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Large GI > Exploratory and rumen surgery, abomasal diseases, abomasal surgery > Flashcards

Exploratory and rumen surgery, abomasal diseases, abomasal surgery Flashcards

1
Q

What are the blocks for paralumbar fossa analgesia?

A

Line block (local)
Inverted L
Proximal/Distal lumbar paravertebral
Caudal epidural

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2
Q

Local analgesia blocks _____ whereas regional analgesia blocks _______.

A

Local–infiltration of local analgesic

Regional–desensitization by blocking major nerves

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3
Q

Why is regional analgesia preferred over local?

A

Better incisional healing.

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4
Q

What nerves do you block with proximal intervertebral?

A

T13, L1, L2

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5
Q

What is the landmark for proximal intervertebral block?

A

Foramen located immediately caudal to corresponding vertebra. ID cranial edge of transverse process, then ID point 1.5-2 inches off midline (this is where you block).

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6
Q

What is the landmark for distal paravertebral block?

A

Distal extremity of transverse processes of L1, L2, L4

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7
Q

Where do you inject block for distal paravertebral?

A

Ventral and dorsal to transverse process, have to block ventral and dorsal rami.

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8
Q

When do you use a standing approach for an exploratory laparotomy?

A

Minimal intra-abdominal pressure

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9
Q

When do you use a left flank approach?

A

problem suspected on the left side (rumen)

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10
Q

When do you use a right flank approach?

A

problem suspected on right side (intestinal, liver)

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11
Q

Sleeve goes on the ____ arm for a right flank approach and the ____ arm for a left flank approach.

A

Left arm–right flank

Right arm–left flank

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12
Q

When in the abdomen, what is an indicator that there is no torsion/volvulus?

A

Find omasum and should palpate vessel on top, this is indicator.

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13
Q

What structure is “home base” when in the abdomen?

A

left kidney

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14
Q

Where do you make your incision for exploratory?

A

Hands width below transverse process and hands width behind last rib

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15
Q

What are the layers that you cut through when making an incision for exploratory?

A
  1. external abdominal oblique (thickest)–fibers run caudal ventral
  2. internal abdominal oblique–fibers run cranial ventral
  3. transverse abdominus (thinnest)–fibers run straight up and down
  4. peritoneum
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16
Q

Air should move ____ abdominal cavity upon incision.

A

INTO, if air comes out suspect rupture

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17
Q

What structures should you be conscious of when cutting through peritoneum?

A

Rumen or LDA in left flank approach.

Duodenum, RDA, abomasal volvulus (AV) in right flank approach.

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18
Q

What is the most common indication for a rumenotomy?

A

Hardware disease

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19
Q

What should be done during a rumenotomy to prevent contamination of abdomen?

A

Anchor rumen to incision, creates a seal.

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20
Q

What order should you place suture when anchoring the rumen during a rumenotomy?

A

External skin
Seromuscular layer of rumen
External skin
Seromuscular layer of rumen

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21
Q

What are your options for suture patterns for rumen closure?

A

Double layer inverting continuous pattern
Cushings
Guard rumen stitch works best

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22
Q

What steps are taken when closing a rumenotomy incision?

A
  1. rumen closure
  2. lavage serosa of rumen prior to removing stay sutures
  3. routine closure of fossa incision
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23
Q

What are indications for a rumenostomy?

A

chronic rumen tympany, enteral nutrition

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24
Q

What are the reasons for a permanent rumen fistula?

A

research, large commercial farms (transfaunation)

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25
Q

What is important in pathophysiology of abomasal displacement?

A

Atony, displacement occurs as a result

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26
Q

What species is abomasal dispalcement most common in?

A

dairy, usually older female Holsteins

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27
Q

Is LDA or RDA more common?

A

LDA

28
Q

What will you find on an exam of a cow with DA?

A

Ping in location of displacement

29
Q

What is the clinical pathology of a DA?

A 
hypokalemia
hypochloremia
metabolic alkalosis
ketosis
hypoglycemia
hypocalcemia
30
Q

What is different about clin path of an AV?

A

hemoconcentration, hyponatremia

31
Q

What causes atony of the abomasum?

A

high VFA concentration, concurrent diseases

32
Q

Is it okay to wait till tomorrow to treat an RDA?

A

NO! Never sleep on an RDA, can easily turn into an AV.

33
Q

What is a nonsurgical procedure to treat a DA?

A

cast and roll

34
Q

What are differentials for a left sided ping?

A

LDA
Rumen void
Pneumoperitoneum or rumen tympany

35
Q

What are the two right sided, off-feed pings?

A

proximal colon distention (spiral colon gas)

Duodendal gas

36
Q

What factors predispose cattle to abomasal ulcers?

A

Stress and high concentrate feeds

37
Q

What are the two categories of abomasal ulcers?

A

Perforating

Non-perforating

38
Q

What signs do you see with a Type 1 ulcer? What signalment?

A

mild anemia, dark soft feces

early post-partum period in dairy cows, calves under stress

39
Q

What signs do you see with a Type 2 ulcer?

A

melena, anemia, depression, acute death

40
Q

What other disease are Type 3 ulcers associated with?

A

Lymphosarcoma

41
Q

What signs do you see with a Type 3nulcer? What signalment?

A

Anemia, melena, enlarged LN or evidence of LSA, grave prognosis
BLV-positive cows

42
Q

What signs do you see with a Type 4 ulcer?

A

Perforation with localized peritonitis, signs similar to hardware disease

43
Q

Where in the abomasum are Type 4 ulcers typically found?

A

LESSER curvature

44
Q

What signs do you see with a Type 5 ulcer? What signalment?

A

Perforation with diffuse peritonitis, severe systemic disease, signs look like shock

45
Q

Where in the abomasum are Type 5 ulcers usually found?

A

GREATER curvature

46
Q

What type of abomasal ulcer may require surgical repair?

A

Type 4

47
Q

Abomasitis is caused by what organism?

A

Clostridium perfringens type A

48
Q

What happens as a result of abomasitis? What is the signalment?

A

profound endotoxemia leads to death

young neonatal calves, usually dairy <21 days old

49
Q

How does abomasitis present?

A

rumen/abomasal tympany
abomastitis
abomasal ulceration

50
Q

What is the better approach for surgical repair of an LDA?

A

standing restraint–left paralumbar fossa abomasopexy on left side

51
Q

What structures should you be conscious of when doing a RIGHT paralumbar omentopexy?

A

Duodenum, RDA, AV

52
Q

What are the goals of a right paralumbar fossa omentopexy?

A

LDA–move back on right side of ventral abdomen
RDA/AV–lift dorsally and push cranially
Incorporate omentum into first layer of closure of peritoneum and transversus abdominus.

53
Q

What are the advantages of doing a standing DA surgery?

A

Can do alone.
Less possibility of cuasing abomasal dysfunction.
Not necessary to have displacement upon presentation.

54
Q

What structures should you be conscious of when doing a LEFT paralumbar fossa abomasopexy?

A

rumen, LDA

55
Q

Which abomasopexy approach gives the most stable and exact fixation?

A

Right paramedian abomasopexy

56
Q

After doing a right paramedian abomasopexy, roll patient into ____ lateral recumbency, then what?

A

LEFT, then sternal

57
Q

What is the sequence of a “Roll and Toggle” procedure?

A

Animal in RIGHT lateral recumb, roll from to dorsal and ping cow, insert trocar into ping area. Place toggle, then repeat 8cm caudal to first trocar with second toggle. Tie toggles, then roll into LEFT lateral recumb.

58
Q

Roll and toggle is a ______ procedure.

A

BLIND

59
Q

It is necessary to have a _________ abomasum for roll and toggle.

A

Gas-filled

60
Q

Which techniques are good for a “floating” LDA?

A

Omentopexy, pyloro-omentopexy

61
Q

Which LDA surgery is best for a pregnant cow?

A

Left flank abomasopexy

62
Q

Which LDA surgery is best for young calves?

A

Right paramedian abomasopexy

63
Q

What kind of situation is abomasal volvulus?

A

SURGICAL EMERGENCY

64
Q

What procedure should you NOT do with an abomasal volvulus?

A

Roll and toggle

65
Q

What condition can lead to an abomasal volvulus?

A

RDA

Large GI (4 decks)

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