Equine 1 - Surgery Flashcards
1
Q
whiter colour on xray
A
radiopaque
more radiation absorbed
2
Q
dark colour on xray
A
radiolucent
more radiation passed through
3
Q
how different organs absorb radiation
A
metal > bone > soft tissue, fat, water > gas
opaque –> lucent
4
Q
3 methods of xray detection
A
conventional
computed
direct/ digital
5
Q
periosteum
A
new bone formation on outside of bone
6
Q
endosteum
A
new bone formation on inside of bone
7
Q
sclerosis
A
increased bone mass
increased opacity
in response to stress, wall off infecton, protect weakened area
8
Q
osteophyte
A
new bone production at margins of articular cartilage and periarticular new bone
9
Q
entheseophyte
A
new bone production where tendons, ligaments or joint capsules attach on the new bone
10
Q
focal demineralisation due to
A
infection, inflammation, neoplasia
continued pressure on the bone
cyst
11
Q
general demineralisation due to
A
osteopenia
long standing non weight bearing lameness
pregnancy, dietary imbalance, metabolic imbalance
12
Q
description of fractures
A
location
complete/ incomplete/ comminuted
displace/ non displaced
articular / non articular
13
Q
physitis
A
widening at epiphseal and metaphyseal margins of the growth plate
immature horses
14
Q
ocd common location
A
hock and stifle
15
Q
ocd on xrays
A
irregular lucent zones in subchondral bone
can be surrounded by increased opacity
alteration in contour of articular surface
16
Q
osteoarthritis on xrau
A
periarticular osteophyte formation
subchonrdal bone lysis / sclerosis
lucent zones in subchonrdal bone
narrowing of joint space
cyst like lesions
joint capsule distension
17
Q
contrast radiography
A
radiodense medium
helps see communications
18
Q
standard view for lamintis
A
LM
19
Q
standard view for farrier
A
LM
DPa
20
Q
standard view for lameness
A
LM
DPa
DPrPaDiO of pedal and navicular bones
oblique and skyline view
21
Q
visible on a LM view
of distal phalanx
A
orientation of distal phalanx
distal interphalangeal joint margins
palmar processes
solar margin of distal phalanx
navicular bone
thickness of dorsal hoof wall and sole
22
Q
visible in dorsopalmar view
of distal phalanx
A
orientation of distal phalanx, thickness of sole
ungular cartilafes
solar margins of distal phalanx
prox border of nav bone
23
Q
visible in dprpadio view of distal phalanx
A
margins of distal phalanx
ungular cartilages
insertion site of cl dip joint
24
Q
name for skyline view of navicular
A
palmaroproximal palmarodistal oblique view
25
name for oblique view of navicular
dorso 6o lateral palmaromedial oblique and dorso 60 medial palmarolateral oblique
26
associated strucutres of navicular disease
navicular bursa
ddft
distal sesamoidean impar lig
collateral ligs of nav bone
chondrosesamoidean lig
27
what is OCLL
irregularity on the solar surface of the distal phalanx and other palmar processes
28
standard views of pastern bone
LM
DPa
DL-PaMO
DM-PaLO
29
standard views of fetlock
LM
DPa
DL- PaMO
DM- PaLO
flexed DPa to highlight metacarpal condyles
oblique view of sesamoid bones - latero30dorso70proximal - mediopalmarmarodistal
skyline of sagittal ridge - dorsoproximo-dorsodistal oblique
30
common injurys to splint bones
fracture
exostosis
31
standard views of carpus
LM
flexed LM
DPa
D45M- PaLO
Pa45 - DMO
skyline
32
which bone is most commonly affected by sclerosis and fractures of carpal bones
3rd carpal cone
33
standard views of radius and elbow
Mediolateral
craniocaudal
34
indications of neck xray
ataxia
neck pain
poor performance
FL lameness cant be localised with diagnostic anaesthesia
35
neck xray
lareral- lateral radiohraphs
at least 4 images
oblique views of articular process joints
36
standard view for MC III bone
LM
DPa
37
standard view for splint bones
oblique
38
stardard view for foot balance
LM
DPl
39
fetlock standard views
LM
DPl
D45- PIM oblique
Pl45L - DM oblique
40
what is sequestrum
part of devitalised bone, seperated from the surrounding bone due to necrosis
41
standard views of hock
LM
D45L - PIMO
PL45L- DMO
DPl
flexed LM
skyline
42
OCD common location
distal intermediate ridge of the tibia
trochlear ridges of the talus
medial malleolus
43
standard views of the stifle
LM
caudocranial
Flexed LM
weight bearing LM
flexed LM
caudocranial
skyline of patella
44
what to include in back xrays
dorsal spinoous processes - laterolateral
vertebral bodies - laterolateral
articular processes - ventral-dorsal- oblique views
45
xray of cranium to view
cranial vault and bony skull
ethmoid bones
