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Surgery I > Lec 22: Principles of LA Soft Tissue Surgery > Flashcards

Lec 22: Principles of LA Soft Tissue Surgery Flashcards

1
Q

handling of large animal tissues differ from small animal tissues in that the tissue is (thicker/thinner), skin (does/does not) bruise, and hemorrhage (is/is not) generally not a problem.

A

thicker ; bruise ; hemorrhage

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2
Q

we can reduce skin trauma by using our ___, placing ____ sutures, and utilizing _____ forceps.

A

fingers ; stay ; atraumatic

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3
Q

true or false: blood loss seriously is not a big deal in large animal.

A

TRUE (for the most part - they have 40 L of blood!!!)

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4
Q

___% blood volume lost is acceptable during surgery.

A

15! –> we see now clinical signs with this amount. it is approx 6 L in a 500kg horse.

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5
Q

standing surgery in horses prevents complications of being ___. it prevents the risk of _____ from anesthesia, and provides better access for _____ structures.

A

recumbent ; recovering ; dorsal

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6
Q

standing surgery is generally _____ than recumbent surgery.

A

less expensive

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7
Q

recumbent surgery in horses is ____ for the surgeon, there is no movement which allows for better _____ of surgical field, and better ___ for most structures.

A

safer ; control ; access

* OPPOSITE OF BOVINE –> more access standing! *

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8
Q

what is depicted by the grey arrow?

A

the epiglottis

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9
Q

upper respiratory endoscopy is a _____ diagnostic tool. horses are _____ sedated, and are usually under ____ or on a treadmill.

A

primary ; not ; saddle

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10
Q

what sites are depicted in A-C in the image?

A

sinus trephination sites

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11
Q

when we incise the blue line depicted in the image, this procedure is called a _____.

A

pharyngotomy

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12
Q

when we incise the red line depicted in the image, this procedure is called a _____.

A

laryngotomy

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13
Q

what is most common, a pharyngotomy or a laryngotomy?

A

laryngotomy

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14
Q

self retaining or hand held ______ are used and are critical in upper respiratory procedures.

A

retractors

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15
Q

can you do both standing and recumbent surgery for URT procedures?

A

yes. easier in recumbent

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16
Q

mucosa heals ______.

A

rapidly

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17
Q

there is potential for mucosal “____” during the healing of URT surgery.

A

webbing –> requires later revision

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18
Q

common complications of URT surgery (most serious)

  • excessive swelling, ____ airway
  • .> can consider a post op ____
  • damage to _____ structures, like ___ nerves
A

blocks ; tracheotomy ; nearby ; cranial

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19
Q

common complications of URT surgery (serious)
- surgeries that are reopening airways can create too large of an opening which can lead to _____, or create too small of an opening which leads to the problem not being _____.

A

aspiration ; corrected

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20
Q

common complications of URT surgery (least serious)
- surgical site infection since respiratory surgery is _____ or _____ surgery.

A

clean contaminated ; contaminated

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21
Q

diagnostics for GI surgery in horses are _____.

A

limited

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22
Q

what can we do for diagnostics before GIT surgery in horses?

A

gastric endoscopy, rectal palpation, abdominal US, abdominal rads, NG tube intubation, abdominocentesis, bloodwork

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23
Q

what diagnostics are considered a colic workup?

A

rectal palpation, abdominal US, abdominal rads, NG tube intubation, abdominocentesis, bloodwork

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24
Q

what is the most common approach for an equine celiotomy?

A

ventral midline

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25
Q

what are other approaches for a equine celiotomy?

A

paramedian (R side), paralumbar fossa, laprascopic portals

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26
Q

what approach for a celiotomy in equine is uncommon?

A

paralumbar fossa

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27
Q

speed is ______!

A

important

28
Q

a GIT surgery is clean if the bowel is ______

A

unopened

29
Q

a GIT surgery is clean contaminated if a bowel is _____.

A

opened (however - game over if ingesta enters the abdomen, euth)

30
Q

exploration, de-rotation, enterotomy, resection and anastomosis, biopsy are all common ______ procedures.

A

GIT

31
Q

when considering healing of the GIT, the ____ can have problems.

