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74 Cards in this Set

  • Front
  • Back
A cleft lip is a(n)...
a) congenital defect of the soft palate
b) traumatic injury of the upper lip
c) congenital defect of the primary palate
d) more than one of the above is correct
c) congenital defect of the primary palate
T or F:
Both dogs and cats handle major glossectomy quite well.
False!
Dogs do but not cats (no grooming behavior)
What artery needs to be avoided when performing tongue surgery?
Lingual artery
What are differentials for mandibular/maxillary neoplasia in the dog? In the cat?
Dog (SCC, Fibrosarcoma, Malignant Melanoma, Osteosarc)
Cat (SCC, SCC, SCC, Fibrosarcoma)
What is the prognosis for maxillectomy in the cat? In the dog?
Dog is very good!
Cat you gotta wait....depends on the tumor (SCC is way invasive)
What are the types of epulids and which is bad news???
Fibromatous
Ossifying
Acanthomatous (invasive)
What are clinical signs of a palatial defect? When do signs manifest typically?
Sneezing and nasal discharge manifest post-weaning
T or F:
Surgery of congenital palate defects should be performed as soon as possible.
False!
Delay until at least 16 wks to wait for facial bones to stabilize.
What are the 4 goals when fixing palatial defects?
1) double layer closure
2) don't close directly over defect
3) avoid cautery
4) avoid tension on suture lines
What is the most common indication for salivary gland surgery?
Sialocoele (salivary mucocoele)
What are the 2 most common salivary glands affected in dogs?
Mandibular #1; sublingual #2
T or F:
Xerostoma is a common sequel following sialodenectomy in dogs.
False! Dogs do fine, even if they lose BOTH mandibular salivary glands
What procedure allows saliva to leak-out into the oral cavity? What conditions are indications for this procedure?
Salivary marsupialization;
For ranulas and pharyngeal mucocoeles
What are indications for tonsillectomy in small animals? What are the prognoses for these?
Neoplasia!
If lymphoma, may not need surgery. If SCC, BAD NEWZ!!! Perform bilateral tonsillectomy
Describe the muscular layers of the esophagus...or DIE!
Inner circumferential
Outer longitudinal
Why doesn't the esophagus heal well?
Incomplete serosal layer
Lots of contamination
Lots of motion
No omentum
Maybe poor blood supply??
Just to prove you're a bad ass....recite Halstead's Principles of surgury WHILE STANDING ON YOUR HEAD!!!
Gentle tissue handling
Closure of dead space
Accurate hemostasis
Preservation of blood supply
Strict asepsis
Careful approximation of tissue planes
No tension on sutures
What is the holding layer in the GI tract?
submucosa!
Your patient has a foreign body lodged cranial to the thoracic inlet. Describe the surgical approach.
Likely a cervical approach
Move trachea to R to visualize the esophagus
Describe surgical approaches for the thoracic esophagus and indications for each.
Always do L thoracotomy via an intercostal space.
However, if at heart base, must do a R thoracotomy since the aorta won't move outta the way
What structures should be avoided when performing a thoracic esophagotomy?
Vagal nerves (start on L and R and move dorsal and ventral)
How can tension be relieved when performing an esophagectomy?
Cut more of the outer (longitudinal) layer.
What are two ways to strengthen an esophageal suture line?
Harvest sternohyoideus/thyroideus for a patch
Pull omentum through diaphragm for a patch
What are the main clinical signs of esophageal disease?
Regurgitation
Coughing
Dysphagia
Dyspnea
Ptyalism
Pyrexia
Altered appetite
Weight loss
What are the 4 common locations for an esophageal foreign body in dogs?
Upper esophageal sphincter (oropharyngeal)
Thoracic inlet
Heart base
Stomach cardia
What neoplasms are associated with esophageal disease? Which has the best and worst prognosis?
SCC
Leiomyosarcoma (BAD)
Fibrosarcoma
Leomyoma (great prognosis)
Osteosarcoma
Esophageal sarcomas in the dog are associated with what parasite?
Spirocerca lupi
What are the 3 types of hiatal hernias?
Sliding hernia
Paraesophagal hernia
Gastroesophageal intussusception
What are the 3 treatments for a hiatal hernia?
Hiatal reduction (suture hiatus tighter)
Esophagopexy
Bilateral gastropexy
Regurgitation in young animals is associated with:
a) Vascular ring anomalies
b) Cricopharyngeal achalasia
c) Both A and B
d) none of the above
a) Vascular ring anomalies
What are possible complications to placing an esophageal tube?
Skin irritation
Mediasteinitis
Hemorrhage (poking the jugggg)
T or F:
Treatment of a PRAA is best corrected with surgery as early as possible.
Tru dat!
What is the treatment for a PRAA? The prognosis?
Tx - ligate and cut ligamentum arteriosum
Prognosis - EXCELLENT!
What are the "4 P's" of GI surgery?
Pink
Peristalsis
Perfusion
Palpation
T or F:
Like esophageal surgery, GI surgical closure should always be a 2-layer closure.
False! Picky questions! Yes, GI sx should be 2 layer but esophageal can be 1 or 2.
What are the more common causes of gastric ulceration?
