Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

EXAM 3 FINAL > Upper GI Surgery > Flashcards

Upper GI Surgery Flashcards

1
Q

What are the clinical signs of Choke?

A

1) BLOAT
- Type 1 Vagal indigestion

2) Salivation
3) Coughing/Retching
4) Extended head and neck
5) Protruding tongue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the first sign you will see in a cow with esophageal choke?

A

BLOAT

-the cow needs to erructate, if this is blocked your going to bloat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How do you diagnose Esophageal Choke in cattle?

A

1) PE, passage of stomach tube
2) Endosocpy
3) Radiographs
—Surgery and contrast films
—Esophagography (contrast) Barium
4)ultrasound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are some Differential Diagnosis for Esophageal choke?

A

1) Pharyngeal trauma

2) Rabies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When diagnosing Esophageal Choke what diagnostic tools are KEY-according to Pappa French?

A
  • PE

- Pass stomach tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the Etiiology of Esophageal Choke?

A

1)Foreign body obstruction

  • hedge apple, potato
  • cabbage, beet, turnips, corn
  • sharp foreign bodies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the complications of Esophageal choke?

A

1) unable to eructate = BLOAT
2) loss of saliva = metabolic acidosis
3) Aspiration pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How would you treat an Esophageal Choke Medically?

A

1) manual retrieval if obstruction is proximal
2) wire snare - may damage mucosa
3) if distal Push into rumen

SEDATION, Buscopan, Lidocaine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How would you treat an Esophageal choke surgically?

A

ESOPHAGOTOMY

  • Only if medical treatment option are exhausted
  • many complications
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What should your mainstay of treatment be for esophageal choke? Medical vs surgical

A

MEDICAL first always

There are too many complications with esophagotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the the initial treatment of Choke?

A

DECOMPRESS the rumen!!!!

  • needle and suction
  • REd Devil Trocar

Hold of feed and water until resolved

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How long can you hold a cow off feed and water before they are affected?

A

48 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the layers you pass through during an Esophageal Anatomy?

A

Layers:

  • Adventitious layer
  • Muscular layer
  • Submucosa
  • Mucosa

No Serosal Covering

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the associated structures you could see during an esophagotomy?

A

Associated structures:

  • Recurrent Large Gael nerve
  • Carotid sheath
  • Vagosympathetic trunk
  • Tracheal lymphatic trunk
  • Deep cervical Inn
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Why are there so many complications for esophageal surgery?

A

1) Dirty procedure
2) No serosal layer
3) constant movement
4) constant suture line tension
5) proximity of laryngeal nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe the process of Cervical Esophagotomy.

A

1)pass the to level of obstruction
2)Exteriorize and isolate
3)linear incision in esophagus
-over healthy tissue (if possible)
4)remove obstruction
5) if healthy tissue—>CLOSE
If compromised tissue —>2nd intention healing required and daily wound care

  • may need to place rumen fistula
  • NO Food/Water for 24-48hrs post op
  • IV fluids with electrolyte supplementation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What approach should be taken for cervical esophagotomy with PRIMARY repair?

A

-Lateral/ventrolateral approach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Following incision for a cervical esophagotomy (Primary repair), How many layers separate and what are they?

A

Incision separates into 2 layers

  • Muscular
  • Mucosa/submucosa
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What suture is used to close a cervical esophagotomy?

-where do you bury the knot

A
  • PDS to close

- IN the LUMEN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What type of strength does Mucosa/Submucosa provide? (Cervical esophagotomy)

A

TENSILE strethgth for closure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

T/F: Lack of serosa contributes to complications post op

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

When is ESOPHAGOSTOMY necessary?

A

1) if tissue is compromised

2) caudal to repaired esophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Describe Esophagostomy

A

1) caudal to repaired esophagus
2) Place POLYETHYLENE NG tube (0.25-1 OD)
3) secure tube
4) leave in place min 7-10 days (allow stoma formation**
5) allow to heal by 2nd intention

24
Q

What material is used for Esophagostomy tube?

A

Polyethylene NG tube (0.25-1” OD)

25
Q

How long must an Esophagostomy tube be left to allow stoma formation?

A

7-10days***

26
Q

How do esophagostomy heal?

A

2nd intention

27
Q

What can be used for immediate relief of chronic bloat (type 1 indigestion)?

A

Temporary Rumen Fistula

28
Q

Where do you place a temporary Rumen fistula?

A

In the rumen bruh so put it in the :

Upper LEFT paralumbar fossa!!!!

29
Q

What size of skin is removed for a temporary rumen fistula?

