Chapter 36 - Cecum Flashcards by Sofs C R

Approximately how long is the cecum?
A) 0.5 meters
B) 1 meter
C) 1.5 meters
D) 2 meters

B) 1 meter

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What is the average capacity of the horse’s cecum?
A) 10 liters
B) 20 liters
C) 30 liters
D) 40 liters

C) 30 liters

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What is the only part of the cecum that is secured to the abdominal wall?
A) The apex
B) The base
C) The body
D) The teniae

B) The base

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Where is the base of the cecum located?
A) In the dorsal right iliac and paralumbar fossa regions
B) Near the pelvic flexure
C) Along the left ventral colon
D) In the middle abdominal cavity

A) In the dorsal right iliac and paralumbar fossa regions

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What structure divides the cranial and caudal aspects of the cecal base?
A) Cecocolic fold
B) Ileal fold
C) Transverse fold
D) Greater curvature

C) Transverse fold

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How many teniae (longitudinal bands) course along the cecum?
A) Two
B) Three
C) Four
D) Five

) Four

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Which teniae are connected to the antimesenteric border of the ileum by the ileocecal fold?
A) Dorsal teniae
B) Lateral teniae
C) Ventral teniae
D) Medial teniae

A) Dorsal teniae

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The lateral cecal tenia is connected to the

lateral free tenia of the right ventral colon by the cecocolic fold

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What artery provides the major blood supply to the cecum?
A) Cranial mesenteric artery
B) Caudal mesenteric artery
C) Celiac artery
D) External iliac artery

A) Cranial mesenteric artery

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(A) Right lateral view of a cadaver cecum and large colon of a horse. (B) Medial view of a cadaver cecum of a horse. (C) Base of the cecum and the proximal part of the ascending colon (right ventral colon), opened laterally to show the ileal and cecocolic orifices, fixed in situ. a, Ileum; b, base of cecum; c, body of cecum; d, apex of cecum; e, lateral tenia; f, right ventral colon; g, ileocecal orifice;
h, cecocolic orifice; i, dorsal tenia of the cecum; j, cecolic fold; k, ventral tenia of the cecum; l, pelvic flexure; m, right dorsal colon; n, duodenum; o, medial tenia of the cecum; p, ileocecal fold.

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a, Ileum; b, base of cecum; c, body of cecum; d, apex of cecum; e, lateral tenia; f, right ventral colon; g, ileocecal orifice;
h, cecocolic orifice; i, dorsal tenia of the cecum; j, cecolic fold; k, ventral tenia of the cecum; l, pelvic flexure; m, right dorsal colon; n, duodenum; o, medial tenia of the cecum; p, ileocecal fold.

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Which cecal artery primarily supplies the cecal apex?
A) Lateral cecal artery
B) Ileocolic artery
C) Medial cecal artery
D) Cecocolic artery

C) Medial cecal artery

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What is the function of the cecal rete?
A) Facilitates digestion of proteins
B) Provides alternative blood supply in case of a thromboembolus
C) Promotes microbial digestion
D) Enhances motility of the cecum

B) Provides alternative blood supply in case of a thromboembolus

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Figure 36-2. Schematic diagram of the cecal arterial rete that form a meshlike network around the cecal veins before continuing into the submucosal network plexus. The extensive rete and submucosal network may provide an alternative route for blood flow in the case of an arterial embolus. 1, Marginal artery; 2, marginal vein; 3, secondary arcade;
4, long artery and vein; 5, tenia; 6, branch supplying the tenia; 7, vascular rete; 8, lymph node and lymph vessels (shown only at one place).

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What structure prevents the reflux of cecal contents into the ileum?
A) Cecocolic valve
B) Ileocecal orifice
C) Cecal apex
D) Lesser curvature

B) Ileocecal orifice

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Which structure allows ingesta to exit the cecum into the right ventral colon?
A) Cecocolic orifice
B) Ileocecal valve
C) Cecal base
D) Transverse fold

A) Cecocolic orifice

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What prevents retrograde movement of ingesta at the cecocolic orifice?
A) Presence of a sphincter
B) Constriction at the ileocecal orifice
C) Cecocolic valve
D) Cecal apex orientation

C) Cecocolic valve

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What are the main physiologic functions of the cecum?
A) Absorption of water and microbial digestion of carbohydrates
B) Protein digestion and glucose absorption
C) Enzyme secretion and lipid metabolism
D) Electrolyte storage and bile production

A) Absorption of water and microbial digestion of carbohydrates

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Which function is the cecum particularly effective at performing?
A) Lipid absorption
B) Reabsorption of water
C) Protein metabolism
D) Digestion of starches

B) Reabsorption of water

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In ponies, how much water is absorbed by the cecum per hour between meals?
A) 100-200 mL/h
B) 300-400 mL/h
C) 600-800 mL/h
D) 900-1000 mL/h

C) 600-800 mL/h, 30 L day

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What impact does microbial fermentation in the cecum have on a horse’s body temperature?
A) It decreases body temperature
B) It produces heat, which helps maintain body temperature
C) It neutralizes heat produced in other parts of the body
D) It causes excessive heat loss

B) It produces heat, which helps maintain body temperature

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Which volatile fatty acids are primarily produced by microbial digestion in the cecum?
A) Acetic, propionic, butyric
B) Lactic, formic, acetic
C) Stearic, butyric, propionic
D) Citric, malic, acetic

A) Acetic, propionic, butyric

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What negative effect could the heat produced by microbial fermentation have on a horse?
A) Increase in gastrointestinal motility
B) Disruption of electrolyte balance
C) Increase in body temperature during exercise in high ambient temperatures
D) Decreased microbial fermentation efficiency

C) Increase in body temperature during exercise in high ambient temperatures

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Which type of exchange occurs during volatile fatty acid absorption in the cecum? A) Ionized volatile fatty acid/bicarbonate exchange B) Glucose/insulin exchange C) Sodium/potassium exchange D) Calcium/magnesium exchange

