Unit 2 Flashcards
Does the duodenum move around and where is it located
No it is in a fixed location with a short mesentery, it is on the right side (dorsal body wall) between the liver and right dorsal colon around the base of the cecum
What is a good landmark for the duodenum
The duodenocolic ligament
Which part of the small intestine has a band
The ileum, has the antimesenteric band aka the ileocecal band (attaches the ileum to the colon)
How many bands are on the ventral colon
Four
What is the path of the large colon
Right ventral colon—> sternal flexure—> Left ventral colon—>pelvic flexure—> left dorsal colon—> diaphragmatic flexure—> right dorsal colon
What is the number one cause of non-strangulating obstructions in the small intestine
Ileal impaction
Where are common locations for impactions in the large colon (4)
Cecum, pelvic flexure, right dorsal colon, and small colon
What are places for enteroliths in the large intestine
Right dorsal colon and aboral (on mouth side)
Where does the left dorsal displacement of the left colon go
Goes up and squeezes between the spleen and kidney
What are peripardium mares prone to for GI colic causes
Left colon volvulus, cecal perforation
What are peripardium mares prone to for extra-GI colic causes
Uterine torsion and uterine artery (uterine artery what idk this is just what she had on the slide)
What colic causes are stallions more prone to compared to mares
Inguinal hernias and testicular torsion
What causes of colic are miniature horses prone to
Non-strangulating large intestinal obstructions like fecoliths
What breeds of horses are prone to inguinal hernias
Standard bred, saddle bred, and Tennessee Walkers
What breeds are prone to enteroliths
Arabians, saddle bred, and Morgans
What causes of colic cause diarrhea
Colitis and small colon impactions
If a horse was on NSAIDs what types of colic might you be concerned about
Right dorsal colitis or cecal impactions
What types of colic can tapeworms cause
Ileal impactions or ileocecal intussusception
What type of diet makes Ileal impactions more likely
Bermuda/costal hay
What type of colic can stall rest put a horse at risk for
Cecal impaction
What type of colic does cribbing make a horse more at risk for
Epiploic foramen entrapment
Gram negative bacteria have what that causes shock and how does it cause the shock
Endotoxin (LPS), specifically lipid A portion
There is a relative hypovolemia because of vasodilation
What stage of shock will there be decreased heart rate and respiratory rate
Decompensatory becuase of a loss of compensatory mechanisms
What is an important therapeutic treatment to do to prevent rupture and what are 3 signs that tell you to do this immediately
Nasogastric intubation, if you see a HR>60, severe colic, or reflux from nose- pass immediately
How should you pass the nasogastric tube
Through the ventral nasal meatus, ventral and central!
Of a horse starts gushing blood during nasogastric tubing, what might you be in
The middle nasal meatus and have hit the ethmoid turbinates (but sometimes they will just get a nose bleed)
Is a bigger or smaller tube better for nasogastric intubation
Bigger is better
Where should the nasogastric tube go to (in the throat)
To the throat latch
How can you check to ensure you are in the esophagus when passing a nasogastric tube
Watch for it to pass down the left side, check for negative pressure, check that it doesn’t rattle, get gas/stomach contents
Coughing is not a reliable sign
How much reflux is normal to get from a horse
2L or less
What can you feel on a rectal on the left side
The small colon and large colon (pelvic flexure), the spleen, left kidney, lateral ligament of the bladder, inguinal rings, uterus/ovaries, aorta
What can you feel on a rectal on the right side
Cecum, small colon, large colon (pelvic flexure), lateral ligaments of the bladder, inguinal rings, ovaries, aorta
What is a good drug to use as a smooth muscle relaxant for rectal exams
N-butylscopolammonium bromide
What may you feel if there is an impaction
No haustra because the colon is distended and there may be gas in the colon and cecum
what would you feel in the colon if the ingesta is dehydrated
The colon would be vacuum packed and not be gas distended
If you feel an overinterpretation of horizontal bands across the abdomen (whatever that means) what might this indicate
Right dorsal displacement of the left colon or other left colon distention causes
What can you see and what should you look for when ultrasounding GI organs
You can see the stomach, small intestine, cecum, large and small colon, looking for location, wall thickness, motility, contents, and size
What are some extra-GI things you can see on ultrasound
The amount and echogenicity of peritoneal fluid and echogenicity and size of spleen, liver, kidney, and bladder
Can you see detail on ultrasound that is behind gas
No
What is a normal abdominocentesis
Straw/clear, total protein less than 2.0 g/dl, 40-80% PMNs, 20-60% mononuclear, <2.0 lactate
