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Soft Tissue Surgery (1-19) Flashcards

1
Q

name the 3 phases of wound healing

A
  1. inflammation
  2. proliferation
  3. maturation
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2
Q

name the 3 goals of the inflammatory phase of wound healing

A
  1. haemorrhage + clot formation
  2. incr. blood flow
  3. start control bacterial infection
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3
Q

what is the role of neutrophils in the inflammatory phase of wound healing

A

phagocytose bacteria & die

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4
Q

name the 3 roles of macrophages in the inflammatory phase of wound healing

A
  1. phagocytosis of debris
  2. produce proteases
  3. release cytokines
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5
Q

name 2 roles of exudate during the inflammatory phase of wound healing

A
  1. sloughing tissue, cells, and bacteria
  2. debridement phase of wound management
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6
Q

name the 2 parts of the proliferative phase of wound healing

A
  1. granulation tissue forms
  2. epithelialisation
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7
Q

name the 3 steps of granulation tissue formation during the proliferative phase of wound healing

A
  1. macrophages promote fibroplasia and angiogenesis
  2. vessels migrate into fibrin clot
  3. collagen matrix is laid down
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8
Q

name 3 features of an unhealthy granulation bed during wound healing

A
  1. pale
  2. not progressing
  3. usually necrotic debris or infection
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9
Q

name 3 features of a healthy granulation bed during wound healing

A
  1. highly resistant to infection
  2. nutrient and oxygen supply
  3. lattice for scar formation (red, moist, flat)
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10
Q

name 5 factors that promote epithelialisation during the proliferative phase of wound healing

A
  1. healthy granulation bed
  2. absence of infection
  3. absence of necrotic debris
  4. oxygen at wound surface (vessels)
  5. moist wound environment
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11
Q

name the 2 parts of the maturation phase of wound healing

A
  1. scar contracts
  2. collagen remodels (increasing strength)
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12
Q

what is the endpoint goal of initial open wound management

A

granulation tissue with epithelialisation

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13
Q

name 2 types of factors affecting wound healing

A
  1. host factors
  2. local factors
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14
Q

name 5 host factors that may delay wound healing

A
  1. old age
  2. hypoalbuminaemia
  3. endocrine disease
  4. metabolic disease
  5. medication
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15
Q

name 5 local factors detrimental to wound healing

A
  1. foreign material
  2. infection
  3. trauma
  4. desiccation
  5. hypoxia
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16
Q

name 6 ways to promote wound healing

A
  1. removal of non-viable tissue
  2. control infection
  3. good tissue oxygenation
  4. moist surface
  5. avoid trauma
  6. control host factors where possible
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17
Q

name 4 wound closure options

A
  1. primary closure
  2. delayed primary closure
  3. secondary closure
  4. second intention healing
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18
Q

what type of wound is able to be closed by primary closure
(immediately)

A

clean or clean-contaminated with aseptic technique

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19
Q

what type of wound is able to be closed by delayed primary closure
(2-5 days)

A

clean contaminated, contaminated

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20
Q

what type of wound is able to be closed by secondary closure
(>5 days)

A

contaminated, dirty

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21
Q

name the type of wound closure

closure after bacteria and debris have been eliminated but before granulation starts;
moderate tissue trauma;
grossly contaminated;
caused by dirty objects

A

delayed primary closure

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22
Q

name the type of wound closure

closure once granulation tissue has formed;
healthy granulation - implies no infection or necrotic debris

A

secondary closure

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23
Q

name the 3 steps of open wound management

A
  1. initial assessment and preparation
  2. debridement (inflamm. phase)
  3. granulation (proliferation phase)
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24
Q

name 4 steps to prevent further contamination during hair clipping for preparation of an open wound

A
  1. pack wound with sterile K-Y jelly
  2. clip widely
  3. gel traps hair
  4. lavage gel off
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25
Q

name 3 ways to debride an open wound for initial debridement

A
  1. sharp dissection
  2. scraping with blade
  3. rub with dry swab
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26
Q

name 4 signs of devitalised tissue that should be debrided

A
  1. white, green black
  2. does not bleed when nicked
  3. loss of skin pliability
  4. thinning of skin
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27
Q

name 3 options for continued debridement of an open wound

A
  1. adhesive dressing (wet-to-dry dressing)
  2. autolytic
  3. surgical
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28
Q

how often should a wet-to-dry dressing for debridement be changed

A

min. 24 h;
usually 12-24h

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29
Q

how long should an adherent dressing be used for continued debridement of an open wound

A

48-72 h
(during exudative period)

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30
Q

when should you change the debridement method of an open wound to non-adherent?

(3 features present)

A
  1. all necrotic tissue removed
  2. exudate reduces
  3. granulation starts
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31
Q

name 3 surgical options for continued debridement of an open wound

A
  1. en bloc
  2. layered debridement
  3. combination
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32
Q

name 2 autolytic options for continued debridement of an open wound

A
  1. hydrogel
  2. honey dressing
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33
Q

what are the 3 goals of autolytic debridement

A
  1. encourage enzyme activity
  2. liquefy exudate
  3. remove exudate

(physiological slough)

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34
Q

name 4 features of honey dressings for an open wound debridement

A
  1. autolytic debridement
  2. osmotic effect
  3. antibacterial effect
  4. accelerate wound healing
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35
Q

name 4 visual features of healthy granulation tissue

A
  1. red
  2. uniform
  3. minimal exudate
  4. progressing daily
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36
Q

name the 3 layers of a bandage

A
  1. primary (contact) layer
  2. intermediary layer
  3. tertiary layer
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37
Q

name 3 functions of the intermediary layer of a bandage for an open wound

A
  1. hold contact layer in place
  2. absorb exudate passing through contact layer
  3. provide padding + support
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38
Q

name the 2 parts of the tertiary layer of a bandage

A
  1. conforming layer
  2. cohesive layer
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39
Q

name the 3 functions of the tertiaru layer of a bandage

A
  1. hold intermediary layer in place
  2. protect environmental contamination
  3. apply pressure to dressing
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40
Q

name the topical antimicrobial

bactericidal broad spectrum;
apply early to prevent bacterial colonization;
burn therapy

A

silver sulfadiazine

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41
Q

name the topical antimicrobial

Ag+ ions;
bactericidal;
independent of culture and sensitivity

A

silver dressings

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42
Q

name the topical antimicrobial

oxidase activity generates H2O2;
acidic pH;
anti-oxidants;
modifies host response;
osmotic effect

A

honey dressings

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43
Q

name the 4 layers of the skin

A
  1. epidermis
  2. dermis
  3. hypodermis
  4. panniculus muscle
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44
Q

name the 4 levels of vasculature in the skin
(superficial to deep)

A
  1. papillary/superficial plexus
  2. middle plexus
  3. subdermal plexus
  4. direct cutaneous vessels
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45
Q

name the 7 Halsted Principles

A
  1. aseptic technique
  2. gentle tissue handling
  3. meticulous haemostasis
  4. preservation of blood supply
  5. obliteration of dead space
  6. accurate apposition of tissue
  7. minimise tension
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46
Q

what kind of suture material should you use for the skin

A

synthetic, monofilament, small diameter

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47
Q

what kind of needle should you use for suturing skin

A

swaged-on reverse cutting needles

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48
Q

what type of forceps are the most traumatic to skin?

A

plain thumb forceps
(crushing injury)

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49
Q

name 3 surgical techniques for eliminating dead space

A
  1. drains
  2. sutures
  3. bandages
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50
Q

what is the surgical technique to preserve blood supply if the panniculus is present

A

dissect below

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51
Q

what is the surgical technique to preserve blood supply if the panniculus is absent?

A

dissect off underlying fascia

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52
Q

name 3 surgical techniques for meticulous haemostasis

A
  1. vessel ligation
  2. electrosurgical devices
  3. tourniquets
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53
Q

name 4 ways to reduce tension during surgery closure

A
  1. distribute tension evenly through all layers of the wound
  2. follow tension lines
  3. tension-relieving suture patterns
  4. reconstructive techniques
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54
Q

this is the primary holding layer of the wound

A

subcutaneous layer

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55
Q

should you close wounds parallel to OR perpendicular to tension lines

A

parallel

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56
Q

name the tension relieving technique

this is the main form of tension relief during surgery;
should be done below the panniculus muscle or below the subcutaneous tissue when the panniculus is absent;
use blunt or sharp technique

A

undermining

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57
Q

name the tension relieving technique

this follows undermining;
distributes tension throughout wound;
reduces tension at primary suture line;
staggered rows of simple interrupted sutures (absorbable)

A

walking sutures

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58
Q

name the 4 types of mattress sutures

A
  1. cruciate mattress
  2. vertical mattress
  3. horizontal mattress
  4. near-far-far-near
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59
Q

name the tension relieving technique

close one wound by creating a second, adjacent wound;
used to shift wound away from pressure point or into an area where there is more available skin

A

relaxing incisions

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60
Q

name 3 types of relaxing incisions that can be made to relieve tension

A
  1. mesh expansion
  2. bipedicle advancement flap
  3. V-Y plasty
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61
Q

name two types of pedicle flaps

A
  1. subdermal plexus flap
  2. axial pattern flap
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62
Q

name the type of pedicle flap

incorporate a large direct cutaneous vessel;
larger flap possible;
anatomical landmarks determined by angiosome

A

axial pattern flaps

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63
Q

name the 4 most commonly used vessels for axial pattern flaps

A
  1. deep circumflex iliac
  2. caudal superficial epigastric
  3. thoracodorsal
  4. omocervical
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64
Q

name the 3 key principles of a free skin graft
(full thickness meshed graft)

A
  1. intolerant of movement
  2. require healthy granulation tissue bed
  3. must stay in close contact with bed
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65
Q

name the term

removal of part of the upper jaw
usually to remove oral neoplasms

A

maxillectomy

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66
Q

name the term

removal of part of the lower jaw

A

mandibulectomy

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67
Q

name the term

removal of part of the toungue;
usually to remove a tumour

A

glossectomy

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68
Q

name the term

plastic surgery to repair lip defects

A

cheiloplasty

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69
Q

name 4 important surgical principles for oral surgery

A
  1. atraumatic tissue handling
  2. haemorrhage
  3. tension-free, supported closure
  4. appositional suture patterns
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70
Q

name 6 general clinical signs that may be seen with oral disease

A
  1. drooling
  2. oral bleeding
  3. dysphagia
  4. anorexia
  5. pain
  6. halitosis
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71
Q

name 3 postoperative concerns of oral surgery

A
  1. eating
  2. preventing wound dehiscence
  3. pain relief
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72
Q

name the 4 major pairs of salivary glands in dogs and cats

A
  1. Parotid gland
  2. Zygomatic gland
  3. subLingual gland
  4. Mandibular gland
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73
Q

name the term

submucosal or subcutaneous collection of saliva;
leakage of saliva from gland or duct;
submandibular, cervical, sublingual

A

sialocoele
(aka salivary mucocoele )

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74
Q

name 3 common locations of sialocoeles (aka salivary mucocoele)

A
  1. submandibular
  2. cervical
  3. sublingual (ranula)
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75
Q

name 6 possible causes of salocoele

A
  1. idiopathic (most common)
  2. trauma
  3. inflammation
  4. neoplasia
  5. sialolithiasis
  6. foreign body
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76
Q

what duct is most commonly the cause for a sialocoele

A

sublingual gland

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77
Q

name 5 clinical signs of a sialocoele

A
  1. fluctuating swelling
  2. dysphagia
  3. oral bleeding
  4. hypersalivation
  5. respiratory obstruction
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78
Q

name 3 features of aspirate from a sialocoele to help with diagnosis

A
  1. honey coloured
  2. viscous
  3. mucin
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79
Q

what is the treatment for a subcutaneous sialocoele?

A

sialoadenectomy
(removal of the salivary gland)

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80
Q

what is the treatment for a ranula (caused by a sialocoele)

A

marsupialisation
+/- sialoadenectomy

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81
Q

name the term

abnormal communication between the oral and nasal cavity

A

oronasal fistula

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82
Q

name 4 clinical signs of an oronasal fistula

A
  1. chronic rhinitis
  2. nasal regurgitation of food
  3. aspiration pneumonia
  4. malnutrition
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83
Q

name 3 possible causes of an oronasal fistula

A
  1. dental disease
  2. trauma
  3. neoplasia
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84
Q

name 3 features of acute presentation of penetrating oropharyngeal injuries

A
  1. oral signs (dysphagia, blood-tinged saliva, pain)
  2. pyrexia
  3. pyothorax + mediastinitis
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85
Q

name 2 features of chronic presentation of penetrating oropharyngeal injuries

A
  1. swelling/abscess
  2. sinus tract
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86
Q

name the term

any incision into abdominal cavity

A

coeliotomy

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87
Q

name the term

incision through muscle into abdomen;
flank incision or paracostal approach

A

laparotomy

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88
Q

name the term

sudden onset abdominal pain;
catastrophic abdominal pathology

A

acute abdomen

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89
Q

name 5 possible characteristics of acute abdomen

A
  1. acute severe abdominal pain
  2. shock
  3. +/- abdo distension
  4. +/- vomiting
  5. +/- diarrhea
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90
Q

name the term

fibrous band running from xiphoid to prepubic tendon;
located between paired rectus abdominus

A

linea alba

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91
Q

the aponeuroses of what muscles forms the linea alba

A
  1. external oblique
  2. internal oblique
  3. transversus abdominus
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92
Q

this is the primary holding layer for abdominal closure

A

external rectus sheath

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93
Q

which 3 muscles contribute to the external rectus sheath

A
  1. external abdominal oblique
  2. internal abdominal oblique
  3. transversus abdominus
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94
Q

name the 3 possible approaches to abdominal surgery

A
  1. ventral midline coeliotomy
  2. flank laparotomy
  3. paracostal laparotomy
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95
Q

name two advantages of an organ centered approach for ventral midline coeliotomy

A
  1. quicker
  2. lower morbidity
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96
Q

name three advantages of a full exploratory approach for ventral midline coeliotomy

A
  1. better exposure
  2. evaluate entire abdomen
  3. easier to deal with complications
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97
Q

how should an animal be clipped for an abdominal surgery

A

for full abdomen approach
(mid-sternum to beyond pubis + up to flank folds)

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98
Q

what two additional structures must be transected/ligated in a male doge for full ventral midline coeliotomy

A
  1. cranial preputial muscle
  2. preputial branches of caudal and superficial epigastric artery and vein
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99
Q

name 2 surgical approaches to maximize exposure during ventral midline coeliotomy

A
  1. excise falciform fat
  2. use abdominal retractors
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100
Q

name 2 types of abdominal retractors

A
  1. Balfour
  2. Gosset
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101
Q

name 2 surgical approaches to prevent tissues from desiccating during abdominal surgical

A
  1. moistened swabs
  2. saline lavage + suction
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102
Q

what 4 organs should be looked at in the cranial quadrant of the abdomen

A
  1. diaphragm
  2. liver
  3. gall bladder
  4. stomach
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103
Q

what 7 structures should be inspected in the right gutter of the abdomen

A
  1. R limb pancreas
  2. kidney
  3. adrenal
  4. portal vein
  5. vena cava
  6. ureter
  7. ovary
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104
Q

what maneuver must be done in order to see into the R gutter of the abdomen

A

mesoduodenal sling

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105
Q

what maneuver must be done in order to see the left gutter of the abdomen

A

mesocolic sling

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106
Q

what 4 structures should be looked at in the left gutter of the abdomen

A
  1. kidney
  2. ureter
  3. ovary
  4. adrenal
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107
Q

what 3 structures should be looked at in the central abdomen quandrant

A
  1. omentum
  2. spleen
  3. left limb of pancreas
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108
Q

what 6 structures should be inspected in the caudal quadrant of the abdomen

A
  1. colon
  2. repro tract
  3. bladder
  4. urethra
  5. prostate
  6. inguinal rings
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109
Q

what suture type should be used to close the first layer from a coeliotomy, the linea alba (external rectus sheath)

A

monofilament, synthetic absorbable suture material

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110
Q

what suture pattern should be used to close the first layer from a coeliotomy, the linea alba (external rectus sheath)

A

simple interrupted or continuous patterns

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111
Q

if using PDS for closure of the ecternal rectus sheath, how many throws should be at the start and finish of the continuous pattern

A

7 throws start + finish

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112
Q

what type of suture should be used for coeliotomy closure of the second layer, the subcutaneous tissue

A

monofilament, absorbable suture

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113
Q

what type of suture should be used for intradermal skin apposition

A

monofilament, absorbable suture

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114
Q

what type of suture should be used for external skin apposition

A

non-absorbable

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115
Q

name the 3 layers that must be sutured for coeliotomy closure in a dog

A
  1. linea alba (external rectus sheath)
  2. subcutaneous tissue
  3. skin apposition
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116
Q

name the term

enlargement of the stomch associated with rotation on its mesenteric axis

A

gastric dilation-volvulus (GDV)

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117
Q

name the term

stomach that is engorged with air or froth but not malpositioned

A

simple dilatation

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118
Q

name 3 types of fluid that may fill the dilated stomach in GDV

A
  1. food + gastric secretions
  2. transudate from mural venous congestion
  3. blood + mucosal slough as stomach necrosis develops
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119
Q

what direction will the stomach typically rotate in a GDV

A

clockwise rotation

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120
Q

where will the spleen be displaced to with GDV

A

right dorsal
(via gastrosplenic ligament)

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121
Q

name 4 possible cardiovascular effects of GDV

A
  1. reduced venous return to heart
  2. reduced circulating blood volume
  3. cardiac arrhythmias
  4. shock (endotoxic + septic)
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122
Q

how can GDV cause respiratory compromise?

A

diaphragmatic compression

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123
Q

name 3 intrinsic factors that may incr. risk for GDV

A
  1. breed (deep-chested)
  2. conformation
  3. genetics
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124
Q

name 3 diets that may be risk factors for GDV

A
  1. single source diet
  2. one daily feeding
  3. processed dry (cereal or soya based)
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125
Q

name 6 recommendations to try and prevent GDV for high-risk dogs

A
  1. several small meals rather than 1 large
  2. avoid stress during feeding
  3. restrict exercise before and after meals
  4. no elevated feed bowl
  5. don’t breed dogs with first-degree relative with GDV history
  6. consider prophylactic gastropexy
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126
Q

how to confirm GDV diagnosis

A

radiography:
1. compartmentalisation
2. cannot identify pylorus on R lateral

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127
Q

what 2 things for patient stabilisation must start immediately for a dog with GDV

A
  1. fluid resuscitation
  2. gastric decompression
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128
Q

what 2 veins should you use for IV fluid resuscitation for a dog with GDV (one of the 2)

A
  1. Jugular
  2. Cephalic
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129
Q

what type of fluid and at what rate should be given to a dog with GDV for fluid resuscitation

A

crystalloids
90+ mL/kg per hour

(squeeze a full bag into them)

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130
Q

name 3 reasons for decompressing a patient with GDV

A
  1. prevents necrosis
  2. stabilize systemically/cardiovascularly
  3. easier to de-rotate
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131
Q

name 2 methods for decompression of a patient with GDV

A
  1. orogastric intubation
  2. percutaneous decompression
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132
Q

where should the large bore tube be premeasured to for orogastric intubation for decompression of GDV

A

to last rib

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133
Q

name 3 goals of GDV surgery

A
  1. decompress and reposition stomach
  2. assess stomach and spleen for necrosis
  3. prevent recurrence
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134
Q

what is the most common site for necrosis from a GDV

A

greater curvature

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135
Q

name 3 indications for a splenectomy from GDV

A
  1. persistent congestion aftr 10 min of repositioning
  2. avulsion or infarction of vessels
  3. gross necrosis

(rarely necessary)

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136
Q

name 4 gastropexy techniques

A
  1. incisional
  2. belt loop
  3. circumcostal
  4. tube
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137
Q

name the gastropexy technique

strong;
technically easiest;
adhesion formation between pyloric antrum and R body wall just behind last rib

A

incisional

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138
Q

where do you put the stomach tube for GDV tube gastropexy

A

tube in pylorus

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139
Q

where do you put the stomach tube for feeding

A

in fundus

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140
Q

what is the minimum time a gastrostomy tube must be maintained/kept in

A

7 days

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141
Q

name 3 possible early post op complication of a GDV surgery

A
  1. cardiac arrhythmias
  2. gastric wall necrosis
  3. peritonitis
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142
Q

name 2 possible longer term post op complications of a GDV surgery

A
  1. gastric hypomotility
  2. recurrence 5 to 10%
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143
Q

name the term

incision into the intestine

A

enterotomy

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144
Q

name the term

removal of a segment of intestine

A

enterectomy

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145
Q

name the term

eneterostomy with reestablishment of continuity between the divided ends

A

intestinal resection and anastomosis

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146
Q

name the term

surgical fixation of one intestinal segment to another

A

enteroplication

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147
Q

name 2 ways to reduce contamination during intestinal surgery

A
  1. isolate intestine
  2. lavage and suction
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148
Q

name 2 ways to minimize tissue trauma during intestinal surgery

A
  1. gentle handling
  2. use correct instruments
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149
Q

what is the holding layer of the intestines that MUST be engaged in EVERY suture or staple

A

submucosa

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150
Q

what is the best choice of forceps to handle the intestines with during surgery

A

Debakey forceps

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151
Q

what type of forceps should NEVER be used with the intestines during surgery

A

rat-toothed forceps

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152
Q

name 3 clinical signs of an intestinal foreign body

A
  1. vomiting
  2. loss of appetite
  3. abdominal discomfort

(+/- diarrhea +/- melaena)

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153
Q

name 3 possible systemic effects of an intestinal foreign body

A
  1. dehydration
  2. electrolyte loss
  3. weight loss (chronic)
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154
Q

name 3 possible local effects of an intestinal foreign body

A
  1. pressure necrosis
  2. perforation
  3. peritonitis
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155
Q

name the 2 surgical options for an intestinal foreign body

A
  1. enterotomy
  2. enterectomy
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156
Q

where should the incision be made for an enterotomy for an intestinal foreign body

A

distally (healthy bowel) to foreign body on antimesenteric surface

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157
Q

how to perform a leak test following closure of an enterotomy

A
  1. occlude intestine with fingers
  2. 25g needle + syringe
  3. slight pressure but no more
158
Q

where should sutures 1 and 2 be placed for anastomosis following intestinal resection

A
  1. mesenteric border
  2. antimesenteric border
159
Q

how to manage luminal disparity during intestinal resection + anastomosis

A

cut smaller diameter end more obliquely

160
Q

at least how big must an intestinal biopsy be

A

5mm in length,
2mm in width

161
Q

where is intussusception of the intestine most common

A

jejunocolic at ileocaecocolic junction

162
Q

what are the 2 options for resolving intussusception of the intestines

A
  1. reduce intussusception
  2. intestinal resection and anastomosis
163
Q

name 3 indications for intestinal rection and anastomosis as treatment for intussusception

A
  1. adhesions prevent reduction
  2. tissue non-viable
  3. tissue tears
164
Q

name the term

incising the stomach

A

gastrotomy

165
Q

name the term

excising a portion of the stomach

A

gastrectomy

166
Q

name the term

creating a stoma (opening) in the stomach usually using a tube

A

gastrostomy

167
Q

name the term

fixing the stomach to body wall

A

gastropexy

168
Q

why are animals fasted prior to ANY general anaesthetic

A

minimize reflux of gastric contents into oesophagus

169
Q

what 2 things can be caused by reflux of gastric contents into oesophagus (esp. during anaesthetic)

A
  1. reflex oesophagitis
  2. aspiration pneumonia
170
Q

name 4 specific risks of gastrointestinal surgery

A
  1. intra-operative contamination
  2. postoperative dehiscence and leakage
  3. peritonitis
  4. iatrogenic blockage
171
Q

name 3 ways to isolate the stomach to control contamination during GI surgery

A
  1. stay sutures
  2. Babcock forceps
  3. packing around site
172
Q

name 3 ways to reduce risk of dehiscence during GI surgery

A
  1. atraumatic tissue handling
  2. omental wrap
  3. serosal seal
173
Q

name 3 benefits of an omental wrap during GI surgery to reduce risk of dehiscence

A
  1. blood supply
  2. physically blocks holes
  3. walls off/protects
174
Q

what are the 2 main indications for a gastrotomy

A
  1. foreign body removal
  2. biopsy
175
Q

name the 6 steps of a gastrotomy

A
  1. expose stomach
  2. pick avascular area away from pylorus
  3. place stay suturs on either side of site
  4. tent stomach up and isolate with swabs
  5. stab incision with no.10/11 scalpel
  6. extend with scalpel or Metzenbaum scissors
176
Q

what suture pattern should be used for a one layer closure of stomach

A

simple appositional
(interruptes or continuous)

177
Q

what tissues make up each layer in a two layer closure of the stomach

A
  1. mucosa and submucosa
  2. muscularis and serosa
178
Q

what suture pattern should be used for each layer in a two layer closure of the stomach

A
  1. simple appositional / simple continuous
  2. appositional/inverting pattern
179
Q

how long after GI surgery should you wait before feeding?

A

feed ASAP!

(fasting delays healing of GI trac)

180
Q

name 5 signs of gastric disease

A
  1. vomiting, haematemesis
  2. melena
  3. dehydration, hypokalaemia
  4. loss of appetite
  5. weight loss
181
Q

how big should a normal fundus of stomach be?

A

less than 3 intercostal spaces

182
Q

name 2 options for stomach foreign body treatment

A
  1. endoscopic removal
  2. gastrotomy
183
Q

name 4 examples of pre-existing abdominal pathology that may lead to secondary generalized peritonitis

A
  1. rupture of GIT
  2. urine leakage
  3. penetrating trauma
  4. bile leakage following trauma
184
Q

what is the most common cause of secondary peritonitis in dogs?

A

infectious

185
Q

what two things may be seen on radiography to indicate septic peritonitis

A
  1. loss of serosal detail - fluid
  2. free abdominal gas
186
Q

what 2 things may be seen on ultrasound to indicate septic peritonitis

A
  1. turbid abdominal fluid
  2. identification of underlying pathology
187
Q

what would neutrophils with intracellular bacteria found in an abdominal fluid analysis indicate

A

septic peritonitis

188
Q

what is the treatment for septic peritonitis

A

emergency surgery!

189
Q

name 3 indications for colonic surgery

A
  1. colonic biopsy
  2. neoplasia
  3. severe constipation (obstipation)
190
Q

which part of the GI tract has the highest bacterial flora and has gram negative anaerobes
-perioperative antibiotics indicated

191
Q

name 3 common large intestine pathologies

A
  1. megacolon
  2. anal sac disease
  3. rectal prolapse
192
Q

name the term

large intestinal enlargement and hypomotility with severe contipation/obstipation

193
Q

finish the phrase:

maybe she’s born with it,
maybe its…

A

megacolon

(congenital, primary)

194
Q

this is the commonest form of megacolon;
acquired disorder;
uncertain aetiology (environment, stress, obesity, primary colonic inertia)

A

feline idiopathic megacolon

195
Q

name 2 causes of an acquired functional megacolon

A
  1. acquired dysautonomias
  2. neurological injury
196
Q

name 3 causes of intramural and mural acquired secondary megacolon

A
  1. foreign body
  2. neoplasia
  3. stricture
197
Q

what type of acquired megacolon will a pelvic fracture cause

A

extramural

198
Q

what is the diameter of a megacolon

A

greater than 1.5 times the length of L7

199
Q

this is when 90-95% of the colon is removed to treat megacolon in CATS only;
+/- removal of ileocaecal junction

A

subtotal colectomy

200
Q

name 3 complications of subtotal colectomy

A
  1. postop diarrhea (inevitable)
  2. faecal incontinence
  3. recurrence
201
Q

name the 3 most common anal sac diseases

A
  1. anal sacculitis (impaction and infection)
  2. anal sac abscess + rupture
  3. apocrine gland adenocarcinoma
202
Q

name 3 indications for a liver biopsy

A
  1. substantially/persistently incr. liver enzymes
  2. diffuse changes in hepatic echogenicity
  3. isolated liver lesions
203
Q

name 3 techniques for taking a liver biopsy

A
  1. percutaneously (U/S-guided)
  2. laparoscopic
  3. open surgical technique
204
Q

name the liver biopsy technique

least invasive;
small specimen size;
U/S guidance;
not possible to observe haemorrhage directly;
relatively cheap and readily available

A

percutaneous

205
Q

name the liver biopsy technique

general anaesthesia required;
medium specimen size;
direct visualization;
haemorrhage can be directly observed;
more expensive, specialized equipment and training required

A

laparoscopic

206
Q

name the liver biopsy technique

most invasive, GA required;
large specimen size;
direct visualisation;
haemorrhage can be directly observed;
variable cost & availability depending on clinic

A

open surgical

207
Q

this is when anomalous vessels enable portal blood to bypass the liver so portal blood passes directly into the systemic circulation

A

portosystemic shunt

208
Q

name 6 systemic effects of a portosystemic shunt

A
  1. failure to thrive
  2. hypoalbuminaemia
  3. hepatic encephalopathy
  4. hypoglycaemia
  5. urinary tract signs
  6. coagulopathy
209
Q

what is the goal of medical management of portosystemic shunt

A

manage hepatic encephalopathy

210
Q

name 4 commonly used medical managements for a portosystemic shunt

A
  1. hepatic diet
  2. lactulose
  3. antibiotics
  4. SAMe
211
Q

what is the goal of surgical management of a portosystemic shunt

A

increase hepatic blood flow by closing anomalous vessel

212
Q

name 3 techniques for surgical management of a portosystemic shunt

A
  1. ameroid constrictor
  2. cellophane banding
  3. ligation
213
Q

name 5 possible post-operative complications of surgical management of a portosystemic shunt

A
  1. hypoglycaemia
  2. haemorrhage/anaemia
  3. portal hypertension
  4. seizures and encephalopathy
  5. recurrence of clinical signs
214
Q

name 4 surgical procedures for the biliary tree

A
  1. cholecystectomy
  2. cholecystojejunostomy
  3. choledochal stenting
  4. choledochotomy
215
Q

name 4 surgical indications of the spleen

A
  1. splenic trauma
  2. splenic torsion
  3. splenic neoplasia
  4. benign splenic mass
216
Q

name 2 possible causes of splenic torsion

A
  1. spontaneous torsion
  2. secondary to GDV
217
Q

name the term

Protrusion of a structure through a defect in the wall of its normal anatomical cavity

218
Q

name the term

herniation of organ out of the abdomen through a defect in the external wall of the abdomen;
usually traumatic

A

external abdominal hernia

219
Q

name the term

occur through a ring of tissue confined within the abdomen or thorax

A

internal abdominal hernias

220
Q

name the type of hernia

enclosed in a peritoneal sac

A

true hernia

221
Q

name the term

protrusion of organs outside a normal abdominal opening;
not enclosed in a peritoneal sac

A

false hernias

222
Q

name 3 examples of external abdominal hernias

A
  1. ventral
  2. paracostal
  3. prepubic
223
Q

name 3 physical findings of external abdominal hernias

A
  1. asymmetry of body contour
  2. palpable organs in subcutaneous location
  3. hernia ring (body wall defect)
224
Q

name the type of hernia

avulsion of cranial pubic (prepubic) tendon;
usually caused by RTA;
often associated pelvic fractures

A

prepubic hernia

225
Q

name the 4 principles of hernia repair

A
  1. access hernia
  2. assess viability contents
  3. reduce contents
  4. repair hernia defect
226
Q

name the 2 options for hernia repair

A
  1. autologous repair
  2. non-autologous repair
227
Q

name the hernia repair option

muscular flaps;
anchor structures through bone tunnels

A

autologous repair

228
Q

name the hernia repair option

synthetic mesh

A

non-autologous repair

229
Q

name the type of hernia

herniation through inguinal canal;
contents adjacent to vaginal process;
may be congenital or acquired;
may be unilateral or bilateral

A

inguinal hernia

230
Q

what can make the repair of an inguinal hernia in male dogs easier?

231
Q

name the type of hernia

rare, unilateral;
organs herniate into the vaginal process adjacent to the spermatic cord in the scrotum;
organ strangulation is common

A

scrotal hernia

232
Q

name the type of hernia

usually traumatic;
herniation of organs through femoral canal;
femoral artery, vein + nerve (repair difficult);
refer for repair

A

femoral hernia

(usually misdiagnosed as inguinal hernias)

233
Q

name the type of hernia

pelvic diaphragm (levator ani muscle) degenerates;
rectum, prostate + abdominal organs herniate

A

perineal hernia

234
Q

name the 4 muscles involved with the pelvic diaphragm and perineal hernias

A
  1. external anal sphincter
  2. lavator ani muscle
  3. coccygeal muscle
  4. internal obturator muscle
235
Q

name 3 typical presentations (clinical signs) of a perineal hernia

A
  1. faecal tenesmus
  2. perineal swelling
  3. constipation
236
Q

name 2 clinical signs of a retroflexed bladder, associated with a perineal hernia

A
  1. dysuria
  2. systemic collapse/acute renal failure
237
Q

what is the best treatment option to repair a perineal hernia

A

internal obturator muscle transposition flap

238
Q

how long does it take for the bladder wall to regain 100% strength

A

14-21 days

239
Q

name 5 indications for a cystotomy

A
  1. remove bladder/urethral stones
  2. biopsy/resection masses
  3. repair of ectopic ureters
  4. biopsy/culture bladder wall (severe cystitis)
  5. repair bladder trauma
240
Q

name 3 advantages of a ventral cystotomy

A
  1. readily accessible
  2. visualise the trigone well
  3. no increased risk of leakage
241
Q

name 3 disadvantages of a dorsal cystotomy

A
  1. potential damage to neurovascular structures
  2. less easy to visualise
  3. ureters enter dorsally
242
Q

what procedure allows bladder drainage whilst bypassing the urethra

A

cystostomy

243
Q

name 3 indications for urethral surgery

A
  1. urethral obstruction
  2. penile/urethral trauma or disease
  3. urethral prolapse
244
Q

name 4 consequences of a urethral obstruction

A
  1. postrenal azotaemia
  2. hyperkalaemia
  3. hydronephrosis
  4. bladder damage
245
Q

name 3 options for management of urethral obstruction by urolithiasis

A
  1. push stones into bladder
  2. remove stones from urethra
  3. create new stoma into urethra above the obstruction
246
Q

what is the preferred method for pushing uroliths out of the urethra and into the bladder?

A

retrograde urohydropropulsion

(then remove stones by medical dissolution or cystotomy)

247
Q

name the 7 steps of a prescrotal urethrotomy in a male dog to remove uroliths

A
  1. place urinary catheter
  2. incise skin behind os penis
  3. reflect retractor penis muscle
  4. incise urethra
  5. remove stones
  6. flush to ensure all stones removed
  7. suture or leave open to heal by second intention
248
Q

at what location should a urethrostomy be performed in a male dog?

A

scrotal urethrostomy

249
Q

at what location should a urethrostomy be performed in a male cat?

A

perineal urethrostomy

250
Q

name 4 possible complications of a urethrostomy

A
  1. haematuria
  2. stenosis
  3. incontinence
  4. urinary tract infection
251
Q

name 3 tests used to diagnose uroabdomen

A
  1. serum biochemistry + urinalysis
  2. Abdominal fluid analysis
  3. urinary tract imaging
252
Q

name 3 methods for abdominal fluid collection

A
  1. abdominocentesis
  2. POCUS scan
  3. diagnostic peritoneal lavage
253
Q

urea or creatinine?

small molecule, equilibrates quickly

254
Q

urea or creatinine?

large molecule; does not equilibrate

A

creatinine

255
Q

how is uroabdomen confirmed usuing creatinine and/or potassium values?

A

[Creatinine (ascites)] > [Creatinine (serum)]
[Potassium (ascites)] > [Potassium (serum)]

256
Q

name 3 treatment options for nephrolithiasis

A
  1. shock wave lithotripsy
  2. nephrotomy
  3. uretero-nephrectomy
257
Q

name 5 causes of urinary incontinence

A
  1. congenital abnormalities
  2. urethral sphincter mechanism incompetence (USMI)
  3. inflammation
  4. neurogenic abnormalities
  5. behavioural problems
258
Q

name the 2 types of ectopic ureters

A
  1. extramural
  2. intramural
259
Q

name 3 surgical treatment options for an intramural ectopic ureter

A
  1. laser ablation
  2. neoureterostomy
  3. ureteroneocystotomy
260
Q

what is the surgical treatment option for an extramural ectopic ureter

A

ureteroneocystostomy

261
Q

name 3 goals of colposuspension

A
  1. increase urethral length
  2. relocate bladder neck to intraabdominal position
  3. increase pressure at bladder neck
262
Q

name 5 surgical management options for Urethral Sphincter Mechanism Incompetence (USMI)

A
  1. colposuspension
  2. pexy techniques
  3. submucosal urethral bulking agent injections
  4. artificial urethral sphincter
  5. transobturator vaginal tape
263
Q

name the USMI surgical management option

pexy bladder more cranial to abdominal wall;
suture ventral wall of proximal urethra to prepubic tendon

A

(cysto)urethropexy

264
Q

name the USMI surgical management option

goal: increase urethral resistance;
endoscopic submucosal injections of collagen

A

bulking agents

265
Q

name the USMI surgical management option

goal: increase urethral resistance;
cuff placed around proximal urethra;
urethral compression can be increased by injecting saline into subcutaneous port

A

artificial urethral sphincter

266
Q

what is the treatment for USMI in cats?

A

excision of the caudoventral portion of the bladder

267
Q

name the procedure

removal of ovaries and uterus

A

ovariohysterectomy

268
Q

name the procedure

removal of ovaries only

A

ovariectomy

269
Q

name the procedure

minimally invasive ovariectomy

A

laparoscopic spay

270
Q

name the procedure

surgical removal of testicles

A

orchiectomy

(aka castration)

271
Q

name the procedure

surgical excision of mammary gland(s)

A

mastectomy

272
Q

name the procedure

incision of the vulvular orifice to expose the vulva & vagina;
access to vaginal and vestibular lesions

A

episiotomy

273
Q

name the procedure

reconstruction of the vulva;
excision of extra folds around the vulva (obesity/breed-related)

A

episioplasty

274
Q

name 5 indications for an ovariohysterectomy (spay)

A
  1. prevent uncontrolled breeding/population control
  2. prevent/reduction of diseases
  3. control of oestrus-associated behaviour
  4. management of disease of reproductive organs
  5. termination of pregnancy
275
Q

name 4 diseases of reproductive disorders that can be managed with an ovariohysterectomy (spay)

A
  1. pyometra
  2. dystocia
  3. pseudopregnancy
  4. vaginal hypertrophy/prolapse
276
Q

what are 2 negatives of spaying a cat

A
  1. obesity
  2. diabetes mellitus
277
Q

name 3 negatives of spaying a dog

A
  1. obesity
  2. orthopaedic conditions
  3. certain neoplastic diseases
278
Q

when are bitches traditionally spayed

A

from 6 months of age
(before first season OR after first season)

279
Q

when are queens traditionally spayed

A

5-6 months of age

280
Q

name 4 pros of early spaying (6-16 weeks)

A
  1. prevent mammary tumours
  2. usually faster/more simple surgery
  3. smaller incision
  4. quicker anaesthetic recovery
281
Q

name 4 cons of early spaying (6-16 weeks)

A
  1. incr. risk of hypothermia/hypoglycaemia under GA
  2. more risk for developing urinary incontinence
  3. incr risk of orthopaedic diseases (CCLR, HD, ED)
  4. vulva may remain small and immature
282
Q

name 3 disadvantages for spaying a bitch during pro-oestrus and oestrus

A
  1. highly vascular/more friable tissue
  2. reduced coagulation
  3. incr. risk of haemorrhage
283
Q

name a risk of spaying a bitch during diaoestrus (luteal phase)

A

pseudopregnancy

284
Q

what is the standard practice/method for spaying a bitch

A

midline ovariohysterectomy

285
Q

what is the standard practice/method for spaying a cat

A

flank ovariohysterectomy

286
Q

should you give perioperative antibiotics during an elective neutering/spay?

A

no
(short, clean procedure)

287
Q

how long should food be withheld before a midline ovariohysterectomy

A

12h
(4h for paediatric)

288
Q

where should the incision be made for a midline ovariohysterectomy

A

from umbilicus to midway to pubic brim

(large enough for you to do it safely)

289
Q

which ovary is more caudal?

290
Q

name the structure

consists of: ovarian artery from aorta, mesovarium and suspensory ligament + fat

A

ovarian pedicle

291
Q

name the structure

continuous with the uterine artery and lies within the broad ligament (mesometrium)

A

ovarian artery

292
Q

name the structure

sits between bladder and colon;
‘Y’ shaped body

293
Q

name the structure

most lateral structure in abdomen;
ovary at proximal end;
linear blood supply

A

uterine horn

294
Q

what ligament must be broken in order to exteriorise the ovary

A

suspensory ligament

295
Q

what technique should be used to ligate the ovarian artery

A

triple clamp technique

296
Q

what forceps should be used for the triple clamp technique to ligate the ovarian artery

A

Rochester-Carmalt forceps

297
Q

where should the first ligature be placed when ligating the ovarian artery using the triple clamp technique

A

circumferential in proximal crush line

298
Q

where should the second ligature be placed when ligating the ovarian artery using the triple clamp technique

A

transfixing between proximal suture and middle clamp

299
Q

what type of suture material should be used for ligating the ovarian artery during a spay

A

synthetic, absorbable, secure knots, monofilament
(PDS)

300
Q

where should you transect the ovarian artery after ligating

A

just distal to middle clamp

301
Q

where should the 3 clamps be placed in order to ligate the ovarian artery using the triple clamp technique

A
  1. proper ligament clamp above ovary
  2. 2 clamps across pedicl, proximal (deep) to ovary
302
Q

what type of suture material should be used for closure of a spay (for the linea alba/external rectus sheath)

A

synthetic, long lasting
(PDS, Prolene)

303
Q

name the 2 landmarks for a flank ovariohysterectomy of a cat

A

triangle between:
1. wing of ilium
2. greater trochanter

304
Q

name 2 possible intraoperative complications of an ovariohysterectomy

A
  1. haemorrhage
  2. ureter ligation/trauma
305
Q

name 2 possible early post-operative complications of an ovariohysterectomy

A
  1. wound healing problems (infection, dehiscence, seroma)
  2. glossypyboma
306
Q

name 5 possible late post-operative complications of an ovariohysterectomy

A
  1. ovarian remnant syndrome
  2. stump granulomas
  3. weight gain
  4. acquired incontinence
  5. associations with certain neoplasia/ortho conditions
307
Q

what is it called when a surgical swab is accidentally left in the abdomen during surgery

A

glossypyboma

308
Q

name 3 advantages of a laparoscopic ovariectomy

A
  1. improved visualisation & magnification
  2. 2 or 3 small incisions (portals)
  3. less post op pain & faster recovery
309
Q

name 3 possible complications of a laparoscopic ovariectomy

A
  1. haemorrhage (spleen/pedicle)
  2. bladder perforation
  3. ovarian remnant/SSI/hernia
310
Q

name 4 indications for a caesarean

A
  1. dystocia
  2. maternal origin (uterine inertia)
  3. foetal origin (over-sized/malpositioned/dead)
  4. previous dystocia
311
Q

name 2 causes of secondary uterine inertia leading to needing a caesarean

A
  1. small pelvic canal
  2. previous pelvic fracture
312
Q

how long should your incision be for a caesarean

A

halfway between xiphoid and umbilicus → the pubis

313
Q

what bacteria is the most common cause of pyometra

314
Q

name 2 reasons why pyometra is rare in cats

A
  1. induced ovulators
  2. usually sterile
315
Q

what 3 issues may need stabilised in a patient prior to pyometra surgery

A
  1. dehydration/hypovolaemia
  2. azotaemia
  3. SIRS/shock
316
Q

name the term

surgical removal of testicles

A

orchiectomy (castration)

317
Q

name 4 reasons for an orchiectomy

A
  1. prevents breeding
  2. reduces aggression and roaming
  3. prevents/treats testosterone driven diseases
  4. removes risk of testicular neoplasia
318
Q

name 3 testosterone driven diseases that can be prevented/treated by an orchiectomy

A
  1. benign prostatic hyperplasia
  2. perianal adenoma
  3. perineal hernia
319
Q

name 3 castration approaches possible in dogs

A
  1. pre-scrotal (routinely)
  2. scrotal ablation
  3. perineal castration
320
Q

what approach is used for castration in cats

321
Q

name 2 risks of an open technique for castration

A
  1. evisceration
  2. peritonitis
322
Q

name a benefit of the open technique of castration

A

better haemostasis

323
Q

name 2 benefits of the closed technique for castration

A
  1. no risk of evisceration
  2. no risk of peritonitis
324
Q

what suture material should be used on the spermatic cord ligation for a closed castration

A

synthetic
long lasting
absorbable
monofilament

(PDS II)

325
Q

what suture material should be used for pre-scrotal closure of a castration

A
  1. synthetic
  2. monofilament

(monocryl)

326
Q

what is the difference between an open and closed castration

A

open castration enters the parietal vaginal tunic

327
Q

what two structures should be ligated separately in an open pre-scrotal castration of a dog

A
  1. ductus
  2. vessels
328
Q

name a possible intraoperative complication of a castration

A

haemorrhage

329
Q

name 3 possible early post-operative complications of a castration

A
  1. scrotal haematoma
  2. wound healing problems
  3. herniation
330
Q

name 2 possible late post operative complications after a castration

A
  1. potential association with some orthopaedic conditions and some cancers
  2. weight gain
331
Q

name the term

congenital failure of testicles to descen into scrotum (unilateral or bilateral)

A

cryptorchidism

332
Q

name 3 reasons a cat/dog with cryptorchidism should be castrated

A
  1. heritable
  2. neoplastic transformation
  3. more prone to torsion
333
Q

at what age can cryptorchidism definitively be diagnosed

334
Q

name 3 possible locations of a cryptorchid testicle

A
  1. abdominal
  2. in inguinal canal
  3. pre-scrotal
335
Q

name 6 common differential diagnoses for prostatic disease

A
  1. benign prostatic hyperplasia (BPH)
  2. prostatitis
  3. prostatic abscess
  4. prostatic cysts
  5. para-prostatic cysts
  6. neoplasis
336
Q

name the prostatic disease

diffuse enlargement due to chronic androgenic stimulation;
common in older castrated males

A

benign prostatic hyperplasia (BPH)

337
Q

what is the treatment of choice for BPH (benign prostatic hyperplasia)

A

castration

(curative)

338
Q

name the type of prostatic cyst

within the capsule

A

prostatic cyst

339
Q

name the type of prostatic cyst

attached to capsule but do not communicate with parenchyma

A

paraprostatic cyst

340
Q

what is the best way to diagnose a prostatic cyst

A

abdominal ultrasound
(‘double bladder’)

341
Q

what is the medical management for prostatic cysts

A

repeated aspiration

(+ castration)

342
Q

name 2 options of surgical management for prostatic cysts

A
  1. complete resection
  2. partial resection and omentalisation

(+ castration)

343
Q

name 2 predisposing factors of prostatic abscesses

A
  1. entire, middle aged/older dogs
  2. BPH
344
Q

what is the treatment of choice for a stable prostatic abscess

A

trial medical treatment
(analgesia, antibiosis)

(+ castration)

345
Q

what is the treatment of choice for a prostatic abscess with sepsis

A

surgical intervention
(drain abscess + omentalisation + castration)

(aggresive IVFT, analgesia, antibiosis)

346
Q

what is the most common neoplasia of the prostate

A

adenocarcinoma

347
Q

name the 3 locations of rapid metastasis of a prostate adenocarcinoma

A
  1. regional LNs
  2. lungs
  3. skeleton
348
Q

name the 3 treatment options for prostate neoplasia (adenocarcinoma)

A
  1. often palliative/euthanasia
  2. stenting
  3. partial/complete prostatectomy & radiation therapy
349
Q

name 4 presentations of moderate to severe respiratory distress

A
  1. open-mouth breathing
  2. abducted forelimbs
  3. laboured breathing
  4. restlessness
350
Q

name 3 sedation options for emergency management of a patient in respiratory distress