A) Ionized volatile fatty acid/bicarbonate exchange

Which motility pattern in the cecum is associated with emptying of cecal contents? A) Pattern I B) Pattern II C) Pattern III D) Pattern IV

D) Pattern IV

How often do muscular contractions that cause cecal emptying occur in a normally fed horse? A) Every 5-10 minutes B) Every 2-3 minutes C) Every 10-15 minutes D) Once per hour

B) Every 2-3 minutes

What anatomical structure is responsible for elevating the cecal base and opening the cecocolic orifice during cecal emptying? A) Cecocolic fold B) Cecal apex C) Cupula of the cecum D) Transverse fold

C) Cupula of the cecum

What tool or technique is used to investigate cecal motility patterns? A) Visual inspection through endoscopy B) Visual inspection through indwelling cannulae C) Cinefluoroscopy D) All of the above

D) All of the above

Where does the electrical pacemaker region for cecal motility appear to be located? A) Near the ileocecal valve B) At the cecal base C) Near the cecal apex D) In the transverse colon

C) Near the cecal apex

Which method directly monitors myoelectric activity of the cecum? A) Electrointestinography B) Ultrasonography C) Radiolabeled markers D) Endoscopy

A) Electrointestinography

Which part of the cecum has the major vascular supply from the medial cecal artery? A) Cecal base B) Cecal body C) Cecal apex D) Cecocolic valve

C) Cecal apex

The ileocolic artery branches off from which major artery? A) External iliac artery B) Internal iliac artery C) Cranial mesenteric artery D) Caudal mesenteric artery

C) Cranial mesenteric artery

What structure connects the lateral cecal tenia to the right ventral colon? A) Ileocecal fold B) Cecocolic fold C) Medial cecal band D) Cecal apex

B) Cecocolic fold

What role do bacteria, protozoa, and fungi in the cecum play? A) Enzyme secretion B) Protein absorption C) Microbial digestion of carbohydrates D) Water reabsorption

C) Microbial digestion of carbohydrates

What happens when the smooth muscle around the ileocecal orifice contracts? A) It opens the orifice to allow ingesta to pass B) The submucosal vessels become engorged C) It relaxes to allow for greater blood flow D) It inhibits the movement of ingesta

B) The submucosal vessels become engorged

Why does microbial fermentation produce volatile fatty acids in the cecum? A) To aid in protein digestion B) To provide energy for the horse C) To produce heat for body temperature regulation D) To facilitate water absorption

B) To provide energy for the horse

Which nutrient type is primarily digested by microbes in the cecum? A) Proteins B) Simple sugars C) Insoluble carbohydrates D) Fats

C) Insoluble carbohydrates

What structural feature is found within the annular fold of the ileocecal orifice? A) A smooth muscle bundle B) Submucosal venous plexus C) Pacemaker region D) Cecal rete

B) Submucosal venous plexus

Which process does not occur at the cecocolic orifice? A) Sphincter contraction B) Ingestion exiting into the right ventral colon C) Movement of ingesta through the cecocolic valve D) Retrograde movement of ingesta

D) Retrograde movement of ingesta

What happens to the cranial and caudal portions of the cecal base during emptying? A) They remain separate B) They fuse C) They are elevated D) They collapse

C) They are elevated

What effect does intravenous xylazine hydrochloride have on cecal motility? A) Increases progressive motility B) Decreases both mechanical activity and progressive motility C) Stimulates contractions D) Has no effect on motility

B) Decreases both mechanical activity and progressive motility

How long does xylazine hydrochloride decrease cecal motility after administration? A) 10-15 minutes B) 15-20 minutes C) 20-30 minutes D) 30-40 minutes

C) 20-30 minutes

What is the dose of butorphanol tartrate that decreases progressive cecal motility? A) 0.02 mg/kg IV B) 0.04 mg/kg IV C) 0.06 mg/kg IV D) 0.08 mg/kg IV

B) 0.04 mg/kg IV

What is buthorphanol?

morphinan-type synthetic agonist kappa–antagonist mu opioid receptors

When administered together, how do xylazine and butorphanol affect cecal motility? A) They counteract each other B) They synergistically reduce motility C) They have no effect D) They increase motility

B) They synergistically reduce motility

What is the dose of detomidine hydrochloride that decreases cecal power ratios? A) 0.010 mg/kg IV B) 0.015 mg/kg IV C) 0.020 mg/kg IV D) 0.025 mg/kg IV

B) 0.015 mg/kg IV

Which method is used to calculate decreased cecal power ratios with detomidine administration? A) Electrocardiography B) Ultrasonography C) Multichannel electrointestinography D) Fluoroscopy

C) Multichannel electrointestinography

How does Buscopan Compositum affect cecal contractions? A) It has no effect on cecal contractions B) It increases cecal contractions C) It induces a reduction in contractions D) It stimulates rapid contractions

C) It induces a reduction in contractions

After administration of Buscopan Compositum, how long does it take for cecal contractions to be restored? A) 10 minutes B) 15 minutes C) 30 minutes D) 45 minutes

C) 30 minutes

What is the dose of bethanechol chloride that increases cecal myoelectric activity? A) 0.020 mg/kg IV B) 0.025 mg/kg IV C) 0.030 mg/kg IV D) 0.035 mg/kg IV

B) 0.025 mg/kg IV

What side effects are associated with bethanechol chloride administration? A) Mild abdominal pain and hypersalivation B) Increased heart rate and sweating C) Reduced appetite and weight loss D) Fever and tachycardia

A) Mild abdominal pain and hypersalivation

What is the main function of neostigmine methylsulfate in cecal motility? A) It decreases cecal motility B) It improves cecal emptying C) It causes cecal atony D) It reduces myoelectric activity

B) It improves cecal emptying

Which of the following medications is associated with abdominal pain in humans and equids? A) Yohimbine B) Bethanechol chloride C) Neostigmine methylsulfate D) Buscopan Compositum

C) Neostigmine methylsulfate

What effect does yohimbine have on the cecum of healthy ponies? A) Decreases myoelectric activity B) Increases myoelectric activity C) Decreases cecal emptying time D) Significantly increases motility