NSAIDS
Steroids
Shock
Gastrinomas
What are the most common gastric neoplasms in...
...cats? Dogs?
Cats - lymphoma
Dogs - adenocarcenoma
Plugging a loop of bowel into the stomach is better known as...
...Gastroenterostomy
Rerouting the biliary tract is known as...
...Cholecystoenterostomy
What is the common signalment for a dog w/GDV?
Middle-aged to older deep chested, large breed
OR Shar pei, Bassett, Cocker Spaniel
Describe the pathogenesis of GDV?
Pylorus rotates dorsally while fundus rotates ventrally (usually in a clockwise fashion)
Describe how a GDV can lead to a V/Q mismatch.
Diaphragmatic impingement leads to decreased tidal volume
What are the major sequelae to the decrease in perfusion caused by GDV?
Obstructive and hypovolemic shock
Arrhythmia and myocardial depression
What are some possible pre-surgical stabilization techniques used in patients w/GDV?
Antiarrthymics (maybe)
Analgesia/premeds
Give O2 (and free radical scavengers)
ET tube + gastric tube
Maybe trocharization
Once the abdomen is open and you are standing on the dogs right, how is a GDV de-torsed? How can positioning be verified afterwards?
Push fundus dorsal and away from you
Pull pylorus ventral and toward you
Palpate @ esophageal hiatus to verify positioning
During GDV repair, what are indications for splenectomy? Gastrectomy?
Splenectomy if spleen is thrombosed or vascularly devitalized
Partial gastrectomy if stomach wall is thin or is excessively dark or pale
How is a gastropexy performed in a GDV repair?
on right side...
Cut into serosa muscularis of pylorus and cut into abdominal muscles; suture the 2 together!
When does the greatest possibility for dehiscence occur post surgury?
Between days 3 and 5
Why is perfusion important in intestinal healing?
Need adequate oxygen for hydroxylation of proline and lysine and for crosslinking of collagen
What fancy-ass intestinal suture pattern ensures that you grab the submucosa?
Gambee
In an enterotomy for foreign body removal, where is the cut made?
In the anti-mesenteric border in a healthy portion of bowel
Non-crushing forceps used for intestinal surgery are better known as...
Doyen forceps
When anastomosing an intestinal resection, what portions are sutured first?
Mesenteric and antimesenteric sites are pegged first
Which is tougher...a colopexy or a gastropexy?
Colopexy is HARRRRRRRD
What is the max intestinal diameter on a lateral radiograph?
2x L5
Which has a better prognosis for linear foreign body, cat or dog?
cat!
You see a double donut on an ultrasound. Which is the "inner donut"?
a) intussusceptum
b) intussusection
c) intussuscipiens
d) intussussussusizzle
a) intussusceptum
('septum invades into the 'scipiens"
What is the intussusception recurrence rate?
Between 6 and 27%
What are indications for surgery to remove a colonic foreign body?
NONE...it'll pass...
Megacolon is relatively common in ...
...CATS
What is the most common cause of megacolon in cats? How is it usually treated?
IDIOPATHIC is 62%; treat by resection and anastomosis of colon (subtotal colectomy)
How much jejunum can be removed with no effect?
70-85%
What are signs and diagnostic test results of post operative intestinal dehiscence?
Anorexia, depression, pain, vomiting
Abdominal tap shows sepsis, toxic and/or degenerate neutrophils
Which of the following is/are associated with apocrine gland carcinomas?
a) Anal sac adenocarcinoma
b) Almost always in intact male dogs
c) Hepatoid tumors
d) Highly malignant tumor
e) Poor prognosis
a) Anal sac adenocarcinoma
d) Highly malignant tumor
e) Poor prognosis
Which of the following is/are associated with perianal gland tumors?
a) Hepatoid tumor
b) No sex predisposition
c) Metastasizes to the sublumbar lymph nodes
d) Excellent prognosis for cure
e) Associated with intact male dogs
a) Hepatoid tumor
d) Excellent prognosis for cure
e) Associated with intact male dogs
What are your top two differentials for a dog with low PTH and hypercalcemia?
Lymphoma
Apocrine gland carcinoma
When should perianal fistulae be treated surgically? How are these commonly treated medically?
Pretty much NEVA treated surgically; use cyclosporin for immunosuppression.
What is a major complication to anal sacculectomy?
Fecal incontinence
Which type of anal sacculectomy should be used when treating a tumor, open or closed?
Closed! Don't wanna seed those nasty tumor cells!
How does testosterone lead to perineal hernias?
Testosterone causes progressive atrophy of the pelvic diaphragm (coccygeus and levator ani), allowing the rectum to dilate and herniate.
How can perineal hernias be diagnosed?
Look at the ass of the dog
Rectal palpation
Ultrasound for bladder involvement
What surgical procedure repairs a perineal hernia? How is this repair achieved?
Herniorrhaphy; pexy anal sphincter to sacrotuberal ligament or elevated external obturator m.
What is a major complication to herniorraphy using a pexy to the sacrotuberal ligament?
Sciatic nerve entrapment!!!
What are some overarching complications to perianal surgery?
Fecal incontinence
Tenesmus
Anal stenosis
Recurrence of problem
Urethral damage