A
  1. Acepromazine
  2. Dexmedetomidine
  3. Butorphanol
351
Q

name the sedative

slower onset;
vasodilation

A

acepromazine

352
Q

name the sedative

quicker onset;
blood pressure alterations and bradycardia

A

dexmedetomidine

353
Q

name 3 ways to cool a patient in respiratory distress

A
  1. fan
  2. clip hair if heavy undercoat
  3. pour cool water over patient
354
Q

name the syndrome

skull has normal width but reduced length;
soft tissues of head not proportionately reduced;
so soft tissue obstruction of nasal and pharyngeal cavities

A

Brachycephalic Obstructive Airway Syndrome (BOAS)

355
Q

name 4 primary disorders that brachycephalics are born with

A
  1. stenotic nares
  2. aberrant nasal turbinates
  3. elongated soft palate
  4. tracheal hypoplasia
356
Q

name the 3 stages of progressive laryngeal collapse in a brachycephalic

A
  1. everted laryngeal saccules
  2. cuneiform processes contact
  3. corniculate processes contact
357
Q

name 3 ways to diagnose Brachycephalic Obstructive Airway Syndrome (BOAS)

A
  1. cervical and throacic radiographs
  2. CT-scan
  3. laryngoscopy under general anaesthesia
358
Q

name 4 surgeries to help correct Brachycephalic Obstructive Airway Syndrome (BOAS)

A
  1. rhinoplasty
  2. staphlectomy (soft palate)
  3. folded flap palatoplasty (soft palate, more traumatic)
  4. excision of everted laryngeal saccules
359
Q

name 2 surgeries to manage laryngeal collapse stage 2-3

A
  1. crico-arytenoid lateralisation
  2. permanent tracheotomy
360
Q

what nerve innervates the dorsal cricoarytenoid muscle?

A

recurrent laryngeal nerve

361
Q

name 3 ways to diagnose laryngeal paralysis

A
  1. thoracic radiographs
  2. blood work: T4
  3. laryngoscopy
362
Q

name 3 types of pneumothorax

A
  1. traumatic
  2. spontaneous
  3. iatrogenic
363
Q

name 4 features of pneumothorax that can be seen on thoracic radiographs

A
  1. elevation cardiac sillhouette from sternum
  2. atelectatic lung lobes are radiopaque
  3. air-filled pleural space
  4. vascular pattern lungs does not extend to chest wall
364
Q

what is the most common type of pneumothorax?

A

closed traumatic pneumothorax

365
Q

name the type of pneumothorax

caused by blunt impact with closed glottis;
bronchial tree/lung parenchyma can rupture;
fractured rib

A

closed traumatic pneumothorax

366
Q

name the type of pneumothorax

caused by bite/stab/gun wound

A

open traumatic pneumothorax

367
Q

name the type of pneumothorax

non-traumatic leakage of air:
bullae, blebs, abscess, neoplasia, severe pneumonia

A

spontaneous pneumothorax

368
Q

name the management for closed traumatic pneumothorax

A

intermittent thoracocentesis

369
Q

name the management for spontaneous pneumothorax & tension pneumothorax

A

thoracostomy tube placement

370
Q

name 4 reasons to take a pneumothorax to surgery for management

A
  1. not resolving after 72h
  2. open traumatic pneumothorax
  3. spontaneous pneumothorax
  4. rapid large volume accumulation
371
Q

name 2 indications for thoracic drainage

A
  1. pneumothorax (therapeutic)
  2. pleural effusion (diagnostic & therapeutic)
372
Q

where to insert needle for thoracocentesis

A

6th-8th intercostal space

373
Q

name the 4 pieces of equipment necessary for thoracocentesis

A
  1. butterfly needle
  2. extension set
  3. 3-way tap
  4. syringe
374
Q

name 3 indications for a thoracostomy tube placement

A
  1. repeated thoracocentesis
  2. continuous suction required
  3. pre-emptive following thoracic surgery
375
Q

name 2 approaches to thoracic surgery

A
  1. intercostal thoracotomy
  2. median sternotomy
376
Q

name the 6 steps/landmarks of the intercostal thoracotomy approach to thoracic surgery

(muscle sparing approach)

A
  1. incise skin and SC tissue
  2. cut latissimus dorsi muscle (or reflect dorsally)
  3. visualise/incise scalenus & serratus ventralis muscles
  4. incise intercostal muscles
  5. open pleural space
  6. Finochietto rib retractors
377
Q

name 2 indications for a temporary thracheotomy

A
  1. relief of upper respiratory tract obstruction
  2. elective prior to upper airway surgery
378
Q

name 5 upper respiratory tract obstructions that can be relieved via a temporary tracheotomy

A
  1. laryngeal foreign body
  2. cervical trauma
  3. neoplasia
  4. laryngeal oedema
  5. laryngeal paralysis
379
Q

name the 7 steps of a temporary tracheotomy

A
  1. ventral midline skin incision behind larynx
  2. separate bluntly sternohyoideus muscles
  3. incise between tracheal rings
  4. incision ~1/3 of circumference
  5. place stay suture around tracheal rings
  6. lift up distal stay suture and push tube in
  7. partly close skin incision & bandage in place
380
Q

name the 4 components of post-operative care of temporary tracheotomy tubes

A
  1. clean tube every 4-6h
  2. use stay sutures to remove and replace
  3. humidify airway
  4. remove tube ASAP
381
Q

name 4 risks of temporary tracheotomy tubes that must be intensively monitored for

A
  1. risk of obstruction if tube dislodges
  2. risk of emphysema
  3. risk of laryngeal paralysis
  4. risk of tracheal stenosis
382
Q

name the 3 openings of the diaphragm

A
  1. caval foramen
  2. oesophageal hiatus
  3. aortic hiatus
383
Q

name 4 signs that may be present on physical exam indicating diaphragmatic rupture

A
  1. dyspnoea +orthopnoea
  2. dull on percussion
  3. muffled heart
  4. auscultation of gut sounds in thorax
384
Q

name 3 signs of diaphragmatic rupture that can be seen on radiographs

A
  1. loss of diaphragmatic and cardiac contours
  2. displacement of abdominal organs
  3. abdominal organ ‘loss’
385
Q

name 3 indications for immediate surgery of diaphragmatic rupture
(most will be delayed for stabilisation)

A
  1. deterioration despite supportive care
  2. gastrothorax
  3. ongoing haemorrhage
386
Q

what pattern(s) can be used to suture the defect in a diaphragmatic rupture?

A

simple interrupted or continuous

387
Q

what direction should the defect in a diaphragmatic rupture be sutured?

A

dorsal to ventral
(radial component first)

388
Q

why is a chest drain necessary following surgery to repair a diaphragmatic rupture (esp. in cats)

A

to re-establish negative pressure safely
(forced re-expansion highly dangerous and kills cats)

389
Q

name 3 possible complications of surgery to repair diaphragmatic rupture

A
  1. pleural effusion reforming
  2. pneumothorax
  3. re-expansion pulmonary oedema
390
Q

name the condition

congenital defect;
pericardial + peritoneal cavities communicate;
often not identified before adulthood;
often clinically silent, possible GI signs

A

Peritoneo-Pericardial Diaphragmatic Hernia (PPDH)

Cat & Dog (19 decks)

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