Brainscape's Knowledge GenomeTM

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


See full index

Year 4 Small Animal Studies > Soft Tissue Surgery: GI surgery > Flashcards

Soft Tissue Surgery: GI surgery Flashcards

1
Q

What is the duodenal dam manoeuvre?

A

Grasp the duodenum and retract most of the intestines over to the left to expose the right abdominal roof

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

What is the colonic dam manoeuvre?

A

Grasp the colon and retract most of the intestines to the left to examine the left abdominal roof

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q
  1. How can intestines be kept moist during surgery?
  2. When are stay sutures indicated?
A
  1. Saline usine a bulb syringe or cover with moistened abdominal swabs
  2. Handling tissues- stomach and gall bladder- 3-4 stay sutures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What extra instruments can be good for abdominal surgery?

A
  • Self-retaining abdominal retractors
  • Malleable retractors
  • Suction- essential for lavage
  • Debakey thumb forceps- least traumatic
  • Doyen bowel forceps or allis tissue forceps
  • Crushing forceps to occlude the lumen of gut
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

The least vascular parts of the gut wall should be incised
Where is best?

A
  • Midway between the greater and lesser curvature of the stomach
  • Antimesenteric border of the duodenum, jejunum or colon
  • Approx 2/3 of the way from mesenteric to antimesenteric border of the ileum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How should the GI tract be ligated?

A

Capillary ooze- small vessels, stops when sutured

Larger vessels- ligate, avoid cautery on gas filled

Oesophagus- ligate and divide segmental BVs as required

SI
* Ligate branches of cranial mesenteric and the terminal arcade vessels running along the mesenteic border

Colon depends on what tissue is being resected

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

How is the liver operated on preventing haemorrhage?

A
  • Check coagulopathies
  • Topical haemostatic agents
  • Pringle manoeuvre- occlude blood flor for 15m
  • Resections- tempory occlusion with combination of ligatures and tourniquets
  • Guillotine method- near the border
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How is a partial lobectomy away from the border or total done?

A

Finger fracture technique
* Incise liver capsule
* crush/seperate the parenchyma along that line with fingers to expose the large vessels and bile ducts to ligate

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

How is pancreas haemostasis performed?

A
  • Pass ligature around the area containing lesion of haemorrhaging
  • Bluntly seperate pancreatic lobules around the lesion, isolate blood vessels and ducts ligate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

when sectioning intestine what how should it be incised?

A

30 degrees to the transverse- ensures adequate blood supply

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

when sectioning intestine what how should it be incised?

A

30 degrees to the transverse- ensures adequate blood supply

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How can intestine viability be subjectively and objectively?

A

Subjective
* Colour- healthy pink
* Arterial pulsations
* Peristalsis

Objective
* Pulse oximetry
* Inject fluroescein dye IV

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

Why can thoracic oesophagus tolerate ligation of segmental blood vessels?

A
  • Has a rich submucosal plexus of blood vessels
  • Avoid cautery

Similar for the jejunum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q
  1. What can resection of the duodenum compramise blood supply to?
  2. What needs to be preserved on a splenecomty for the stomach?
  3. What needs to be avoided around the pylorus?
A
  1. Pancreatic blood supply
  2. Left gastroepiploic artery
  3. Cranial pancreaticoduodenal and hepatic arteries
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How can contamination of the peritoneal cavity be minimalised during surgery?

A
  • Use moistened swabs
  • Before opening intestine- milk contents from incision site
  • Elevate the oesophagus and stomach with stay sutures
  • Discard contaminated instruments and gloves
  • After lavage with 1-3L of warm water
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When should prophylactic ABs be used for GIT surgery?

A

IV just after induction
* Clavulanate-amoxicillin- common contaminants
* Colonic or hepatic surgery- metronidazole (anaerobes)
* Amoxicillin- bile

16
Q

Where are issues of tension in the GI?

A

Oesophagus and proximal colon

17
Q

What is required for accurate tissue apposition of the GI?

A

Submucosa
* High collagen content
* Must be incorporate into suture line

18
Q

What are the two closure techniques of the GI for longitudinal incisions

A
  • Longitudinal closure- general purpose
  • Transverse- maintains lumen diameter, small patients

Transverse incisions may cause stricture

19
Q

How is section of intestine sutured together?

A

End to end appositional anastomosis

20
Q

What suture material is used for most intestinal surgery?

A

2 metric or 1.5 monofilament, synthetic absorbable

Can use nonabsorbable for colonic surgery

21
Q

What suture patterns are used in GI sugery?

A
  • Simple interupted or continuous
  • Oesophagus- single later blosure
  • Stomach- 2 layer closure- simple then inverting cushing
  • 3-4mm from cut edge and 3mm apart
  • Check by injecting sterile saline
22
Q

How can luminal disparity be dealt with?

A

Different diameters
* Eliminate gaps by spacing sutures further apart on the larger side

23
Q

How is the mesentery closed?

A

Simple continous synthetic monofilament

24
Q

How can the omentum be used to an advantage of GI surgery?

A

Omental wrapping:
* protects GI incisions
* Increases local tissue O2
* Promotes angiogenesis
* Phagocytic immunity
* Seal
* Or serosal patching- suture intestine to itself

25
Q

What fluid and electrolyte imbalance is acceptable before GI surgery?

A

Correct to 50-75% before

26
Q

What are complications of GIT surgery?

A
  • Peritonitis
  • Adhesions
  • Small bowel syndrome
  • Strictures
27
Q
  1. What causes primary and secondary peritonitis?
  2. What are the clinical signs?
  3. What is the pathophysiology?
A
  1. Primary- rare- FIP, secondary chemical (bile), septic (necrosis/perforation)
  2. Variable- depression, anorexia, abdominal pain, ileus, pyrexia, shock
  3. Hypovolaemia- decreased fluid intake, losses from vomiting/diarrhoea, metabolic acidosis form decreased tissue perfusion, electrolyte imbalance, endotoxic shock
28
Q

How is peritonititis diagnosed?

A
  • Radiography- loss of abdominal detail
  • Haem- left shift
  • Biochem- azotaemia
  • Abdominal paracentesis- US
  • C&S
29
Q

How is peritonitis treated?

A
  • Correct fluid and acid/base imbalance
  • Broad spec ABs
  • Correct cause
  • Lavage
  • Drainage
30
Q

What causes adhesions?

A

Tissue anoxia, serosal injury, FB
Can be restrictive

Minimise with appropriate tissue handling, removing blood clots

31
Q

What is short bowel syndrome?

How is it medically managed?

A

Removal of about 80% SI
* Maldigestion- reduced pancreas secretions
* Malabsorption- reduced SA
* Bile salt deficiency- enterohepatic circulation

Medical managment
* Frequent small low fat meals
* Diet supplements
* Medium chain triglyceride oil
* Oral antidiarrhoeals, ABs, antacids

Poor prognosis

32
Q

What is ileus?
What are the clinical signs?
What is the treatment?

A
  1. Inadequate peristaltic activity of the entire GI, functional obstruction
  2. Vomiting, diarrhoea, fluid and gas retention
  3. Difficult- address cause, correct fluid and electrolyte imbalance, normalise motility
33
Q

How can the oesophagus be approached?

A
  • Access to level of second rib via a cervical midline
  • Access the intrathoracic via intercostal thoracotomy
34
Q

How is the terminal colon, rectum and anus approached?

A

Ventral approach
* split pelvis- colorectal junction

Anal approach
* Suitable for foal lesions close to anus- every anus

Pull through approach- distal colonic or mid-rectal lesions
* evert rectal wall through anus and transect distal rectum

Dorsal- caudal or middle rectum
* Inverted U incision dorsal to anus

Lateral- between external anal sphincter and levator ani

Year 4 Small Animal Studies (97 decks)

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