Food Animal Exam Lecture 2: Clinical Anatomy of spine, abdomen, and perineum Flashcards
what is the difference between a spinal anesthesia and epidural
- Epidural is injected into epidural space where there is NO CSF but negative pressure
- Spinal anesthesia is through dura and into CSF in subarachnoid space
How much lidocaine do you use in cattle for caudal epidural
1mL/200lbs, maximum 6mL’s
How much lidocaine do you use for small ruminants in caudal epidurals
1mL/100lbs
What are some indications for caudal epidurals
- Dystocia
- C-section
- Rectal prolapse
- Vaginal prolapse
- Uterine prolapse
- PU-urolithiasis
What are the 3 possible locations for a caudal epidural
- Sacroccoygeal joint
- 1st intercoccygeal joint
- 2nd intercoccygeal joint
Which location for the caudal epidural has the best access
1st intercoccygeal joint
How should you place the needle during a caudal epidural
Perpendicular to skin NOT ground
How do you know you are in correct space when doing an epidural
Place a lidocaine bleb in the hub and advance until negative pressure sucks lidocaine down
What are some indications for a LS epidural
- C-section
- Umbilical surgery
- Mastectomy
- Tube cystotomy
- Painful fracture near hind end
In additional to LS epidural what other blocks must be done for umbilical surgery
Local blocks cranial to umbilicus
What does the LS epidural blocks
Sensory and motor to caudal 1/2 of body
How much lidocaine should be given to small ruminant for LS epidural
1m/l15lb
How much lidocaine should be given to small ruminant for LS spinal anesthesia
0.5mL/15lb
What is the correct technique for a CSF aspirate in LS region
Use midline just caudal to line connecting tuber coaxes
What are some negative effects of line blocks/inverted L blocks
- Incomplete block of peritoneum
- Hematomas in incision
- Large amounts of lidocaine—> toxicity
Paravertebral local anesthesia blocks are good for ___relaxation
Muscle
What are the two types of paravertebral local anesthesia
- Proximal/dorsal
- Distal/lateral- “tip”
Which paravertebral local anesthetic injection uses less lidocaine and is better for fat/heavily muscled animals
Proximal/dorsal
What paravertebral anesthetic injection uses more lidocaine and is easily done on this cows
Distal/lateral- “tip”
Which paravertebral injection is indicated by 1-2
- proximal/dorsal
- Distal/lateral/tip
Where is the spinal nerve located for the proximal/dorsal paravertebral injection
Closer to caudal edge of lumbar transverse process than to cranial edge of the next, thus we want to “walk off the back” when possible
For the proximal/dorsal paravertebral injection where is the nerve root located and what does it split into
Nerve root is below the transverse process and splits into dorsal and ventral branches
For the proximal/dorsal paravertebral injection where do we want to inject the greater volume and why
Below the transverse process because split into two branches
To desensitize T13 in proximal/dorsal paravertebral block where should your needle go
In front of L1
To desensitize T1 in proximal/dorsal block where should your needle go
Back of L1
How many mL’s of lidocaine should be injected below the transverse process in the proximal/dorsal paravertebral block
15mL
How many mL’s lidocaine should be injected above the transverse process in the proximal/dosral paravertebral block
5mL above
Where are the spinal nerves located for the distal/tip paravertebral block
Near the tip of the next caudal transverse process
If you want to hit T13 and L1 with a distal/tip paravertebral block where do you insert your needle
L1 (for T13) and L2 (for L1)
If you want to hit L2 with a distal/tip paravertebral block where do you insert your needle
L4
How much volume do we want to put above and below the transverse process in the distal/tip paravertebral block and why
Equal amounts because the branches have split in both regions
How many mL’s of lidocaine would we inject at the tip of L1,L2, and L4 for a distal/tip paravertebral block
17mL above and below
Which paravertebral block causes less epaxial and hypoxia blockade and therefore less scoliosis and is better for a weak/lame cow
Distal/tip
What are some indications for a rumen trocar
- Esophageal foreign obstruction
- Frothy bloat with severe abdominal distention and obvious respiratory compromise
Where is the gas cap located that requires a rumeostomy
Dorsal left paralumbar fossa
What are some indications for rumenostomy
- Recurrent bloat
What 3 muscles make up the flank
1.external abdominal oblique
2. Internal abdominal oblique
3. Trans versus abdominus
How do the muscle fibers run for the external abdominal oblique
Caudoventral
How do muscle fibers run in internal abdominal oblique
Cranioventral
How do muscle fibers run in trans versus abdominus
Dorsoventral
Label 1-5 and what side of abdomen are we on
left side
1. Reticulum
2. Spleen
3. Greater momentum
4. 13th rib
5. Dorsal sac or rumen
Label 1-3 and what side of abdomen are we on
right side
1. Spiral colon
2. Abomasum
3. Omasum
What is the function of the reticular groove
Facilitates flow of milk form esophagus directly into omasum and abomasum thereby passing the reticulum and rumen in calves
Identify the forestomachs 1-3 based on their varying papillae/laminae
- Rumen
- Reticulum (honeycombs)
- Omasum (laminae)
What portion of the ruminant forestomach is structurally and functionally similar to the simple stomach of monogastrics
Abomasum
A left sided ping in the red, green or white areas would indicate what
Red: left displaced abomasum
Green: rumen gas cap
White: pneumoperitoneum
How do to differentiate left sided pings
- Location
- Quality of ping
- Succession
- Pass stomach tube
- Liptact test
- Ultrasound
Pings for a right displaced abomasum are typically over what rib spaces
10-11th ribs
Is a right displaced abomasum typically palpable on rectal exam
No
What are some differential diagnoses for right sided pings in the red, blue, yellow and white areas
Red: RDA, abomasal volvulus
Blue: colonic distention
Yellow: cecal dilation/volvulus
White: pneumoperitoneum
What rib spaces is a volvulus ping usually centered over
10-12th
What ICS is typically large in volvulus ping
9th
Where do you perform a rumoenocentesis
10cm caudal to the costochondral junction and 10cm below 13th rib
When is an abdominocentesis indicated
- Peritonitis (hardware, abomasal ulcers, liver abscess)
- Intestinal accidents (strangulating vs impactions)
- Intra-abdominal neoplasia (lymphosarcoma, mesothelioma)
- Ruptured bladder
Where do you perform an abdominocentesis
Lateral to udder about 6cm caudal to xiphoid and 6cm lateral to midline
When is a liver biopsy indicated
To confirm presence of liver disease whether toxic, infectious or metabolic
Where do you perform a liver biopsy externally
Between ICS 9, 10, or 11
Draw two lines from tubercoaxae to shoulder and elbow
Usually 10th intercostal space
What stitch is performed after correction of uterine prolapse
Buhner stitch
Describe the how to do a buhner stitch
Stab incision ventral to vulva and thread through. Leave a 3 finger wide opening
If a bull or boar presents with an obstructive urolithiasis why can’t you unblock with a normal urethral catheter and what must be done instead
Sigmoid flexure prevents you from using normal urethral catheter
Instead must do perineal urethrostomy
What is an episiotomy
Surgical incision of the vulvar to facilitate vaginal delivery when there is a dystocia caused by Fe to-maternal disproportion
Where do you make your incision for episiotomy
10 o’clock and 2 o’clock positions
Where are some common locations for obstructive urolithiasis
Where diameter of urethra decreases
1. Urethral process/verniform appendage
2. Sigmoid flexura
For castration you want to use ___in small ruminants and camelids
Injectable anesthesia
Where is the abomasum located
Right hand side of ventral abdomen between omasum and SI
What is on the left side of the ruminant
Rumen (majority) and reticulum
Where do you place a rumen Trocar to treat bloat and help with breathing
Dorsal region of paralumbar fossa- where the gas cap is
Why don’t you want to place rumen trocar ventrally
Rumen fluid
