Ch 65 - Amputations Flashcards
What local anaesthetics can be used for blocking nerves during amputation?
What is the maximum dose?
- 0.5% bupivicaine or 0.5% ropivicaine
- Maximum 2mg/kg
What are the options for thoracic limb amputation?
- Removal of the scapula
- Disarticulation
What vessels and nerves are encountered during amputation by removal of the scapula?
- Omobrachial and cephalic vein
- Branches of superficial cervical artery including suprascapular artery
- Lateral thoracic artery, vein and nerve
- Thoracodorsal artery, vein and nerve
- Brachial plexus
- Axillary artery and vein
- External thoracic artery
Where can the superficial cervical and axillary LNs be located during forelimb amuptation?
- Superficial cervical LN: Located along prescapular branch of superficial cervical artery at its cranial aspect, deep to brachiocephalicus muscle
- Axillary LN: Located along lateral thoracic artery, caudal to axillary vein, medial to latissimus dorsi and deep pectoral muscles
List the options for pelvic limb amputation
- Disarticulation
- Osteotomy of the femur (mid-femoral)
- En bloc with acetabulectomy
Why does osteosarcoma more commonly cross the hip joint?
Ligament of the head of the femur is though to act as a bridge
What blood vessels and nerves are encountered during a pelvic limb amputation via disarticulation?
- Femoral artery and vein
- Saphenous nerve (cranial/lateral to femoral artery)
- Medial circumflex femoral artery (caudally in femoral triangle)
- Superficial circumflex iliac artery and lateral circumflex femoral artery and vein may need to be ligated if femoral artery and vein are ligated distal to these branches
- Caudal gluteal artery and vein
- Sciatic nerve
- Femoral nerve
What osteotomies are required for an acetabulectomy?
Ilial body, ischium and pubis
What alteration is recommended if performing a THR in a dog with a contralateral pelvic limb amputation?
Recommended to place the acetabular cup in a more closed position to decreases the risk of luxation (4/9 amputees had post-THR luxation in one study)
List the options for prostheses after a partial limb amputation
- Intraosseous (intraosseous transcutaneous amputation prosthesis ITAP)
- Socket prosthesis
How much of the limb must be remaining for a socket prosthesis?
At least 30% of the radius/ulna or tib/fib
What is a partial foot amputation?
Amputation of two adjacent digits en bloc, with or without the corresponding MC/MT bones
How does the vasculature of the tail differ in the cranial tail compared to the tip of the tail?
- Cranial 1/3 of the tail, there are typically 7 longitudinal arterial trunks
- Only the 2 lateral caudal arteries and the median caudal artery reach the tip