CONTUSIONS AND LACERATIONS OF THE BIRTH CANAL AND NEIGHBOURING STRUCTURE Flashcards
___ and ___are more likely to be lacerated
than the dilatable vagina
cervix and vulva
The ____
surrounding the vagina of heifers of the beef
breeds makes such animals particularly prone to
vaginal contusion when the fetus is oversized
retroperitoneal fat
Infection with ____ is then
probable, and a most severe necrotic vaginitis
ensue
Fusiformis necrophorum
(very painful and causes
continuous, exhausting straining and marked toxaemia)
All
vaginal contusions and lacerations should be
treated with mild ____ and antibiotic preparations; parenteral ____should also be
given
emollient
antibiotics
Caudal epidural anaesthesia, particularly
when demetodine is used, gives temporary relief from
straining t/f
f - xylazine
vagina:
rupture complications
peritonitis,
severe pelvic cellulitis with marked toxaemia
straining,
to abscess formation with subsequent vaginal constriction
Lacerations of the cervix may
be sutured by applying _____ to the organ and withdrawing it to the
vulva
vulsellum retraction forceps
Mattress sutures of nylon, or other
multifilament, absorbable suture material,
should be used, devitalised tissue, including any
loosely attached portions of adipose tissue, being
first removed t/f
F - mono, non abs
If lacerations of the vulva and
perineum are left unsutured, scar tissue formation
and distortion impede the ____ of the
vulva, with consequent aspiration of air, vaginitis
and metritis; a special, and much more difficult,
operation is then required.
sphincter action .
In cows, previously unsuspected organising
haematomata of the vagina may suddenly prolapse from the vulva ___ weeks after parturition.
These lesions resemble fibromata and are neoplastic and are easily excised.t/f
4-6
f- NOT neoplastic
This is a sequel to contusion of the submucous
tissue during delivery.
Haematoma of the vulva
two of the lip of the vulva is
usually affected and an obvious round swelling
occupies the vulva orifice t/f
f - one lip
The condition may
arise spontaneously in the cows, but in both cows
and mares it is likely to follow assisted delivery in
which considerable manipulation, or forced traction, was required t/f
f - sponty in mares
____ of the vulva may
be confused with prolapse, tumour or cyst of the
vagina
hematoma
vulva hematoma: If left untreated, natural resolution usually
occurs within a few weeks with resorption of fluid
and regression of swelling t/f
t
vulva hematoma: pyogenic
infection ensues and may be accompanied by
____ and distortion of the vulva, with vaginal
aspiration
fibrosis
If left for ___ days after labour the
haematoma may be safely incised and the clot
removed without recurrence of haemorrhage. An
abscess should be opened and drained
3 or 4
Serious perineal injuries occur during the ___
stage of labour in both the cow and the mare,
mostly in primiparous animal
2nd
(.These injuries may
be classified as first-, second- and third-degree
tears and rectovaginal fistulae)
Many heifers sustain slight tearing of the lower
commissure because of vulval stretching during
normal labour but such lesions heal satisfactorily
by 2nd intention without suturing t/g
F - upper comm and 1st intention
(tears that extend deeply into the perineum) Such lesions destroy the sphincteric effect of the
vulva and lead to aspiration of air into the vagina, the integrity of the anus is impaired. as well t/f
f - not impaired
With greater stretching and tearing during
the second stage of labour, the wound may extend
into and destroy the anal sphincter, thus creating a
___ through which faeces fall into the terminal
vagina
cloaca
epithelial repair is rapid t/f
t
Despite rapid
epithelialisation, the abnormal communication
between the terminal rectum and vagina persists,
although its extent may be considerably reduced by
wound_____
granulation
uncommon spontaneous injuries to cattle, although they occur as
developmental anomalies in cases of anal atresia
simple rectovaginal fistulae
result from unsuccessful attempted
closure of a third-degree perineal tear, as in the
mare.
