Surgery Final Exam Flashcards
What drug is used to sedate cattle? Goats?
Cattle - Xylazine Goats - Diazepam or Midazolam
True or False: 10 mg/kg of lidocaine is toxic to goats
true
Name two NSAID drugs available for food animals.
Meloxicam and Flunixin meglumine
Why do we castrate?
Behavior modification, prevent unintended births, improve carcass quality, and pathologic processes
What are the basic means of castration?
hormonal, chemical, and physical (non-surgical and surgical)
Describe the process of surgical castration of camelids using a newberry knife.
- 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
Post-castration, what should you check for?
bleeding, stretch your incision, look for swelling, infection, hemorrhage, and tetanus
True or False: It is best to wait until cattle are over 6 months of age to dehorn
false - it is best if they are under 6 weeks of age
When should you utilize paste disbudding?
at less than 48 hours of age (before feeding)
How long to you apply a cautery/hot iron to calves, male goats, and female goats?
calves: 5-7 seconds male goats: 5 seconds female goat: 3 seconds
What is a potential complication of using a Barnes dehorner?
you can expose the sinus, causing sinusitis
What dehorner is used in older cattle?
keystone dehorner
What complications are associated with the keystone dehorner?
sinusitis, surgical site infection, hemorrhage, and improperly performed procedures
What is the most common neoplasia of the bovine eye?
squamous cell carcinoma
Aside from neoplasia, what are some indications for enucleation?
infectious bovine keratoconjunctivitis, panophthalmitis, and trauma
Where can you apply lidocaine for enucleation blocks?
retrobulbar and four point
What are the potential complications of enucleation?
hemorrhage, infection, dehiscence, recurrence of disease, and convulsions if you inject lidocaine into the meningeal reflection optic nerve
What are some indications for digit amputation?
injury, septic arthritis to the distal interphalangeal joint, severe foot rot and secondary osteomyelitis, and severe phalangeal fractures
When should you not amputate a digit?
sepsis of the fetlock joint or involvement of both digits on the same foot
While there is a rapid recovery and it is fairly cheap to amputate a digit, what are potential disadvantages to digit amputation?
early removal from herd because of early breakdown and lower market value
What antibiotics can you give to prevent infection after digit amputation?
Ampicillin-sulbactam, ampicillin, florfenicol
What do we use to make an angled cut for ampuation of a claw?
Obstetric wire between proximal and distal interphalangeal ligament
What can help an umbilical hernia heal post-surgery?
a hernia belt
What can be used to help hernia healing in non-surgical cases?
hernial clamps, elastrator bands, and the hernia belt
What are the two types of hernia repairs?
open and closed
What instrument does minimally invasive surgery usually utilize?
a camera
Not sure why this is important… but who used a cytoscope to examine the abdominal cavity of dogs?
George Kelling
Why do we choose to do minimally invasive surgery?
less blood loss, less scarring, shorter hospital stays, decreased pain, and earlier resumptions of new activities
What are some cons to minimally invasive surgeries?
operations are longer, may cost more, need extra training, may not see all of the lesions, higher mortality
Identify some of the applications for minimally invasive surgery.
laparoscopy, arthroscopy, endoscopy, cytoscopy, hysteroscopy, biopsies, orthopedics
What are the two cameras you can use for minimally invasive surgery?
flexible or rigid
What are flexible cameras used for?
colonoscopy, laryngoscopy, bronchoscopy, and sinoscopy
What are rigid cameras used for?
laparoscopy, arthroscopy, thoracoscopy, and sinoscopy
What do we use arthroscopy for?
diagnostic or therapeutic treatment
True or False: You can see a joint better with arthrotomy than you can with arthroscopy?
false
what instruments besides the camera are used in arthroscopy?
probes, curettes, and grasping forceps
What do we distend joints with during arthroscopy?
LRS or saline through needle and syringe - it removes debris, controls hemorrhage, and flattens synovial membrane for better visualization
What do you use to create a pneumoperitoneum for laparoscopy?
gas (CO2, air, oxygen, nitrous oxide, argon, helium, and mixtures)
True or False: Laparoscopy instruments are typically longer than arthroscopy instruments
true
What instrument can be used to cauterize while performing a laparoscopy?
Ligasure
What are the three primary uses for flexible endoscopy?
respiratory, gastrointestinal, and urogenital diagnosis and treatment
True or False: You can use minimally invasive procedures to repair fractures
true
What is the benefit of using a robot in surgery?
it reduces tremors and improves precision
_______ is a pathological gait alteration associated with pain.
lameness
What will you ask about first when discussing a lameness case?
history
True or False: You begin a lameness exam with palpation of the limb and hoof testers.
true
What does jogging on a hard surface emphasize?
asymmetry of the gait
How can we objectively determine lameness?
inerital body mounted sensors (accelerometer + gyroscope)
What are you looking for in lameness evaluations?
Asymmetry: head bobs, hip hike, fetlock drop asymmetry, decrease cranial phase of stride, joint flexion/extension, hoof landing pattern
What is grade 5 on the AAEP lameness scale?
lameness produces minimal weight bearing in motion and/or at rest or a complete inability to move
What is a grade 4 on the AAEP lameness scale?
lameness is obvious at a walk
What is a grade 3 on the AAEP lameness scale?
lameness is consistently observable at a trot under all circumstances
What is a grade 2 on the AAEP lameness scale?
lameness is difficult to observe at a walk or when trotting in a straight line but consistently apparent under certain circumstances
What is a grade 1 on the AAEP lameness scale?
lameness is difficult to observe and is not consistently apparent, regardless of circumstance
What is a grade 0 on the AAEP lameness scale?
lameness is not perceptible under any circumstances
What is ipsilateral lameness likely due to?
primary hind leg lameness
What is contralateral lameness likely originating from?
the forelimb
What tests do we perform on the forelimb?
flexion tests - carpal and pastern
What makes it impossible to isolate hind-limb flexion tests?
the reciprocal apparatus
What can you use to narrow in on lameness?
Analgesia - nerve blocks
What drug do we use most often for equine nerve blocks?
carbocaine
What blocks the heel bulbs, digital cushion, and navicular region, but not the front of the toe?
palmar digital
What blocks the foot pastern region (not fetlock)?
abaxial nerve block
What blocks the fetlock and suspensory branches in addition to the rest of the lower limb?
low palmar
How do you block the leg below the carpas?
high palmar
How do you prevent proximal diffusion of analgesia to other structures?
utilize a small volume, maybe use a compression bandage
What is a unique method of imaging seen most often in equine medicine?
nuclear scintigraphy
Describe the Gustilo-Anderson classification system.
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
What does S stand for in the Salter classification system?
Type 1 - straight across
What does A stand for in the Salter classification system?
type II - above
What does L stand for in the salter classification system?
type III - lower or below
What does T stand for in the Salter classification system?
Type IV - two or through
What does ER stand for in the Salter classification system?
erasure of growth plate or crush
What are the four fracture configurations?
transverse, short oblique, long oblique, and comminuted
How do you know on radiograph if the bone has punctured the skin?
gas pockets
What’s the difference between long oblique and short oblique fractures?
the fracture is greater than twice the diameter of the bone
What two types of metal can you use in implants?
316 LVM Stainless steel and titanium
True or False: There is a linear relationship with the height/diameter and its strength.
false
True or false: two plates in a plane doubles the stiffness of the plates
true
Stiffness of a rod is radius to the ____ power.
4th
Stiffness of a square beam is height to the ____ power.
3rd
Stiffness of a square beam is width to the ____ power.
1st
Stiffness of the length of a beam is length to the ____ power.
3rd
True or False: Healing fractures respond favorably to about 10% strain.
false - they respond well to about 5% strain
What is required to use cerclage wire?
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
True or False: If a fracture is open, prognosis is poorer than if a fracture is closed
true
True or False: It’s safest to end fixation methods in the middle of a long bone/diaphysis.
false -you should always end them at the joint below and above
If you have no splint material, what can you use to stabilize a large animal leg?
casting material
What are some of the problems with large animal fracture repair?
weight, ability to return to athletic career, strength of muscles. cost
True or False: Cast management alone is adequate in equine fracture treatment.
False - it can be in bovine and small ruminants
What fixation method places a cortical bone screw such that it compresses the two sides of the bone it interfaces?
lag screw fixation
What is the strongest method of fixation available?
bone plates
True or false: skull fractures are more amenable to repair
true
What type of fracture do you use cerclage wire on?
long oblique
True or false: Cerclage wire is meant to be used as the sole means of repair.
false
What are tension bands used for?
when muscle ligaments or tendons are pulling on bones
What size of intramedullary pins should you use?
the pin should be 50-70% of the diameter of the medullary cavity in the area of the fracture
True or False: Lag screws are used parallel to the fracture line
false
How big of a hole can you drill into a bone when preparing to plate a bone?
up to 20% of the bone diameter being plated
True or False: Dynamic compression plate screws must engage both the near and far cortices.
true
What is the order of screw placement?
- drill 2. measure 3. tap 4. screw
How many screws do we prefer to place on either side of a fracture when using a locking plate?
4 is preferred but 3 is acceptable
What are the two ways bone heals?
primary/direct or secondary/indirect (intramembranous or endochondrial ossification)
True or False: Bone is the only tissue in the body that reforms without a scar
true
What forms during secondary bone healing?
callus
In situations in which there is low blood supply, do we aim to get primary or secondary bony union?
primary, as we need a great deal of blood supply for secondary union to occur
A _____ is a transfer of living tissue.
graft
An ______ is from the same species from a different individual.
allograft
What is the transfer of living tissue from a different species known as?
xenograft
What is the insertion of non-living material called?
implant
What is the transfer of living cells for bone regeneration known as?
osteogenesis
What is the induction of cells to become bone known as?
osteoinduction
What is the scaffold for bone cells known as?
osteoconduction
What is improving bone mechanical or biological environment to encourage bone growth known as?
osteopromotion
Identify some autograft harvest sites.
proximal humerus, iliac wing, distal femur, proximal tibia, rib
Describe the fracture.
Closed, comminuted, proximal half metaphyseal and diaphyseal of tibia
Describe the fracture.
Closed transverse fracture of the distal quarter of the diaphysis of the radius, displaced laterally and overriding 10mm.
Describe the fracture.
Grade II open, highly comminuted fracture of the mid diaphysis of the tibia, displaced laterally and overriding 15mm.
What Salter grade is this?
Grade IV
Closed Salter IV fracture of the Humeral condyle, displaced laterally, overriding 5mm
Describe.
Closed long oblique fracture of the diaphysis of the humerus, displaced cranially, overriding 2 cm.
Descirbe the fracture.
Cannon bone diaphysis, short oblique, open, non-articular, acute edges, laterally displaced, neonate.
Describe the fracture.
Cannon bone, articular, acute, mildly displaced, closed, adult.
What is unique about the fracture of this bone?
The coffin is already immobilized and can be casted to prevent heel bulb expansion.
What is this splint called?
Thomas Schroeder splint
What is this cast known as?
Transfixation pin cast
What are the different types of bone grafts?
Autogenous cancellous bone graft, cortical, and combination
