Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

RUSVM Small Animal Surgery I > Liver > Flashcards

Liver Flashcards

1
Q

T/F You may need to remove multiple lobes of the liver because you can’t remove one without sacrificing blood flow to another

A

true

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

where does 80% of the liver’s blood supply come from

A

portal VEIN

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

What is the most common liver biopsy done? when would you use it?

A

Guillotine technique use if you have diffuse or lesion at the periphery of the lobe
-3-0 absorb braided will cut through the liver well

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

When would you use a punch biopsy?

A

lesion that is more central or closer to the hilus

NEEDS to be closer to the surface and you need to get multiple samples

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

When would you use laparoscopy biopsy?

A

more common at universities one down fall is that you cant feel the tissue
can do a true cut or guiletine style

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

What are the two non surgical biopsy techniques

A

percutaneous tru cut-good sliver or core tissue

fine needle aspirate and cytology- neoplastic lesions may exfoliate this has a POOR diagnostic yield

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

When may you need to do a complete and partial liver lobectomy?

A

neoplasia, trauma, abscess, cysts

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

Complete liver lobectomy should be done on what liver lobes and with what technique?

A

left lateral and left medial in SMALL dogs and cats

use the guiletine technique go up to the hilus and with one swoop tie off the vessels

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

What is a TA stapler

A

thoracoabdominal stapler that fires multiple rows of staples to crush the tissue and blood supply before you release your cut.
can use it for complete or partial lobectomies

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

Parital liver lobectomy- what is a parenchymal fracture and ligation

A

cut through the capsule at the lvl of proposed excision

  • crush or aspirate parenchyma
  • ligate or cauterize the vessels
  • ***results in the greatest blood loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

T/F the parenchymal fracture and ligation done for a partial lobectomy results in the greatest blood loss

A

true

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

What are overlapping sutures

A

full thickness series of overlappng guillotine sutures and make sure they overlap so no vessels are left unoccluded

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

What are the two big complications you are worried about with sx of the liver?

A

Hemorrhage

accidental ligation or occlusion of portal veins and cystic ducts of the remaining lobes—->necrosis of the lobe

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

T/F tumors in the liver are most likely primary tumors

A

false most of them are metastatic

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

What are the two types of hepatocellular tumors?

A

Adenomas - tumors in cats benign may show cs if space occupying
Adenocarcinomas- MOST common primary malignant tumor in dogs

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

what are the three forms of hepatocellular adenocarcinomas

A

Massive-malignant but good prog because in left lateral and left medial liver lobs
Nodular- poor prog metastasis likely and complete excise hard
Diffuse- poor prog mets in lymphnodes and lungs

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

What are the cholangiocellular tumors in dogs and cats?

A

dogs- second most common primary malignancy most will be intrahepatic and mets of 88%
cats MOST common primary hepatobiliary tumor
50% are adenomas (benign
50% carcinoma number one malignant liver tumor in cats poor prog with mets GROUND GLASS

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

T/F liver and splenic trauma is usually self limiting and does not require sx

A

TRUE :)

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

How are you going to treat trauma of the liver

A

supportive care with fluids and a possible trasfusion

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

Where would trauma to the liver have to be to need sx?

A

closer to the hilus use the PRINGLE maneuver

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

What is a cholecystectomy ?

A

incising the gall bladder

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

When do you need to do a cholecystectomy?

A

Mucocele

necrotizing, chronic, lihiasis, tumor, trauma

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

Biliary mucoceles what are they

A

hyperplasia of mucous secreting cells line the gall bladder -more distension can lead to rupture

24
Q

What is the signalment and clinical signs of biliary mucoceles

A

dogs around 9 small and med breeds including cockers, min schnauzer
vomit, anorexia, lethargy, PU/PD D+

25
Q

With a cholecystectomy you want to ensure patency of ________ before removing gall bladder

A

bile duct

26
Q

What are the two ways you can go in to remove the gall bladder? where are you ligating?

A

retro or normograde both are hard

ligate the cystic duct DO NOT get hepatic duct

27
Q

What are the two complications from cholecystotomy

A

bile peritonitis

bleeding

28
Q

What if I have a biliary obstruction how am I going to fix it?

A

Choledochotomy

incise into the common bile duct and remove the stones, sludge

29
Q

When would I need bile duct stenting

A

do this in chronic pancreatitis

-pass catheter from major duodenal papilla up the common bile duct and suture to duodenal wall

30
Q

When would I need a bliary diversion? best one?

