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GI Final Information > Surgery Final > Flashcards

Surgery Final Flashcards

1
Q

In GDV what is the stomach rotating on?

A

The long axis

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2
Q

What vein does the stomach compress venous flow through?

A

The vena cava and the portal vein

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3
Q

What systemic signs of GDV will you see?

A

portal hypertension and systemic hypotensionand cariogenic shock

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4
Q

What is the pathophysiology of a GDV?

A

Duodenum is displaced to the left, the funds moved ventrally and ends up in ventral abdomen, then the greater curvature is displaced ventral.

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5
Q

What do you see in compensated shock?

A

injected mm, rapid pulses , increased heart rate, rapid CRT

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6
Q

What do you see in decompensated shock?

A

pale mm, bradycardia, low CRT low temp

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7
Q

What is the shock dose for dogs?

A

90ml/kg/hr , give 1/4 at a time

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8
Q

What three parts make up the SI?

A

Duodenum, Jejunum, Illeum

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9
Q

What are the three parts of the LA?

A

Ascending, Transverse, Descending

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10
Q

What is the location of the duodenum? What attaches it to the body wall?

A

Proximal portion from pylorus to jejunum, it is attached to the colon via the duodenocolic ligament.

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11
Q

What is the latin term for jejunum?

A

Jejunus meaning empty of food

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12
Q

How many meters of intestine do dogs and cats have?

A

Dogs: 2-5
Cats: 1-1.5

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13
Q

What demarcates the ileum?

A

antimesentartic band of vessles

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14
Q

What is important about the ileums job?

A

absorbs folate, cobalamin and bile acids

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15
Q

What are the major functions of the large intestine?

A

electrolyte and water transport and absorption also has GALT and produced short chain fatty acids.

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16
Q

How do you know you have reached large intestine?

A

It is pale with a thinner wall

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17
Q

In the SA what is a the cecum? Is it important?

A

Blind small dead end pouch between small and large intestine. It has very little purpose.

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18
Q

What is the major blood supply to the small intestine?

A

Cranial mesenteric artery.

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19
Q

What do you ligate in the small intestine?

A

The vasa recta not the main supply!

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20
Q

What do the satellite veins of the SI drain into?

A

The portal vein.

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21
Q

What are the three major blood supplies to the large intestine?

A

Cranial mesenteric artery, caudal mesenteric artery, cranial rectal artery.

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22
Q

What are the four layers of the small and large intestine?

A

Mucosa
Submucosa
Muscularis
Serosa

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23
Q

What is the holding layer for both the SI and LI?

A

Submucosa

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24
Q

What is the difference in the SI and LI intestinal histology?

A

In the SI there are villi and crypts and lymphoid follicles in the SI. In the LA there are no villi and there are lymphoglandular complexes.

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25
Q

What are the three phases of intestinal healing? How long does each take?

A
  1. ) Inflammation: First three days
    2) Proliferative: 2-4 days up to 14 days
  2. ) Maturation Phase
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26
Q

When is dehiscence most common?

A

First 3-5 days post surgery

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27
Q

How many layers should intestinal closure be? What suture patterns?

A

1 layer thick, simple interrupted is preferred.

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28
Q

What type of needle should you use in intestinal surgery?

A

Taper point

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29
Q

What do you see in a focal foreign body?

A

Dilation of loops oral to obstruction , can see pressure necrosis or perforation.

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30
Q

What do you see in a linear foreign body?

A

Bunches and scrunches of intestine can be anchored at tounge or pylorus.

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31
Q

What are the five factors that can negatively impact intestinal healing?

A 
Hypoperfusion
Poor wound apposition
Wound tension
Infection
Distal obstruction
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32
Q

What is the normal intestinal height on radiograph?

A

2-3x rib width or 1-1.5x height of body of L2

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33
Q

Should jejunum be empty or full of food on radiograph?

A

empty

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34
Q

Should you incise tissue oral or aboral to the FB?

A

ABoral

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35
Q

What are the two clamps you use in intestinal surgery. What does each do?

A

Doyen; non- crushing goes on what you want to save.

Carmalt; crushing goes on what you want to take out

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36
Q

What are the 5 factors that determine if you are doing a resection or an anastomosis?

A

Color, blanching, thickness, peristalsis, bleeding pulses.

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37
Q

Can you ligate the arcuate vessles?

A

Yes.

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38
Q

When you anastomose bowel ends which side do you start on?

A

the mesenteric side

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39
Q

What is the most common cause of focal thickening in dogs and cats?

A

Neoplasia. In dogs adenocarcinoma in cats lymphoma

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40
Q

What is the consistant finding on radiograph for adenocarcinoma?

A

Applecore lesion

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41
Q

How large should your margins be in neoplasia removal?

A

3-5 cm

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42
Q

What is a serosal patch?

A

2 healthy loops of bowel in apposition with loop of concern.

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43
Q

What are the keys of medical management of focal intestinal neoplasia?

A

Gastro protectants, appetite stimulants, feeding tube, chemo(post healing time)

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44
Q

What are the two most common complications with focal neoplasia surgery?

A

Dehiscence, Pancreatitis

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45
Q

What is the portion that is telescoped into in an intussusception called?

A

Intussusceptum

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46
Q

What is the portion that is causing the telescoping caused?

A

Intussuscipiens

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47
Q

What are the two most common reasons for intussusception?

A

Parvo and Parasites

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48
Q

What is enteroplication?

A

Creating lasy loops of entire bowel with intermittent sutures between the loops to prevent future intussusception.

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49
Q

What is a mesenteric volvulus? What is the prognosis?

A

SI twists on its mesenteric axis, grave prognosis due to venous obstruction and pain.

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50
Q

What are the clinical signs of diseases of the cecum?

A

Tenesmus, weight loss, diarrhea, hematochezia, vomiting.

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51
Q

What is the treatment of choice for a cecal inversion in dogs? What about cecal impaction?

A

Typhlectomy: take it out

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52
Q

What is megacolon in cats?

A

End-stage obstipation with progressive, severe and irreversible colonic distention and flaccidity.

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53
Q

What are the causes of acquired megacolon?

A

Neurological disease, pelvic stensosi, tumor, perineal hernia, idopathic

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54
Q

What is the most common cause of megacolon?

A

Idiopathic

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55
Q

What is the ideal surgical treatment of megacolon?

A

Subtotal colectomy, transect ascending colon 1-2cm aboral to cecum then transect colon 2cm cranial to pelvic brim.

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56
Q

What type of enemas do you not use in cats?

A

phosphate enemas

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57
Q

What is the prokinetic drug of choice for megacolon?

A

Cisapride

58
Q

What are the clinical signs of a colonic volvulus or entrapment in SA?

A

Abdominal distention, dehydration, abdominal pain, hematochezia.

59
Q

What is the blood supply to the rectum and anus?

A

Crainal, middle and caudal recal arteries

60
Q

What is the innervation to the rectum and anus?

A

PNS: Pelvic plexus
SNS; Hypogastric plexus
Somatic: Pudenal and caudal rectal nerve.

61
Q

When do you use a ventral approach to the rectum and anus?

A

disease and masses involving the caudal colon cranial or intrapelvic rectum also a midline celiotomy

62
Q

What are the two names for pubic splitting?

A

Symphysiotomy, Osteotomy

63
Q

When is a dorsal approach to the rectum used? How is it done?

A

Lesions in middle of rectum,animal in sternal make a inverted U shaped incision. Be sure to repair muscle.

64
Q

When is a rectal pull through used? What is it?

A

mid-caudal lesions, make a circular incision external to anus and pull rectum through opening.

65
Q

What CBC sign do you see with an AGASACA?

A

Hypercalcemia

66
Q

What are the two indications for an anal sacculectomy?

A

recurrent anal sacculitits or anal sac tumors.

67
Q

What is the preferred technique for an anal sacculectomy?

A

Closed

68
Q

What are the five complications of recto-anal surgery?

A

Infection, dehiscence, stricture, incontince(caudal rectal n.), bleeding

69
Q

What are the best antibiotics post recto-anal surgery?

A

Cefoxitin, metro, en/ciprofloxacin.. want it against gram - an anerobic bacteria.

70
Q

Why does perineal herniation happen?

A

Loss of strength of pelvic diaphragm, normally the levator ani muscle is what goes weak.

71
Q

Are perineal herniations normally unilateral or bilateral?

A

Unilateral, right side most common

72
Q

What is the sx for a perineal herniation?

A

Interal obturator transposition flap.

73
Q

When you do an internal obturator transposition flap what other surgery must you do?

A

Castration

74
Q

What is the procedure for an IOTF?

A

Flap internal obturator dorsally and suture to external anal sphincter ventromedially and coccygeus dorsolaterally.

75
Q

In a double layer oronasla fistula repair what are the steps?

A
  1. ) large semi-circular palatal mucoperiosteal flap created from the palatal side of the defect and folded over the defect.
    2) make a second flap and pull over the intital flap and suture over palatal mucosa.
76
Q

When are congenital palatal defects most common in development?

A

25 to 28 days

77
Q

What are some causes of congenital palatal defects?

A

Trauma, Stress, Brachycephalics.

78
Q

What are the three primary congenital palatal defects?

A

Cleft hard palate
Cleft soft palate
Hypoplastic soft palate

79
Q

What are some of the clinical signs of a cleft palate?

A

Failure to thrive, nasal discharge, coughing, gagging, sneezing

80
Q

When is the ideal time for a congenital palatal defect repair?

A

3-4 months of age

81
Q

How many layers should a palate repair closure be?

A

Twi wil absorbable sutures

82
Q

What is done in a medially reposititioned double flap technique?

A

Incisions are make a few millimeters from the dental arch
bilaterally, the palatal mucosa is subperiosteally elevated
and repositioned medially to appose the edges of palatal mucosa in
two layers

83
Q

Bilateral Overlapping Mucosal Single-

Pedicle Flap Technique

A 
The overlapping flap
is performed by
creating a flap that
is hinged at the edge
of the palatal defect
and placed beneath
the other side of the
palatal mucosa and
sutured in place with
a vest-over-pants
type suture pattern.
84
Q

Simple Double Layer Appositional

Soft Palate Repair

A

A: An incision is made on each side of the soft palatal
defect to separate the soft palate into two layers
B: Each layer is apposed separately with simple interrupted
sutures to close the midline soft palatal defect.

85
Q

Buccal flaps

A

large marginal palatal defects in endentuous regions

86
Q

Rotation flaps

A

small circular defects later to midline

87
Q

Advancement flaps

A

For caudal defects that cross midline

88
Q

Tongue flaps

A

For large rostral defects

89
Q

Axial Pattern Flap

A

Use orbicularis oris for large defects

90
Q

What are the three indications for a ventral approach to the nasal cavity?

A

Removal of foreign bodies, biopsy of nasal tumors, nasopharyngeal stenosis and choanal atresia

91
Q

What are the most common nasal tumors in cats?

A

Squamous cell carcinoma followed by fibrosarcoma

92
Q

What are the most common nasal tumors in dogs?

A
  1. ) malignant melanoma
  2. ) Squamous cell carcinoma
  3. ) Fibrosarcoma
93
Q

What are the types of partial mandibulectomies?

A

bilateral rostral,
unilateral rostral, segmental, complete unilateral,
vertical ramus

94
Q

What are the types of partial maxillectomies?

A

bilateral rostral,

unilateral rostral, lateral, bilateral and caudal

95
Q

What are some cardiac signs you can see with GDV?

A

myocardial ischemia, VPC’s , tachycardia

96
Q

What is the signalment for GDV?

A

Deep chested large breed dogs

97
Q

What is the radiographic view you need for GDV?

A

Right lateral

98
Q

What are the principles of fluid therapy in a GDV?

A

Large bore catheters with Crystalloid and Colloids

99
Q

What is the preferred method of gastric decompression?

A

Orogastric tube

100
Q

What is the best way to derotate the stomach?

A

Pull pylorus with right hand ventrally toward right, push stomach with left hand dorsally toward left.

101
Q

How many layers should you close the stomach with? What pattern?

A

2 layers, simple interrupted/cont. followed by an inverting

102
Q

If you need to use a stapler for gastric resection which one do you use?

A

90mm thoracoabdomial

103
Q

What are the four pairs of salivary glands?

A

Parotid, Mandibular, Sublingual, Zygomatic

104
Q

What is the location of the Parotid gland?

A

base of the auricular cartilage and duct opens on mucosa apical to distal aspect of 4th premolar

105
Q

What is the location of the mandibular salivary gland?

A

between maxillary and linguofacial veins

106
Q

What are the four major diseases of salivary glands?

A

Mucoceles, Sialoiths, Sialoadenitis, neoplasia

107
Q

How do salivary mucoceles happen?

A

Result from damage to the duct or gland with leakage of saliva into surrounding tissues.

108
Q

What are salivary mucoceles lined by?

A

Inflammatory connective tissue

109
Q

Where are ranulas located?

A

sublingual tissues on one side of the tongue

110
Q

What are the clinical signs of animals with pharyngeal mucocele?

A

difficulty breathing or swallowing, fluid filled mass.

111
Q

What are the clinical signs of animals with zygomatic mucoceles?

A

exophthalmos, divergent strabismus, non painful swelling of orbit

112
Q

What two things are the diagnosis of mucoceles based on?

A

Palpation and aspiration of clear viscous blood tinged to light brown fluid.

113
Q

What is the recommended treatment for mucoceles?

A

surgical excision of involved glands and drainage of mucocele

114
Q

What is the ideal treatment for an Aural hematoma?

A

Incision and drainage combined with suturing the skin to the cartilage

115
Q

What is important in aural hematomas for cats?

A

delay opening of hematoma for 5-6 days to allow hemostasis.

116
Q

How should the mattress sutures in the pinna be placed?

A

parallel to the skin incision to not disrupt blood supply.

117
Q

What is the purpose of a lateral ear canal resection?

A

Increases drainage of the external ear canal and improves ventilation of the canal.

118
Q

What are the indications for a lateral ear canal resection?

A

Chronic otitis media without significant changes that are causing obstruction.

119
Q

When do you do a total ear canal ablation with lateral bulla osteotomy?

A

irreversible hyperplastic ear canal dz, hyperplastic otitis externa, neoplasia of the horizontal ear canal.

120
Q

When do you do a vertical ear canal resection?

A

tumors confined to vertical ear canal, stenosis or trauma

121
Q

What are the possible complications with a TECA-LBO

A

Facial nerve injuries, vestibular injury, infection, pain

122
Q

Why would you do a ventral bulla osteotomy?

A

treatment of otitis media that has not responded to appropriate medical therapy or less invasion surgical therapy.

123
Q

What are some less common indications for a ventral bulla osteotomy?

A

exploration of tympanic cavity in animals with polyps, neoplasia, osteomyelitis

124
Q

What are three things that horses with a small intestinal strangulating obstruction usually have?

A

Severe abdominal pain, increased heart rate and PCV, hypo perfusion and metabolic acidosis

125
Q

If you get large amount of reflux what is the number one possible diagnosis?

A

Duodenitits-proximal jejunitis aka proximal enteritis

126
Q

What part of the intestine is normally involved in an epiploic foramen entrapment?

A

Ileum and Jejunum

127
Q

What are the typical presenting complaints for urinary problems in horses?

A

low grade abdominal pain, weightless, stranguria, dysuria, hematuria, oliguria, incontinence

128
Q

What is important to remember about your suture choice for equine urinary surgery?

A

never use non-absorbable suture

129
Q

What is one of the most important organs in pharmacology?

A

Kidney. Drugs can have nephrotoxic effects and are sensitive to hypo perfusion and hypotension.

130
Q

What is the vast majority of stones in equines? How do they present?

A

Calcium carbonate. Weight loss, colic, anorexia.

131
Q

What is the treatment of choice for unilateral diseases of the kidney in horses?

A

Nephrectomy

132
Q

What is different if you decide to do a nephrotomy in a horse?

A

You have to do capsular sutures, for this reason it is not recommended to do. Nephrectomy is better.

133
Q

What clinical abnormalities do you see in a uroperitoneum in horses?

A

Uremia, severe electrolyte and acid base abnormalities.

134
Q

What is the number one rule to remember in uroperitoneum?

A

Medically stabilize before surgery. They are medical nor surgical emergencies

135
Q

What should you remember to check in a patent urachus?

A

They are normally systemically sick.

136
Q

How long should you wait to fix a patent urachus before surgery?

A

5 to 7 days max

137
Q

What is the most common location for stones in horses?

A

Bladder

138
Q

What is the indicated surgery for bladder rupture?

A

Cystorrhaphy.

139
Q

What is the indicated surgery for a patent urachus?

A

Cystoplasty

140
Q

What is the indicated surgery in horses for urinary calculi?

A

Cystotomy

141
Q

In urethral obstruction which drug should you avoid?

A

Xylazine, it has diuretic effects

GI Final Information (3 decks)

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