exploratory laparotomy Flashcards
what is an exploratory laparotomy (coeliotomy)?
a laparotomy perfomed with the objective of obtaining information that is not avalible via clinical diagnostic methods
once the underlying pathology has been determined the procedure may continue as a theraputic procedure
if no underlying patholgoy can be found then **organ biopsy **should be performed
what does the duodenal-colic ligament do in relation to examination of the intestine?
prevents exterization of the last portion of the duodenum
what are the 5 regions that the abdomen can be dived into for the purpose of exploration?
- cranial abdomen
- gastrointestinal tract
- right paravertebral region
- left paravertebral region
- caudal abdomen
when examining the greater peritioneal cavity what organ/tissue are you assesing?
peritoneal fluid
when examining the greater peritioneal cavity what specific manoeuvers can you do to aid examination?
-excision of falciform ligament
examination of right and left paravertebral ‘gutters’
when examining the cranial abdomen what organs/tissues are you assesing?
- liver
- gallbladder and bile ducts
- hepatic hilus (portal vein, hepatic artery, caudal vena cava)
- epiploic foramen
- spleen
when examining the cranial abdomen what specific manoeuvers can you do to aid examination?
- tiliting surgical table and transection of the triangular ligaments will facilitate exam of diagphragmatic surface of liver. palpate parenchyma caudal retraction of the stomach
- duodenal manoeuvre
- exteriorization of spleen
when examining the gastrointestinal tract what organs/tissues are you assesing?
stomach
intestinal tract
pancrease
regional lymph nodes
when examining the gastrointestinal tract what specific manoeuvers can you do to aid examination?
exteriorization of intestinal tract
exteriorization of spleen facilitates exam of left limb of pancrease
right limb of pancrease may be examed when assesing descending duodenum. palpate parenchyma
when examining the right paravertebral region what organs/tissues are you assesing?
- hepatic portal vein
- caudal vena cava
- coeliac artery
- hepatic lymph nodes
- right adrenal glands
- right kidney and proximal ureter
- right ovary and uterine horn
when examining the right paravertebral region what specific manoeuvers can you do to aid examination?
duodenal manoeuvre
when examining the left paravertebral region what organs/tissues are you assesing?
- aorta
- left adrenal gland
- left kidney adn proximal ureter
- left ovary and uterine horn
when examining the left paravertebral region what specific manoeuvers can you do to aid examination?
colonic manoeuvre
when examining the caudal abdomen what organs/tissues are you assesing?
- blader and distal ureters
- proximal urethra
- prostate gland and ductus deferens
- uterine body and proximal vagina
- regional lymph nodes
when examining the caudal abdomen what specific manoeuvers can you do to aid examination?
- cranial traction of the small intestine
- caudal reflection of the bladder
- cranial traction of the bladder
- cranial traction on bladder or traction on ductus deferens in neutred males
- caudal reflection of bladder
when examining the abdominal wall, peritoneal surface and mesenteries what organs/tissues are you assesing?
- diaphragm
- oesophageal hiatus
- aortic nad caval hiatus
- greater and lesser omentum
- internal inguinal ring
when examining the abdominal wall, peritoneal surface and mesenteries what specific manoeuvers can you do to aid examination?
- tilting the surgical table and caudal reetraction of liver loabs will facilitate exam of the visceral surface of the diaphragm
- caudal retration of the stomach
- caudal retraction of the liver lobes and sectioning the triangular ligaments
- caudal retractinoof the stomach (lesser omentum) and exteriorization (greater omentum)
how do you differentiate the duodenum from the jejunum?
the jejunum is the intestine after the duodenal-colic ligament
what part of the intestine has an unusual blood suply and what is this supply called?
ileum - antimesenteric ileal branch of ileo-colic artery
how is the spleen attached to the stomach?
the spleen is attached to the greater curvature of the stomach by ther gastro-splenic ligament
what is the colonic manuover?
pulling the descendign colon to the right utilising the mesocolon (mesentery) to view the left kidney
where is the left adreal gland found?
cranial to the left kidney sat under the left phreno-abdominal vein