A

serosa

32
Q

a common serosal problem during GIT healing after surgery is ________ adhesions, a dysfunction of ______.

A

intrabdominal ; fibrinolysis

33
Q

what serosal healing problem is a major cause of post-operative colic and death?

A

intra-abdominal adhesions

34
Q

we can reduce adhesions by:

  1. _____ handling of tissues
  2. keeping tissues ____
  3. use of ____
  4. strict ______
  5. prevent blood from entering _____
  6. NOT using ___ gauze EVER!
A
  1. gentle
  2. moist
  3. lubricants
  4. asepsis
  5. abdomen
    1. dry
35
Q

complications that can arise during GIT surgery are:

A

adhesions, hemoabdomen, peritonitis, ileus, diarrhea, endotoxemia, incisional infection

36
Q

what are some diagnostics we can use for the urogenital tract?

A

palpation, US, endoscopy

37
Q

what are some common urogenital surgeries in males?

A

castration, cryptorchid castration, urolithiasis, penile injuries/problems, preputial injuries/problems, inguinal hernia

38
Q

what are some common female urogenital surgeries?

A

repair foaling injuries, correct vaginal confirmation, ovariectomy

39
Q

what is a common urogenital surgery seen in foals?

A

bladder rupture sx

40
Q

inguinal, parainguinal, and laprascipic are all approaches for a male _____ surgery.

A

cryptorchid

41
Q

we should always provide an ____ and sedation for a standing procedure of repairing the back end of a female.

A

epidural

42
Q

laparoscopym flank, vagina, ventral midline celiotomy are all approaches for this female urogenital surgical procedure

A

ovariectomy

43
Q

we may need to ______ the bladder in urogenital surgery

A

catheterize

44
Q

____ is an important outcome in urogenital surgery

A

function

45
Q

small spaces and difficult access to the bladder make _____ challenging in urogenital surgery.

A

approaches

46
Q

____ formation and break down of repair are both challenges in urogenital surgical healing.

A

stricture

47
Q

the back end of the mare has a lot of _____ and therefor, repair breakdown is common.

A

contamination

48
Q

we can give the distal urethra a rest by creating a perineal ______.

A

urethrostomy (PU surgery)

49
Q

bleeding, loss of function, breakdown of repair, stricture and infection are all common complications in _____ surgery.

A

urogenital

50
Q

in laparoscopy, the abdomen is insufflated with ____, to ______ mm Hg.

A

CO2, 8-12

51
Q

a ____ stab incision is made in a laparoscopy to place the scope portal

A

blind

52
Q

the scope is introduced through _____ that maintains pressure in the abdomen.

A

portal

53
Q

we generally need ___ total portals.

A

3

54
Q

out of the 3 portals, we need ___ scope and ___ instrument portals.

A

1 ; 2

55
Q

once the scope is introduced, the remaining portals are created with ______ that the scope provides.

A

visualization

56
Q

the scope has a ___ degree lens

A

zero

57
Q

what are common procedures we will use equine laparoscopy for?

A

cryptorchidectomy, ovariectomy, abdominal explore in chronic cases

58
Q

a laparoscopic _______ is usually done in dorsal recumbency, but can be done standing.

A

cyrptorchidectomy

59
Q

an laparoscopic ovariectomy is usually done _____. (standing or dorsal recumbency)

A

standing

60
Q

a laporoscopic abdominal explore is usually done_____.

A

standing

61
Q

we should always _____ before lapraoscopy, because it frees up space in the abdomen, there is less weight on the diaphragm (esp if in Trendelenburg position), and increases time withheld for dorsal recumbency,

A

withold

62
Q

it is speculated that withholding feed may increase the risk of _____.

A

colitis

63
Q

we need to know if the surgical patient was/is on _____ drugs.

A

non steroidal anti-inflammatory

64
Q

in a minimally invasive procedure that is clean like a laparoscopy, ____ are not necessary.

A

antibiotics

65
Q

subcutaneous emphysema, retroperitoneal insufflation, bowel perforation, and hemorrhage are all common general complications seen in _______ procedures.

A

laparoscopic

66
Q

hemorrhage as a complication after laparoscopic procedures can be due to…

A

body wall incisions, mesovarium or mesochium, ligature slippage

Surgery I (10 decks)

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