
Q

Other than the standing PL celiotomy (standard) what approach can be used for C-section?

A

Left oblique Celiotomy

1) gravity horn readily exteriorized
- lesss strength needed to exteriorize uterus
- large calves
- minimized abdominal contamination

2) anesthesia of ventral body wall may occur

3) Incision 10 cm cranial and 10 cm ventral to cranial aspect to TC
- extended cranioventrally @ 45 degrees
- end 3 cm caudal to last rib
- grid technique

29
Q

When should you use the Ventral midline celiotomy approach?

A

1) fractious cattle not amendable for standing Sx
2) Recumbent cows

40 cm incision starting just cranial to udder
-extend cranially

More risk of vessel damage
-mainly in diary cattle

30
Q

What vien runs just cranial to the udder?

A

MAjor Transverse vein

31
Q

What is the best approach for a recumbent cow that requires Celiotomy?

A

Ventrolateral

32
Q

What C-section approach is recommended when you have an EMphysematous calf and why?

A

Ventrolateral Celiotomy

  • minimalists abdominal contaimination
  • want to be able to bring the uterus out of the abdomen before incising
33
Q

Describe Ventrolateral celiotomy (C-section)

A

1) incision parallel to superficial mammary vien
- mark vien when cow is standing (more prominent)
- Axial to vein

2) time consuming

3) large incision
- wound care
- wound closure

34
Q

Why is the Paramedian celiotomy approach a poor surgical approach for C-section?

A

1) dorsal recumbancy —> CV compromise
2) Poor holding layer for closure
3) hemorrhage
4) No additional advantages—> NOT recommended

35
Q

What are the complications of C-section?

A

1) Peritonitis, Metritis (ET), Adhesions

2) wound infections
- 25% more with emphysematous fetus

3) 15% decline in fertility vs vaginal delivery

4) calf survival rate 60%
- shorter duration of Sx

5) Cow survival rate 80%
- uterus exteriorization upon Sx
- removal of blood clots upon Sx
- no retained placenta

36
Q

What is the survival rate of the calf during C-section?

A

60%

37
Q

What is the survival rate of the Cow during C-section?

A

80%

Decreased mortality due to:

1) uterus exteriorization
2) removal of blood clots
3) no retained placenta

38
Q

What percent decline in fertility do you have with c-section compared with vaginal delivery?

A

15%

39
Q

What is another indication for C-section in SMALL Ruminants ?

A

Pregnancy ketosis

40
Q

What are the most commonly used approaches for C-section in SMALL ruminants?

A

1) PL fossa Celiotomy (STANDARD)
2) Ventrolateral approach
3) ventral midline Celiotomy

EXAM 3 FINAL (19 decks)

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