Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Small Animal Surgery > Exploratory Celiotomy Biopsy Techniques > Flashcards

Exploratory Celiotomy Biopsy Techniques Flashcards

1
Q

Primary reason for doing an Exploratory Celiotomy Biopsy?

A

Most efficient path (DX tool) to a definitive DX

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Causes for Exploratory Celiotomy

A
  • Trauma → open to eval. internal damage
  • Neoplasia → locate silent tumor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When do you perform an Exploratory Celiotomy?

A
  • Timing depends on history & PE
  • Critical w/ trauma P
  • DPL (Diagnostic Peritoneal Lavage) reduced uncertainty
    • higher accuracy than abdominocentesis
  • P is not responding
  • Need stable P for successful surgery → sometimes stabilization cannot be reached → OPTIMIZE P
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How do you prep for an Exploratory Celiotomy?

A
  • Wide clip
  • Scrub SX site
  • KY jelly →protects area from being soiled w/ fur
  • Line incision w/ moist lap sponges →helps w/ sterility
  • Towel drapes, then overdrape
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How do you position your P for an exploratory celiotomy?

(4 options)

A
  • **Trendelemburg → caudal abdomen exploration **
  • Reverse Trendelemburg → cranial abdomen exploration
  • Horizontal table → thorough exploration of entire abdomen
  • Dorsal recumbency = most common
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What approach do you take when performing an exploratory celiotomy?

(multiple options)

A
  • Ventral midline = most common
    • From xiphoid to pubis
    • NO “keyhole” incisions!!!!
  • Paracostal + ventral midline incision
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Equipment needed for an exploratory celiotomy?

A
  • Balfour or Gosset Retractors
  • Gelpi Retractors
  • Lap Sponges
  • Suction
  • Doyen Intestinal Foreps
  • Electroscapel
  • Delicate thumb forceps - less traumatic than Adson-Brown or Rat thooth forceps
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Surgical Techniques for Exploratory Celiotomy

A
  • Obtaind samples of free fluid after entering the peritoneal cavity
  • Ignore obvious lesions unless life threatening
  • Perform a thorough exploration
  • Evaluation of size, shape, color, location, surface
  • _Begin cranially w/ diaphragm _
  • “Four quadrants” → cranial, caudal, left, right
  • Always use the same technique
  • **Utilize “anatomical” retractors **
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Biopsy Techniques during an Exploratory Celiotomy

A
  1. CLEAN tissues first!
    • tissues w/ the LEAST potential for contamination (ex. biopsy of small nodule)
  2. Dirty tissues last!
    • tissues w/ greater potential for contamination (ex. draining abscess)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does a P get chemical peritonitis?

A

From ruptured gallbladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Term for excising tissue w/ minimal safety margin?

(send whole piece to Path)

A

Excisional Biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the removal “protocol” for an excisional biopsy?

A
  • Mark edges w/ sharpie or stitches
  • Be careful w/ depth of biopsy
    • don’t leave diseased tissue →may recur
    • need 360 safety margin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Term for taking a V shape or little piece of tissue & send to pathologist

A

Incisional Biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Why would you do an incisional biopsy over an excisional biopsy?

A

If you cant remove the entire mass b/c it is too big, but need to obtain a sample

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

5 organs that are commonly biopsied

A
  • Liver
  • Intestines
  • Lymph nodes
  • Kidneys
  • Prostate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Why is the liver commonly biopsied?

A
  • due to liver failure
  • common site for metastasis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the biopsy techniques used on the liver?

A
  • Finger crushing
  • Ligature Fracture Technique (Guillotine)
  • Instrument fragmentation
  • Wedge resection
  • Biopsy punch
  • Tru-cut
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How is the Finger crushing biosy technique done on the liver?

A
  • One of the easiest techniques
  • Best w/ dry sponge
  • Squeeze w/ fingers
  • **Double ligate any vessels **
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How is the Ligature fracture technique performed on the liver?

A
  • Pass suture around piece of liver and tie strongly → makes knot → ligate vessels
  • Leave 0.5 - 1 cm from ligature when cutting
  • Can place pre-cut sutures & tie them → if tied too tight, it will create another biopsy → just cut section out
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Disadvantages of the Ligature Fracture Technique

(Guillotine Biopsy)

A
  • Can only sample the margin of the hepatic lobe
  • Requires a SX assistant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How do you achieve hemostasis with a liver biopsy?

A
  • Surgically
  • Vetspon
  • Omentum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

After finishing your liver biopsy and before you close, what should you check for?

A

Make sure there is NO biliary leakage!

23
Q

When taken a liver biopsy, do NOT excede ____ of intestinal _____

A

**Do NOT excede 20% of intestinal circumference **

24
Q

What suture pattern(s) do you use to close the intestines?

A
  • Single layer closure
    • NO INVERTING SUTURE PATTERNS!!! (Lambert, Cushing, Connell)
25
Q

Technique for taking an intestinal biopsy

A
  • Clamp w/ Doyen → milk contents to the side →make parallel incision → take sample w/ scissors
  • Finger clamp is less traumatic
  • Obtain multiple full thickness samples along length of intestine (~ 1 cm long)
  • Preserve luminal diameter
    • if significantly reduced after biopsy→ make dog ear suture (dilates bowel)
  • Water leak test (inject saline into clamped intestines)- may need to place another stitch & recheck
26
Q

What tissue/organ can you biopsy to determine if there is extension to dz?

