Foundational Neonatal Surgery

Question 1

what are the potential umbilical problems?

Answer 1

omphalophlebitis: vein
omphaloarteritis: arteries
patent urachus

Question 2

when does the urachus normally seal?

Answer 2

after being disconnected from placenta

Question 3

when should surgery be performed on a patent urachus?

Answer 3

if fails to close in 2-3 days

Question 4

what is acquired patent urachus usually from?

Answer 4

secondary to infection of an associated structure

Question 5

when does bladder rupture occur?

Answer 5

during parturition/dystocia

Question 6

what diagnostics can you do for a bladder rupture?

Answer 6

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

Question 7

what serum chemistry changes are seen with a bladder rupture?

Answer 7

hyponatremia
hypochloremia
hyperkalemia
metabolic acidosis
peritoneal:serum creatinine >2

Question 8

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

Answer 8

cardiac arrest during general anesthesia

Question 9

what are the components of an umbilical hernia?

Answer 9

umbilical ring
umbilical sac
umbilical remnants

Question 10

what is the most common type of hernia?

Answer 10

umbilical hernia

Question 11

what is an umbilical abscess likee?

Answer 11

firm
not reducible

Question 12

when can conservative treatment be used for an umbilical hernia?

Answer 12

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

Question 13

what is most commonly in an inguinal hernia?

Answer 13

small intestine +/- small colon

Question 14

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

Answer 14

small intestine passes through vaginal ring into vaginal tunic

Question 15

when does a indirect inguinal hernia usually resolve?

Answer 15

after first few weeks of life

Question 16

why should you ultrasound a body wall hernia?

Answer 16

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

Question 17

what are the risk factors for umbilical infections?

Answer 17

poor sanitation
failure of passive transfer
inappropriate care of umbilicus

Question 18

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

Answer 18

liver
bladder

Question 19

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

Answer 19

within a week of treatment
surgery if does not improve

Question 20

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

Answer 20

remove infected umbilicus surgically

Question 21

when can an acquired patent urachus occur?

Answer 21

up to 14 days after birth

Question 22

when should surgery be performed on an acquired patent urachus?

Answer 22

if not resolution with antimicrobials

Question 23

what should you remove in umbilical surgery?

Answer 23

umbilicus
arteries
vein
urachus

Question 24

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

Answer 24

K+ >6 mEq/L

Question 25

what should you not give to a foal with a bladder rupture?

Answer 25

mare's milk: K+ >7.5 mg/dL

Question 26

what is the primary complication of bladder rupture?

Answer 26

intra-op dysrhythmia

Question 27

what can umbilical hernias be secondary to?

Answer 27

trauma to umbilical cord during birth excessive straining during birth infection of umbilicus

Question 28

what would make an umbilical hernia nonreducible?

Answer 28

incarcerated: hernia content cannot be reduced strangulated: incarceration obstructs vascular supply to herniated tissue

Question 29

what is the closed method of umbilical heerniorrhaphy like?

Answer 29

skin removed peritoneum inverted abdomen not inspected

Question 30

what is thee aftercare of umbilical herniorrhaphy?

Answer 30

abdominal bandage antibiotic coverage NSAIDs omeprazole

Question 31

who are inguinal hernias common in?

Answer 31

standardbreds belgians tennessee walkers saddlebreds

Question 32

how is an indirect inguinal hernia diagnosed?

Answer 32

palpate ultrasound auscultate no centesis

Question 33

what is a direct or false hernia for inguinal hernias?

Answer 33

small intestine passes through rent in peritoneum to subcutaneous space of scrotum and prepuce between vaginal tunic and skin

Question 34

when are clinical signs of direct inguinal hernias seen?

Answer 34

4-48 hours of age

Question 35

what should you do for a body wall hernia with GI tract but no strangulation?

Answer 35

repair in 10-14 days as swelling decreases

Question 36

what should you do for a body wall hernia without GI tract involvement?

Answer 36

stall rest 4-6 months repair if still a problem