Q&A Thorax and Abdomen Flashcards
What are the two major parts of a typical vertebra?
Body and arch
What is an intervertebral foramen?
Opening between adjacent vertebrae allowing passage of the spinal nn.
How do ribs articulate with the thoracic vertebrae?
Head articulates with bodies of contiguous vertebrae and the tubercle articulates with the transverse process of same numbered
What is the name of the space between two adjacent ribs?
Intercostal space (ICS)
What do the costal cartilages of the last sternal and all asternal ribs form?
Costal arch
What are the first and last sternebrae?
Manubrium and xiphoid, respectively
What caps the xiphoid process?
Xiphoid cartilage
what thoracic vertebrae usually has the most vertically oriented spine?
Anticlinal vertebrae, usually T11 in dog
How is inspiration accomplished?
Increased size of thorax decreases pressure = air rushes in
What is the main respiratory muscle?
Diaphragm
Name the 2 muscles extending between adjacent ribs.
External and internal intercostal mm.
What is the opening into the thorax?
Thoracic inlet
What forms the thoracic inlet?
1st thoracic vertebra, right and left 1st ribs and sternum
What palpable structure is formed by the costal cartilages of the false ribs?
Costal arch
What divides the thorax into two spaces?
Mediastinum
Where is the heart located in the thoracic cavity?
(2nd) 3rd to (5th) 6th intercostal space (ICS) in the bottom 2/3rds of the cavity
Which side of the aorta does the thoracic esophagus normally cross?
Right side of the aortic arch
What covers the trachea in the cranial neck?
Only strap muscles (sternohyoideus and sternothyroideus mm)
What part of the trachea splits into right and left primary bronchi?
Tracheal biforcation
What separates lobes of the lungs?
Interlobar fissures
What is the opening between the lobes of the lung where the surgeon’s pericardium comes in contact with the thoracic wall?
Cardiac notch
What do radiologists call the pulmonary trunk?
Main pulmonary artery/segment, MPA
What is the mediastinum?
Space or wall (depending on text read, wall makes parietal work for the pleura) separating the thoracic cavity into 2 cavities and thus, separating the 2 pleural cavities
What are the divisions of the mediastinum?
Cranial, middle (contains heart), and caudal (all divided into dorsal and ventral parts)
List the parts of the pericardium.
Fibrous pericardium, serous pericardium (visceral and parietal parts)
What is located in the pericardial cavity?
scant amount of serous fluid only
which side of the heart is part of the pulmonary circulation?
Right side: pulmonary side
The left side of the heart is part of what circulation and why?
Systemic circulation, pumps blood to body
What side of the heart is the right ventricle on? Left ventricle?
Right: cranial (right, cranial, and left sides); left: caudal
What is the vestigial, fetal connection form the pulmonary trunk to the aorta?
Ligamentum arteriosum
What is the most caudoventral part of the heart? Is it on the right or left?
Apex, left
What is the adult remnant of the fetal foramen ovale?
Fossa ovale
What separates the atria?
Interatrial septum
Name the wall separating the 2 ventricles.
Interventricular (IV) septum
Which ventricle has a thinner wall and why?
Right, less strength needed to reach lungs
Name the three layers of the heart.
Endocardium, myocardium, and epicardium
What are the valves of the heart?
Right and left atrioventricular (AV); aortic and pulmonic valves (semilunar valves)
What is the function of the AV valves?
Prevent back flow into the atria during ventricular contraction
What is the function of the semilunar valves?
Prevent return to heart during diastole
What abnormal sounds are caused by blood flow turbulence in the heart?
Murmurs
What are the three parts of the conduction system of the heart?
Sinoatrial node (SA) (pacemaker), atrioventricular (AV) node, and atrioventricular bundle branches
What is the term for ventricular contraction and relaxation?
Ventricular systole, ventricular diastole
How do diastole and systole relate to the heart sounds?
Systole: between 1st and 2nd sounds, Diastole: between 2nd and 1st heart sounds
What do the 1st and 2nd hearts sounds sound like and roughly represent?
1st (“lub”): closure of AV valves (start of systole),2nd (“dub”): closure of semilunar valve (diastole)
What causes closure and opening of the AV and semilunar valves?
Opening: AV: diastole; Semilunar: systole. -Closure: AV: systole; Semilunar: diastole
What does the recoil of the elastic aorta at the end of systole cause?
Pushes blood to body and back toward the heart, closing aortic valve and filling the coronary arteries
How is the esophagus normally related to the arch of the aorta?
To the right of the arch or aorta
What arteries travel up the neck to supply the head and face?
Common carotid aa.
What artery travels on the floor of the thorax?
Internal thoracic a.
What vessels and nerves travel in the intercostal spaces caudal to the ribs?
Intercostal a., v., and n.
What three fetal structures bypass the lungs and liver?
Ductus arteriosus, ductus venosus, and foramen ovale
Where does the ductus arteriosus shunt most of the blood in the right ventricle from the pulmonary to the systemic circulation?
From the pulmonary trunk and aorta (2 aa.)
What in the adult is a remnant of the following structures? Ductus arteriosus, Foramen ovale,Umbilical arteries, Umbilical veins
Ductus arteriosus–ligamentum arteriosum; Foramen ovale–oval fossa or fossa oval; Umbilical arteries–round ligaments of urinary bladder;Umbilical veins–round ligament of liver
What is the large lymphatic channel draining the caudal animal?
Thoracic duct (from abdomen, pelvis, and pelvic limb)
What lymph nodes are near the bifurcation of the trachea?
Tracheobronchial lymph nodes
What is the lymphatic structure in the cranial mediastinum?
Cranial mediastinal lymph node
What is the large nerve crossing the heart to the diaphragm?
Phrenic n.
What is the branch of the vagus that returns to the neck? Where is it located in the thorax on the left and right sides?
Recurrent laryngeal nerve; Lt: around the arch of the aorta, Rt: around right subclavian artery
What does the recurrent laryngeal nerve innervate? Which is clinically important in dogs and horses with laryngeal paralysis?
Most laryngeal skeletal muscles; Cricoarytenoideus dorsalis m.
What supplies cutaneous innervation to the top of the thoracic and abdominal walls?
Both the dorsal and ventral branches of the spinal nn. in the thoracic and lumbar region
What is the parasympathetic innervation to the thorax?
Vagus nerve
What are the two series of connected ganglia lying on either side of the bodies of the thoracolumbar vertebrae and longus colli muscle?
Sympahtetic trunk (chain)
Which way do the motor fibers travel in the vagosympathetic trunk?
Sympathetic toward the head, vagus away from the head
What is a serosa (serous membrane)?
A thin, continuous membrane lining a closed cavity and covering the cavity’s organs
What are the serous membranes of the pericardial cavity, thorax, abdomen, and spermatic cord called respectively?
Pericardial: pericardium; Thorax: pleura; Abdomen: peritoneum; Spermatic cord: vaginal tunics
What serosa covers walls of a cavity?
Parietal serosa
What serosa covers an organ?
Visceral serosa
What connects parietal and visceral or visceral with visceral serosa?
Connecting serosa
What is the serosa lining the thoracic cavity?
Pleura
Are the lungs located in the pleural cavities?
No, just a scant amount of serous fluid
What is the line of pleural reflection?
Point costal pleura reflects onto diaphragm
What is the plural cupula?
Cranial pleural sac extending out through the thoracic inlet
How should VD/DV and lateral films be placed on viewing screen?
DV/VD: Right side to you left in both; Lateral: Cranial side to the left
What does a R or L marker on different film views indicate?
Lateral trunk: right or left lateral=side on cassette
Lateral trunk (thorax or abdomen), DV or VD films, One limb in film
DV or VD: side of animal, one limb: limb in film
How are thoracic films evaluated for rotation?
Lateral: costochondral junctions and shoulder joints-same level, -VD and DV: sternum and spinal column superimposed
What structure is used to tell an expiratory from an inspiratory film?
Position of diaphragm
Once you have picked a method to evaluate films, what should you do each time you evaluate a film?
Always read in the same manner (every time!)-get into a routine
What is the cranial limit of the abdomen?
Diaphragm
Can you visualize the sides of the diaphragm?
Cranial: yes as contrasted air (lungs); Caudal: no, against water densities (liver and stomach)
What is the junction between the two crura?
Intercrural cleft
What mediastinal structures are normally seen in the lateral view?
Trachea, aorta, heart in the pericardium, caudal vena cava
What mediastinal structures can be seen the VD view?
Heart in the pericardium, caudal vena cava, left edge of the descending aorta
Is the esophagus usually visible on radiograph? When is it visible?
No, only if it contains swallowed air or contrast material
What is the thick dark line in lateral radiograph of the cranial mediastinum?
Trachea
What is the dark oval over the heart base in a lateral radiograph?
Tracheal bifurcation, “carina”
The trachea normally makes a _____ angle to the vertebral column in a lateral view.
15 degrees
Which way does a megaesophagus displace the trachea and heart?
Ventrally
Name a dilation of caudal cervical and thoracic esophagus.
Megaesophagus.
What is the line caused by the air in a megaesophagus and air in trachea contrasting the adjacent walls of the two structures?
Tracheal-esophageal stripe.
What is the name for the VD appearance of a megaesophagus as it passes caudally to the diaphragm?
Esophageal cone
What are the 2 continuations of the trachea into the lungs?
Main stem bronchi or primary bronchi
Which is the most ventral (dependent/handing down) of the bronchi?
Right middle bronchus
What are the normal longitudinal water densities in the lungs?
Pulmonary vessels, not bronchi
What is a lobar bronchus and associated lobar pulmonary artery and vein?
Pulmonary triad
What is the normal relative size of the artery and vein of a pulmonary triad?
About the same size
Veins are always ______ and _______ (______) to the arteries of pulmonary triads in the lateral and DV views respectively.
Ventral and Central (medial)
In the DV/VD films, what is the position of the lobar arteries to the caudal lungs?
4 and 8 o’clock positions
What conditions will result in visible lung fissures (lobular pattern)?
Collapsed lungs or pleural fluid and pleural thickenings
How many left lung lobes are there anatomically and radiographically?
Anatomically - 2; Radiographically - 3
The cranial lobe of the _______ lung is seen in front of the cranial lobe of the _______ lung on a lateral view as a separate round air filled structure.
Left, right
What is located in the normal pleural space?
only a little fluid
What is the cranial extent of the pleural cavity?