What electrolyte abnormality would show up on blood work if an animal is anorexic
Decreased potassium and calcium (very dependent on diet and lose through urine)
What electrolyte abnormality shows up when an animal is refluxing a lot
Hypochloremia (get hypochloremic alkalosis)
What electrolyte abnormalities show up with diarrhea
Hyponatremia and hypochloremia (+/- HCO3)
What can cause a leukocytosis
Stress or inflammation
Leukopenia is common with what
SIRS, especially colitis
What is the single most important factor when deciding to refer or take a horse to surgery
Pain! Severity, duration
What is the point of giving fluids in shock treatment
To increase preload
What specific therapy can be used in impactions
Laxatives
What is the definitive treatment for spasmodic colic
Trocharization
What is the best laxative to use
Water, electrolytes, and MgSO4
What are the five main parts of endotoxemia treatment
Bind endotoxin (ex. Activated charcoal), blood products (plasma, serum), anti-inflammatories, remove source, prevent complications (ice boots)
What are physical methods for correcting LDDLC
Jogging, rolling (jostle colon off nephrosplenic ligament)
What should you use to contract the spleen to help treat LDDLC
Alpha 1 agonist (phenylephrine)
T/F all surgeries for colic are exploratory
True, it is the final, definitive diagnostic
When I say a horse is hypsodont, diphyodont, and lophodont, what does that mean
Hypsodont is because their teeth keep growing, diphyodont is the teeth they have that have baby teeth that are lost once the adult ones come in, and lophodont is because the teeth have transverse ridges
What is a horse predisposed to if the pulp canal is exposed
Infection/ sepsis because the pulp canal comes all the way to the base of the tooth and provides the blood supply to the tooth
What seals the pulp chamber
Secondary dentin
T/F the infundibulum canal goes all the way to the base of the tooth like the pulp canal
False, nope, nada- this can be exposed and may not even be a problem it can get packed with food though
Which teeth do not have an infundibulum
The mandibular teeth
What are the two main sinusoid systems (idk how else to ask this, think broad) and they don’t communicate
Rostral and caudal
Which sinuses communicate in the rostral sinus system
Rostral maxillary and ventral conchal
What hole do the sinuses drain out of
Nasomaxillary opening
If a horse has bilateral discharge where is the most likely infection/problem and thus what could it not be
Behind the nasal septum so it can’t be sinusitis
What radiographically views are used to highlight the maxillary arcades and sinuses
RDLVO or LDRVO
T/F sinusitis is often from a primary cause
False, always assume a secondary cause
What are different routes of tooth root infection
Blood borne/lymphatic, periodontal disease, endodontic pathology (fractured tooth, pulp exposure, etc.)
Nasal discharge, chewing on one side, quidditch (LOL this was supposed to say quidding but I’m leaving the original I like it better), weight loss, and colic are all potential signs of what
Tooth root infection
What is the first step of a dental exam (after sedation, cleaning, etc.)
Examining the front of the mouth! Want to do before inserting the speculum
What is a diastemata
A gap between teeth
When floating is it important to completely file down one tooth and really stay with it before moving onto the next to ensure you don’t miss any places?
No you should move around a lot to ensure the teeth don’t get too hot
What is a disease that thoroughbreds and warm bloods are over represented in that requires incision extractions as a mainstay of treatment
Equine odontoblasts tooth resorption and hypercementosis
If a horse has a tooth that needs to be removed should you start with apical repulsion, simple extraction, or a minimally invasive transbuccal approach
Always start with a simple extraction and only when that fails should you try something more invasive
T/F the esophageal wall in a horse includes a fibrous layer, serosa, muscular layer, submucosal layer, and mucous membrane
False, the horse doesn’t have a serosa in the esophageal wall
What is something to think about in regards to the esophagus and healing
There is minimal collateral blood supply and no serosa so the healing is slower
On X-ray you should be able to see the gas-filled esophagus
Not normally in the horse, if it is distended with gas there’s a problem
What is the most common cause of choke in horses
Food related! Like feeding dry pelleted food or beet pulp or horses who eat their food quickly (bolters)
If a horse is acting anxious, has an elevated heart rate, has nasal discharge bilaterally, extension of the neck, and coughing and you can’t pass an NG tube what are you thinking might be going on
Choke
Why is sedation helpful if a horse is choking
It relaxes the muscle and it causes them to drop their head which can help prevent aspiration pneumonia
What matters the most in terms of preventing complications from obstruction and what are some complications
Duration matters the most!!
Complications are aspiration pneumonia, ulcerative esophagitis, ruptured esophagus
What part of the small intestine can really “go anywhere” in the abdomen because of a longer mesentary
Jejunum
How is the jejunum and ileum blood supply different
The jejunum has an arcuate vascular supply, which is more repetitive and the ileum has a single vessel
How many bands are on the cecum and which can you feel on palpation and why are they important in terms of diagnostics
4
The lateral band is the cecocolic band and when it is straight then you know your colon doesn’t have a right dorsal displacement or volvulus
The dorsal band is the ileocecal band and you can use it to run up the small intestines to orient yourself
What side of the body is the cecum on
Right (think about the cecum as like the horse’s rumen, because this is where a lot of fermentation takes place and the rumen is on the right)
Can you have something happen to right dorsal and have it not happen to the right ventral colon
No they are connected by mesentary
T/F the large colon is freely hanging out in the abdomen
True it only really is attached at the cecum and transverse colon (only the right dorsal and right ventral parts of the large colon are attached
What are 4 ways to identify the small colon
Wide antimesenteric band, sacculations, and fecal balls, fatty mesentery
What parasite causes thrombotic GI disease
Strongus vulgaris
Why do non-strangulating obstructions hurt
Distension and pull on mesentery
Why do strangulating colics hurt
Stretch receptors- Distention and pull on mesentery
Chemo receptors- ischemia
What is the main source of pain in inflammatory colic
Chemoreceptors reacting to inflammation
T/F often we don’t know why horses colic
True
Where does the large colon end up with a right dorsal displacement
On the right side of the Cecum (does a 180) and will see wrapped around the back of the cecum
What deadly thing can happen when you are surgically fixing an epiploic foramen entrapment
Rupture of the portal vein and caudal vena cava- horse bleeds out
Strangulating lipomas are often in older or younger horses
Older horses (over age 15 usually)
What diet is associated with enteroliths
Alfalfa hay
What are 4 SIRS criteria in horses
Fever, tachycardia, tachypnea, white blood cell changes (left shift)
What are signs of decrease cardiac output
Prolonged CRT, poor pulse quality, cool extremities, depressed mentation
What is the most common strangulating large colon form of colic and how do these animals present
Large colon volvulus, present super sick and painful, can show obstructive, distributive, and hypovolemic shock signs
When are you likely to see abdominal distention
With large intestinal colics
What is the one exception of a form of colic that has gut sounds (all others don’t really)
Large intestinal inflammatory
What type of colic has a LOT of reflux
Small intestinal inflammatory
You are doing a rectal and feel something that feels like balloon animals and doesn’t have any fiberous bands you can feel. What are you feeling?
The small intestine
What NSO of the small intestine can you feel on rectal
Ileal impaction
What SO can you feel in the small intestine on rectal
Inguinal hernia and/or ischemic and thickened intestine
What NSO of the large intestine can you feel
LDDLC- colon over NS ligament and impactions
What would you feel on rectal with large intestinal colitis
Fluid
Can you feel a LCV on a rectal
Yes and distention can be severe
If you feel horizontal bands across the abdomen what can you say
There is a large intestinal distention- Non-strangulating obstruction of large intestine
Thickened, distended, and amotile is related to what type of small intestinal colic
Strangulating lesion
What type of colic is there usually pretty severe distention of the intestines
Non-strangulating and strangulating small intestine
Wall thickness is usually because of what types of colic
Especially strangulating obstructions (especially LCV) but also some with inflammatory
If you do an abdominocentesis and the lactate is increased a lot more than the blood, likely what type of colic is this
Strangulating obstruction
If spleen and kidney can be seen next to each other on ultrasound what does this rule out
LDDLC