B) Increases myoelectric activity

Does yohimbine significantly affect cecal emptying time? A) Yes B) No

B) No

Which medication is recommended at 1.5-2 mg/kg PO to increase cecal motility? A) Erythromycin lactobionate B) Mosapride C) Yohimbine D) Neostigmine methylsulfate

B) Mosapride

What is the dose of erythromycin lactobionate that increases cecal activity in healthy horses? A) 0.5 mg/kg IV B) 1 mg/kg IV C) 1.5 mg/kg IV D) 2 mg/kg IV

B) 1 mg/kg IV

When did erythromycin (0.5 mg/kg IV) show an effect on cecal activity after exploratory celiotomy? A) 12 hours post-surgery B) 24 hours post-surgery C) 8 days post-surgery D) No effect observed

C) 8 days post-surgery

What important factor should be considered when using prokinetic medications in diseased animals? A) They may cause diarrhea B) Effects may vary with gastrointestinal disease C) They work faster in diseased animals D) They are ineffective in healthy animals

B) Effects may vary with gastrointestinal disease

Which breed is reported to have a predisposition for cecal impaction? A) Thoroughbred B) Arabian C) Quarter Horse D) Standardbred

B) Arabian

Cecal impactions are more frequently reported in horses of what age? A) Younger than 5 years B) 5-10 years C) 10-15 years D) Over 15 years

D) Over 15 years

Which type of cecal impaction involves motility dysfunction preventing cecal outflow? A) Type I B) Type II C) Acute impaction D) Chronic impaction

B) Type II

Which of the following describes a Type I cecal impaction? A) Firm dry ingesta B) Gas-filled cecum C) Motility dysfunction D) Cecal ulceration

A) Firm dry ingesta

Cecal tympany is most commonly associated with what underlying condition? A) Colonic displacement B) Cecal ulceration C) Inflammation of the colon D) Dehydration

A) Colonic displacement

What is the primary treatment for cecal tympany? A) NSAIDs B) Antibiotics C) Cecal trocharization D) Fluid therapy

C) Cecal trocharization

What risk is associated with cecal trocharization? A) Cecal perforation B) Gas trapping C) Abscess formation D) Over-stimulation of motility

C) Abscess formation

Which anatomical structure is important to avoid during cecal trocharization? A) Cecal apex B) Cecal tenia C) Cecal vasculature D) Cecocolic fold

C) Cecal vasculature

What percentage of cecal diseases are represented by cecal impaction? A) 10-15% B) 20-30% C) 40-55% D) 60-75%

C) 40-55%

Which factor is NOT a known risk for cecal impaction? A) Poor dentition B) Use of NSAIDs C) Feeding dry hay D) Overhydration

D) Overhydration

What clinical sign may indicate impending cecal rupture? A) Severe tachycardia B) Increased gut sounds C) Sudden relief of abdominal pain D) Fever and sweating

C) Sudden relief of abdominal pain

What is a hallmark of Type II cecal impaction? A) Soft ingesta buildup B) Severe pain on palpation C) Lack of detectable cecal contractions D) High fecal output

What is the typical treatment protocol for Type I cecal impaction? A) Surgery B) Dietary changes C) Trocharization D) Fluid therapy and NSAIDs

D) Fluid therapy and NSAIDs

1. What is the primary aim of medical therapy for cecal impaction? A) Eliminate the impaction surgically B) Soften the impaction for passage and restore motility C) Stimulate appetite and gastrointestinal activity D) Prevent electrolyte imbalances

B) Soften the impaction for passage and restore motility

1. Why is feed generally withheld from horses with cecal impaction? A) To improve electrolyte balance B) To prevent enlargement of the impaction C) To increase the effectiveness of oral fluids D) To facilitate surgery

B) To prevent enlargement of the impaction

2. What role does hand walking play in the treatment of cecal impaction? A) Increases fluid absorption B) Stimulates gastrointestinal motility C) Prevents electrolyte imbalances D) Reduces the need for surgery

B) Stimulates gastrointestinal motility

What is a potential risk associated with administering large volumes of oral fluids? A) Hypoglycemia B) Cecal rupture C) Hypertension D) Hypercalcemia

B) Cecal rupture

Which electrolyte abnormality is NOT a risk associated with large volumes of oral hypotonic fluids? A) Hypokalemia B) Hyponatremia C) Hypocalcemia D) Hyperkalemia

D) Hyperkalemia

What is the recommended composition of isotonic oral fluids for cecal impaction? A) 4.9 g NaCl and 0.37 g “Lite salt” B) 5.0 g KCl and 1.0 g NaCl C) 2.0 g NaCl and 0.5 g potassium phosphate D) 6.0 g NaCl and 0.5 g magnesium sulfate

A) 4.9 g NaCl and 0.37 g “Lite salt”

What is the typical tolerance of adult horses for oral fluid administration? A) 2-4 L/h B) 4-6 L/h C) 6-10 L/h D) 10-12 L/h

C) 6-10 L/h

What is a common side effect of large volume oral fluid administration? A) Diarrhea B) Constipation C) Fever D) Hypertension

A) Diarrhea

Which laxative agent has limited evidence of effectiveness in resolving cecal impactions? A) Psyllium B) Magnesium sulfate C) Mineral oil D) Dioctyl sodium sulfosuccinate (DSS)

C) Mineral oil

How is mineral oil most useful in managing cecal impaction? A) Reducing inflammation B) As a marker of transit time C) Hydrating feces D) Preventing dehydration

B) As a marker of transit time

What could the appearance of mineral oil in feces indicate in horses with cecal impaction? A) Resolution of the impaction B) Increased gastrointestinal motility C) Passage of oil despite impaction D) Dehydration

C) Passage of oil despite impaction

Which of the following is NOT a potential surgical intervention for cecal impaction? A) Typhlotomy B) Ileocecal bypass C) Gastrectomy D) Cecocolic anastomosis