Pleural cupula
The pleural cupula normally extends cranially past the _____ ______.
First rib
What is located between the vessels of the lungs?
Interstitium, parenchyma
For what should the parenchyma of the lungs be evaluated?
Increase (more radiopaque) or decrease (more radiolucent) opacity
Why don’t you see the chambers of the heart in survey radiographs?
Heart is muscle, chambers filled with blood (both water densities)
Since you can’t see the chambers of the heart in survey radiographs how do you evaluate the heart?
Evaluate the borders or silhouette
What are the lateral radiographic location of the different compartments of the heart listed below :1.right ventricle;2.left ventricle 3.caudal heart
1:descending aorta 2.dorsal thorax-well seen 3.lower part of cranial edge
What is usually all that can be seen of the cranial vena cava in the lateral projection?
ventral edge
Tell if the structures are seen and where they are located in a DV/VD view: 1.Caudal vena cava 2.Right ventricle 3.Pulmonary trunk 4.Left ventricle 5.Apex 6.Descending aorta
1.Caudal vena cava: yes; right side, heart to diaphragm 2.Right ventricle: yes; right side of heart, 3.Pulmonary trunk: yes; cranial/left side of heart; 4.Left ventricle:yes; caudal half of heart Left ventricle:yes; caudal half of heart 5.Apex: yes; pointing to left 6.Descending aorta: yes; left lateral edge
On what side of a DV view is the caudal vena cava seen? VD view?
right, right
What part of the DV silhouette does the right ventricle make up?
Right side from apex around cranial side to cranial left side
The left atrium is over the _______ heart directly above the left ventricle. It is located just caudal to the _______ _______.
Caudal, tracheal bifurcation
On what side of the heart is the apex, a radiographic landmark, located?
Left
How does the descendign aorta appear in a DV view?
A line to left=left edge of aorta
What is the normal amount of sternal contact of the heart?
3 sternebrae (rule of thumb)
What is found on the VD/DV and lateral views at each time area according to the clock faced analogy? 1. 2-6 o’clock 2. 5 o’clock 3.6-9 o’clock
1.Left ventricle 2.Apex 3.Right ventricle
What is found on the VD/DV at the 1-2 o’clock position on the clock faced analogy?
MPA/pulmonary trunk
List some problems needing thoracic radiographs.
Cough, heart problems, dyspnea, abnormal lung sounds, etc.
What is a radiographic indication of a diaphragmatic hernia?
Entire diaphragm can’t be seen
When are the mediastinal lymph nodes visible?
When enlarged (i.e. lymphosarcoma, common in cats)
What is moving of the mediastinum to the right or left?
Mediastinal shift
What is the common term for bowing of the principal bronchi in VD and DV views?
Cowboy legs
Fluid or air in the pleural space will eliminate the _______ pressure of the space and cause the lungs to collapse away from the chest wall.
Negative
What is excess fluid in the pleural space?
Pleural effusions
What is the main radiographic sign of pleural effusion?
Separation of lungs and body wall allowing visualization of lugn borders and fissure lines
What are the 4 basic opaque lung patterns?
Interstitial, alveolar, peribronchiolar and vascular
What characterizes each of the opaque lung patterns?
interstitial: opaque lung, “fuzzy”; -Alveolar: air bronchogram; -Peribronchiolar: “donuts and tram lines”- Vascular: increased, decreased, or normal
What is the number one cause of an interstitial pattern?
expiratory film (normal)
Give two signs of a peribronchiolar pattern.
Perivascular cuffing; donuts ;tram lines
What should be the first thing that comes to mind when enlarged arteries of the lungs are seen?
Heart worm diease
What is fluid in the lungs?
Pulmonary edema
The increased radiographic opacity of pulmonary edema can be either a ______ or ______ pattern or both depending on where the fluid is.
Interstitial or alveolar
What is the mechanism of cardiogenic pulmonary edema?
Left heart failure backing up into lungs
Right ventricular enlargement is seen as a ______ bulging on the lateral view. This will cause the heart to have more ______ _______.
Cranial; sternal contact
On VD view, right ventricular enlargement will bulge to the right. How is this shape often referred to?
Backwards or reverse “D”
Give a cause of right ventricular enlargement.
Pulmonic stenosis and heart worm disease
What is a common radiographic finding of right ventricular enlargement on a lateral projection.
Increased sternal contact
What is a common finding of right ventricle enlargement on the DV projection?
Reversed “D” sign
What clinical condition should you think of if you see tortuous, dilated pulmonary arteries?
Heart worm disease
What are the three bumps seen on a DV view of a dog with PDA?
MPA, left auricle and aorta
What is a possible effect on the main stem bronchi in left atrial enlargement in a VD film?
Spread out (“cowboy legs”)
List two most common findings of left atrial enlargement in the DV projection.
Auricle projects at 2-3 o’clock position; “cowboy legs”
What is the reflex arch for the panniculus response?
Sensation from skin of trunk over thoracic and lumbar spinal nn. to spinal cord, up cord to lateral thoracic n., out to cutaneous trunci m.
What is used clinically to evaluate the level of thoracic spinal cord damage?
Panniculus response
If the spinal cord damage is at the level of T10, where will the panniculus response not elicit a response?
Level of the 12th thoracic vertebra caudally. (segment 2 vertebrae cranial to level of skin because nerves pass caudoventrally)
What is the surgical opening of the thoracic cavity?
Thoracotomy
How is the vacuum of the pleural cavity regained when closing the thoracic wall?
Maximally inflate the lungs during last part of closure
Where is the intercostal space incised to open the thorax and why?
In center to avoid the vessels caudal to ribs
What vessels are of concern in midsternal thoracotomies?
Internal thoracic artery and vein
What is the term for segmental fractures of a number of sequential ribs causing the chest wall to move in during inspiration?
Flail chest
What is aspiration pneumonia?
Swallowing foreign material into the lungs and subsequent pneumonia
Which lobe is the most common site for aspiration pneumonia? What is the second most common lung lobe?
Right middle lobe (most dependent); cranial right lung lobe
To which lung lobe will a light, inhaled foreign body (grass awn), which moves by air flow and not gravity, tend to go?
Right caudal lobe, straight shot
What is chylothorax?
Lymph in the pleural cavity usually from a ruptured lymphatic vessel (thoracic duct)
What are three common locations of clinical blockage of the esophagus in the thorax?
Thoracic inlet, base of heart, esophageal hiatus of diaphragm (start of esophagus)
What is air in the mediastinum/
Pneumomediastinum
What is the surgeon’s pericardium?
Sac opened to access epicardial covered heart
What is compression of the heart due to collection of blood or fluid in the pericardial sac?
Cardiac tamponade
What is done with the pericardium after open heart surgery?
Left unsutured or only loosely approximated ot avoid cardiac tamponade
Where does blood back up into when the right heart is damaged (clinical signs)?
Body (venae cavae (cranial and caudal)-ascites, jugular pulse)
What is ascites? What causes it?
Fluid in abdomen, caused by right heart failure
Where does blood back up into in left heart failure?
Lungs
What are cardiomyopathies?
Progressive cardiac disease
What is inflammation of the heart muscle?
Myocarditis
What parasite may reside in the right ventricle of the dog’s heart?
Heartworms (dirofilariasis): adult round worms (nematodes-Dirofilaria immitis)
What is the normal blood pressure of the dog?
120/80
Define PRAA (Persistent right aortic arch).
Right instead of left 4th aortic arch becomes the aorta resulting in entrapment of the esophagus
What structures constrict the esophagus in a persistent right aortic arch?
Aorta, ligamentum arteriosum, pulmonary trunk, and base of heart
What is a clinical sign of a persistent right aortic arch?
Regurgitates undigested food when weaned to solid food as large particles can’t get past this constriction
The constriction due to a persistent right aortic arch causes food to be stopped and the esophagus to balloon cranial to the ______ ____ ______.
Base of heart
How is a persistent right aortic arch treated?
Ligamentum arteriosum surgically isolated, ligated twice and cut between 2 ligatures
What is the difference between a congenital and a hereditary defect?
Congenital: present at birth, can be due to hereditary or environmental causes. Hereditary: passed on to offspring, may or may not be present at birth
What is a PDA?
Patent ductus arteriosus, a failure of the fetal ductus arteriosus (arterial duct) to close
What causes a washing machine murmur, and why?
PDA, continuous, thus, systolic and diastolic
How is a PDA treated?
Ends are tied off and cut between them if caught early
What would happen if a reversed PDA was tied off?
Blow out lungs, pressure above left ventricle
List the developmental anomalies making up Tetralogy of Fallot.
Pulmonic stenosis, overriding aorta, VSD, hypertrophy of right ventricle
What does cyanosis mean?
Bluish discoloration of tissues due to poor oxygenation
What are the three bumps seen on a DV view of a dog with PDA?
MPA, left auricle, and aorta
Of what is a patent ductus venosus an example?
Portosystemic shunt (bypasses liver)
What causes the sound heard as a heart murmur?
Blood flow turbulence
What are the two types of murmurs related to location heart cycle?
Diastolic or systolic murmurs
What causes valvular murmurs?
Leaky (insufficient) or narrowed (stenotic) valves
What could cause a systolic murmur?
Semilunar (aortic or pulmonic) stenosis, insufficiency (Left>right AV)
What can cause a diastolic murmur?
Semiliunar (aortic or pulmonic) insufficiency; or AV stenosis (very rare)
What is the clinical significance of the line of pleural reflection?
Demarcates the pleural from the peritoneal cavity
What is pleurocentesis/thoracocentesis?
Surgical puncture of the chest wall for drainage of fluid
Where is thoracocentesis done?
Middle of the 7th-8th intercostal space just dorsal to the costochondral junction
How can the pleural cupula be clinically important?
Can open the pleural cavity with and incision near the thoracic inlet
What is the term for inflammation of the pleura?
Pleuritis
Why is pneumothorax or pyothorax usually bilateral in carnivores?
Mediastinum is fenestrated (holes)
What is hyaline membrane disease?
Premature parturition before the lungs mature with insufficient surfactant produced
What is air or gas, pus or chyle in the pleural space?
Pneumothorax, pyothorax, chylothorax
In what could a tear in the thoracic part of the trachea result?
Pneumomediastinum
How can infections of the neck migrate to the thorax?
Down the deep fascia to the endothoracic fascia
What is the normal respiratory rate for dogs? Cats?
Dogs: 20 breaths/min; Cats: 25/min
How do the olecranon and the intercostal spaces relate when standing?
Olecranon at the 5th intercostal space or 5th rib
How far cranially does the dome of the diaphragm extend?
6th intercostal space just behind the olecranon/heart
Where is the heart located in relationship to the intercostal spaces and the arm muscles?
Between 2(3)-5(6) intercostal space, mostly under muscles
What is a memory aid for the heart valve’s point of maximum intensity?
PAM 345, right AV: low 5th right
Outline how you auscultate the heart with a stethoscope.
1st locate the point of elbow (5th ICS), find Lt. AV: 5th ICS, move 1 ICS cranial and up; aortic, then 1 ICS cranial and up: pulmonic
What vessels should be considered when opening the thorax? How?
Internal thoracic aa. on thoracic floor of the thorax (don’t cut near sternum); intercostal vessels and nn.: caudal to rib (cut in center of intercostal spaces)
Describe the cavity entered when inserting a needle to either side of the line of pleural reflection.
Craniodorsal=thorax 1st; caaudoventral=abdomen
Where is the basal border of the lung?
Roughly 1-2” craniodorsal to and parallel to the line of pleural reflection
What are the boundaries of the auxcultation triangle?
Cranial: caudal border of the triceps brachii m.; -dorsal: epaxial mm.; caudoventral: curved line from olecranon to next to the last dorsal intercostal space
Generally in relationship to what structure is a lung biopsy performed?
Craniodorsal to the basal border of the lung
How is cardiocentesis performed?
Into 5th ICS (intercostal space) (behind elbow) into palpated heartbeat
What is the location for thoracocentesis?
7th-8th ICS (intercostal space) at intercostal space level of the olecranon on right
what are the four quadrants of the abdomen?
right and left cranial, right and left caudal
what is the lateral part of the middle region of the abdomen?
flank
what are the inguinal regions?
lateral abdominal area next to the junction with thigh
what is the dorsal part of the flank region?
paralumbar fossa
where is the fundus of the stomach located?
left cranial/dorsal abdomen
how many mammar are generally present in the *****? cat?
usually 10 in dog, 8 in cat and small dogs
what are extra mammary glands called?
supernumerary mammary glands
generally where do the mammary glands lymphatics drain?
caudal: superficial inguinal ln.; cranial: to axillary ln (also accessory axillary if present sternal)
list the abdominal muscles from superficial to deep
external abdominal oblique (EAO), internal abdominal oblique (IAO), transverse abdominus, rectus abdominis (ventrally)
what is a flat thin tendon called?
aponeurosis
what is the caudal free edge of the aponeurosis of EAO extending from the tuber coxae around the iliopsoas muscle to the prepubic tendon?
inguinal ligament
what is the rectus sheath?
aponeuroses of the abdominal mm. around the rectus abdominis m., meet/fuse at the linea alba
which rectus sheath is most clinically important?
external rectus sheath
what passes through the openings of the diaphragm?
aortic: aorta, azygous, cisterna chyli/thoracic duct; Esophageal: esophagus, dorsal and ventral vagal trunks, Caval foramen: caudal vena cava
what is the motor nerve of the diaphragm?
phrenic nerve (somatic)
how does the cavity of the bony thorax relate to the thoracic cavity?
larger, dome of diaphragm extends into bony thorax to 6th intercostal space (encases abdomen)
what is the intrathoracic part of the abdominal cavity?
cranial part, protected by caudal ribs and costal cartilages
what is a directional terms for a part further from and closer to the mouth?
further: abroad, closer: orad
What are the two named curvatures of the stomach?
Greater and lesser curvature
What is the muscular sphincter surrounding the stomach’s outflow?
Pylorus
List the parts of the stomach
Cardia, fundus, body, pylorus (pyloric antrim, pylorus, pyloric opening)
What is the least vascular part if the stomach?
Body between two curvatures
On which sides of the animal is the pylorus? The fundus?
Pylorus: right (as duodenum) and ventral, fundusvleft and dorsal
Which is more ventral the fundus or the pylorus of the stomach?
Pylorus
the descending duodenum is on what side of the abdomen?
right
list the parts of the small and large intestine?
small: duodenum, jejunum, ileum
large: cecum, colon (ascending, transverse, descending), rectum, and anal canal
on what side is the cecum located?
right side
to what are species differences in the large intestine due?
modification of the ascending colon
what is the opening of the ileum into the colon (not cecum)?
ileocolic (ileal) opening (orifice)
what is the course of the transverse colon in all domestic species?
right to left cranial to root of mesentery
on which side of the animal is the descending colon?
left, often called the left colon
where do the anal sacs open in the anal canal?
4 and 8 o’clock positions
where is the liver located?
cranial abdomen abutting diaphragm, almost completely intrathoracic
the renal impression is in which liver lobe? which side of liver?
caudate lobe (caudate process), right
what ligament attaches the liver to the stomach?
lesser omentum
the (common) bile duct enters the duodenum at the _____ along with the __________ duct
major duodenal papillae
-pancreatic duct
list the parts of the pancreas and their locations
right limb: mesoduodenum, body: near pylorus; left limb: deep leaf greater omentum
where is the dorsal end of spleen located? ventral?
dorsal: on left (fixated to greater curvature)
ventral: variable
what is the elongated area of the spleen where vessels enter?
hilus
which arteries pass from the spleen to the fundus of the stomach?
short gastric aa.
what is an easy way to remember which kidney is more cranial or caudal?
right in renal impression of liver, or left is left behind
what is the expanded proximal end of ureters?
renal pelvis
where does urine drip from the kidney?
renal crest
which specie has capsular veins on the outside of its kidneys?
cat
what parts of the renal pelvis surround the pseudopapillae?
pelvic recesses/diverticulae
how do the ureters pass through the bladder wall and why?
oblique angle to prevent back flow
where is the trigone of the urinary bladder?
dorsal internal area between the two ureteral openings and opening of the urethra
what is a serous membrane?
a thin, continuous membrane lining a closed cavity of the obdy and covering its organs
name the serous membranes of the pericardium, thorax, abdomen, and vaginal process
serous pericardium; pleura; peritoneum; vaginal tunic
what serous membrane covers the walls of a cavity?
parietal (parietal means wall)
what serous membrane or serosa covers an organ?
visceral peritoneum (often just called serosa or peritoneum)
what serous membrane connects parietal and visceral or visceral with visceral serosa?
connecting
list three different types of peritoneum.
parietal, visceral, and connecting
list three or four types of connecting peritoneum
mesenteries, omenta, ligaments and folds
what peritoneum connects the liver and the ventral abdominal wall?
falciform ligamet
how many layers are in the different classifications of peritoneum?
parietal and visceral-1; connecting-2
what is the peritoneal cavity?
potential space between parietal and visceral peritoneum
what does retroperitoneal mean?
behind peritoneum
what are the two layers of the greater omentum?
superficial and deep leaves
what is the opening into the omental bursa from the peritoneal cavity?
epiploic (omental) foramen
how are mesenteries named?
meso + organ connected
what is the root of the mesentery?
attachment of the mesentery to the dorsal abdomen
name the 3 main unpaired branches of the abdominal aorta?
celiac a, cranial and caudal mesenteric arteries
what do the celiac, cranial and caudal mesenteric arteries supply?
viscera drained by portal vein
what are the three branches of the celiac artery?
hepatic, splenic, and left gastric
how do the jejunal arteries terminate to supply the jejunum?
form arcades and vasa recti to jejunum
what vessels supply the fundus of the stomach?
short gastric arteries from splenic artery
how are the ovarian arteries located?
lift up ovary and look for vessels in mesovarium
how are testicular arteries located in the abdomen?
passing caudal to kidney to vaginal ring
what vein carries the blood from the abdominal viscera to the liver?
portal vein (hepatic portal vein)
what are the 1˚ abdominal organs not drained by the portal vein?
kidneys, adrenal glands, gonads, liver
why aren’t the kidneys, adrenals and gonads drained by the portal vein?
their hormones would be destroyed by liver
where does the left gonadal vein empty?
into left renal v. instead of crossing aorta to vena cava
what lymphatic vessel drains the lymph from cisterna chyli that drains the caudal animal?
thoracic duct
to which lymph nodes does lymph drain to from the caudal and cranial mammae?
Ca.: superficial inguinal, Cr.: axillary
what are the large lymph nodes beneath the termination of the aorta?
medial iliac lymph nodes
what are the intestinal lymphatic vessels that absorb fats?
lacteals
what directions do the ventral branches of the spinal nerve travel?
caudoventral direction
what supplies cutaneous innervation to the top of the thoracic and abdominal walls?
both the dorsal and ventral branches of the spinal nn. in the thoracic and lumbar region
where are the collateral ganglia of the sympathetic division located?
near branches of abdominal aorta
what gland is part if the sympathetic ANS?
adrenal glands (medulla)
what are standing lateral views using a horizontal beam direction through a standing animal used to detect?
fluid levels in bowel or abdomen
on what does peritoneal (serosal) detail depend?
serosal (peritoneal) fat around organs
what is the term for an abdomen with an overall gray appearance due to loss of serosal detail?
“ground glass” appearance
what is the use of opaque media (positive contrast agents) or gas (negative contrast agent) to delineate portions of the GI tract called?
contrast studies
what must always precede all contrast studies?
survey radiographs
name one structure that normally is in the left caudal quadrant
descending colon
which sides of the diaphragm can be seen in radiographs?
yes: cranial surface (lungs);
no: caudal (water densities against it)
where are the parts of the stomach located in VD and lateral films?
fundus VD: left, Lat: dorsal
body: VD: midline (dog), left (cat)
pylorus: DV: right (dog), midline (cat) Lat: ventral
where is the air likely to be seen in the stomach of a radiograph taken in right lateral recumbency (right view)? left view?
right: fundus (eft side up, fundus is up), left: pylorus
where would gas be expected in the stomach in a DV view? VD?
DV: fundic region (dorsal up), VD: pylorus
what is the normal stomachs axis used for clinically?
between lines vertical to spine and parallel to ribs
what is the use of air and contrast material within an organ called?
double contrast studies (applied to bladder also)
how would you precisely locate a radiopaque foreign body to the stomach?
take 2 radiographs 90˚ to each other (lateral and VD)
what does full 360˚ gastric dilation and volvulus look like on a lateral radiograph?
enlarged gas filed stomach with a fold dividing the stomach into dorsal and ventral compartments (fold in volvulus)
what is the large distended loop of small intestine, named because they indicate trouble?
sentinel loop
what is the shape and location of the cecum in a VD radiograph?
