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Small Animal Surgery > Unit 2: 4 - Head & Neck > Flashcards

Unit 2: 4 - Head & Neck Flashcards

1
Q

What salivary glands do dogs have?

A

Parotid, mandibular, sublingual (mono/polystomatic), zygomatic

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2
Q

What salivary glands do cats have?

A

Parotid, mandibular, sublingual (mono/polystomatic), zygomatic, molar

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3
Q

What are 3 indications for surgery of the salivary glands?

A
  1. Mucoceles
  2. Tumors
  3. Trauma
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4
Q

What SG tumor is common in dogs?

A

parotid

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5
Q

What SG tumor is common in cats?

A

Mandibular

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6
Q

What is a mucocele?

A

Collection of saliva in tissues surrounded by granulation tissue

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7
Q

What are the 5 types of mucoceles?

A

Cervical, sublingual (ranula), pharyngeal, complex, zygomatic/parotid/molar

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8
Q

What are mucoceles caused by?

A

Unknown

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9
Q

What is the most common CS for a mucocele?

A

Asymptomatic

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10
Q

What diagnostics are done when a mucocele is suspected?

A

Cytology, imaging, histopath

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11
Q

How are mandibular and sublingual SGs excised?

A
  1. Incise capsule
  2. Dissect
  3. Ligate and transect duct caudal to lingual nerve
  4. Drain or marsupialize mucocele
  5. Histopath - rule out neoplasia
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12
Q

How is the parotid SG excised?

A

By tedious dissection

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13
Q

How is the zygomatic SG excised?

A

By transecting the arch

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14
Q

What are 3 things that can happen after a SG excision?

A

Recurrence, seroma, infection

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15
Q

What is the prognosis for a SG excision?

A

Good with mucocele but varies with a tumor

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16
Q

What structures make up the external ear?

A

Pinna, auditory meatus (vertical and horizontal canals)

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17
Q

What structures make up the middle ear?

A

Tympanic membrane, auditory ossicles, auditory tube (Eustachian)

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18
Q

What structures make up the inner ear?

A

Semicircular canals, cochlea

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19
Q

What are indications for surgery of the ear?

A

Aural hematomas, otitis, tumors/masses, trauma

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20
Q

What is the cause for an aural hematoma?

A

Trauma, irritation

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21
Q

What is the cause for otitis?

A

Derm-related (allergies, parasites, bacteria, yeast, immune-mediated dz, FB, conformation)

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22
Q

What are CS for aural hematomas?

A

Swollen fluid filled mass, head shaking, scratching

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23
Q

What are CS for otitis?

A

Foul odor, pain, rubbing/scratching ears, discharge, canal narrowing/proliferation, hearing loss, neuro signs

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24
Q

What are the components of an otic exam?

A

+/- sedation, otoscope, swab (cytology, C&S)

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25
Q

What is the preferred imaging for the ear?

A

CT

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26
Q

What are 6 procedures that can be done surgically to the ear?

A
  1. Pinna drainage
  2. Pinnectomy
  3. Lateral ear canal resection
  4. Vertical ear canal resection
  5. Total ear canal resection (with lateral bulla osteotomy)
  6. Ventral bulla osteotomy
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27
Q

How is an aural hematoma treated?

A

Treat cause –> remove clots & fibrin, lavage –> place a teat cannula, active drain, “S” incision, and/or bandage

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28
Q

What are complications that can happen from an aural hematoma?

A

Can recur, cauliflower

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29
Q

T/F: No bandage is needed for an aural hematoma when a teat cannula is placed

A

True

30
Q

Which way are sutures oriented around an “S” incision?

A

vertically, parallelling major vessels and obliterating dead space

31
Q

What tumors are common in the ear?

A

SCC, melanoma, mast cell

32
Q

What are 3 things that can be done to mitigate trauma?

A
  1. Repair (appose epith edges and exclude cartilage)
  2. Partial pinnectomy (cosmetically contour and appose epith edges)
  3. Bandage (primary, concurrent)
33
Q

What are 2 benefits to doing a lateral ear canal resection?

A
  1. Improves drainage and ventilation
  2. Facilitates topical treatment
34
Q

Lateral ear canal resections should be done before _____ and _____.

A

proliferation, calcification

35
Q

What are 3 indications for a total ear canal resection?

A

Irreversible hyperplasia, stenosis, calcification

36
Q

What are indications for a ventral bulla osteotomy?

A

Polyps, otitis media (w/o externa), problems post TECA

37
Q

What part of a cat’s bulla is the largest?

A

ventromedial compartment

38
Q

What is the promontory part of the cat’s bulla?

A

Plexus of postganglionic sympathetic nerves

39
Q

What is the purpose of a ventral bulla osteotomy?

A

Increased exposure and drainage

40
Q

What are 3 complications associated with the lateral and vertical ear canal resections?

A
  1. Inadequate drainage
  2. Persistent otitis and progression
  3. Dirty tumor margins
41
Q

What are 7 complications that can happen after total ear canal resection and ventral bulla osteotomy?

A
  1. Hemorrhage
  2. Infection/abscess
  3. Facial n. paralysis
  4. Deafness
  5. Vestibular dysfunction
  6. Horner’s syndrome (cats)
  7. Fistula/otitis media - remnants
42
Q

What are 3 indications for surgery of the thyroid/parathyroid glands?

A

Tumors, adenomatous hyperplasia, cysts

43
Q

What CS are associated with thyroid carcinomas in dogs?

A

Cervical mass, dysphagia, laryngeal dysfunction, cough, dyspnea, exercise intolerance, hemorrhage

44
Q

What CS are associated with parathyroid tumors?

A

PU/PD, vomiting, weakness, constipation, lethargy, inappetance, cystic calculi, bone and joint pain

45
Q

What CS are associated with adenomatous hyperplasia in cats?

A

Unthrifty, weakness, muscle tremors, ataxia, incoordination, muscle atrophy, breathless, collapse

46
Q

Where does the thyroid get its blood supply?

A

Common carotid and brachiocephalic trunk

47
Q

Where do the parathyroid glands get their blood supply?

A

Cranial thyroid artery

48
Q

What should be done in a thyroidectomy?

A

It is a bilateral procedure but should preserve one parathyroid

49
Q

What are 6 complications that can arise from surgery of the thyroid/parathyroid?

A
  1. Hypothyroidism
  2. Hypocalcemia (rare if unilateral)
  3. Hemorrhage
  4. Laryngeal paralysis
  5. Dysphagia
  6. Recurrence
50
Q

What is the most common thyroid tumor and what is the prevalence?

A

Thyroid carcinoma - 90%

51
Q

How often are thyroid carcinomas metastatic and how often are they functional?

A

Metastatic = 40-80%

Functional = 10%

52
Q

What is the risk to taking a thyroid biopsy?

A

High risk of severe or fatal hemorrhage

53
Q

What is the prognosis for surgical removal of thyroid adenomas?

A

Excellent - curative

54
Q

What is the prognosis for surgical removal of carcinomas?

A

Depends on mobility, size, and stage

3 years if movable

6-12 months if invasive

3 months if untreated

55
Q

Bilateral thyroid tumors are ___ times more likely to metastasize.

A

16

56
Q

What are adjunct treatments for thyroid tumors?

A

I131 = cats

Radiation

Chemo

57
Q

What is primary hyperparathyroidism caused by?

A

Excess excretion of PTH

58
Q

What is secondary hyperparathyroidism caused by?

A

Chronic renal failure, diet imbalance

59
Q

What does excess PTH result in?

A

Increased Ca and P release from bone –> Ca resorption and P excretion by kidneys & Ca and P absorption in the intestines

60
Q

How hoes hypercalcemia cause PU/PD?

A

Elevated Ca levels interfere with proper functioning of the renal tubule cells that normally respond to ADH –> increased urination –> increased thirst and dehydration

61
Q

How can hyperparathyroidism be diagnosed?

A

Measure persistent ionized hypercalcemia, inappropriate or high PTH, no PTHrp

62
Q

What % of patients have hypocalcemia after parathyroid surgery?

A

33%

63
Q

When do we treat for post op hypocalcemia?

A
  1. Total Ca <8.0 mg/dL
  2. iCa <0.8 - 0.9 mmol/L
  3. CS = face rubbing, muscle tremors, convulsions
64
Q

How can we treat acute hypocalcemia?

A

10% Ca gluconate

65
Q

How can we treat long term hypocalcemia?

A

Calcitriol, Ca, maintain serum Ca at low/low normal

66
Q

What are the LNs of the head and neck?

A

Mandibular, parotid, retropharyngeal, superficial cervical (prescapular)

67
Q

Branchial and pharyngeal cysts have an _____ lining.

A

epithelial

68
Q

Where are branchial cysts?

A

Lateral or dorsolateral neck

69
Q

Where are Rathke’s cleft cysts?

A

Nasopharyngeal obstruction

70
Q

Where are thymic cysts?

A

Mediastinal or SQ neck

71
Q

Where are thyroglossal duct cysts?

A

Ventral midline

Small Animal Surgery (17 decks)

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