Foundational Neonatal Surgery Flashcards

1
Q

what are the potential umbilical problems?

A

omphalophlebitis: vein
omphaloarteritis: arteries
patent urachus

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2
Q

when does the urachus normally seal?

A

after being disconnected from placenta

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3
Q

when should surgery be performed on a patent urachus?

A

if fails to close in 2-3 days

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4
Q

what is acquired patent urachus usually from?

A

secondary to infection of an associated structure

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5
Q

when does bladder rupture occur?

A

during parturition/dystocia

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6
Q

what diagnostics can you do for a bladder rupture?

A

serum chemistry profile
abdominal ultrasound
abdominocentesis
contrast radiograph
methylenblue instillation of of bladder colors the abdominal fluid if defect present

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7
Q

what serum chemistry changes are seen with a bladder rupture?

A

hyponatremia
hypochloremia
hyperkalemia
metabolic acidosis
peritoneal:serum creatinine >2

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8
Q

what is the most common complication of treatment for bladder rupture?

A

cardiac arrest during general anesthesia

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9
Q

what are the components of an umbilical hernia?

A

umbilical ring
umbilical sac
umbilical remnants

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10
Q

what is the most common type of hernia?

A

umbilical hernia

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11
Q

what is an umbilical abscess likee?

A

firm
not reducible

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12
Q

when can conservative treatment be used for an umbilical hernia?

A

less than 5 cm
less than 6 months of age
many close within a week

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13
Q

what is most commonly in an inguinal hernia?

A

small intestine +/- small colon

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14
Q

what is an indirect or true hernia for an inguinal hernia?

A

small intestine passes through vaginal ring into vaginal tunic

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15
Q

when does a indirect inguinal hernia usually resolve?

A

after first few weeks of life

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16
Q

why should you ultrasound a body wall hernia?

A

to assess content and size of hernia ring
is there strangulation of bowel

17
Q

what are the risk factors for umbilical infections?

A

poor sanitation
failure of passive transfer
inappropriate care of umbilicus

18
Q

important to follow the umbilical vein all the way up to the __________ and the arteries to the ___________

A

liver
bladder

19
Q

how quickly should improvement be seen on ultrasound for umbilical infections?

A

within a week of treatment
surgery if does not improve

20
Q

what should you do if septic joints are seen with an umbilical infection?

A

remove infected umbilicus surgically

21
Q

when can an acquired patent urachus occur?

A

up to 14 days after birth

22
Q

when should surgery be performed on an acquired patent urachus?

A

if not resolution with antimicrobials

23
Q

what should you remove in umbilical surgery?

A

umbilicus
arteries
vein
urachus

24
Q

when should you not proceed with treatment for a bladder rupture?

A

K+ >6 mEq/L

25
what should you not give to a foal with a bladder rupture?
mare's milk: K+ >7.5 mg/dL
26
what is the primary complication of bladder rupture?
intra-op dysrhythmia
27
what can umbilical hernias be secondary to?
trauma to umbilical cord during birth excessive straining during birth infection of umbilicus
28
what would make an umbilical hernia nonreducible?
incarcerated: hernia content cannot be reduced strangulated: incarceration obstructs vascular supply to herniated tissue
29
what is the closed method of umbilical heerniorrhaphy like?
skin removed peritoneum inverted abdomen not inspected
30
what is thee aftercare of umbilical herniorrhaphy?
abdominal bandage antibiotic coverage NSAIDs omeprazole
31
who are inguinal hernias common in?
standardbreds belgians tennessee walkers saddlebreds
32
how is an indirect inguinal hernia diagnosed?
palpate ultrasound auscultate no centesis
33
what is a direct or false hernia for inguinal hernias?
small intestine passes through rent in peritoneum to subcutaneous space of scrotum and prepuce between vaginal tunic and skin
34
when are clinical signs of direct inguinal hernias seen?
4-48 hours of age
35
what should you do for a body wall hernia with GI tract but no strangulation?
repair in 10-14 days as swelling decreases
36
what should you do for a body wall hernia without GI tract involvement?
stall rest 4-6 months repair if still a problem