simple rectovaginal fistulae
in mares, the initial injury is
usually perforation of the vaginal roof by a ___ which may be deflected ___ during
the second stage of labour by a hymeneal rim
As
a result of vigorous sustained straining, the limb is
then likely to perforate the rectum and be forced,
possibly with the fetal head, through the ____ , which in turn may be ruptured
fetal forelimb
dorsally
anal orifice
e a third-degree
defect is easier to repair surgically than a rectovaginal fistula which would otherwise resu t/f
t
_____ of the injury may allow
repositioning of the fetal extremities and normal
vaginal delivery, but deliberate incision of the
perineum and anal sphincter is usually expedient
if the rectum is perforated
early recognition
most
common perineal injury in the mare but rectovaginal fistula formation is still more frequent in
the mare than the cow
third-degree tears
second-degree
defects are rare in the ___ but not uncommon in
___, simply because of the different mechanisms
of tearing in the two species
mares, cows
advisable to stitch deep
perineal wounds that have not perforated the anal
sphincter as soon as possible t/f
t
Third-degree tears
with destruction of the sphincter and rectovaginal
fistulae should be stitched up as well t/f
f -
left to heal by granulation and
surgical reconstruction can be undertaken later if
necessary
The extent of such defects is considerably reduced by
cicatrisation
small, oblique fistulae in the mare does not close completely,
but in most cases a significant defect remain t/f
f - walang does not
The clinical effects of a third-degree defect are
two-fold: continuous ____ of air into the
vagina and contamination of the vaginal lumen with
____ or, worse still, accumulation of ____ in its terminal segment
aspiration
fecal fluids
fecal boluses
distorting the lumen, may lead to pooling
of urine cranial to the external urethral meatus.
pneuomovagina
In both
species(cow and mare), therefore, sizeable cloacal lesions result
in ____and affected mares are also aesthetically unsuited for other uses because of perineal
incompetence
infertility
The few animals that are able
to maintain a normal pregnancy are generally
found to have a caudally sited lesion of very
long diameter t/f
f - limited diameter
Surgical intervention should be delayed until
all tissue surfaces are covered by _____ and
this usually takes 6 weeks or so
epithelium
In the mares, the
____r is sometimes everted soon after
the injury occurs , but it is easily
replaced and retained if necessary with sutures.
There is no need for other treatment during the
intervening period except perhaps for_____ prophylaxis in the mare
urinary bladder
tetanus
Second-degree defects are easily obliterated by
stripping the vaginal mucosa from the normal
level of the upper vulval commissure dorsally on
both sides and suturing the submucosal tissues as
in a ___ operation.
caslick
For many years, surgical reconstruction of the
perineum was based on the technique described
by ____ in 1938
Götze
stripping of mucosal surface –> residual shelf b/w rectum and vagina fixed ____ –> seperating the two caviies
caudally
rectum and vagina are
separated by the construction of a new shelf from
tissues in situ without undue tension on suture
lines. whose technique is this?
Aanes
n cattle, the operation is ideally performed
under general anesthesia t/f
f - caudal epi only
animal in dorsal recumbency and the hindquarters raised, under general anaesth what animal ?
mare
Mares
require no dietary preparation. In the cow, a laxative diet without roughage is advisable for 3 days
beforehand, followed by overnight starvation t/f
F - baliktad, cows ang walang dietary prep
Mares
require no dietary preparation. In the cow, a laxative diet without roughage is advisable for 3 days
beforehand, followed by overnight starvation t/f
F - baliktad, cows ang walang dietary prep
the mare is anaesthetised, a ____ may be inserted to
divert urine from the operation si
vesical catheter
in cows 6cm deep from the perineum
mares longer than this and sometimes extends to the cervix t/f
t
cicatrisation results in considerable ____ of
the cloaca which should be corrected before
suturing is begun
assymetry
The curtain of separated
vaginal mucosa is then included in the______ sutures of polyglycolic acid which are
placed and tied serially from the depth of the
wound outward
purse string
The operation is completed
with ____sutures in the perineal ski
mattress
TUnless the vulval length is inadvertently shortened during reconstruction, subsequent parturition in both the cow and the mare usually occurs
____ without the risk of vulval tearing or the
need for episiotomy
normllya
y.
Paradoxically, a simple rectovaginal fistula is
easier to repair than a third-degree defectvt/f
f - fistula mas difficult
Unless the
fistula is deeply sited, it can be exposed satisfactorily by a dorsal commissure ____ which is
extended cranially under the anal sphincter and
rectal floor beyond the fistula
episiotomy
Aanes (1964) recommends that such lesions
should first be converted into a cloaca and
repaired as such after granulation stops t/f
t
Aanes advocated a one-stage operation, but
the method to be described for repair of a thirddegree defect is a two-stage procedure with other
minor modifications of his suturing technique t/f
f -2 stage yung kay aanes, one stage yung 3rd degree
Perineal defects are usually obvious in cows but
are nevertheless sometimes not noticed by unwary
purchasers.They are less obvious in mares, particularly if the anal orifice remains intact t/f
f - mas obvious sa mares
