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6th MELEAH SAS 1 > Female Repro > Flashcards

Female Repro Flashcards

1
Q

Anatomy of the female repro tract is supplied by the ______ from the ______ artery

A

Vaginal from the internal pudendal artery

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2
Q

What are the 3 types of Vestibulovaginal stenosis? What type of abnormality is Vestibulovaginal stenosis?

A

Vestibulovaginal stenosis is a congenital abnormality

  1. Septal stenosis
  2. Annular stenosis
  3. Vaginal hypoplasia
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3
Q

What are the clinical signs of Vestibulovaginal stenosis?

A
  • Vaginitis
  • UTI
  • Painful breeding
  • Hydrocolpos
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4
Q

_______:

distension of the vagina caused by accumulation of fluid due to congenital vaginal obstruction

A

Hydrocolpos

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5
Q

_____ ______:

Connection between the rectum and vagina. Describe what type of abnormality it is?

A

Rectovaginal fistula (congenital abnormality)

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6
Q

With use of contrast rads and sterile iodinated contrast media, Vestibulovaginal stenosis is confirmed as severe when it is this value or less

A

<0.2

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7
Q

What is the BEST diagnostic modality to determine Stenosis?

A

Vaginoscopy (bc direct visualisation, and can eval the entire urogenital tract and repro. tracts and look for ectopic ureters and neoplasia

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8
Q

You can treat stenosis with a _____

A

scope

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9
Q

What are the indications of treating Vestibulovaginal stenosis? what do you always do to the urethra?

A
  1. Breeding dogs
  2. Spayed dogs with CS

Always catheterise the urethra

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10
Q

Can digital breakdown of Vestibulovaginal stenosis to break up the narrowing with your finger work??

A

It’s ineffective!!!

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11
Q

Describe how the tissue band is oriented in a septal stenosis?

A

Dorsoventrally

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12
Q

What is the common name for septal stenosis?

A

Double vagina

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13
Q

How do you treat septal stenosis?

A
  1. perform episiotomy
  2. Mucosal resection at the attachments
  3. Suture mucosa
  4. LASER ABLATION
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14
Q

________:

a surgical cut made at the opening of the vagina during childbirth, to aid a difficult delivery and prevent rupture of tissues.

A

Episiotomy

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15
Q

_______:

Incision of vulvar orifice to all access to the vestibule and vagina

A

Episiotomy

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16
Q

Why would you do a Episiotomy?

A
  1. Explore the vagina
  2. Excise vaginal masses
  3. Repair lacerations
  4. Modify strictures
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17
Q

When you perform a Episiotomy they animal is in the ______ position and you place the instrument in the _____ ______. You incise from _____ _____ to the limits of the _______

A

perineal position

place the instrument in the vulvar fissure

Incise from dorsal commissure to limits of vestibule

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18
Q

What do you do to control the hemorrhage with an episiotomy (2)? and you close in ____ layers

A

Electrocautery; Doyen forceps

Close in 3 layers (mucosa, muscle, skin)

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19
Q

Describe the shaped lesion for annular stenosis?

A

V-v junction ring shaped lesion

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20
Q

Annular stenosis includes the _____ and +/- ______

A

mucosa and submucosa and +/- muscularis

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21
Q

Annular stenosis is manifested with an _____ ______, a congenital disorder where a hymen without an opening completely obstructs the vagina. It is caused by a failure of the hymen to perforate during fetal development.

A

Imperforate hymen

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22
Q

Describe the sx apporach to annular stenosis if caudal to the pelvis?

A

Dorsal approach (vaginal resection and anastomosis)

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23
Q

Describe the sx apporach to annular stenosis if intrapelvic to the pelvis?

A

Transpelvic approach (vaginectomy)

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24
Q

_______:

often used with annular stenosis, this is a surgery to remove all or part of the vagina. It is usually used as a treatment for vaginal cancer.

A

Vaginectomy

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25
Q

Vaginal Hypoplasia causes _____ of the _____ _____

A

narrowing of the vaginal vault

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26
Q

Where does vaginal hypoplasia occur between?