part of frontal bones
ventral rami of bones
pharynx, larynx and guttural pouch
46
views of cranium
LL
VD - centre at larynx
obliques - temporomandibular joint
47
pathologies of cranium
sinusitis
cyst
tumour
proliferative ethmoid haematoma
trauma
48
suture of young horses cranium
os frontale - 3-5months
nasofrontalis - 6months
speheno- occipitalis - 5yrs
49
xray bean for LL of cranium
btw orbit and lateral opening of infraorbital canal
50
xray beam for VD of cranium
midline btw horizontal rami of mandible
at level of caudal and mid third border
51
xray of DV of cranium
saggital plane, btw orbit and foramen infrorbital
52
views for teeth and mandibles
lateral-lateral
ventrodorsal
L30V/D-RDO
53
to see on xray of teeth and mandibles
mandibular symphysis
incisors, canines, wolf teeth, premolars, molars
triadan system
54
views for [harynx, larynx, guttural pouch
LL
VD
55
fields of LL views of thorax
dorsocaudal
ventrocaudal
dorsocranial
ventrocranial
56
vascular lung disease patterns
vessels withing interstitium
changes in shape, size of pul arteries and veins
close relationship of vasculature to interstitium
inflammatory lung disease
cardiac disease
57
fields of LL in abdominal xray
cranioventral
mid ventral
mid dorsal
corsocaudal
58
risk factors of anaesthesia
age
type of surgery
position
premedication
duration of anaesthesia
time of day
59
which position is least risk
lateral is 1/3 the risk of dorsal
60
which is least risky premed
ACP
61
ASA classification of horses
1
a healthy horse
62
ASA classification of horses
2
horse with mild systemic disease - mild anaemia, rao
63
ASA classification of horses
3
horse with severe systemic disease = severe rao
64
ASA classification of horses
4
horse with severe systemic disease that is a constant threat to life - colic
65
ASA classification of horses
5
moribund horse not expected to survive - foal with uroperitoneum
66
ASA classification of horses
6
emergency
67
fasting recommended prior to anaesthesia
6hrs
68
4 steps prior to sedation
antimicrobials
antiinflammatorys
IV catheter into jugular
flushing oral cavity with tap water
69
4 steps of GA
premed
induction
maintenance
recovery
70
why is ACP good for premed
decreases risk of death
improved recovery
MAC decrease -30%
71
why are alpha2agonists good for premed
MAC decrease
analgesia
increase urine though so need to catheterise
72
opioids used for premed
dont use them alone
good analgesia
excitement at high doses
73
benzodiazepines for premed
neonates
74
combinations for premed
alpha2agonist + phenothiazine/opioid
phenothiazine +alpha2/opioid
75
drugs of induction
ketamine
guaiphenesin
barbiturates
propofol
76
effects of ketamine
analgesia
amnesia
MAC decrease
increased cardiac output
catalepsy
77
effects of guaiphenesin
centrally acting muscle relaxant
no sedation
no analgesion
also use in combo
severe ataxia
78
effects of barbiturates - thiopental
fast onset
hypotension
apnoe
no analgesia
prolonged recovery
79
effects of propofol
min organ toxicity
expensive
poor quality of inducation
min analgesia
80
combos to give for induction
ketamine + diazepam
guan + ketamin + thiopental
tiletamine + zolazepam
81
maintenance of anaesthesia
TIVA
inhalation
PIVA
82
what is ideal anaesthesia based on
hypnosis
analgesia
muscle relaxation
83
advantages of TIVA
less cardioresp depression
good analgesia
less complication
less movement
better recovery
min tissue toxicity
less polution into surgery room
84
Disadvantages of TIVA
infusion pump needed
give either bolus or continuous infusion
85
TIVA combos
guan + xylazine + ketamine
ketamine + xylazine + diazepam
86
advantages of inhalation anaesthesia
depth can chagne rapidly
can be monitores
min drug acculumation
87
disadvantages of inhalation
pollution
cardioresp depression
min analgesia
expensive
recovery not as good as tiva
88
drugs for inhalation
isoflurane
sevoflurane
desflurane
89
advantages of PIVA
less cardioresp depression
increase analgesia
decreased organ toxiicty
less pollution
increased recovery
90
disadvantages of piva
both sets of equipment needed
iv drugs accumulate in long procedures
91
drugs for piva
ketamine
alpha 2 agonists
ketamine + alpha2
lidocaine
lidocaine + ketamine
92
methods to modify stress response post op
increase tissue perfusion
LA
CRI buturphanol - decrease cortisol response
93
8 complications that may arise during/after surgery
CPR
anaphlyaxis
intraoperative hypotension
hypoxemia & hypoxia
hypercapnia
postoperative myopathy
postoperative neuropathy
postoperative laryngeal oedema
94
CPR
cause
deep anaesthesia
hypotension
95
CPR
signs
EtCO2 decrease
weak pulse
cyanotic mm
dilated pupils
agonic breath
96
CPR
treatment
discontinue anaesthesia
IPPV
compressions
ventilate with pure o2
iv drugs
97
CPR
drugs
epinephrine
dobutamine
atropine
lidocaine
98
anaphlyaxis signs
SpO2 decrease
weak pulse
ABP decrease
cardiac arrest
bronchospasm
oedema
99
anaphlyaxis
treatment
no drugs
IPPV
ventilate with o2
fluid therapy
100
anaphlyaxis
drugs
epinephrine
bronchodilator
corticosteroids
antihistamines
101
intraoperative hypotension
cause
myocardial depression, bradycardia
102
intraoperative hypotension
consequence
poor tissue perfusion
postop myopathy
spinal cord ischemia
cerebral necrosis
myocardial dysfunction
103
intraoperative hypotension
treatment
infusion - electrolyte, colloic, hypertonic
104
hypoxia
cause
inadequate tissue oxygenation
decreased perfusion
anaemia
105
hypoxemia
cause
PaO2 <60mmhg
failure in o2 supply
problem with tube
pressure on diaphragm
106
hypercapnia
cause
PaCo2 > 45mmHg
resp centre depression
hypoventilation
increased co2 production (malignant hyperthermia, HYPP)
107
hypercapnia
effects
sympathic stimulation
arrhythmia resp
incracranial pressure increase
108
hypercapnia
treatment
IPPV
109
postoperative myopathy
cause and treatment
inadepquate positioning
intraop hypotension or hypoxemia
treat - paddiny, assistance to stand, light exercise
110
postoperative neuropathy
cause & treatment
inadequate padding
overextension of limbs
treat - sling
111
postoperative laryngeal oedema
cause
negative pressure pul oedema
hemiplegia
112
postoperative laryngeal oedema
treatment
temporary tracheostomy
113
10 most common risk patietns
foals
geriatric horse
donkey
horse with intestinal emergency
pregnant mare
anesthesia and hyperkalemic periodic paralysis
anesthesia and equine malignant hyperthermia
horse with RAO
horse with laryngeal hemiplegia
horse with cv problem
114
PaO2 of foals
at birth
40mmhg
115
PaO2 of foals
at 1hr
60mmhg
116
PaO2 of foals
at 4hrs
75mmhg
117
PaO2 of foals
at 7days - adult
90mmhg
118
risks of foals during anaesthesia
hypothermia
hypoxemia
hypoglycaemia
119
effects of hypothermia
decreased MAC
bradycardia
decreased - tissue perfusion, metabolism
increased - bleeding time
delayed recovery
120
when to give alpha 2 to foals
over 4 weeks
121
what is safest for foals
diazepam IV to neonates
122
induction of foals
inhal - not recommended
iv - ket + diazepam (or alpha2) or propofol
123
maintenance of foals
inhal/TIVA/ PIVA
124
why are geriatric horses considered high risk
lower ABP
decreased ventricular filling and total body water
decreased metabolic, excretory capacity of the liver, renal, heart function
125
age associated diseases
RAO
cushings
aortic vlave insufficiency
hypothyroidism
126
why are donkeys considered high risl
narrower, deeper larynx
eliminate drugs faster
hemolysis if use gge
127
preop for colic horses
stomach tube
rapid fluid therapy
polymixin, flunixin - antiendotoxins
128
sedation for pregnant mares
opiods cross the placenta barrier
flunixin blocks pgf2a release and protects against foetal loss
129
maintenance for pregnant mare
tiva can cause bradycardia in foal
lidoaine can be toxic
130
signs during anaesthesia for horses with HYRR
hyperkaemia
tachy/brady cardia
ecg chagnes
hypotension
muscle tremor
hypercapnia
normothermia
131
alpha 2 agonists affect
presynaptic alpha 2 receptors
decrease release of catecholamines
132
effects of alpha 2 agonists
sedation
analgesia
hypertension followed by hypotension
133
cardiopulmonary effects of alpha 2 agonists
increased vagal tone
bradycardia
redruced cardiac output
reduced resp
134
gi effects of alpha 2 agonists
swallow reflex blocked
reduced bowel motility
hyperglycaemia
urination
135
intra arterial alpha 2 agonists
collapse, reversible central blindness
136
alpha 2 agonists antidotes
yohimbine
atipamezole
137
phenothiazines effects
blocks dopamine receptors
138
cardiopul effects of phenothiazines
hypotension
antiarrhythmia
antipyretic
decrease resp rate
139
contraindication of phenothiazines
hypovolaemic/ endotoxaemic shock
pain
shock
ileus
foal
stallion
140
intra arterial admin of phenothiazines
seizures
sudden death
141
septic joint synovia
WBC
> 40 g/l
142
septic joint synovia
TP
>2 g/dl
143
2 processes involved in wound healing
repair
regeneration
144
what is repair
a stopgap reaction which reestablish the continuity of interrupted tissues, results in scar tissue.
145
what is regeneration
Replacement of damaged tissues with normal cells of type lost: the cells need to be capable to mitosis
146
partial thickness wounds
migration
proliferation
147
full thickness wounds 3 steps
inflammation
proliferation
matrix synthesis and remodelling/ maturation stage
148
acute inflammatory phase
scar formation
accumulation of inflammatory exsudate
149
scar formation
bleeding - vasoconstriction - vasodilation - increased capillary permeability - cellular and non cellular components enter wound - fibrin - clot - dehydration - scab
150
cellular proliferation stage
begins when blood clots and infection has been removed
- fibroplasia
- granulation tissue
- wound contraction
151
when does First fibroblast appear
in 2-3 days
152
when does - First collagen appear
5-7 days
153
when does First elastic fibers appear
4 weeks
154
granulation tissue is composed of
capillaries, fibroblast, macrophages, mast cells
155
wound contraction is composed of
Myofibroblast
Contractile
156
effect of **Zinc** on wound healing
delayed wound
157
effect of **cu** on wound healing
collagen synthesis important
158
effect of **vitamin a** on wound healing
elasticity, collagen synthesis and epithelization
159
effect of **vitamin k ** on wound healing
haemorrhage
160
effect of **vitamin c** on wound healing
epithet anigo and collagen
161
effect of **nsaids** on wound healing
Decrease inflammation and granulation tissue formation
-painkiller
-increase blood flow
-Prefer COX-2 selective inhibitors
162
effect of **steroids** on wound healing
Stops wounds healing
Decreases collagen synthesis
Decrease Angiogenesis
Decrease Granulation tissue formation
Decrease epithelization
163
effect of **trauma** on wound healing
Infections – sensitivity
Dull trauma causes severe problems
Decrease contractility
164
effect of **local anaesthetics** on wound healing
Less leukocyte can adhere to the endothelium
Decreases blood vessel lumens
165
steps of primary wound healing
7
1. incised space fills with blood and clot
2. neutrophil accumulation
3. mitotic activity
4. macrophages dominant on day 3
5. angiogenesis dominant on day 5
6. collagen and fibroblast proliferation on the 2nd week decreased edema,
7. No sign of inflammation after 1 month, avascularisated scab.
166
disorders of primary wound healing
hematoma
wound dysjunction
resorption fever
septic signs
suture failure
167
sedcond intention steps
clean wound
granulation
constriction
epitheliazation
168
disorders of 2nd intention
clean wound
-Decreased vascularity
- necrosis
169
disorders of 2nd intention
granulation
-Not enough -too much -irregular
170
disorders of 2nd intention
constriction
no conscritction
171
disorders of 2nd intention
epitheliazation
-Tired wound – torpid wound
-Typical in large, lacerated wounds
-imperfect epithelialization, epithel detachment -Usually by irregular granulation tissue
172
increased sounds of gi
colitis
173
decreased sounds of gi
displacement
obstipation
ileus
174
percussion of gi
Left Upper third:
dulled tympanic
175
percussion of gi
left middle third
dulled tympanic
176
percussion of gi
left Lower third
dull
177
percussion of gi
Right o Upper third:
tympanic (caecum always have come gas)
178
percussion of gi
Right
o Middle third:
dulled tympanic
179
percussion of gi
Right
o Lower third:
dull
