Lecture 4: Abdominal Anesthesia and Surgeries (Wronski)

Question 1

3 borders of paralumbar fossa

Answer 1

1) cranial: last rib
2) dorsal: lateral border of large spinal muscles between last rib and tuber coxae
3) caudoventral: junction of tendinous and muscular parts of transversus abdominis m. between last rib and tuber coxae

Question 2

nerve supply to paralumbar fossa

Answer 2

dorsolateral branch of spinal nerve

Question 3

3 methods of desensitizing paralumbar fossa

Answer 3

1) epidural
2) paravertebral
3) inverted L (simplest method)

Question 4

describe use of epidural to desenthesize paralumbar fossa

Answer 4

anesthetic agent is deposited in epidural space of vertebral canal

Question 5

describe paravertebral method of desensitizing paralumbar fossa

Answer 5

anesthetic agent is deposited at cranial tips of lumbar transverse processes

Question 6

describe inverted L method of desenstitizing paralumbar fossa

Answer 6

SQ injection of anesthetic agent cranial and dorsal to the site of incision

Question 7

where is CSF located?

Answer 7

subarachnoid space

Question 8

where is epidural space located?

Answer 8

in fat cells between bone and dura mater in the vertebral canal

Question 9

3 nerves you want to block to paralyze paralumbar fossa **

Answer 9

T13, L1, L2

Question 10

Rumenotomy =

Answer 10

surgical entry into the rumen

Question 11

Entry into the rumen via paralumbar fossa would enter which sac of the rumen?

Answer 11

dorsal sac

Question 12

Where is interarcuate space? Why is it important?

Answer 12

Space between L1 and L2. Where anesthesia should be deposited to anesthetize paralumbar fossa. (It will diffuse and anesthetize T13, L1, and L2).

Question 13

If too much anesthetic is given during epidural, and it diffuses too far caudally, what happens?

Answer 13

Can anesthetize area of L4/L5, which contains roots of the femoral n., which is motor to the extensor mm. of stifle joint. Stifle will collapse.

Question 14

Describe 3 injections given in paravertebral method of anesthesia to paralumbar fossa.

Answer 14

1) injection to cranial tip of transverse process of L1 to block T13
2) L2 to block L1
3) L4 to block L2

Question 15

direction of external abdominal oblique fibers?

Answer 15

caudoventral

Question 16

direction of internal abdominal oblique fibers?

Answer 16

cranioventral

Question 17

What is a line block?

Answer 17

Same as inverted L block, but extends line further cranially instead of dorsoventrally

Question 18

High vs. lumbosacral vs. low epidurals

Answer 18

High: b/w L1 and L2 to paralyze paralumbar fossa

lumbosacral: at L/S junction. Blocks femoral, sciatic, and obturator nn. and results in loss of motor and sensory fx

Low: at 1st intercoccygeal space. Blocks pudendal n. (sensory to perineal region). Used in parturition

Question 19

Structures you have to go through before getting into abdominal cavity ***

Answer 19

1) skin
2) superficial fascia
3) cutaneous trunci
4) abdominal tunic
5) external abdominal oblique
6) internal abdominal oblique
7) transversus abdominis
8) retroperitoneal fat
9) parietal peritoneum

Question 20

Grid technique

Answer 20

method used during sx in which abdominal muscles are cut along their natural fiber orientation

Question 21

structures visualized on R lateral view of cow

Answer 21

omasum
abomasum
liver
descending duodenum
greater omentum (hides the other organs)
R lobe of pancreas

Question 22

LDA

Answer 22

left displacement of abomasum. Abomasum displaces between the L body wall and rumen

Question 23

what does “volvulus” mean?

Answer 23

twisting

Question 24

2 methods to maintain abomasum in its proper anatomical position

Answer 24

1) abomasopexy (suture abomasal wall to parietal peritoneum)

2) omentopexy (suture greater omentum to muscles of abdominal wall near R paralumbar fossa)

Question 25

structures visualized on R lateral view of horse

Answer 25

R dorsal colon
R ventral colon
cecum
liver
R kidney
descending duodenum

Question 26

What structures are seen in R paralumbar fossa of cow?

Answer 26

descending duodenum, R lobe of pancreas

Question 27

What structures are seen in L paralumbar fossa of horse?

Answer 27

L descending colon

Question 28

where does apex of cecum lie in situ in horse?

Answer 28

along ventral midline. It is the first abdominal organ visualized during a ventral midline incision during Sx

Question 29

common site of impaction in horse

Answer 29

pelvic flexure

Question 30

what artery supplies the dorsal colon?

Answer 30

R colic a.

Question 31

what artery supplies the ventral colon?

Answer 31

colic branch of ileocolic a.

Question 32

nephrosplenic entrapment (LDDLC)

Answer 32

L dorsal displacement of large colon above nephrosplenic ligament. Spleen enlarges due to occlusion of blood supply, which traps colon even more firmly in place

Question 33

Treatment for LDDLC

Answer 33

phenylephrine (vasoconstrictor) and trot the horse

Question 34

Proper sites for liver biopsies in horses

Answer 34

R 12th intercostal space or L 8th intercostal space

Question 35

Know bands/sacculations and organs that can/can’t be rectally palpated pg. 7/8 of clinical correlates

Answer 35

:)