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29 Cards in this Set

  • Front
  • Back
What are 4 types of ligatures/ligations?
1) Circumferential: all the way around, slips
-place away from cut edge
2) Transfixation: go into vessel then around, won't slip
-place towards cut edge
3) Miller's knot
4) Hemoclip or staple
How do you ensure that a ligation ends up in the crushed tissue?
Use carmalt forceps and slide ligature into the crushed tissue and tighten there
What does a castration or orchiectomy mean?
Removing testicles
-according to baltzer neuter means anyway of preventing pregnancy (OVH or cast)
What are 7 indications for an orchiectomy?
1) Overpopulation
2) Undesirable behavior
3) Prostatic disease
-benign hyperplasia, abscess, cysts, prostatitis
4) Perianal adenomas
-older intact males
5) Perineal hernias
-2.7 fold increased recurrence if do not castrate at repair surgery
6) Testicular neoplasia
-seminomas, sertoli cell tumor, interstitial Leydig cell tumor
7) Orchitis, especially following trauma
What age are dogs and cats typically castrated?
5-7 months
Castration increases the risk of developing what 8 things?
1) Longer legs
2) ACL rupture
-especially when fixed 6 mo or younger- need sex hormones to develop tendons and ligaments
3) Bladder cancer
4) Prostate cancer
5) Parvoviral infection
6) Hip dysplasia
-severity increases w/ cast
7) Hemangiosarcoma
8) Osteosarcoma
What are the 4 components of a preoperative work-up for a castration?
1) Cryptorchid?
2) General health of patient
3) Blood work
4) Prophylactic/ elective antibiotics
-only indicated for orchitis or prostatic disease
What area needs to be clipped during the surgical prep for a castration?
Clip entire ventral caudal abdomen
-clip scrotum but do not touch the clippers to the skin-induces severe inflammation
What must you do to the prepuce to surgically prep for a castration? What follows this?
Rinse prepuce w/ dilute chlorhexidine 3 times
-follow w/ sterile aseptic prep of surgical site
Where is the primary incision for a prescrotal canine castration?
INCISE OVER THE TESTICLE
-push testicle rostral over the ventral midline= prevents incision into penis/ urethra
What is a closed castration? Open?
Closed: Unincised parietal vaginal tunic
Open: incise parietal vaginal tunic
When do you perform a scrotal canine castration?
When performing a scrotal ablation
How do you make your primary incision for a scortal ablation?
Incise around the scrotum NOT through scrotal tissue in an elliptical manner
Why can't you incise through the scotum when performing a scrotal ablation?
If scrotum is incised and sutured it will develop severe inflammation
What are the next 5 steps of a scrotal ablation after performing the primary incision?
-Scrotum is dissected from the surrounding soft tissue
-vaginal tunic is opened over the testicle as w/ prescrotal approach
-ligate spermatic cord (routine)
-discard testes, scrotum & spermatic cord
-close incision where scrotum used to be
When is a perineal canine castration typically performed?
In conjunction with perineal hernia repair
How is a dog positioned in order to perform a perineal canine castration?
Dorsal recumbency
What are 2 things that must be done differently in order to perform a perineal canine castration/
1) Must displace testicle caudodorsal
2) Must use open technique to ligate spermatic cord
What are the 11 general steps of a closed prescrotal castration?
1) One testicle manipulated cranially
2) Incise over testicle through skin, fascia
3) Manually extract testicle through incision (pop like zit)
4) Strip all subcutaneous fat and fascia from spermatic cord w/ dry gauze
5) 3 clamp technique
6) Ligation (1 encircling & 1 transfixation)
7) Cut and evaluate for hemorrhage
8) replace into incision and check for bleeding
9) Repeat for contralateral testis
10) suture parietal tunic simple continuous
11) Suture skin w/ intradermal pattern
What do you need to remember when ligating the entire spermatic cord together with double ligatures during a closed castration?
-1 circumferential 1 transfixing
-transfixing suture should be aimed for passing the suture through the ductus deferens
When is a closed canine castration recommended?
For dogs < 20 kgs
What are the pros of a closed castration?
-Decreased chance of ascending infection
-Reduced surgery time and suture time
What are the cons of a closed canine castration?
Less secure ligation than open
What is different in the procedure for an open castration compared to a closed castration?
-ductus deferens and pampiniform plexus ligated together or separate
-parietal vaginal tunic and cremaster muscle ligated distal to ductus/pampiniform ligatures
When is an open castration recommended?
> 20 kg
What are the pros of an open castration?
More secure ligatures
What are the cons of an open castration?
Vaginal tunic communicates with the peritoneum:
-increased chance of ascending infection
-increased operating time
-increased amount of suture used
What is different when performing a modified open K9 castration?
-incise into parietal vaginal tunic and extend incision w/ metzenbaums
-breakdown ligament of tail of epididymis
-double ligate pampiniform plexus and replace into tunic
-ligate the tunic, ductus deferens, cremaster together proximal to the opening you made in the parietal vaginal tunic
What are the 3 components of post-operative care of a castration?
1) Prevent self trauma
2) Pain management
3) Remove adherent blood