ganjei Flashcards

1
Q

Contaminated versus Dirty surgical wound

A

Contaminated: any traumatic wound without evidence of infection, a sx wound with gross spillage, a sx wound with major break in aseptic technique

Dirty: woundwith obvious infection, abscess, purulent discharge, necrotic tissue

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2
Q

Major difference b/w clean and clean-contaminated wounds

A

Clean: no luminal structures entered (OVH, Neuter, ABD explore, liver biopsy, splenectomy, prophylactic gastropexy)

Clean-Contaminated: luminal structures entered in controlled manner (gastrotomy, gastrectomy, enterotomy, R&A, cystotomy)

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3
Q

Ways to reduce risk of surgical site infection other than via ABX (4)

A
  1. Aseptic technique
  2. Decr. tissue resistance by supporting overall tissue health
  3. Minimize sx time
  4. Minimize anesthesia time

Halsted’s Principles: gentle tissue handling, preserve blood supply, control hemorrhage, eliminate dead space, appose tissue accurately, aseptic technique

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4
Q

Perioperative versus Therapeutic antibiotic use

A

Perioperative: administration of ABX prior to sx or during sx to prevent infection: start 30-60mins prior and stop within 24h post op

Therapeutic: administration of **full course ** of ABX for an active infection (e.g., pt with UTI who is undergoing cystotomy sx –> receiving abx prior, during and post op, 1 week)

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5
Q

Boundaries of abdominal wall (during laparotomy)

A

Dorsally: quadtratus lumborum
Ventrally: rectus abdominus
Laterally: EAO, IAO, transverse abdominus

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6
Q

What artery must be ligated in male dog in ventral midline laparotomy?

A

Preputial branch of the caudal SF epigastric artery

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7
Q

Technique to avoid inadvertent organ damage when incising abdominal body wall on midline

A
  1. tent body wall
  2. reverse press cut”
  3. blade directed upside down & horizontal
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8
Q

Closure of abdominal wall inbolves what suture type?

A

Monofilament (e.g., PDS) + taper needle

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9
Q

What is the most critical layer to engage for abd wall closure?

A

linea alba (suture should engage ≥5mm of fascia)

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10
Q

Approach for abdominal exploratory sx in bovines

A

Left or right paralumbar celiotomy

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11
Q

Approach for abomasal displacement sx in bovines

A

Right paramedian celiotomy

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12
Q

Which 3 nerves must be blocked to access the paralumbar fossa in ruminant abd sx? What are 2 methodfs of doing so?

A

T13, L1 & L2 nerves - blocked w/ lidocaine

1. Distal paravertebral block (above & below TPs of L1, L2, & L4)
2. Inverted L (left side) or 7 (right side) - just caudal to last rib under TPs

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13
Q

What is the most anchored region in stomach?

A

Cardiac region

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14
Q

What region of stomach suffers most vascular compromise in GDV?

A

cardiac/fundic region

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15
Q

Holding layer of the stomach

A

Submucosa layer

Layer with the most collagen to hold suture during healing period

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16
Q

Methods for atraumatic handling in gastrotomy

A
  • stay sutures (3-0 & clamp w/ hemostats)
  • specialized forceps (Babcock)
17
Q

Most common pattern in gastrotomy closure

A

Double Layer (where 2nd layer is inverting)
- appositional -> inverting
- inverting -> inverting
- appositional (mucosal engaged) -> inverting (outer 3 layers engaged)

18
Q

Describe technique when incising into stomach during a gastrotomy

A
  1. “Press-cut” (stab incision) w/ blade in pencil grip
  2. Then, extend incision with Metzenbaum scissors
19
Q

What is the favored type of gastropexy? What type should be avoided?

A

Favored = Incisional

Avoid! = Incorporating

20
Q

Where are the 2 incisions in incisional gastropexy made?

A
  1. pyloric antrum area (or perpendicular to long axis of stomach)
  2. thru peritoneum & transverse abdominus on V-L right abd wall, caudal to last rib
21
Q

Rectal prolapse versus colonic intussusception

A

Rectal prolapse: when rectum protrudes thru anus, leading to edema & congestion –> probe will hit a wall when passing through

Colonic Intussusception: probe will be able to pass through all the way

22
Q

How is rectal prolapse treated? Risks of each?

  1. Viable & reduceable
  2. Non-viable
  3. Viable but non-reduceable
  4. Recurrent despsite tx
A
  1. Viable & reduceable = reduction + purse string –> PRONE TO RECURRENCE
  2. Non-viable = R&A –> recurrence & stricture in cats!!
  3. Viable but non-reduceable = Colopexy or R&A –> do NOT penetrate the colonic mucosa!!!
  4. Recurrent despsite tx = consider colopexy -> recurrence & tenesmus common
23
Q

What rectal prolapse technique should be avoided in cats?

A

R&A due to high risk of stricture formation

24
Q

Perineal Hernia
- signalment
- pathogenesis

A

signalment = Older, intact male dogs

pathogenesis = weakened pelvic diaphragm –> rectum & abd organ herniation, +/- fecal obstruction. Assumed hormonal effect (testosterone).

25
Q

What tumor commonly arises from the circumanal glands?

A

SF, benign tumors - Perianal Adenomas

26
Q

Where does AGASACA commonly metastasize to?

A

the lungs & lymph nodes

27
Q

Anal Sac Impaction versus Anal Sacculitis

A

Anal Sac Impaction: no inflammation, large, non-painful anal sacs. Tx = expression

Anal Sacculitis: PAINFUL anal sacs + inflammation –> more severe form = anal sac abscess. Tx = flush or anal sacculectomy for recurrent/persistent cases

28
Q

What tumor commonly arises from the glands of the anal sacs?

A

Deeper, malignant timors (Anal Sac Adenocarcinoma - AGASACA)