A

Irreparable obstruciton or trauma of the common bile duct

best is the cholecystoduodenostomy because its the most physiologic

31
Q

What do you have to make sure about the size of the stoma in a cholecystoduodenostomy? what is the number one complication?

A

make it 2.5-3cm because it will close by 50%
leakage :/ —> septic peritonitis
infection, stricture,
CATS DO WORSE

32
Q

If I have an obstruction of the common bile duct that will resolve but my stent placement isn’t working what is my other option?

A

Cholecystostomy -with a folley or pig tail catheter
place it into the gall bladder and through the body wall
allows the gall bladder to be out of the body and into the GI tract

33
Q

What is most of the blood supply to the spleen coming from?

A

celiac

-splenic is a major contributer that supplies the pancreas

34
Q

What is a splenorrhaphy?

A

suturing a rupture spleen
rare to be done for lacerations and puncture
use 4 or 5-0

35
Q

when would you use a partial splenectomy?

A

focal benign dz

abscess laceration, infaction, biopsy

36
Q

When would you do a complete splenectomy?

A

Severe trauma, torsion, neoplasm, infiltrative dz, immune

37
Q

Two techniques for a splenectomy?

A

non emergent- individual ligation of hilar vessels

Emergent- rapid 3 clamp techniniqe

38
Q

what are the two surgical approaches for the splenectomy?

A

ventral midline celiotomy

Laparoscopic assisted

39
Q

What are the big post op complications with splenectomy?

A

hemorrhag, compromise to the kidney, arrhythmias VPC), DIC

40
Q

Dogs neoplasias 50% of their malignant tumors are_______ and 75% will present with _______

A

hemangiosarcoma

hemoabdomen

41
Q

cats ____% splenic masses are malignant

A

75%

42
Q

When doing a splenectomy due to a tumor what do you also want to remove

A

any omentum adhered to the tumor and perform a thorough explore to look for evidence of mets

43
Q

Hemangiosarcoma is the most common splenic neoplasia in _____

A

dogs its a neoplasm of endothelial cells invasive highly mets

44
Q

What is the prognosis of hemangiosarcoma?

A

sx alone stage I and II 86 days less than 6% survive passed one year

45
Q

Who gets splenic torsion

A

uncommon in dogs NOT in cats

>large giant male dogs may be associated with GDV

46
Q

How are you going to DX a splenic torsion?

A

xray

ULTRASOUND :)))))

47
Q

How do you treat splenic torsion?

A

DO NOT UNTORSE

do a splenectomy and maybe a gastropexy better prog for chronic torsion

48
Q

What are you going to do for a splenic trauma?

A

conservative monitor PCV and abdominal fluid

49
Q

What are your two types of biopsy of the pancreas?

A

laparoscopic and celiotomy

50
Q

What are the techniques used for biopsy of the pancreas? diffuse dz?

A

guillotine-isolate at periphery and ligate at base
lobar dissection- dissect small group lobules from surrounding tissue
***right distal limb for diffuse dz

51
Q

when would you do a partial pancreatectomy?

A

tumor removal or biopsy of large lesion

52
Q

Pseudocysts happens in who? dx? tx

A

middle age to older animals more common in dogs similar signs to pancreatitis and may have palpable mass
dx ultrasound and cytology
tx three options
us guid percut aspiration, surgical resect, debride drain and omentalize

53
Q

Abscess in the pancreas occurs as a sequela to _____

A

pancreatitis

54
Q

How do you tx pancreatic abscess

A

ER sx with debride and omentalize vs resection

-debride has significantly less morbidity

55
Q

What is the most common pancreatic tumor of dogs and cats?

A

Exocrine pancreatic adenocarcinoma
highly malignant locally invasive and early mets
POOR PROG

56
Q

what is the tumor of non beta islet cells in the pancreas

A

gastinoma may be from pancreas, dudenum, ln or mesentery
mets at time of dx in 70%
dx with fasting gasrin and sx resection may be wanted
PROG 1w-18m

57
Q

What is an insulinoma

A 
adenocarcinoma of the beta islaet cells secrete insulin in spite of hypoglycemia 
show weak, seize, collapse 
dx US 
SERUM insulin 
SX resect all abnorm tissue

RUSVM Small Animal Surgery I (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions