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Small animal surgery I > Eyes and Ears > Flashcards

Eyes and Ears Flashcards

1
Q

What are three surgical diseases most commonly associated with the pinna?

A

Aural hematomas, neoplasias, and lacerations

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2
Q

What is happening with an auricular hematoma?

A

Blood is bleeding out and collecting within the cartilage plate of the pinna.

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3
Q

How do aural hematomas usually happen?

A

Excessive shaking and scratching, probably from a otitis externa

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4
Q

What endocrine disease may lead to an aural hematoma?

A

Cushings - capillary fragility

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5
Q

As a surgeon, what are your goals in treating an aural hematoma?

A

Remove the blood/clot, prevent reoccurrence, keep the ear’s shape and appearance

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6
Q

What are some indications for surgically treating an ear hematoma?

A

Chronic occurance, difficult to remove through aspiration, larger than usual

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7
Q

What are some non-surgical methods of treating an aural hematoma?

A

Aspiration - high chance of reoccurrence

Aspiration with IV Dex- 88% effective

Aspiration with local dex - 93% effective

Aspiration with local pred - 98% effective

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8
Q

What are some surgical methods of treating an aural hematoma?

A

drain tube, incisional drainage, ear hematoma kit (practivet system)

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9
Q

What are the types of drains used in aural hematomas?

A

Passive drains - penrose, teat

Active drains - butterfly catheter with suction tube

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10
Q

What is the method of incisional drainage in aural hematomas?

A

Incision (straight/S-shaped, dermal punch, laser) -> Concave surface -> removal of clot and irrigation -> Multiple mattress sutures

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11
Q

What direction must the sutures be when placing the suture patterns on an aural hematoma?

A

Vertical/ same direction with the blood vessels

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12
Q

T/F: when bandaging an ear hematoma surgery, you should use a non-adherent bandage on the incision side, and adherent bandage on the opposite side

A

True

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13
Q

With lacerations on the pinna, if only one skin surface is affected, how would you treat it?

A

Second intention healing or suture it closed

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14
Q

With lacerations of the pinna, if two skin surfaces or the cartilage is affected, what type of closure must you perform?

A

Primary closure. Use deep bites to align the cartilage and superficial bites to align the skin

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15
Q

T/F: Squamous cell carcinoma of the ear is not locally invasive, has less bleeding but high metastatic rates compared to other SCC areas.

A

False. It is locally invasive, bleeds, and has a low metastatic rate

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16
Q

How would you treat SCC of the pinna?

A

Pinnectomy (maybe even an ear canal ablation)

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17
Q

What are some predisposing factors that can lead to an animal susceptible to otitis externa?

A

pendulous ears, narrow canals, excessive hair, excessive cerumen, chronic ear moisture, inappropriate abs, polyps/tumors

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18
Q

When is surgery on an animal with otitis externa indicated?

A

When there have been multiple failed attempts to treat it medically.

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19
Q

What are some surgical procedures for otitis externa?

A

Lateral and vertical ear canal resections, total ear canal ablation with lateral bulla osteotomy

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20
Q

What are some indications for using a lateral ear canal resection?

A

Tumor involving the tragus or the lateral wall of vertical canal

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21
Q

What does performing a lateral ear canal resection do for the ear?

A

It improves ventilation and also decreases the moisture in the ear, where bacteria love to live in

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22
Q

T/F: when suturing a lateral ear canal resection, you suture the the epithelium and cartilage to the skin to close it

A

True

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23
Q

What are some complications with the lateral ear canal resection?

A

Inadequate drainage, infection is continued

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24
Q

What breed of dog do you NOT perform this procedure on?

A

Cocker Spaniels

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25
Q

What does TECA stand for?

A

Total Ear Canal Ablation

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26
Q

What are some indications for performing this sugery?

A

Ceruminous gland adenocarcinoma, extensive benign otitis, middle ear disease

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27
Q

If the lateral ear canal resection fails, what surgery would you perform after?

A

TECA

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28
Q

What are two nerve damage complications that can happen with aural surgeries?

A

Horner’s syndrome, facial nerve paralysis

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29
Q

How would you diagnose otitis media?

A

Palpate lymphs nodes, palpate temporomandibular joint, neuro exam, X-rays, CT, MRI

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30
Q

Define myringotomy

A

A surgical incision into the ear drum to relieve pressure built up inside

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31
Q

How would you medically manage middle ear disease?

A

Clean the external ear, perform myringotomy, saline, antibiotics

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32
Q

What are the surgeries procedures used to treat otitis media?

A

Ventral bulla osteotomy (VBO), and Lateral bulla osteotomy (LBO)

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33
Q

T/F: Middle ear polyps are neoplastic

A

False.

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34
Q

What are some reasons as to why ophthalmic surgical prep is different from the standard preps?

A

The eyelid skins are more delicate, so alcohol and detergents can damage the cornea and conjunctiva. Also, ocular surfaces, deep conjunctiva and 3rd eyelid have potential pathogens

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35
Q

T/F: You need to lubricate the eye area before clipping the hairs

A

True

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36
Q

What % iodine solution do you use to clean the eye for surgery?

A

0.2% (1:50) in saline solution

37
Q

T/F: There is a special draping procedure used for ophthalmic surgeries

A

False. Drape normally

38
Q

What forceps are used for ophthalmic surgeries?

A

Bishop-Harmon forceps

39
Q

What needle holders are used for ophthalmic surgeries?

A

Derf needle holder

40
Q

What scissors are used for opthalmic surgeries?

A

Stevens tenotomy scissors

41
Q

What’s the name of the speculum used for ophthalmic surgeries?

A

Barraquer eyelid speculum

42
Q

Besides direct cotton tips and sponges, what are somethings you can use to stop bleeding in the blood?

A

Cautery, phenylephrine, 1:10,000 epinephrine

43
Q

What often causes eyelid lacerations?

A

Trauma

44
Q

How many layers do you need to close when suturing up an eyelid laceration?

A

Two.

45
Q

What suture pattern should you use to close an eyelid laceration?

A

Figure of 8

46
Q

How much of the canine eyelid tumor is needed before treating it like a laceration?

A

1/3 minimum

47
Q

T/F: Most canine eyelid tumors are benign

A

True

48
Q

What cutting pattern do you use to remove a canine eyelid tumor?

A

H-Shaped resection

49
Q

What are two methods of eyelid reconstruction?

A

Single pedicle advancement flap, lip to lid flap (for lower eyelid)

50
Q

What kind of tumor is most common in feline eyelid tumors?

A

Squamous cell carcinoma

51
Q

T/F: The darker the skin on the cat, the more likely it is to have SCC

A

false. lighter skinned

52
Q

Which species, dog or cat, more commonly has eyelid agenesis?

A

Cat

53
Q

How old must the animal be before performing surgery on the animal with eyelid agenesis?

A

> 4 months

54
Q

What surgical procedure do you use to treat eyelid agenesis?

A

Dziezye Millichamp mucocutaneous pedicle graft

55
Q

What are some clinical signs of entropion?

A

Asymptomatic, but irritation, epiphora, corneal erosion/ulceration

56
Q

T/F: congenital entropion is usually unilateral

A

False. Bilateral

57
Q

How old should the dog be to surgically correct entropion?

A

> 8 months old

58
Q

What are some predisposed breeds for entropion?

A

Chow chow, Shar-Pei, Saint Bernard

59
Q

What is the acquired form of entropion represent?

A

Lid spasm from an underlying cause.

60
Q

T/F: Acquired entropion is usually unilateral

A

True

61
Q

What are four surgical options to treat entropion?

A

Eyelid tacking, Hotz Celsus, Modified Hotz Celsus, Arrowhead resection

62
Q

What is the modified Hotz-Celsus procedure used for specifically?

A

Medial canthal entropion

63
Q

What is something you must do in a modified Hotz-Celsus before cutting?

A

Isolate the lacrimal puncta!

64
Q

What areas of the eyelid are arrowhead resections for?

A

Concurrent upper and lower lateral canthal entropion

65
Q

What are two causes of acquired ectropion?

A

Contraction of scar tissue and overcorrection of entropion

66
Q

If needed surgical treatment, what two methods would you use to treat ectropion?

A

Wedge resection

V-Y blepharoplasty

67
Q

What is the most common sign with a defect in the nasolacrimal system?

A

Epiphora

68
Q

What are so tests to measure nasolacrimal function?

A

Jones 1 test, flushing, dacryocystorhinography, CT, MRI

69
Q

What are four diseases of the nasolacrimal system?

A

Punctal aplasia, micropunctum, trauma/scarring, KCS

70
Q

How would you test for trauma in the nasolacrimal system?

A

Bubble test

Inject air into puncta and look for bubbles

71
Q

How do you treat a tramatic wound on the NLS?

A

Cannulation of both lacerated sides

72
Q

What surgical diseases can the nictitating membrane have?

A

Everting nictitating membrane, prolapsed membrane (cherry eye), neoplasia

73
Q

How would you treat an everting nictitating membrane?

A

Surgical excision

74
Q

What surgical methods can be used to treat a prolapsed nictitating membrane (cherry eye)?

A

Orbital rim anchoring technique, Morgan pocket technique

75
Q

How does an anchoring technique for cherry eye work?

A

Make an incision in the anterior conjuncitva, pass suture through the hole and engage the periosteum, then make a purse string around the gland and tie it off

76
Q

How does a Morgan Pocket technique work?

A

Makes parallel incisions in the bulbar conjunctiva, and connects those without fully closing the incision (to let tears drain)

77
Q

What is the most common neoplasia of the nictitating membrane?

A

SCC

78
Q

How would you treat a neoplastic nictitating membrane?

A

Excise all of it

79
Q

When would you want to perform an enucleation?

A

Painful non visual eye

Neoplasia and non-responsive infections

80
Q

What are the two surgical techniques of enucleation?

A

Subconjunctival, transpalpebral

81
Q

How is the subconjunctival enucleation performed?

A

Lateral canthotomy, excuse eyelid margin and 3rd eyelid, separation of conjunctiva, muscles and tendons, ligate and sever optic nerve

82
Q

How is the transpalpebral enucleation performed?

A

Suture eye closed, cut around the palpebral fissure, dissect along the orbital walls and remove entire eye

83
Q

What is exenteration?

A

The removal of all viscera in the target organ

84
Q

What indication is a transpalpebral enucleation performed?

A

Neoplasia

85
Q

When should you enucleate a traumatic proptosis?

A

When 2 or more rectus muscles are ripped, or is the globe is ruptured

86
Q

How often do traumatic proptosis dogs regain vision?

A

20%

87
Q

How would you treat traumatic proptosis?

A

Temporary tarsorrhaphy for 2-3 weeks

88
Q

What are some indications for a temporary tarsorrhaphy?

A

eyelid reconstruction, entropion, lacerations, mass removals, proptosis

Small animal surgery I (8 decks)

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