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FAMS > Wounds & Fractures > Flashcards

Wounds & Fractures Flashcards

1
Q

T/F: epithelialization can be seen histologically within the first days of injury, however it appears grossly around day 7 during the proliferation phase.

A

true

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2
Q

how long do the following phases approximately last?
A. Inflammation
B. Proliferation
C. Maturation/Remodeling

A

A. Inflammation = day 0-7
B. Proliferation = day 4-14
C. Maturation/Remodeling = day 14+

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3
Q

What 3 events occur in the VASCULAR portion of the inflammation phase of wound healing? These things occur within the first 15 minutes of the wound occurring.

List them in the correct order of events.

A
  1. vasoconstriction (platelets aggregate to stop bleeding)
  2. vasodilation (with fibrocellular clot)
  3. polymorphonuclear leukocytes (phagocytize bacteria and release proteases)
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4
Q

What occurs in the debridement phase of wound healing?

A

First, neutrophils come in and destruct.
Then, macrophages phagocytize necrotic tissue and release proteases and kill bacteria.

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5
Q

T/F: debridement phase of wound healing is influenced by the presence of necrotic tissue and debris.

A

true

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6
Q

what is the major cell and cell purpose within the proliferation phase of wound healing?

A

fibroblasts to synthesize extracellular matrix and collagen;
Granulation tissue is formed

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7
Q

what is granulation tissue composed of?

A

Capillaries and fibroblasts
NO nerve tissue.

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8
Q

In what large animal species does granulation tissue get out of control in? Why is it important?

A

horses – this is called proud flesh.
Proud flesh inhibits epithelialization

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9
Q

A _____ has decreased strength, vascularity, and cellularity.

A

scar

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10
Q

What type of wound is a right flank pyloro-ometopexy of abomasum?

A

clean wound (surgical wound that we create)

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11
Q

what type of wound is a c-section?

A

clean-contaminated (surgical wound in which a luminal organ was entered, but no spillage)

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12
Q

what type of wound are the following procedures: barnes dehorning, castration, rumen cannulation, mammary vein laceration repair?

A

contaminated wounds

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13
Q

What type of wound are the following: wire injuries, puncture wounds, equipment wounds, calving injuries, and “found her this way”

A

dirty

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14
Q

what should you clean a wound with after you have clipped the fur?

A

mild neutral soap (ivory) and water to remove gross debris on actual wound
and can use surgical scrub for intact skin around wound (esp if suturing).

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15
Q

You should never enter joints for wound repair unless…

A

you have sterile instruments and practice asepetic technique.

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16
Q

what is the perfect lavage fluid to use for wounds?

A

isotonic, warm LRS or 0.9% saline onto wound at 8 psi
In the last liter, add 25 mL of chlorhexidine for residual effect.

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17
Q

T/F: scraping/rubbing the wound is the best way to perform debridement

A

false – this is not recommended; the best way is to perform sharp excision of the entire surface of the wound with copious lavage.

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18
Q

what suture should you use when performing a primary closure of a wound?
remember there are 2 layers

A

muscle & fascia: absorbable (chromic gut)
skin: non-absorbable monofilament (polyamid or braunamid)

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19
Q

why do we use tension relieving sutures such as vertical mattress and near-far-far-near?

A

excessive tension can cause pressure necrosis, suture failure, interrupt circulation, and inhibit wound healing

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20
Q

why vertical mattress over horizontal?

A

vertical mattress sutures do not constrict as many peripheral healing capillaries.

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21
Q

Dead space is the space left in a wound following a surgical procedure that can fill with blood or serum and increase risk of infection, prevent tissue apposition, and prevent healing.
How is dead space managed in large animals?

A

suture ALL tissue planes – tack upper plane to lower plane of external fascia.
Can also use drains or pressure dressings but these are less common in large animals.

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22
Q

What are 3 reasons drains are placed after a surgical procedure?

A
  1. evacuate accumulated fluid
  2. prevent expected accumulation of fluid
  3. eliminate dead space
23
Q

why are drains not used in food animals?

A

bandaging is difficult
they have to be attended to daily

24
Q

T/F: if you feel like you poorly debrided and sutured a wound, you can place a drain to prevent accumulation of fluid and subsequently prevent infection.

A

false – drains are NOT fixes for poor debridement and suturing.

25
Q

what is the defintion of a delayed primary closure?

A

wound is sutured closed BEFORE granulation tissue forms but several days after the wound occurred, was lavaged, debrided, and bandaged.

26
Q

T/F: healing by second intention is very common in food animals

A

true – usually done when there is excessive contamination, delayed responses, and field conditions.

27
Q

You are presented with a herd of sheep that have discolored wool (some of which is falling out) and overall the farmer reports they are not eating as much and being more stationary. You see lots of flys on this farm.
What is most likely the issue?

A

fly strike (myiasis)

wool retains moisture (feces and sweat)
then flies lay eggs and larvae damage the tissue.

28
Q

how do you prevent fly strike?

A

shearing/clutching at appropriate times
environmental fly control

29
Q

how do you TREAT fly strike?

A

Clip all fiber (leave 5 cm area on intact health skin without fiber around wound)
Spray with CATRON to kill maggots
Clean wound, debride and lavage
Give systemic antibiotics, pain meds, and topical skin treatments
Spray with CATRON daily until skin is healed.

30
Q

what OTC and Prescription topicals are available to treat myiasis?

A

OTC: Aluspray, New skin, Aloe vera extract (with allatoin), triple antibiotic, Icththammol, povidone iodine ointment

Rx: silver sulfodiazine

31
Q

The majority of food animal wounds are…

A

iatrogenic (castration, dehorning, etc.) or treatment (c-section, DA, claw amputation)

32
Q

what is the advantage of surgical dehorning?

A

shorter healing times and eliminate open wounds infection/fly risk.

33
Q

when should you debud using caustic paste (bloodless form of disbudding)?

A

at 1-3 days of age

34
Q

when should you disbud using an iron?

A

Ideally, less than 4 weeks of age.
In goats, less than 2 weeks.
You should use a cornual block for local anesthesia and have pain meds on board.

35
Q

What types of blocks are performed when doing barnes dehorning?

A

cornual block and SQ line block (caudal to horn)

36
Q

T/F: castration in food animals is best done when the animal is younger.

A

true

37
Q

T/F: topicals do not effectively improve healing, but fly spray (catron) is essential for the healing process.

A

true – keeps flys away which decreases risk of infection and necrosis.

38
Q

what is the frequency of bones fractured in ruminants in order from most likely to be fractured to least likely?

A

metacarpus > metatarsus > tibia > radius/ulna > humerus > femur

39
Q

what are the advantages to repairing a fracture in a ruminant as opposed to horses?

A

Ruminants lay down more often which provides a great potential for bone healing
Ruminants rarely suffer contralateral limb break down
Ruminants rarely resist orthopedic devices.

40
Q

The presence of what 3 things decreases prognosis for ruminants needing fracture repair?

A
  1. sepsis
  2. nerve damage
  3. vascular trauma
41
Q

What types of fractures have the worst prognosis for food animals?

A

open
articular
proximal limb (if adult > 2y)

42
Q

what is the biggest downsides to internal fixation for food animal fractures?

(there are 6)

A
  1. cost
  2. general anesthesia required
  3. equipment required
  4. can never be slaughtered
  5. requires 9 months stall confinement
  6. infection/implant migration/breaking is a complication
43
Q

external skeletal fixations are an option for fracture repair that works better in what types of animals?

A

SMALL food animals

44
Q

When placing a cast on an animal for fracture repair, what must you include in your cast?

A

the joint above and below

45
Q

T/F: casting a fracture requires stall confinement, the length of which is determined by the age of the animal.

A

false – stall not required, only small pen for 4-8 weeks. Just needs to be protected from rain. Length is determined by age and severity.

46
Q

how many layers should a cast be for fracture repair?

A

if animal < 330 lbs: 4-6 layers
if animal >330 lbs (adult): 8-12 layers

47
Q

how often do you change a cast for fracture repair?

A

0-6 months: every 3 weeks
6-12 months: every 6 weeks
12+ months: every 6-8 weeks

48
Q

In calves, what types of fractures are common?

A

physeal fractures (salter 1 and 2)

49
Q

Open fractures carry a poor to grave prognosis in food animals. If you decide you are going to repair them, what is the best way to achieve success?

A

very good debridement of skin,
soft tissue, and bone curettage
antibiotics for 2 weeks minimum
external skeletal fixation

50
Q

why is the thomas schroeder splint difficult to do in the field?

A

requires 1” steel and heat to make it (requires farrier).

51
Q

When animals have thomas schroeder splints, they must be confied for 6-10 weeks and examined multiple times a day during the first week. What is a complication that could occur?

A

animal cannot get up and bloats.

52
Q

T/F: thomas schroeders splints are best for animals >500 kg or > 1 year old

A

false – opposite. they are best for smaller animals <500 kg and < 1 yo, so basically young, small animals

53
Q

why are dairy cows more likely to get coxofemoral joint luxations?

A

they do not have as much muscle around those joints compared to beef cattle. Muscles keep those joints in socket better.

54
Q

Which coxofemoral joint luxation has a worse prognosis – cranial dorsal or ventral?

A

ventral – usually these cows cannot rise.
cranial dorsal are usually ambulatory and have an ok prognosis if fixed surgically.

FAMS (36 decks)

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