A

5cm X 3cm

30
Q

Describe the placement of a Temporary Rumen Fistula.

A

1) 5X3cmm circle through skin
- upper Left paralumbar fossa

2) Blunt direction of GRID muscle layers
3) grasp and tent rumen wall
4) suture rumen to skin in MATTRESS pattern
5) Need 1” of rumen sticking out of skin

31
Q

What suture pattern is used to suture the rumen to the skin for a temporary rumen fistula?

A

Mattress pattern

32
Q

How long does it take for a temporary rumen fistula to close

A

Few weeks

33
Q

What can be used to secure a temporary rumen fistula?

A

35ml syringe casing

34
Q

What are the indications for a Rumenotomy?

A

1) Chronic bloat
2) Foreign body
3) Reticular abscess

4) Type 2 vagal indigestion
—failure of Omaha’s transport
—results in distention of reticulum/rumen
—multiple causes

35
Q

What should be done pre-op for rumenotomy?

A

1) off feed 24-36 hrs
2) single dose of pre-op antibiotics
3) left flank approach

36
Q

What type of surgery is a Rumenotomy?

A

Clean-contaminated procedure

37
Q

What is the antibiotic of choice for pre-op Rumenotomy?

A

Procaine Penicillin

38
Q

What suture pattern is used to suture the rumen to the skin for a Rumenotomy?

A

Cushing

39
Q

Which aspect of the incision should be sutured for for a Rumenotomy?

A

Start suturing at the DORSAL aspect

-creating a seal between skin and rumen

40
Q

T/F: during a rumenotomy the ventral aspect of the incision has the same amount of sutures as the dorsal aspec

A

FALSE

The ventral aspect has extra sutures

41
Q

What type of forceps are used to grasp the rumen and hooked onto a rumen board, during Rumenotomy?

A

Non-crushing rumen forceps

  • allow exteriorize toon of rumen
  • incision is made dorsally
42
Q

How do you remove the fluid during a rumenotomy?

A

1) gravity

2) Kingman Tube

43
Q

What type of closure is required for a rumenotomy?

A

2 layer closure

  • inverting
  • lavage site
44
Q

When closing a rumenotomy what must be done (order)?

A

1)2 layer inverting closure of RUMEN

…….Prior to body wall closure……
I
2)Change gloves/sleeve

3)Change instruments

45
Q

What is the prognosis for Rumenotomy?

A

Depends on reason for surgery:

Foreign Body:
-Good—>doesn’t penetrate thoracic cavity or involve right side of reticulum

  • Guarded—>involvement of right side of reticulum
  • Poor—>FB penetrated diaphragm
46
Q

You perform a Rumenotomy on a cow and find that the thoracic cavity is intact and there is no involvement of the right side of the reticulum……What is your prognosis?

A

GOOD

47
Q

You perform a Rumenotomy and find there is penetration of the right side of the reticulum …..What is your prognosis?

A

GUARDED

48
Q

You perform a Rumenotomy and find a FB has penetrated the diaphragm …What is your prognosis?

A

POOR

49
Q

What is TRP

A

Traumatic reticular pericarditis

50
Q

What are the CS of TRP?

A

1) Tachycardia with muffled heart sounds
- Washing machine murmur

2) GI issues
- 7days, febrile, painful

3) Right heart failure
- Distended Jugular
- Brisket edema
- TAchypnea

51
Q

How would you Diagnose TRP?

A

1) Radiographs
2) Ultrasound
3) Pericardiocentesis

52
Q

T/F tulathromycin is NOT allow in LACTATING animals greater than 20 months of age

A

TRUE

53
Q

What are some differential diagnosis for TRP?

A

1) Pericardial disease
2) Bovine Leukemia
3) Lymphosarcoma

54
Q

What IV anesthesia would you use to sedate a 2 year old heifer for TRP?

A

1) Xylaxine
2) Ketamine
3) Butorphanol

55
Q

You culture Trueperella progenies in a 2yo Heifer. Sample came from cloudy, grey-brown, putrid pericardial fluid.

What would you use to treat this?

A

Procaine Penicillin

56
Q

What are some Differential Diagnosis for RIGHT sided Heart Failure?

A

1) TRP
2) Endocarditits
3) Lymphosarcoma
4) Mediastinal mass

57
Q

How would you treat a cow with Traumatic Pericaditis?

A

1) Pericardectomy
2) Rib resection
3) Foreign body removal

*sequelae—>usually die of constrictive pericarditis

EXAM 3 FINAL (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions