Head And Neck Fractures Flashcards
What is the most common cause of head and neck fractures?
TRAUMA
What are the clinical signs associated with head and neck fractures?
- None
- Mild
- Severe
- instant death
What does the emergency protocol involve?
A-airway
B-breathing, bleeding
C- cardio-vascular, circulation
D-Drugs
Can you use Ketamine in patients with suspected head trauma or Increased intracranial pressure?
No
Because it increase ICP (intracranial pressure)
T/F: Horses are obligate nasal breathers
TRUE
-so if there is something that impedes the airflow of the nostrils a tracheostomy must be performed
Describe the procedure of Tracheostomy
1) +/- clip
2) local anesthetic (mid line)
3) skin incision (upper third/middle)
4) blunt dissection of the sternothyrohyoid muscle
5) remove tracheal ring
6) tracheostomy tube
Why might the removal of the tracheal rings in an older horse be more difficult?
The tracheal rings calcify
What muscle must be bluntly dissected when performing a tracheostomy on a horse?
Sternothyrohyoid muscle
How long can you leave a tracheostomy tube in place
Until resolution of original problem blocking breathing
Following a head or neck fracture, what is the prognosis dependent on?
1) prognosis for life
2) prognosis for use
- function
- cosmetics
- open/closed
Can be anything from excellent to Grave
What is Hyphaema?
Blood in the eye
A Yearlying horse being halter trained, presents with neurological symptoms. What do you expect?
Basilar fracture
What is a Dacryocysto-Rhinography
Radiographic contrast evaluation of the nasolacrimal duct
How do you perform a dacryocysto-Rhinography?
1) Catheterize nasal punctum of the nasolacrimal duct
2) inject contrast fluid
3) Radiograph immediately
Where is the nasal punctum located
Edge of pigmented and non pigmented mucousa
How would you repair a facial fracture?
Surgical repair:
- skin incision
- elevate bone depression (with periosteal elevator)
What is important to do when using cerclage wire?
Twist and pull at the same time
How can you drain sinuses (facial fracture)?
Foley Catheter
What is Chemosis?
Swelling of the conjunctiva of the eye
What are the treatment options for incisive fractures?
- conservative
- cerclage
- screws
- plates
- fixates extern
What does the tension band technique do?
Transforms tensile forces into compressive forces
What technique should be used to correct interdental space fractures
Tension band technique
Is surgery always required for Vertical ramus fractures?
No if it is not displaced
-because of the large Masseter muscle
What is the strongest repair for mandibular fractures?
DCP plating
What is the order Strongest to weakest, treatment options for mandibular fracture repair?
DCP>PMMA + cerclage > cerclage + external fixature > external fixature
What is a distraction screw?
One turn (360degrees) = 1mm
What are the 2 most common causes of Neck fractures?
- Trauma
- Electrocution (struck by lightening)
What is a clinically relevant compressive vertebral neck lesion?
When BOTH dorsal and ventral contrast columns narrow at the same level
What treatment can be done for neck fractures?
- REst
- Dorsal laminectomy
- Cervical ventral interbody fusion
Describe the procedure for laminectomy
- lateral recumbency
- hanging over surgery table
- 30-40 cm incision on dorsal midline
- large self-retaining retractors
Describe the Cervical ventral interbody techniques
- dorsal recumbency
- over stretching neck
- place needles and assess correct position with radiograph
- remove ventral spinous process
- 16mm pilot hole + overdillled with 25mm core saw
- place basket
REFERAL
What spinal process needs to be removed during a Cervical ventral interbody fusion?
Ventral spinous process
