Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

GI MED & SX > GI surgery > Flashcards

GI surgery Flashcards

1
Q

What is the most common approach to the abdominal cavity of dog or cat

A

Ventral midline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What part of the canine gastrointenstinal tract has the lowest healing potential
A) Stomach
B) Duodenum
C) Jejunum
D) Colon

A

D) Colon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Is hypo or hyperalbuminemia a risk factor for visceral dehiscence

A

hypoalbuminemia

give nutritional support

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the weakest point of visceral healing

A

3-5 days (second phase of healing) and often out of the hospital

12-24 for surgical error

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What suture pttern is inappropriate for visceral closure

A

Everting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Why would a double layer pattern be inappropriate for enterotomy closure in a 6kg cat

A

Compromise of luminal diameter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is a possible consequence of partial thickness closure of a visceral (luminal) organ

A

Dehiscence from not incorporating the submucosal layer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What would be most appropiate for simple gastrotomy closure in a dog

A

PDS or Maxon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is an inverting partial thickness pattern

A

Cushing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What pattern should you do if you are concerned for adhesion

A

Inverting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What pattern should you do if you are concerned for viability

A

Double layer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What pattern should you do if you are concerned for luminal diameter compromise

A

Appositional instead of inverting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What pattern should you do if you are concerned for suture breakdown (exposure to acid)

A

Partial thickness - just get submucosa

acid doesnt really affect suture as suture is covered in serosa quickly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What pattern should you do if you are concerned for dehisence

A

full thickness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What suture should you use for GI surgery

A

Synthetic
Monofilament
Absorbable
Taper
3-0 or 4-0

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

why should you not use Biosyn for the colon

A

because the colon has poor tissue healing

use Maxon or PDS instead

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the risk factors of GI surgery closure

A

Immunosuppression
-Diabetes mellitus
-Cachexia
-Neoplasia

Hypoalbuminemia <2.5mg/dl

Peritonitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the risk factors for surgical dehiscence

A

Skill level
Anesthetic duration
Linear foreign body
perforations
Healing capability (age, early enteral nutrition, hypothermia, albumin, hypotension, total solids)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the type of monofilament absorbable sutures longer lasting

A

Maxon
PDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the type of monofilament rapidly absorbable sutures

A

Monocryl
Biosyn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What suture patterns should you use for GI tract **

A

Appositional
Continuous
Single layer
Full thickness

2-3mm apart, 2-3 mm each edge
snug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are commonly used suture materials in GI surgery

A

1) Monofilament absorbable
-Maxon
-PDS

2) Monofilament rapidly absorbable
-Monocryl
-Biosyn

3) Nonabsorbable suture

4) Staples

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the gastric foreign body options

A

-Do nothing
-Induce emesis
-Endoscopy
-Surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the risk of perforation with intestinal foreign bodies