C) Gastrectomy

Which factor could influence a surgeon’s decision on cecal bypass? A) Patient age B) Likelihood of functional recovery C) Amount of mineral oil administered D) Availability of oral fluids

B) Likelihood of functional recovery

What is the difference between Type I and Type II cecal impactions regarding surgery? A) Type II is more likely to require cecal bypass B) Type I requires immediate bypass C) Type II is more responsive to mineral oil D) Type I requires no surgical intervention

A) Type II is more likely to require cecal bypass

Cecal impaction can be caused by accumulation of dry ingesta (type ___) or abnormal caecal motility resulting in a feed impaction of fluid consistency (type____)

Type I or type II

What type of anesthesia is generally used for a typhlotomy? A) Local anesthesia B) General anesthesia C) Epidural anesthesia D) Regional nerve block

B) General anesthesia

What is a potential risk when exteriorizing the cecal apex during a typhlotomy? A) Cecal rupture B) Loss of motility C) Excessive dehydration D) Hemorrhage

A) Cecal rupture

How large is the incision typically made during a typhlotomy? A) 4-6 cm B) 6-8 cm C) 8-12 cm D) 12-15 cm

C) 8-12 cm

Why is manual evacuation of cecal contents rarely performed during typhlotomy? A) Risk of damaging the incision site B) High likelihood of excessive trauma and contamination C) Ineffectiveness in removing ingesta D) Requires too many assistants

B) High likelihood of excessive trauma and contamination

What solution is typically used to lavage the typhlotomy site before closure? A) Isotonic saline B) Balanced electrolyte solution C) Magnesium sulfate D) Dextrose solution

B) Balanced electrolyte solution

What type of closure technique is typically used for a typhlotomy? A) Single-layer closure B) Two- or three-layer closure C) Four-layer closure D) No closure is required

B) Two- or three-layer closure

What is a potential reason for treatment failure after a typhlotomy? A) Early return to feeding B) Cecal rupture during exteriorization C) Hypotension during surgery D) Use of isotonic fluids

B) Cecal rupture during exteriorization

What factor could make typhlotomy technically easier than a cecal bypass procedure? A) Requires fewer assistants B) Less risk of recurrence C) Quicker to perform D) Less risk of contamination

C) Quicker to perform

What percentage of horses generally survive after typhlotomy? A) 25-50% B) 50-75% C) 77-100% D) 100%

C) 77-100%

Why might partial typhlectomy be considered during cecal evacuation? A) To increase motility B) Due to excessive contamination during evacuation C) To prevent recurrence of the impaction D) To remove necrotic tissue

B) Due to excessive contamination during evacuation

What can cause nonsurvival in horses post-typhlotomy? A) Cecal filling post-operation B) Lack of motility after surgery C) Surgical infection D) High fluid intake

A) Cecal filling post-operation

What is considered crucial for successful treatment outcomes in cecal impaction surgery? A) Correct case selection B) Use of mineral oil C) Hand-walking post-surgery D) Administering oral fluids

A) Correct case selection

Why might some surgeons not choose to bypass the cecum in some cases? A) Bypassing the cecum has higher risks B) Normal motility and healthy cecal wall C) Mineral oil appeared in feces D) Cecal contents were too hard

B) Normal motility and healthy cecal wall

What is the purpose of Cecocolic Anastomosis (CCA)? A) To improve cecal motility B) To prevent peritonitis C) To provide an alternative route for ingesta to pass from the cecum to the right ventral colon D) To treat intestinal adhesions

C) To provide an alternative route for ingesta to pass from the cecum to the right ventral colon

Which of the following is the correct placement of stay sutures during CCA? A) 15 cm apart in both the cecum and right ventral colon B) 10 cm apart in both the cecum and right ventral colon C) 25 cm apart in the right ventral colon only D) 20 cm apart in both the cecum and right ventral colon

D) 20 cm apart in both the cecum and right ventral colon

Which instrument is preferred for performing CCA to reduce contamination? A) GIA-90 stapling instrument B) TA-90 stapling instrument C) Hand-sewn technique D) Parker-Kerr stapler

A) GIA-90 stapling instrument

What complication does the closure of the seromuscular layers between the cecum and colon help prevent? A) Peritonitis B) Internal herniation C) Cecal rupture D) Adhesion formation

B) Internal herniation

Why is a complete cecal bypass recommended over a partial bypass for horses at risk of recurrent cecal impaction? A) It reduces cecal filling more effectively B) It minimizes the need for NSAIDs C) It is quicker to perform D) It prevents intestinal necrosis

A) It reduces cecal filling more effectively

What suture material is recommended for apposing the seromuscular layers during CCA? A) 2-0 silk B) 2-0 polyglactin 910 C) Nylon 1-0 D) Polypropylene

B) 2-0 polyglactin 910

What percentage of horses treated with CCA experienced recurrent signs of abdominal pain and cecal tympany? A) 30% B) 40% C) 50% D) 70%

B) 40%

What is a common complication after a cecocolic anastomosis? A) Diarrhea B) Adhesion formation C) Reimpaction D) Abdominal pain and tympany

D) Abdominal pain and tympany

What is a significant advantage of using surgical stapling devices over hand-sewn techniques in CCA? A) Faster surgery time B) Reduced cecal motility C) Minimized contamination and peritonitis D) Reduced postoperative pain

C) Minimized contamination and peritonitis

Which of the following complications are commonly associated with cecal impaction surgery? A) Diarrhea, pyrexia, peritonitis B) Hemorrhage, fever, necrosis C) Infection, adhesions, sepsis D) Typhlitis, fever, liver failure

A) Diarrhea, pyrexia, peritonitis

What surgical procedure is recommended for horses with abnormal cecal motility leading to impactions? A) Cecocolic anastomosis B) Ileocolostomy C) Jejunocolostomy D) Partial resection of cecum

B) Ileocolostomy

Which complication is commonly associated with partial cecal bypass techniques? A) Postoperative fever B) Recurrent cecal filling and colic C) Peritonitis D) Adhesion formation

B) Recurrent cecal filling and colic

What percentage of horses treated with a typhlotomy and jejunocolostomy survived to discharge? A) 50% B) 60% C) 87.5% D) 90%