A

Occurs B/w the vestibulovaginal junction and cervix

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27
Q

Vaginal hypoplasia requires _____ along with ____ and may require a ____ approach

A

vaginectomy along with OHE; pubic

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28
Q

What are the indications for a vaginectomy? (3)

A

More extensive lesions

Intrapelvic annular stenosis

Vaginal hypoplasia

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29
Q

When performing a vaginectomy you may also perform a ______ ______ approach and ____

A

ventral abdominal; OHE

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30
Q

What is the conformational abnormality where the vulva is engulfed by skin and what sized breeds are predisposed

A

Recessed Vulva (hooded vulva) medium to large breeds, overweight

31
Q

Does early spaying cause hooded vulvas??

A

Study proved no!!! so tell your clients its okay!!

32
Q

What are the clinical signs of hooded vulvas? (4)

A
  1. Skin fold dermatitis
  2. Vaginitis
  3. Recurrent UTI
  4. Incontinence
33
Q

What treatment options are there for recessed vulva?

A
  1. Cleansing regularly (prevent skin fold dermatits)
  2. Weightloss
  3. Episioplasty (vulvoplasty)
34
Q

_______:

(also known as vulvoplasty) is a surgical procedure to remove excess folds of skin which form a curtain around or over the vulva

A

Episioplasty

35
Q

Vaginal edema / hyperplasia occurs during _____ ____ and is due to high _____ levels. Seen most commonly in _____ ( < ___ years old) _____ breed dogs.

A

proestrus / estrus

high estrogen levels

<2 years old large breed

36
Q

Vaginal edema / hyperplasia happens during this time and what do we see?

A

one of first 3 estrus cycles

Mucosa protrudes from the vulva

37
Q

Where does the tissue arise from with Vaginal edema / hyperplasia and subject to _____ and _____

A

ventral vaginal floor subject to dessication and self trauma

38
Q

What is the general medical treatment for Vaginal edema / hyperplasia

A

conservative management and use of lubricants and e collars

  • reduce the exposed tissue
  • recommend OHE to prevent reoccurrence
39
Q

What is the surgical treatment of Vaginal edema / hyperplasia

A

Significant mucosal injury, OHE of the breeding animal, mucosal resection through EPISIOTOMY

40
Q

Vaginal edema / hyperplasia resolves with this?

A

termination of estrus

41
Q

______ ______:

very rare, often mistake for edema, the entire circumference prolapses and appears DONUT SHAPED

A

Vaginal prolapse

42
Q

How do you treat vaginal prolapse?

A

manual reduction and OHE

43
Q

_____ _____ ______:

takes place with recurrence of estrus cycle following OHE/OVE and is caused by these etiologies (3)?

A

Ovarian Remnant Syndrome

  • Decreased visualisation
  • Improper surgical technique
  • Dropped ovarian tissue revascularizes
44
Q

Ovarian Remnant Syndrome is more common in ____

A

cats

45
Q

What are the clinical signs of Ovarian Remnant Syndrome (3)?

A

Vulvar enlargement (dog)

Attraction to males

Willingness to breed

46
Q

Upon vaginal cytology in dogs with Ovarian Remnant Syndrome what does it mimic?

A

normal heat cycles

47
Q

Ovarian Remnant Syndrome treatment is often _____ removal during _____ by a _____ surgeon. The remnant is usually at this location and why do you need to be carefuL?

A
  1. Surgical removal during estrus by referral surgean

2. Remnant usually at the caudal pole of the kidney careful to avoid the ureter

48
Q

Ovarian Remnant Syndrome hormones are elevated (3)?

A
  • estrogen
  • progesterone
  • Cats require lutinization to evaluate progesterone
49
Q

______:

Inability to expel a fetus through the birth canal and _____ causes responsible for 75% and are these 3 reasons?

A

Dystocia; maternal

  1. Primary uterine inertia
  2. Secondary uterine inertia
  3. Birth canal obstruction (small pelvic canal, malunion fracture)
50
Q

Dystocia due to fetal causes are from these 4 things?

A
  1. Malposition
  2. Malformation
  3. Oversized
  4. Fetal etiology can cause secondary uterine inertia
51
Q

______ _____ ______:

os where parturition fails to proceed and the birth canal/ fetal size present normal?

A

Primary uterine Inertia

52
Q

With Primary uterine Inertia are neonates born?

A

No neonates born

53
Q

what is the etiology of Primary uterine Inertia

A

Oversized litters (uterine stretching)

Undersized litters (uterine stimulation)

54
Q

What are the clinical signs of Primary uterine Inertia? (3)

A
  • No signs of parturition
  • Prolonged gestation > 68 days
  • ***No puppies 36 hours after temp is <100 degrees F
55
Q

Describe the 2 main components of Secondary uterine Inertia

A

Normal delivery of part of the litter

develops uterine fatigue!!!

56
Q

What are the 4 etiologies of Secondary uterine Inertia

A
  1. Fetal obstruction
  2. Pelvic obstruction
  3. Fetal malposition
  4. Fetal size
57
Q

What are the 2 clinical signs of Secondary uterine Inertia

A
  1. prolonged interval between neonates > 4 hours

2. Weak or absent uterine contractions from fatigue

58
Q

_______:

the normal discharge from the uterus after childbirth.

A

Lochia

59
Q

With a dystocia physical exam you will often see _____ without delivery and feel an obstructed canal on palpation from abnormal fetal presentation characterized by lack of _____ _____ in response to ______ ______

A

Lochia; uterine contractions; Fergusons reflex

60
Q

Which type of uterine inertia can be treated medically?

A

Primary (NEVER secondary)

61
Q

How do you medically treat primary uterine inertia? (4)

A
  1. Oxytocin and repeat in 30 min if necessary
  2. If positive results can contine to repeat oxytocic
  3. manual manipulation of fetus if in vaginal vaulta if obstructed
  4. Perform c section if no results?
62
Q

Why would you do a C section? (5)

A

Secondary to uterine inertia

primary uterine inertia refractory to treatment

Systemic signs of bitch

fetal distress diagnosed by ultrasound

planned for high risk patients

63
Q

WHere is the incision for C section compared to hysterotomy?

A

Be careful!!! Midway between xiphoid and umbilicus to cranial pubis

Hysterotomy Ventral midline into uterine body

64
Q

With C sections what must you do carefully?

A

Exteriorize the uterus (vascular and friable)

65
Q

What do you need todo during a c section and avoid? (3)

A

Avoid incison over fetus

milk fetus to incision

pull placenta releases

66
Q

C section patients are packed off with these?

A

Pack off with laparotomy sponges

67
Q

With C sections you first engage the _____ layer, and clamp the umbilical cord _____ cm from abdominal and then pass the fetus to assistant. Placent can pass naturally if….

A

Sub Q; 2-6; firmly attached

68
Q

Describe the closure for c section and suture (check for?) (what type suture) (layers?) (what dont you penetrate)

A

Check uterus for more fetus

3/0 monofilament absorbable

single layer or double layer with inverting

holding layer

do not penetrate lumen

69
Q

With c sections, if visible involution has not started or excessive hemorrhage what can you give?

A

Oxytocin IM

70
Q

With c section, if you are finishing with a OHE there is no need for ______. (enbloc resection)

A

closure

71
Q

What are the advantages of enbloc resection? (5)

A
  1. OHE
  2. Dystocia Tx
  3. Decreased anesthesia time
  4. Decreased abdominal contamination
  5. No increased fetal mortality
72
Q

Describe the basic procedure for enblock resection? (5)

A
  • Break down SUSPENSORY ligament**
  • Triple clamp pedicles
  • Transect
  • Hand uterus to assitant
  • Remove puppies < 60 seconds after clamps
73
Q

______

a congenital condition in males in which the opening of the urethra is on the underside of the penis.

A

Hypospadius

6th MELEAH SAS 1 (8 decks)

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