A

can be up to 20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Animals with foreign bodies that go to surgery >6 hours after clinical diagnosis have
longer duration of clinical signs increased lactate linear material
26
What are the clinical causes of gastrointestinal foreign bodies
focal foreign bodies linear foreign bodies intestinal neoplasia intussusception volvulus/torsion
27
What might make you suspicious of a gastrointestinal obstruction
-suggestive history: getting into trash, etc -painful abdomen: sharp pain or uncomfortable -palpable mass -electrolytes -acid/base -diagnostic imaging GO to surgery if you have a high level of suspicion
28
Does using maropitant delay the recognition of foreign body obstruction
Yes but it is not wrong to give it can mask the signs of obstruction if they vomit with maropitant it is alarming
29
What do you do if you have a low index of foreign body suspicion and surgery might not be warranted
-IV fluid diuresis -Gastrointestinal medications (controversial) -Follow electrolyte status -Repeat abdominal radiographs -Consider other diagnostics like abdominal ultrasound and contrast studies, advance imaging
30
What are the radiographic features of a linear foreign body
Right-sided intestinal gathering Enteroplication Eccentric gas bubbles, tapered *might need contrast study
31
A negative contrast study that you can use to differentiate intestine from colon
Pneumorectum - highlights the colon
32
What are the consequences of going to surgery for foreign body and being wrong
-Negative explore -Cost -Obtain biopsies
33
What What are the consequences of waiting to go to surgery for foreign body and being wrong
Perforation Septic peritonitis Worse prognosis Money
34
At a minimum gastrointestinal surgeries need to be
clean-contaminated
35
When do you stop prophylactic antibiotics in clean and clean-contaminated procedures with no severe risk factors
Stop immediately after surgery
36
You should stop prophylactic antibiotics based on the
degree of contamination and the location of the problem
37
What are the consequences of using prophylactic antibiotics
1) Mask the early signs of visceral dehiscence 2) Unnecessary cost 3) Adverse effects - altered microbiome
38
When should Prophylactic Antibiotics be given
15 to 30 minutes prior to skin incsion
39
How do you give Prophylactic Antibiotics
IV admin
40
Prophylactic Antibiotics should be repeated every
90 to 150 minutes
41
What specific Prophylactic Antibiotic should be given for clean surgeries
Cefazolin (22mg/kg) a 1st generation cephalosporin, gram + spectrum
42
What specific Prophylactic Antibiotic should be given for clean -contaminated to dirty surgeries
1) Cefoxitin 2) Ampicillin / Sulbactam (Unasyn; 30mg/kg)
43
a 2nd generational cephalosporin with increased gram - and anaerobic spectrum that can be used in clean-contaminated to dirty procedures as aProphylactic Antibiotic
Cefoxitin (22mg/kg)
44
a 1st generation cephalosporin, gram + spectrum, that can be used a prophylactic antibiotic for clean procedures
Cefazolin (22mg/kg)
45
For GI surgery, you should use therapeutic antibiotics if there is
Contaminated or dirty -Peritonitis Bacterial translocation
46
What should you do for if the surgery is contaminated or dirty so there is no risk of peritonitis and bacterial translocation
Therapeutic antibiotics- 4 quadrant coverage surveillance Culture and sensitivity
47
How do I monitor for dehiscence of gastrointestinal closures
PE (serialO Serial AFAST (POCUS) Peritoneal drain Abdominocentesis
48
The body should clear contamination in
6-8 hours
49
how do you minimize gastrotomy/ enterotomy contamination
1) Pack off abdominal cavity 2) Stay sutures 3) Double-glove; re-glove 4) Separate instruments 5) Isolate intestine outside of the abdominal cavity 6) Lavage
50
What is the procedure of a gastrotomy
1) Isolate stomach 2) add stay sutures - either end of proposed incision 3) Stab incision into body of stomach 4) Extend with Metzenbaum scissors 5) Remove foreign material 6) Palpate lumen 7) Everything contaminated off the table 8) change globes 9) Closure Offer gastropexy or abdominal lavage
51
With intestinal foreign bodies, do you cut into the oral or aboral side
aboral side (more narrow side) the oral side should be dilated
52
For enterotomy foreign bodies, where should you make your incision
Longitudinal incision Antimesenteric border Aboral to obstruction Remove obstruction and assess for viability
53
With intestinal foreign bodies, do you cut into the mesenteric or antimesenteric border
Antimesenteric
54
With intestinal foreign bodies, do you cut longitudinal or transversely
Longitudinal cut
55
What are indicators of intestinal viability
Color Thickness Peristalsis Arterial pulsation
56
What are indications for resection and anastomosis
-Nonviable tissue (foreign body or perforation) -Intussusception -Intestinal neoplasia
57
How should you close an enterotomy
Appositional -Single layer, simple continuous or interrupted 2mm apart, 2-3mm from edge 3-0 or 4-0 monofilament absorbable suture
58
What are the steps of resection and anatomosis
1) Tie off mesenteric vessels 2) Hold back ingesta 3) Crushing clamps- oblique to vasa recta
59
for resection, how should you place your crushing clamps
oblique to vasa recta
60
How should you close resection and anastomosis
Modified single layer simple continuous Single layer simple interrupted Staples
61
Do you leak test intestinal closures?
No - its not predictive of dehiscense there are some worries with this- false sense of security or cause over engineering
62
What should you do for post-op for GI surgery
Intravenous fluids Off food until awake - maybe provide other nutritional support monitor for dehiscence pain management GI drugs? - do minimally
63
Should you use NSAIDs in post-op GI surgery
NO
64
What should you use for post-op pain management
opioids Lidocaine Ketamine traditional line block intra-abdominal splash block
65
What is the prognosis of GI foreign body
>90% survival Increased mortality with longer duration of clinical signs, linear foreign body, multiple intestinal procedures
66
What are the layers of the GI tract
Serosa Muscular Submucosa Mucosa
67
What is the holding layer of the GIT
Submucosa
68
How does the GI tract heal
1) Initially by blood clot 2) granulation tissue begins 24-48 hours dependent on the proximity of tissue edges and inflammation 3) Blood vessels emerge at 72 hours - hypervascularization by 7 days, normal by 14 days 4) Blood clot replaced with fibrous tissue by 14 days
69
What is the weakest point in GIT healing
3-5 days can be accelerated or prolonged
70
What might cause Gastrointestinal perforation
Drugs (NSAIDs) Trauma
71
What surgical technique factors influence intestinal healing
1) Tissue handling 2) Hemostasis 3) Preservation of vascular supply 4) Avoiding anastomotic tension 5) Minimizing contamination
72
What host factors influence intestinal healing
1) Hypotension 2) Hypoproteinemia 3) Endotoxemia 4) Septicemia 5) Coagulopathies 6) Age ileus 7) Catabolic nutritional state 8) Immunosuppression- DM, cachexia, neoplasia
73
Types of Inverting suture patterns
Cushing Connell Lembert Modified Gambee Stapling Devices
74
Types of appositional suture patterns
Simple Interrupted Simple Continuous Interrupted Cruciate
75
An inverting suture pattern that does not penetrate the lumen
Cushing
76
An inverting suture pattern that penetrates the lumen
Connell
77
How should you close entertomy
Appositional- best for primary healing

GI MED & SX (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions