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Intro to Surgery > Surgery Final Exam > Flashcards

Surgery Final Exam Flashcards

1
Q

What drug is used to sedate cattle? Goats?

A

Cattle - Xylazine Goats - Diazepam or Midazolam

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2
Q

True or False: 10 mg/kg of lidocaine is toxic to goats

A

true

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3
Q

Name two NSAID drugs available for food animals.

A

Meloxicam and Flunixin meglumine

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4
Q

Why do we castrate?

A

Behavior modification, prevent unintended births, improve carcass quality, and pathologic processes

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5
Q

What are the basic means of castration?

A

hormonal, chemical, and physical (non-surgical and surgical)

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6
Q

Describe the process of surgical castration of camelids using a newberry knife.

A
  1. Give ketamine/xylazine/butorphanol mixture 2. Give lidocaine locally 3. Use either the newberry knife or a blade at the junction of the middle and distal third of the testicles
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7
Q

Post-castration, what should you check for?

A

bleeding, stretch your incision, look for swelling, infection, hemorrhage, and tetanus

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8
Q

True or False: It is best to wait until cattle are over 6 months of age to dehorn

A

false - it is best if they are under 6 weeks of age

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9
Q

When should you utilize paste disbudding?

A

at less than 48 hours of age (before feeding)

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10
Q

How long to you apply a cautery/hot iron to calves, male goats, and female goats?

A

calves: 5-7 seconds male goats: 5 seconds female goat: 3 seconds

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11
Q

What is a potential complication of using a Barnes dehorner?

A

you can expose the sinus, causing sinusitis

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12
Q

What dehorner is used in older cattle?

A

keystone dehorner

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13
Q

What complications are associated with the keystone dehorner?

A

sinusitis, surgical site infection, hemorrhage, and improperly performed procedures

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14
Q

What is the most common neoplasia of the bovine eye?

A

squamous cell carcinoma

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15
Q

Aside from neoplasia, what are some indications for enucleation?

A

infectious bovine keratoconjunctivitis, panophthalmitis, and trauma

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16
Q

Where can you apply lidocaine for enucleation blocks?

A

retrobulbar and four point

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17
Q

What are the potential complications of enucleation?

A

hemorrhage, infection, dehiscence, recurrence of disease, and convulsions if you inject lidocaine into the meningeal reflection optic nerve

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18
Q

What are some indications for digit amputation?

A

injury, septic arthritis to the distal interphalangeal joint, severe foot rot and secondary osteomyelitis, and severe phalangeal fractures

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19
Q

When should you not amputate a digit?

A

sepsis of the fetlock joint or involvement of both digits on the same foot

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20
Q

While there is a rapid recovery and it is fairly cheap to amputate a digit, what are potential disadvantages to digit amputation?

A

early removal from herd because of early breakdown and lower market value

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21
Q

What antibiotics can you give to prevent infection after digit amputation?

A

Ampicillin-sulbactam, ampicillin, florfenicol

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22
Q

What do we use to make an angled cut for ampuation of a claw?

A

Obstetric wire between proximal and distal interphalangeal ligament

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23
Q

What can help an umbilical hernia heal post-surgery?

A

a hernia belt

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24
Q

What can be used to help hernia healing in non-surgical cases?

A

hernial clamps, elastrator bands, and the hernia belt

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25
Q

What are the two types of hernia repairs?

A

open and closed

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26
Q

What instrument does minimally invasive surgery usually utilize?

A

a camera

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27
Q

Not sure why this is important… but who used a cytoscope to examine the abdominal cavity of dogs?

A

George Kelling

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28
Q

Why do we choose to do minimally invasive surgery?

A

less blood loss, less scarring, shorter hospital stays, decreased pain, and earlier resumptions of new activities

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29
Q

What are some cons to minimally invasive surgeries?

A

operations are longer, may cost more, need extra training, may not see all of the lesions, higher mortality

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30
Q

Identify some of the applications for minimally invasive surgery.

A

laparoscopy, arthroscopy, endoscopy, cytoscopy, hysteroscopy, biopsies, orthopedics

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31
Q

What are the two cameras you can use for minimally invasive surgery?

A

flexible or rigid

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32
Q

What are flexible cameras used for?

A

colonoscopy, laryngoscopy, bronchoscopy, and sinoscopy

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33
Q

What are rigid cameras used for?

A

laparoscopy, arthroscopy, thoracoscopy, and sinoscopy

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34
Q

What do we use arthroscopy for?

A

diagnostic or therapeutic treatment

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35
Q

True or False: You can see a joint better with arthrotomy than you can with arthroscopy?

A

false

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36
Q

what instruments besides the camera are used in arthroscopy?

A

probes, curettes, and grasping forceps

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37
Q

What do we distend joints with during arthroscopy?

A

LRS or saline through needle and syringe - it removes debris, controls hemorrhage, and flattens synovial membrane for better visualization

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38
Q

What do you use to create a pneumoperitoneum for laparoscopy?

A

gas (CO2, air, oxygen, nitrous oxide, argon, helium, and mixtures)

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39
Q

True or False: Laparoscopy instruments are typically longer than arthroscopy instruments

A

true

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40
Q

What instrument can be used to cauterize while performing a laparoscopy?

A

Ligasure

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41
Q

What are the three primary uses for flexible endoscopy?

A

respiratory, gastrointestinal, and urogenital diagnosis and treatment

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42
Q

True or False: You can use minimally invasive procedures to repair fractures

A

true

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43
Q

What is the benefit of using a robot in surgery?

A

it reduces tremors and improves precision

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44
Q

_______ is a pathological gait alteration associated with pain.

A

lameness

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45
Q

What will you ask about first when discussing a lameness case?

A

history

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46
Q

True or False: You begin a lameness exam with palpation of the limb and hoof testers.

A

true

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47
Q

What does jogging on a hard surface emphasize?

A

asymmetry of the gait

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48
Q

How can we objectively determine lameness?

A

inerital body mounted sensors (accelerometer + gyroscope)

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49
Q

What are you looking for in lameness evaluations?

A

Asymmetry: head bobs, hip hike, fetlock drop asymmetry, decrease cranial phase of stride, joint flexion/extension, hoof landing pattern

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50
Q

What is grade 5 on the AAEP lameness scale?

A

lameness produces minimal weight bearing in motion and/or at rest or a complete inability to move

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51
Q

What is a grade 4 on the AAEP lameness scale?

A

lameness is obvious at a walk

52
Q

What is a grade 3 on the AAEP lameness scale?

A

lameness is consistently observable at a trot under all circumstances

53
Q

What is a grade 2 on the AAEP lameness scale?

A

lameness is difficult to observe at a walk or when trotting in a straight line but consistently apparent under certain circumstances

54
Q

What is a grade 1 on the AAEP lameness scale?

A

lameness is difficult to observe and is not consistently apparent, regardless of circumstance

55
Q

What is a grade 0 on the AAEP lameness scale?

A

lameness is not perceptible under any circumstances

56
Q

What is ipsilateral lameness likely due to?

A

primary hind leg lameness

57
Q

What is contralateral lameness likely originating from?

A

the forelimb

58
Q

What tests do we perform on the forelimb?

A

flexion tests - carpal and pastern

59
Q

What makes it impossible to isolate hind-limb flexion tests?

A

the reciprocal apparatus

60
Q

What can you use to narrow in on lameness?

A

Analgesia - nerve blocks

61
Q

What drug do we use most often for equine nerve blocks?

A

carbocaine

62
Q

What blocks the heel bulbs, digital cushion, and navicular region, but not the front of the toe?

A

palmar digital

63
Q

What blocks the foot pastern region (not fetlock)?

A

abaxial nerve block

64
Q

What blocks the fetlock and suspensory branches in addition to the rest of the lower limb?

A

low palmar

65
Q

How do you block the leg below the carpas?

A

high palmar

66
Q

How do you prevent proximal diffusion of analgesia to other structures?

A

utilize a small volume, maybe use a compression bandage

67
Q

What is a unique method of imaging seen most often in equine medicine?

A

nuclear scintigraphy

68
Q

Describe the Gustilo-Anderson classification system.

A

Grade 1 - open fracture, clean wound, wound <1 cm

Grade 2 - Open fracture, wound >1cm, without extensive soft tissue damage

Grade 3 - Extensive soft tissue laceration >10cm

IIIA - periosteal coverage

IIIB - periosteal stripping

IIIC - arterial injury require vascular repair

69
Q

What does S stand for in the Salter classification system?

A

Type 1 - straight across

70
Q

What does A stand for in the Salter classification system?

A

type II - above

71
Q

What does L stand for in the salter classification system?

A

type III - lower or below

72
Q

What does T stand for in the Salter classification system?

A

Type IV - two or through

73
Q

What does ER stand for in the Salter classification system?

A

erasure of growth plate or crush

74
Q

What are the four fracture configurations?

A

transverse, short oblique, long oblique, and comminuted

75
Q

How do you know on radiograph if the bone has punctured the skin?

A

gas pockets

76
Q

What’s the difference between long oblique and short oblique fractures?

A

the fracture is greater than twice the diameter of the bone

77
Q

What two types of metal can you use in implants?

A

316 LVM Stainless steel and titanium

78
Q

True or False: There is a linear relationship with the height/diameter and its strength.

A

false

79
Q

True or false: two plates in a plane doubles the stiffness of the plates

A

true

80
Q

Stiffness of a rod is radius to the ____ power.

A

4th

81
Q

Stiffness of a square beam is height to the ____ power.

A

3rd

82
Q

Stiffness of a square beam is width to the ____ power.

A

1st

83
Q

Stiffness of the length of a beam is length to the ____ power.

A

3rd

84
Q

True or False: Healing fractures respond favorably to about 10% strain.

A

false - they respond well to about 5% strain

85
Q

What is required to use cerclage wire?

A

fractures must be long oblique, two or more circumferential cerclage wires must be used, cerclage should be no closer than 5 mm from the fracture ends, wire must reside directly on the bone

86
Q

True or False: If a fracture is open, prognosis is poorer than if a fracture is closed

A

true

87
Q

True or False: It’s safest to end fixation methods in the middle of a long bone/diaphysis.

A

false -you should always end them at the joint below and above

88
Q

If you have no splint material, what can you use to stabilize a large animal leg?

A

casting material

89
Q

What are some of the problems with large animal fracture repair?

A

weight, ability to return to athletic career, strength of muscles. cost

90
Q

True or False: Cast management alone is adequate in equine fracture treatment.

A

False - it can be in bovine and small ruminants

91
Q

What fixation method places a cortical bone screw such that it compresses the two sides of the bone it interfaces?

A

lag screw fixation

92
Q

What is the strongest method of fixation available?

A

bone plates

93
Q

True or false: skull fractures are more amenable to repair

A

true

94
Q

What type of fracture do you use cerclage wire on?

A

long oblique

95
Q

True or false: Cerclage wire is meant to be used as the sole means of repair.

A

false

96
Q

What are tension bands used for?

A

when muscle ligaments or tendons are pulling on bones

97
Q

What size of intramedullary pins should you use?

A

the pin should be 50-70% of the diameter of the medullary cavity in the area of the fracture

98
Q

True or False: Lag screws are used parallel to the fracture line

A

false

99
Q

How big of a hole can you drill into a bone when preparing to plate a bone?

A

up to 20% of the bone diameter being plated

100
Q

True or False: Dynamic compression plate screws must engage both the near and far cortices.

A

true

101
Q

What is the order of screw placement?

A
  1. drill 2. measure 3. tap 4. screw
102
Q

How many screws do we prefer to place on either side of a fracture when using a locking plate?

A

4 is preferred but 3 is acceptable

103
Q

What are the two ways bone heals?

A

primary/direct or secondary/indirect (intramembranous or endochondrial ossification)

104
Q

True or False: Bone is the only tissue in the body that reforms without a scar

A

true

105
Q

What forms during secondary bone healing?

A

callus

106
Q

In situations in which there is low blood supply, do we aim to get primary or secondary bony union?

A

primary, as we need a great deal of blood supply for secondary union to occur

107
Q

A _____ is a transfer of living tissue.

A

graft

108
Q

An ______ is from the same species from a different individual.

A

allograft

109
Q

What is the transfer of living tissue from a different species known as?

A

xenograft

110
Q

What is the insertion of non-living material called?

A

implant

111
Q

What is the transfer of living cells for bone regeneration known as?

A

osteogenesis

112
Q

What is the induction of cells to become bone known as?

A

osteoinduction

113
Q

What is the scaffold for bone cells known as?

A

osteoconduction

114
Q

What is improving bone mechanical or biological environment to encourage bone growth known as?

A

osteopromotion

115
Q

Identify some autograft harvest sites.

A

proximal humerus, iliac wing, distal femur, proximal tibia, rib

116
Q

Describe the fracture.

A

Closed, comminuted, proximal half metaphyseal and diaphyseal of tibia

117
Q

Describe the fracture.

A

Closed transverse fracture of the distal quarter of the diaphysis of the radius, displaced laterally and overriding 10mm.

118
Q

Describe the fracture.

A

Grade II open, highly comminuted fracture of the mid diaphysis of the tibia, displaced laterally and overriding 15mm.

119
Q

What Salter grade is this?

A

Grade IV

Closed Salter IV fracture of the Humeral condyle, displaced laterally, overriding 5mm

120
Q

Describe.

A

Closed long oblique fracture of the diaphysis of the humerus, displaced cranially, overriding 2 cm.

121
Q

Descirbe the fracture.

A

Cannon bone diaphysis, short oblique, open, non-articular, acute edges, laterally displaced, neonate.

122
Q

Describe the fracture.

A

Cannon bone, articular, acute, mildly displaced, closed, adult.

123
Q

What is unique about the fracture of this bone?

A

The coffin is already immobilized and can be casted to prevent heel bulb expansion.

124
Q

What is this splint called?

A

Thomas Schroeder splint

125
Q

What is this cast known as?

A

Transfixation pin cast

126
Q

What are the different types of bone grafts?

A

Autogenous cancellous bone graft, cortical, and combination

Intro to Surgery (36 decks)

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