“C” corkscrew shape; right side level of L3, seen only if air filled
is the descending colon seen in VD and lateral survey films?
yes if fecal filled
what structure may be surmised to be enlarged in lateral radiographs by ventral displacement of the descending coon?
medial iliac lymph nodes
linear foreign bodies in the small intestine, such as string, will cause the bowel to ________ __________ on the string due to peristalsis
bunch up, plicated or accordion pleating, very apparent with a contrast study
what should you do if you see a string hanging out of either end of a cat or god?
do not pull or it may saw through bunched up bowel (peritinitis). surgically remove
in normal adult dogs on an expiratory abdominal radiograph, the liver usually doesn’t extend past the _____.
rib
how is the stomach axis positioned in a lateral film when there is an enlarged liver?
exceeds angle parallel to ribs
why is the cranial pole of the right kidney not visualized in a lateral radiograph?
in renal impression of liver: same density
where is the speen seen in VD and lateral radiographs?
VD: triangular water density caudal to stomach on left
Rt, Lat: triangle
what causes a focal loss of detail to the right cranial abdomen
pancreatitis
what part of the right kidney can’t be seen normally?
cranial pole embedded in liver
where is the left kidney in relationship to the right kidney?
1/2 kidney length caudal, slightly ventral
on what does visualization of the renal borders depend?
amount of perirenal fat present
are the ureters visible on survey radiographs?
no
what structure of the renal pelvis shows up in contrast studies of the kidney that can give clues to problems?
pelvic diverticula/recesses
what is a protrusion of an organ or tissue through the umbilicus?
umbilical hernia
what is a direct and indirect inguinal hernia?
direct: explodes directly through the wall
indirect: passes down inguinal canal (scrotal hernia)
what is paracentesis?
puncture of peritoneal cavity to remove fluid
define a laparotomy or celiotomy incision
an incision opening the abdomen
what is done with a falciform ligament that obscures the view of the abdomen?
removed
what structures can be visualized through a xiphoid to pubic laparotomy incision without manipulation, and their locations?
cranial: falciform ligament
middle: greater omentum and +- tail of spleen
caudal: bladder
where is the spleen located when doing a laparotomy incision? how does this affect your incision?
left side of across midline
tent wall when opening the abdomen
what is an incision into the abdomen just off the midline?
paramedian incision (approach)
what is the most important layer that must be opposed when closing a paramedian midline incision?
external rectus sheath
what is an abdominal incisio made in the paralumbar fossa?
paralumbar incision, flank incision
what must be blocked to anesthetize the paralumbar fossa of the large animal’s flank?
both the dorsal and ventral branch’s must be blocked
what type of restraint is used for small animal surgery?
general anesthesia anesthesia instead of ocal
what is a common sequela to peritonitis (inflammation of the peritoneum)?
adhesions between sheets of peritoneum
visualize what is seen through a long midline incision
faciform ligament (cr.), greater omentum, urinary bladder (caudal), and +- spleen
must the peritoneum be apposed when closing the ventral midline incision?
no, best to leave it alone
why must including the falciform ligament or its fat in the closure of the abdomen be avoided?
lt may delay healing and contribute to wound dehiscence
what is the most important structure to close in a midline incision?
linea albe
what is a common cause of diaphragmatic hernias?
trauma (cars #1, fights, kicks, falls)
how is a diaphragmatic hernia reached surgically?
from abdominal side
when opening the abdomen of a dog with diaphragmatic hernia, what must you be prepared to do?
breath for dog, as when the abdomen opened there will be a pneumothorax
is the peritoneum opposed when closing the abdomen?
no, less trauma
what is wound dehiscence?
separation of layers of a surgical wound
what is paracentesis? abdominocentesis/abdominal puncture?
surgical puncture of a cavity for an aspiration of fuid; puncture of abdomen
what is a common sequela to inflammation of the peritoneum?
adhesions between sheets of peritoneum
where is a gastrotomy performed in the stomach?
through body between curvatures (less blood)
what emergency twisting of the stomach occurs in large and giant breed dogs with deep chests, rarely occuring in small dogs?
gastric dilation/volvulus complex, bloat
what common problems results in projectile vomiting?
pyloric stenosis/obstruction
where is the descending duodenum?
right side
what is intussusception?
telescoping of a segment of the intestine into the lumen of an adjacent segment
what is an incision into the intestines?
enterotomy
what structure identifies and locates the rest of the large and small intestines during an exploratory surgery?
cecum
what is the inflammation of the cecum?
typhlitis
what is the surgical removal of the cecum?
typhlectomy
how are the “abdominal gutters” (paravertebral gutters) visualized?
pull the duodenum and mesoduodenum or colon and mesocolon medially, packing off the rest of the viscera.
how are plugged anal sacs treated?
manually evacuation (gloved hand holds 4x4 gauze pushed forward cranial to the sacs, squeeze in and pull caudally evacuating sac; or gloved finger in anus, thumb lateral and deep to a sac, squeeze ad withdraw)
what must be avoided when surgically removing the anal sac?
external anus sphincters and caudal rectal nerves
what are pathological tracts between rectum and skin surrounding anus?
rectucutaneous fistulas
what is eversion of the inner rectum through the anus?
rectal prolapse
what is the removal of part of the liver?
partial hepatectomy
how is a liver biopsy taken in a dog?
laparotomy caudal to the xiphoid process, finger holds the liver in place, biopsy needle through a separate stab incision
what is inflammation of the gall bladder?
cholecystitus
how is the right limb of the pancreas exposed during exploratory surgery?
retract duodenum ventromedially
how is the left lobe of the pancreas exposed surgically?
retract stomach and spleen cranially and transverse colon caudally
what is the removal of the spleen?
splenectomy
how are the vessels ligated during a splenectomy and why?
close to hilus, preserve short gastrics and eft gastroepiploic supply to the stomach
what arteries to the stomach come off the splenic artery?
short gastrics and left gastroepiploic arteries
how would you locate the adrenal gland during surgery?
phrenicoabdomina v. crosses it ventrally.
how do you visualize the kidneys during a laparotomy?
pull the descending colon and its mesocolon or descending duodenum and its mesdoduodenum medially and look in the “abdominal gutter” for left and right kidneys respectivey
what is inflammation of the kidney?
nephritis
what structure of the renal pelvis shows up in contrast studies of the kidney that can give clues to problems?
pelvic recesses
what is the removal of a kidney? what should be checked first?
nephrectomy; check for another kidney
what is an incision into the kidney?
nephrotomy
what is inflammation of the kidney and its pelvis?
pyelonephritis
what is a patent urachus?
persistent urachus from the bladder to umbilicus
what is a clinical sign of a patent urachus?
dribbling of urine from the bladder to umbilicus
what is an abnormal concentration in any part of the urinary system?
urinary calculi
what is FUS (feline urinary syndrome) in tom cat?
urinary tract disease characterized by dysuria and hematuria with or without obstruction
what is the common site of urethra obstruction in the tomcat?
penie urethra
what is the creation of a permanent opening for the urethra in the perineum, a common treatments for FUS?
urethrostomy
what abnormal termination of a ureter some place besides the urinary bladder?
ectopic ureter
how is an ectopic ureter corrected?
surgically reimplant ureter obliquely through the bladder wall
what is tapping the uriary bladder with a needle to remove urine?
cystocentesis
what is surgical opening of the urinary bladder?
cystotomy
what is the #1 iatrogenic ureteral injury occurring during a spay?
ligature or clamp mistakenly applied to ureter
what vessles have to be considered when opening in the abdomen?
cranial and caudal superficial epigastric vessels
where would you make an incision to open the stomach and why?
between curvatures, less vessels
what artery is surgically important in operations of the cecum?
large ceca artery hidden on the dorsal surface
what must not be ligated when removing the spleen?
short gastrics and left gastroepiploic arteries or artery supplying them
how are vessels ligated during a splenectomy and why?
close to hilus, preserving short gastrics and left gastroepiploic supply to the stomach
where is the largest artery (cecal) of the cecum located?
hidden on dorsal side of cecum
how is the intestine cut when doing a resection and anastomoses?
“angle cuts toward lesion” (antimesenteric> mesenteric side of removed piece)
what arteries should surgeons watch for when doing nephrectomies?
renal arteries: usually singular but double or triple possible
what vascular incidence can cause paralysis of the rear limb of cats?
saddle thrombus in caudal aorta, blocking external iliac arteries
what is the landmark for finding adrenal glands?
phrenicoabdominal vein over ventral surface
what is a portosystemic shunt?
splanchnic (visceral) circulation bypasses normal hepatic system and empties into systemic veins
what is the removal of one or more mammary glands?
mastectomy
when wouldn’t a mastectomy be performed on a mammary tumor?
if distal lung metastasis present already
what is a metastasis?
transfer of disease from 1 part of body to another
what do the following surgical suffixes mean?
- ectomy
- ostomy
- otomy
- plexy
- plasty
- ectomy: removal of organ or part by surgery (hysterectomy)
- ostomy: surgically creating an artifical opening between a hollow organ and abdomina wall ( tracheostomy/tracheotomy)
- otomy: surgical incision
- plexy: fixation (pyloroplexy)
- plasty: shaping or surgical formation of (rhinoplasty)
how are the “abdomina gutters” (paravertebral gutters) exposed?
pull descending duodenum and mesoduodenum or colon and mesocolon medially
what is ileus?
obstruction of the intestines
can the liver be palpable in the normal dog?
no
how is the descending colon palpated? when is this easiest?
on left side; when constipated
can the kidneys be palpated in the dog?
in some dogs, right is more difficult
how easy can the cat’s kidneys be palpated through the abdominal wall?
usually left pendulous enough to palpate, right may also be palpated
is the urinary bladder palpable in the dog and cat?
readily
when can and can’t the uterus be palpated?
can’t/rarely: nonpregnant *****
-pregnant: vesicle palpable ranging (marble to egg) at 25-35 days then horns uniformly enarged: nonpalpable
how is the superficial inguinal lymph node papated?
subcutaneoulsy just craniomedial to thigh
how are plugged anal sacs treated?
manually evaculation (gloved hand holds 4x4 gauze pushed forward cranial to sacs, squeeze in and pull caudally evacuation sac; or gloved finger in anus, thumb lateral and deep to a sac, squeeze and withdraw)