A

Lymph Nodes

27
Q

What is the easiest methods to biopsy a lymph node

A

FNA

28
Q

What is the preferred biopsy method for Lymph Nodes?

A

Excisional BX

29
Q

What is the advantage of an excisional lymph node biopsy?

A

Provides morphologic information

30
Q

When perfoming a biopsy on the kidney, how to you acheive hemostasis?

A

Digital pressure

31
Q

What suture pattern do you use to close after taking a biopsy of the kidney?

A

Use a mattress or continuous suture pattern

32
Q

What type of biopsy is usually done on the prostate?

A

FNA or Wedge Biopsy

33
Q

When performing a biopsy on the prostate, what do you need to watch out for?

What do you need to avoid?

A
  • Watch out for bleeders
  • Avoid:
    • **penetrating urethra **
    • dosal aspect (trigone of the bladder)
34
Q

Organs that are less commonly biopsied

(5)

A
  • Stomach
  • Spleen
  • Pancreas
  • Urinary Bladder
  • Greater Omentum
35
Q

What is the disadvantage of using an endoscope to biopsy the stomach?

A

Can’t get full thickness BX

36
Q

What procedure(s) do you use to perform a biopsy on the spleen?

A

Partial Spleenectomy

Wedge Resection

37
Q

How do you perform a biopsy on the pancreas?

A

Partial Pancreatectomy - distal aspect

38
Q

What should you do when removing an lymph node?

A
  • Preserve regional blood supply
  • Minimal handling
  • Ligate blood supply
39
Q

How do you perform an FNA of the kidney?

A
  • Caudal → cranial direction
  • Parallel to the cortex
40
Q

How should you perfom a BX of the Urinary Bladder?

A
  • Full thickness sample
  • Inverting suture pattern
    • (Lambert, Cushing, or Connell)
41
Q

Where should you BX the Greater Omentum?

A

The distal aspect

42
Q

Why should you ALWAYS perfrom an Abdominal Lavage before closing a contaminated abdomen?

A
  • Removal of contaminants
    • less chance of complications from foreign material in the abdomen
  • Warms P
    • shortens recovery time
  • Increases survival & significantly reduces abscess formatino
43
Q

What should you use for an Abdominal Lavage?

A

warm Isotonic fluid + heparin

(repeat until clear fluid is retrieved)

44
Q

When do you NOT perfom abdominal closure?

A

when peritoneal drainage is provided

(??)

45
Q

What is the technique for closing the abdomen?

A
  • Use cruciate or simple interuppted pattern
    • remove sutures after 7-10 d.
  • ONLY incoporate the External Abdominal Fasica
    • Avoid the rectus abdominus mm. → incr. adhesions & complicates healing
    • Internal sheath does NOT yield additional strength
  • Avoid dead space → risks of seromas
46
Q

What is this positioning technique called?

A

Trendelenburg

47
Q

What is this positioning technique called?

A

Reverse Trendelenburg

48
Q

Name the 5 structures that are located in BOTH CRANIAL Quadrants of the abdomen.

(likely won’t ask)

A
  • Body of the stomach
  • Transverse colon
  • L limb of the pancreas
  • Liver
  • Diaphragm
49
Q

Name the 8 structures that are located in the R CRANIAL Quadrant of the abdomen.

(likely won’t ask)

A
  • Diaphragm
  • Epiploic foramen
  • Caudal lobe of Liver
  • R lobe & body of pancreas
  • Pylorus & pyloric antrum
  • Descending duodenum
  • R Adrenal gland
  • Cranial lobe of R kidney
50
Q

Name the 6 structures that are located in the L CRANIAL Quadrant of the abdomen.

(likely won’t ask)

A
  • Diaphragm
  • L liver lobes
  • Fundus & body of stomach
  • Cranial pole of L kidney
  • Spleen
  • L limb of the pancreas
51
Q

Name the 8 structures that are located in the R CAUDAL Quadrant of the abdomen.

(likely won’t ask)

A
  • Descending duodenum
  • Cecum
  • R uterine horn
  • R ovary
  • Caudal pole of R kidney
  • R ductus deferens
  • R vaginal ring
  • R ureter
52
Q

Name the 8 structures that are located in the L CAUDAL Quadrant of the abdomen.

(likely won’t ask)

A
  • Descending colon
  • Caudal mesenteric artery
  • Mesocolon
  • L uterine horn
  • L ovary
  • L ductus deferens
  • L vaginal ring
  • L ureter
53
Q

Name the 6 structures that are located in BOTH CAUDAL quadrants of the abdomen.

(Likely won’t ask)

A
  • Uterine body
  • Bladder
  • Prostate (if enlarged)
  • Terminal branches of Aorta
  • Caudal flexure of duodenum
  • Ileum

Small Animal Surgery (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions