Lab: Emergency Sx, Ceilotomy, OVH, Castration Flashcards
What should the internal diameter of a temporary tracheostomy tube be in relation to the diameter of the trachea?
1/2 of diameter of trachea
Why should you extend a dog’s neck over a rolled towel when preparing to place a tracheostomy tube?
To get the trachea closer to the skin
Where is the incision usually made for a temporary tracheostomy?
Between 3rd and 4th OR 4th and 5th rings, through the annular ligament
For how long should you suction the trachea and at what level, after placing a trach tube?
<10 sec (to prevent hypoxia)
Carina
What wound classification is used when you remove a trach tube? How do you close this?
Clean contaminated
Don’t close, allow to heal by second intention
What start and end point do you use to pre-measure a thoracostomy tube?
Start: Dorsal third of thoracic wall at 7-9 ICS
End: Around point of elbow
How far from the desired intercostal entry point do you make your incision for a thoracostomy tube?
2-3 rib spaces caudal
Why is this hemostat placement for a thoracostomy tube incorrect?
Hemostat tips should extend beyond the end of the tube (otherwise difficult to get through hole)
How do you secure a thoracostomy tube? (incl suture type)
Mattress or purse-string suture and fingertrap suture
Non-absorbable suture
You take an x-ray to evaluate the placement of a thoracostomy tube and notice that it is not deep enough in the thorax. Can you reposition the tube?
No, must re-place tube
(can back out but not insert further into thorax)
In what position do you place a dog for pericardiocentesis? How should you position your patient to clip the area which you will insert the needle? Where is this area?
Left lateral recumbency (left side down)
Sternal recumbency
Mid-ventral right 5th-6th ICS (point of elbow)
Why do you need to advance a catheter before removing th stylette?
Stylette extends beyond the catheter
What is the least invasive enteral feeding tube?
Nasoesophageal
Which side of the stomach do you place a feeding tube for nutritonal support?
Left side
What layer must you include when securing a gastrostomy tube?
Fascia (not just skin)
What is one of the most important things to do when placing an enterostomy tube to prevent food accumulating in case of gastro/interstinal paresis?
Advance tube down further into the GIT
What type of approach is a laparotomy?
Flank
What is gossypiboma? How do you prevent it?
Retained foreign object during surgery
Sponge and instrument counts pre- and post-op
(Also: Radioopaque sponges, but $$$)
What is a common reason to use a paramedian approach for a neuter?
Inguinal Cryptorchid
When would you do a flank approach?
To access ovaries, kidneys or adrenals
What must you ID and ligate when you deviate your incision laterally from ventral midline?
Branches of caudal superficial epigastric vessels
Which muscle do you want to avoid when making a ventral midline approach?
Rectus abdominis muscle
How can you deal with the falciform ligament when doing a ceiliotomy?
- Push it out of the way
- Ligate and remove
- Cauterize and remove
What is almost always indicated with an exploratory ceilotomy even if no gross lesions are identified?
Biopsies
What is found in the cranial quadrant?
Diaphragm
Stomach
Gallbladder
Left limb of pancreas
What is found in the right quadrant?
Right limb of pancreas
Right kidney
Ureter
Adrenal gland (right)
What is found in the left quadrant?
Descending colon
Adrenal gland (left)
Left uterine horn
Spleen
What is found in the central quadrant?
Cecum
Mesentery
Mesenteric/intestinal LNs
Transverse, ascending colon
What is found in the caudal quadrant?
Duodenocolic ligament
Bladder
Ventral ligament of bladder
Prostate
Uterine body
Until when do you lavage the abdomen with warm saline before closing?
Until what you’re taking out looks like what you’re putting in
What is the layer of strength on the abdomen?
External rectus shealth
What closure patterns can you use to close the abdominal cavity? Which suture types do you AVOID using?
Simple interrupted
Simple continuous
Avoid: Chromic gut (inflammatory), Silk (inflammatorY), Vicryl Rapid (absorbs too fast), Polymerized caprolactam (granuloma formation)
What bites do you take when closing the abdominal fascia? How do you check if you have good bites?
5mm by 5mm
Lift up on suture bite or place finger in incision and lift up
Why do you close the SQ tissue?
Relieve dead space
Better skin apposition
What can you do as an alternative to a SQ closure? What migh this make unnecessary?
Intradermal/subcuticular pattern
May not need to close the skin
Why are tension patterns counter-indicated for skin unless tension is present? What suture type and size is typically used to close the skin?
Tendence to evert the skin and thus dely healing
3.0 monofilament (absorbable or non-absorbable)
According to the Veterinary Surgery invited review Making a Rational choice between Ovariectomy and Ovariohysterectomy in the Dog: A discussion of the benefits of either technique, what is the preferred method of gonadectomy in the healthy bitch?
OVE (ovariectomy)
Why does OVE not predispose a patient to pyometra?
Because this condition is hormonally induced, removing the source (ovaries) prevents the disease
Why is spaying an animal a possible treatment for idiopathic epilepsy?
Estrogen decreases the seizure threshold
Why is spaying an animal a possible treatment for diabetes mellitus?
Progesterone blocks insulin receptors
Why is a spayed patient more prone to obestity?
Cycling estrogens decrease appetite
Spaying reduces the metabolic rate
A spayed animal requires fewer calories
Why can spaying cause urinary incontinence?
Estrogen affects the urethral sphincter mechanism
Which types of neoplasia occur at a higher incidence in spayed animals?
Hemangiosarcoma
Lymphoma
T/F: A patient should always be prepped from xiphoid to pubis for an OVH.
True
Between which organs is the uterine body?
Colon and bladder
Which ligament is between the ovary and uterine horn?
Proper ligament
What prevents the ovary from being completely exteriorized unless it is broken?
Suspensory ligament
The ovarian arteries branch off of the _________. The right ovarian vein drains into the _______ while the left drains into the _________.
Aorta
Vena cava
Left renal vein
What type of suture, absorbable or non-absorbable, is preferred for OVH?
Absorbable
At Ross probably 2.0 PDS
Why do you need to break down the broad ligament before making ligatures?
To minimize tissue in ligatures - more stable, secure
What are the signs of shock that you need to watch out for post-OVH?
Slow recovery
Pale membranes
Distended abdomen
Decreased BP
Neuter or Castration?
1: Any sterilization procedure
2: Any pocedure in whcih an individual looses his testicles
Neuter or Castration?
Neuter: Any sterilization procedure
Castration: Any pocedure in whcih an individual looses his testicles
T/F: Sterilization does not treat prostatic cancer.
True
Why does an orchectomy help prevent perineal hernias?
Testosterone weaknes pelvic muscles
What is the most common surgical approach for castrating dogs? Cats?
Dogs- Pre-scrotal
Cats- Scrotal
Which surgical approach is indicated for testicular or scrotal neoplasia, but not for routine neuters?
Scrotal with ablation
In how may layers do you close the incision of a closed castration? What structure must you be careful to avoid?
2 (deep facia + SQ and skin )
Urethra
In an open castration you incise the ___ and avoid the ____.
PVT
VVT
What is the most common post-op complication after a neuter?
Scrotal hemorrhage
What is the first step when you prep a feline scrotum for an orchectomy? In which direction do you incise ove the testicle (caudal to cranial or cranial to caudal)?
PLUCK the hair (don’t clip)
Cranial to caudal
How do you close the incision from a closed feline castration?
You don’t
Let it heal by second intention
The overhand knot, figure 8 knot, and ductus deferens tie are used in feline castrations. Which is used in an open castration?
Ductus deferens tie
Funiculitis is a reported complication from feline neuters. What is it? (Hint- it’s not fun for Mr.Kitty)
Spermatic cord inflammation
At what age can an animal with an undescended testicle be considered cryptorchid?
6 months
What effect does a cryptorchid testicle have on the normal testicle?
Supresses spermatogenesis
In which species can eyelid agenesis and a kinked tail indicate a cryptorchid testicle?
Felines
Which testicle do you remove first if one of them is cryptochid and prescrotal?
The normal testicle
Nerve and blood supply to the prostate are on the _____(dorsal or ventral) aspect.
Dorsal
T/F: Benign prostatic hypertrophy (BPH) is very common in older intact dogs and the dogs usually present as painful and incontinent.
False
It is common in older intact dogs, but it is not painful nor does it cause incontinence. Usually they present asymptomatic.
What organism is most commonly involved in prostatitis?
E.coli
What adjunct treatment should you peform after draining a prostatic abscess?
Omentalization