D) 90%

What is the primary clinical sign of acute cecocecal intussusception? A) Mild abdominal discomfort B) Moderate to severe abdominal pain C) Pyrexia D) Diarrhea

B) Moderate to severe abdominal pain

In which geographical region is the prevalence of cecocolic intussusception higher? A) Australia B) New Zealand C) United States D) Europe

B) New Zealand

What is the reported survival rate after surgery for cecocolic intussusception when manual reduction is possible? A) 50% B) 75% C) 83% D) 100%

C) 83%

Which diagnostic method may reveal a mass-like structure during cecocecal intussusception? A) Ultrasonography B) Rectal examination C) Endoscopy D) Blood work

B) Rectal examination

What is the typical appearance on ultrasonography for a cecocecal intussusception? A) Star-shaped pattern B) Linear pattern with striations C) "Target" or "bull's-eye" lesion D) None of the above

C) "Target" or "bull's-eye" lesion

Which of the following may cause cecocolic intussusception? A) Cecal abscesses and dietary changes B) Inflammation of the liver C) Celiac artery obstruction D) Abdominal herniation

A) Cecal abscesses and dietary changes

Which parasite is controversially associated with cecal intussusception? A) Strongylus vulgaris B) Ascaris suum C) A. perfoliata (Tapeworm) D) Toxocara canis

C) A. perfoliata (Tapeworm)

Which surgical option is sometimes necessary if manual reduction of cecocolic intussusception fails? A) Ileocolostomy B) Partial typhlectomy C) Cecal amputation D) Right ventral colotomy

B) Partial typhlectomy

How often is manual reduction of cecocecal intussusception successful? A) 20% B) 33% C) 50% D) 75%

B) 33%

Why is right ventral colotomy sometimes performed in cecocolic intussusception? A) To allow full manual reduction B) To resect the colon C) To reduce adhesions D) To stop bleeding

A) To allow full manual reduction

What type of suture pattern is recommended for closing colotomy sites? A) Simple interrupted B) Parker-Kerr pattern C) Double-layer inverting pattern D) None of the above

C) Double-layer inverting pattern

In cases of cecocolic intussusception, when is a partial typhlectomy indicated? A) When manual reduction is unsuccessful B) When there is vascular compromise of the cecal wall C) When the cecum is ruptured D) After a jejunocolostomy

B) When there is vascular compromise of the cecal wall

Which factor increases the risk of developing cecocolic intussusception? A) Increased exercise B) Cecal wall abscesses or masses C) High fiber diet D) Stomach ulcers

B) Cecal wall abscesses or masses

What surgical technique can minimize the risk of internal herniation after ileocolostomy? A) Stapling the mesentery to the bowel B) Performing a partial bypass C) Suturing the serosa to the colon D) Closing the ileocecal fold

D) Closing the ileocecal fold

What is the primary purpose of performing cecocolic anastomosis (CCA) in horses? A) To treat cecal torsion B) To reduce the risk of cecal impaction recurrence C) To enhance cecal motility D) To prevent diarrhea

B) To reduce the risk of cecal impaction recurrence

During the CCA procedure, which part of the intestine is primarily accessed through a ventral midline celiotomy? A) Cecum B) Right dorsal colon C) Small intestine D) Left ventral colon

A) Cecum

What type of suturing technique is recommended for closing the CCA? A) Single-layer interrupted sutures B) Two-layer side-to-side technique C) Continuous running sutures D) Simple interrupted sutures

B) Two-layer side-to-side technique

What is the preferred method for creating the CCA to minimize contamination? A) Hand sewing B) Surgical stapling instruments C) Clips and ties D) Ligatures

B) Surgical stapling instruments

How far apart should stay sutures be placed during the CCA procedure? A) 10 cm B) 15 cm C) 20 cm D) 25 cm

C) 20 cm

Which suture material is typically used for the seromuscular layers in CCA? A) Silk B) Polyglactin 910 C) Nylon D) Catgut

B) Polyglactin 910

What is a common postoperative complication following CCA? A) Peritonitis B) Colonic volvulus C) Intestinal adhesions D) Cecal rupture

A) Peritonitis

In CCA, which anatomical layers are primarily apposed during the procedure? A) Mucosal layers B) Seromuscular layers C) Epithelial layers D) Mesenteric layers

B) Seromuscular layers

What percentage of horses treated with CCA reported successful outcomes in the studies mentioned? A) 30% B) 50% C) 75% D) 86%

D) 86%

Which technique is preferred over CCA for horses at high risk of recurrent cecal impaction? A) Cecopexy B) Cecal bypass techniques C) Celiac resection D) Gastrojejunostomy

B) Cecal bypass techniques

What is the primary risk associated with cecal bypass procedures? A) Internal herniation B) Serosal contamination C) Vascular compromise D) Recurrent colic

D) Recurrent colic

What is the typical duration for NSAID therapy following CCA? A) 1 to 3 days B) 3 to 5 days C) 5 to 7 days D) 7 to 10 days

B) 3 to 5 days

Which feeding strategy is recommended for horses post-surgery after CCA? A) Immediate refeeding of hay B) Gradual introduction of short fiber feeds C) Complete fasting for 72 hours D) Only liquid diets for one week

B) Gradual introduction of short fiber feeds

What complication can arise from not closing the seromuscular layer between the cecum and colon properly? A) Cecal rupture B) Internal herniation C) Colonic torsion D) Impaction

B) Internal herniation

What is the major concern when performing partial bypass techniques? A) Increased blood loss B) Incomplete reduction of cecal size C) Anastomotic leak D) Quick refeeding

B) Incomplete reduction of cecal size

In the case of cecocecal intussusception, what is the typical age group of horses affected? A) Young horses (≤3 years) B) Mature horses (4-10 years) C) Older horses (≥11 years) D) All age groups equally

A) Young horses (≤3 years)

What type of clinical signs are typically observed with ACUTE cecal intussusceptions? A) Severe acute abdominal pain B) Weight gain and lethargy C) Chronic diarrhea D) Mild abdominal discomfort

A) Severe acute abdominal pain

What should be done if manual reduction of cecal intussusception fails? A) Immediate euthanasia B) Surgical resection C) Medical therapy for 24 hours D) Observation for 48 hours

B) Surgical resection (typhletomy)

What is the typical survival rate of horses after surgical correction of cecocolic intussusceptions? A) 10-30% B) 40-60% C) 70-90% D) 90-100%

C) 70-90%

What anatomical feature of the cecum can predispose it to intussusception? A) Teniae B) Haustra C) Cecocolic orifice D) Apex

C) Cecocolic orifice

Which form of intussusception is more likely to be non-strangulating? A) Cecocolic intussusception B) Cecocecal intussusception C) Colonic intussusception D) Jejunoileal intussusception

B) Cecocecal intussusception

Which of the following is a reported risk factor for cecal intussusception? A) Excessive exercise B) Dietary changes C) Increased water intake D) Age over 10 years

B) Dietary changes

What is the primary reason for performing cecal resection in cases of intussusception? A) To relieve pain B) To prevent further obstruction C) To address vascular compromise D) To improve digestion

C) To address vascular compromise

What type of feeding is usually reintroduced after surgery for cecal impaction? A) High-fiber pellets B) Grain-based diet C) Short fiber feeds D) Dry hay

C) Short fiber feeds

What is the function of the cecum that can be compromised in cecal bypass surgeries? A) Absorption of water B) Fermentation of fiber C) Production of bile D) Storage of food

B) Fermentation of fiber

What should be monitored post-surgery for signs of cecal complications? A) Appetite and hydration B) Temperature and heart rate C) Fecal output and abdominal pain D) All of the above

D) All of the above

Which parameter is critical to evaluate during surgery for cecal diseases? A) Abdominal distension B) Blood loss C) Vascular supply to the cecum D) Color of intestinal contents

C) Vascular supply to the cecum

What is the most common cause of cecal rupture? A) Trauma B) Intussusception C) Parasites D) Neoplasia

B) Intussusception

What type of incision is typically made for cecal surgeries? A) Vertical B) Oblique C) Laparoscopic D) Horizontal

A) Vertical

What is one of the primary indicators for surgical intervention in cecal diseases? A) Mild colic signs B) Unresponsive pain to analgesics C) Decreased appetite D) Weight loss

B) Unresponsive pain to analgesics

How can internal herniation be prevented during CCA? A) Tight closure of the abdominal wall B) Avoiding excessive manipulation of intestines C) Closing the mesenteric defect D) Using larger sutures

C) Closing the mesenteric defect

What is the primary advantage of early detection of cecal disease? A) Lower surgical costs B) Increased survival rates C) Reduced hospital stay D) Easier surgery

B) Increased survival rates

What is a potential long-term complication after CCA? A) Short bowel syndrome B) Chronic diarrhea C) Recurrent colic episodes D) Reduced fertility

C) Recurrent colic episodes

What percentage of primary cecal disorders can be attributed to infarctions? A) 5% B) 11% C) 20% D) 30%

B) 11%

Which anatomical feature is primarily responsible for the collateral blood supply to the cecum? A) Mesenteric artery B) Cecal rete C) Ileocolic artery D) Aortic branches

B) Cecal rete

Cecal infarctions are reported to be more frequent in which age group of horses? A) Foals (≤1 year) B) Young horses (1-3 years) C) Mature horses (4-10 years) D) Older horses (≥11 years)

B) Young horses (1-3 years)

Which parasite is associated with cecal infarctions in horses? A) Strongylus vulgaris B) Ascaris suum C) Cyathostomes D) Toxocara canis

A) Strongylus vulgaris

What clinical sign is NOT typically associated with cecal infarction? A) Severe abdominal pain B) Chronic diarrhea C) Cardiovascular collapse D) Mild abdominal discomfort

B) Chronic diarrhea

In the diagnosis of cecal infarction, what might abdominocentesis reveal? A) High levels of glucose B) Decreased total protein C) Elevated nucleated cell counts D) Normal electrolyte levels

C) Elevated nucleated cell counts

What surgical procedure is indicated for horses with cecal infarction? A) Typhlectomy B) Cecopexy C) Colostomy D) Enterotomy

A) Typhlectomy

What is the prognosis for survival after partial typhlectomy for cecal infarction? A) Poor B) Fair C) Good D) Excellent

C) Good

What is the most common age group for horses with cecal tumors? A) Foals B) Young horses C) Middle-aged horses D) Aged horses

D) Aged horses

What is a common clinical sign in horses with cecal tumors? A) Acute abdominal pain B) Diarrhea C) Weight loss D) Colic

C) Weight loss

Which of the following tumors has been reported in the equine cecum? A) Rhabdomyosarcoma B) Hemangiosarcoma C) Carcinoid tumor D) Squamous cell carcinoma

B) Hemangiosarcoma

How are gastrointestinal stromal tumors (GISTs) typically discovered in horses? A) During routine check-ups B) Postmortem examinations C) On radiographs D) Laparoscopic examination

B) Postmortem examinations

What is a characteristic histopathological feature of cecal GISTs? A) Solid sheets of epithelial cells B) Spindle cells in trabecular patterns C) Necrotic tissue D) Abundant mucin production

B) Spindle cells in trabecular patterns

What treatment option is primarily recommended for cecal tumors? A) Chemotherapy B) Radiation therapy C) Complete surgical resection D) Palliative care

C) Complete surgical resection

What condition has been reported as a congenital cecal issue in horses? A) Cecal volvulus B) Intraluminal vascular hamartoma C) Cecal impaction D) Cecal torsion

B) Intraluminal vascular hamartoma

What complication can arise from cecal adhesions? A) Strangulation B) Inflammation C) Ischemia D) Tumor development

A) Strangulation

Cecocutaneous fistulas may occur after which surgical procedure? A) Enterotomy B) Hernia repair C) Typhlectomy D) Gastrotomy

B) Hernia repair

What was noted about the anatomy of the cecocolic fold in cadaver ponies? A) Uniformity across all specimens B) Variability in anatomy C) Absence of defects D) Consistent size

B) Variability in anatomy

What is one possible outcome after surgical repair of cecocutaneous fistulas? A) No change B) Good prognosis C) Increased recurrence D) Immediate euthanasia

B) Good prognosis

What can cecal lipomatosis cause in horses? A) Strangulating colic B) Nonstrangulating acute colic C) Chronic diarrhea D) Weight gain

B) Nonstrangulating acute colic

What anatomical structure was implicated in the strangulation of the intestine in one report? A) Cecocolic fold B) Mesenteric root C) Right dorsal colon D) Ileal orifice

A) Cecocolic fold

What type of surgery was performed for intestinal strangulation through the cecocolic fold? A) Resection B) Typhlectomy C) Enterotomy D) Colonoscopy

A) Resection

What type of cecal tumor is most commonly found incidentally? A) Leiomyoma B) GIST C) Adenocarcinoma D) Hemangiosarcoma

B) GIST

What is the typical size range for cecal GISTs? A) 1 to 3 cm B) 1 to 10 cm C) 5 to 15 cm D) 10 to 20 cm

1-10cm

What characterizes cecal tumors in histopathological examination? A) Spindle-shaped cells B) Cuboidal epithelial cells C) Glandular structures D) Lymphocytic infiltration

A) spindle cells

What surgical technique may be necessary for complete tumor resection in some cases? A) Rib resection B) Intestinal bypass C) Laparoscopic technique D) Endoscopic approach

A) Rib resection

What is a possible treatment for cecal abscessation? A) Antibiotic therapy B) Surgical resection of adhesions C) Dietary management D) Steroid administration

B) Surgical resection of adhesions

In a case of cecal infarction, what clinical sign would likely indicate progression of the condition? A) Mild discomfort B) Severe abdominal pain C) Weight gain D) Increased appetite

B) Severe abdominal pain

Which condition is characterized by excessive fat deposition in the cecum? A) Cecal torsion B) Cecal lipomatosis C) Cecal impaction D) Cecal neoplasia

B) Cecal lipomatosis

Which finding in a horse's abdominal fluid might indicate ischemic intestine? A) Low protein concentration B) Increased white blood cell count C) Clear and straw-colored fluid D) Decreased cell count

B) Increased white blood cell count

Which of the following is true regarding cecal tumors in horses? A) They are common in young horses. B) They often present with acute colic. C) They can be found incidentally during surgery. D) They always require immediate surgery.

C) They can be found incidentally during surgery.

What indicates a successful surgical outcome for cecal tumors? A) Immediate weight gain B) Successful resection of the tumor C) Resolution of colic signs within 24 hours D) Lack of postoperative complications

B) Successful resection of the tumor

What is the most significant risk factor for developing cecal tumors in horses? A) Breed B) Age C) Diet D) Previous surgery

B) Age

What is the expected recovery period for horses after partial typhlectomy for cecal infarction? A) 1-2 days B) 2-4 days C) 1-2 weeks D) 3-4 weeks

C) 1-2 weeks

In terms of prognosis, how does the presence of adjacent bowel disease affect cecal tumors? A) Improves prognosis B) Has no effect C) Worsens prognosis D) Guarantees successful treatment

C) Worsens prognosis

Which condition can lead to secondary complications in the cecum? A) Ischemic bowel B) Gastroenteritis C) Appendicitis D) Gastric ulcers

A) Ischemic bowel

Small Intestinal Obstruction Gandini et al 2021 Combination of end-to-end jejuno-ileal anastomosis and side-to-side incomplete ileocecal bypass (hybrid jejuno-ileo-cecal anastomosis) following subtotal ileal resection in seven horses What type of surgical anastomosis was primarily performed in five of the horses after resection of the affected intestinal segments? A) End-to-end jejuno-ileal anastomosis B) Jejuno-colonic anastomosis C) Hybrid jejuno-ileo-cecal anastomosis D) Ileocecal anastomosis

C) Hybrid jejuno-ileo-cecal anastomosis

Gandini et al 2021 What was the primary clinical outcome reported for the horses after the surgical intervention? A) Development of postoperative ileus B) Survival to hospital discharge without complications C) Recurrence of colic symptoms within 6 months D) Need for additional surgical procedures

B) Survival to hospital discharge without complications

Gandini et al 2021 How many months after surgery did follow-up reveal that six horses were living without signs of colic? A) 2 to 6 months B) 4 to 17 months C) 6 to 12 months D) 1 to 3 months

B) 4 to 17 months

The new device for elective inversion of the necrotic ileal stump from article EVJ 2023 Use of a new device for inversion of the necrotic ileal stump in the caecum in four horses Gandini and Giusto

The technique for inverting the ileal stump after resection with the new device: (A) The device is inserted through the enterotomy and fed (B) through the ileocaecal orifice into the caecum until the junction between the cable puller and the hemp tape is in the caecum. (C) A full-thickness suture comprising the ileal wall and the hemp tape is placed with USP 2 PDS II suture material as deep as possible in the abdomen. (D) A Glassman or Lloyd–Davis right-angled clamp is placed deep in the abdomen as deep as possible but orad to the suture line or staple line, and the intestine is resected between the clamp and the suture line and removed. During the process, the hemp tape is also resected. (E) At this stage, the surgeon gently pushes the ileal stump through the ileocaecal orifice. This, combined with the pulling force exerted by the assistant on the device, inverts the stump through the ileocaecal orifice. (F) The caecal wall is then slid toward the ileocaecal orifice until it reaches the inverted ileal stump, the hemp tape is then cut flush to the everted ileal mucosa, and the typhlotomy is closed in a routine manner.

FIGURE 3 (A) The ileal stump is resected, the mesentery is gathered, and the jejunal stump is brought onto the caecal body. (B) A suture is started from the ileal stump and loosely passed between the ileocaecal fold and the jejunal mesentery. The suture is not tied. (C) The ileal stump is inverted and the jejunocaecostomy is completed and the suture on the mesentery and ileocaecal fold is tightened. (D) The suture is continued to completely close the rent between the caecum and jejunal mesentery.

Glassman resection clamp

Disadvantages of Gandini e Giusto 2023 Use of a new device for inversion of the necrotic ileal stump in the caecum in four horses technique?

In cases where the lieum is excessively thick and oedematous, the device may not allow for the inversion of the stump, risk of laceration of the stump while attempting to invert it.

Advantages of Gandini et al 2023 tx?

reducing the risk of caecocolic orifice obstruction, and ideally leaving less necrotic material in the abdomen but allowing for the closure of the mesenteric defect.

what was the size of thypholotomy and jejeunocecal anastomosis?

2cm and 8 cm

Gandini 2023 Ex vivo evaluation of a technique for equine jejunocecal anastomosis using radiofrequency thermofusion and a Cushing oversew - the RF causes serosal tissu damage and may increase the risk of adhesions : how far is the tissue damage? A) 4 mm B) 6 mm C) 8 mm D) 10 mm

A) 4 mm

Gandini 2023 Ex vivo evaluation of a technique for equine jejunocecal anastomosis using radiofrequency thermofusion and a Cushing oversew - what was the size of the used staples? A) 3.8 mm B) 4.5 mm C) 3.5 mm D) 4.0 mm

C) 3.5 mm

Gandini 20213Side-to-Side Jejunocecal Anastomosis Using Radiofrequency Thermofusion in Horses What parameters were compared between the radiofrequency thermofusion (TF), hand-sewn (HS), and stapled (ST) techniques? a) Blood flow and oxygen saturation b) Bursting pressure and construction time c) Tissue adhesion and infection rates d) Thermal damage and healing time

b) Bursting pressure and construction time

How did the bursting pressure of the radiofrequency-assisted anastomosis (RFA) compare to the hand-sewn (HS) and stapled (ST) groups? a) RFA had a lower bursting pressure than both HS and ST. b) RFA had the highest bursting pressure of all three groups. c) RFA had a higher bursting pressure than ST but lower than HS. d) RFA had the same bursting pressure as HS and ST.

c) RFA had a higher bursting pressure than ST but lower than HS.

What histological findings were observed regarding the thermal damage caused by the radiofrequency device? a) Thermal damage extended beyond the oversew in all layers. b) Thermal damage was within the oversew in deeper layers but extended beyond the suture line in the serosa. c) No thermal damage was observed. d) Thermal damage caused perforation in the intestinal wall.

b) Thermal damage was within the oversew in deeper layers but extended beyond the suture line in the serosa.

What potential clinical risk does the thermal damage from radiofrequency thermofusion (TF) pose? a) Increased risk of infection at the anastomosis site b) Increased risk of tissue perforation c) Increased risk of tissue adhesions d) Reduced bursting pressure of the anastomosis

c) Increased risk of tissue adhesions

Gandini 2023 Elective Inversion of Necrotic Ileal Stumps Using a New Device in Jejunocaecal Anastomosis in Horses What complications are typically associated with leaving a necrotic ileal stump during jejunocaecal anastomosis? a) Increased blood loss and infection b) Caecocolic orifice occlusion and poor outcomes c) Reduced healing time and faster recovery d) Increased bursting pressure and improved prognosis

b) Caecocolic orifice occlusion and poor outcomes

How was the device used for elective inversion of necrotic ileal stumps secured and inserted during the procedure? a) The device was stapled to the caecum and passed through the colon. b) The device was attached to hemp tape and passed through the caecum. c) The device was sutured to the ileum and passed through the stomach. d) The device was clamped to the ileum and passed through the jejunum.

b) The device was attached to hemp tape and passed through the caecum.

What were the clinical outcomes in the four cases reported in the study? a) All four horses recovered uneventfully and were discharged. b) Two horses recovered, one was euthanized, and one developed colic. c) Three horses recovered uneventfully, and one was euthanized due to colic 27 months later. d) None of the horses survived post-surgery.

c) Three horses recovered uneventfully, and one was euthanized due to colic 27 months later.

Kooper 2019 Effect of body condition on intestinal permeability in horses What was the primary method used to assess mucosal permeability in the study? A) Endoscopic examination B) Oral sugar test (OST) C) Measurement of transepithelial resistance and LPS flux D) Serum biochemical analysis

C) Measurement of transepithelial resistance and LPS flux

Which group of horses showed evidence of insulin dysregulation based on the OST? A) All lean horses B) All obese horses C) 5 obese horses and 1 lean horse D) 6 lean horses

C) 5 obese horses and 1 lean horse

What significant difference was found between obese and lean horses regarding LPS flux? A) Higher LPS flux in lean horses across all intestinal segments B) Higher LPS flux in obese horses specifically in the jejunum C) No difference in LPS flux between the two groups D) Higher LPS flux in obese horses across all intestinal segments

B) Higher LPS flux in obese horses specifically in the jejunum

Ochonski et al EVJ 2020 ECaecal fermentation characteristics of commonly used feed ingredients What percentage of body weight (BW) per day was used for the feed treatments, and how were they split? a) 0.50% BW/d split into 4 feedings b) 0.25% BW/d split into 2 feedings c) 2.00% BW/d split into 2 feedings d) 1.00% BW/d split into 3 feedings

b) 0.25% BW/d split into 2 feedings

Ochonski 2020 How many of the horses showed signs of lower oesophageal choke after consuming beet pulp (BP) pellets? a) 1 horse (16.67%) b) 2 horses (33.33%) c) 4 horses (66.67%) d) 3 horses (50%)

For type I caecal impaction, medical management consists of aggressive fluid therapy, both intravenous and enteral, to soften ingesta. Surgery is indicated if results of transrectal abdominal examination indicate that the impaction is unchanged or has enlarged, signs of abdominal pain increase, or if there is cardiovascular deterioration. Horses with type II caecal impaction have a greater chance of survival if managed ___________

surgically