Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
150 Cards in this Set
- Front
- Back
|
What will happen if the fragments in a fracture can slip over each other?
|
The edges will move and break the new vessels trying to form = shearing, which will slow healing.
|
|
|
What are the three primary forces acting on bones and that need to be taken into account in fracture repair?
Which one causes avulsion fractures? |
Compression
Bending Rotation/torsion, causes avulsion fractures |
|
|
Describe the "open but do not touch" technique.
|
You open the soft tissues just enough to see and manipulate the major bone fragments, but you leave the smaller pieces and the soft tissue alone.
|
|
|
What is the "orthopedic race" when dealing with implants?
|
You are trying to get the bones to heal before the implant fails.
You increase your chances by using strong fixation, getting it stable with a good callus, controlled loading (restricting use, no jumping out of cars), good asceptic technique |
|
|
If you are using external fixation with pins and bars, what are the three main configurations you can have? (Think sides)
|
Unilateral = one on one side
Bilateral = one on each side in same plane Biplanar = two but not in the same plane |
|
|
What are some advantages and disadvantages to external fixators?
|
Advantages:
All-purpose Simple equipment All metal is removed when healed Disadvantages: Pins may become infected, loosen and fixator fail Have to manage the pin-skin interface (cleaning, etc) Pins may be painful and penetrate muscle Look scary, damage the sofa |
|
|
What's neat and helpful about using a carbon connecting bar in an external fixator?
|
It's radiolucent, so you can see around it on radiographs. It's also lightweight.
|
|
|
What is a free-form external fixator?
|
One where the pins are connected by a moldable putty (acrylic, epoxy), which gives the surgeon freedom to work and it is good for small animals because it is lightweight.
|
|
|
What are some guidelines for inserting pins for external fixators?
|
1. You need at least 2 pins, 3 is ideal and may use 4
2. The pin should not be > 20-25% of the diameter of the bone or else you will weaken the bone. 3. Angling pins increases rigidity for smooth pins but is less important for threaded pins. 4. Try to get the pins as close to the fracture but 2-3 pin diameters from the fracture edge. |
|
|
*T/F An IM pin is not good at resisting compression forces.
|
True, because there is little grip between the ends and the bone and the pin. Interlocking nails and bone plates are better at resisting compression.
|
|
|
What is the difference between a bridging/buttress implant and a supportive one?
|
A bridging implant takes all of the weight because it spans a gap in the bone.
Supporting implants help but only take some of the weight. |
|
|
Why are external fixators weakest to bending forces?
|
Because the connecting bar has to be so far from the bone.
|
|
|
If you are fixing an avulsion fracture, what force do you especially have to account for?
|
Rotational/torsional, as it is what caused the fracture in the first place and it needs to be stabilized, such as with a tension wire.
|
|
|
While IM pins are bad at resisting _______ and ______ forces they are good at resisting ______ forces.
What is a general rule when trying to place an IM pin in a bone with respect to size? |
IM pins are bad at resisting compressional and rotational forces but are excellent at reducing bending forces.
The thicker the pin you can fit in there the better, within reason. It should be 70-80% of the diameter of the medullary cavity. |
|
|
What are the advantages internal fixators have over external fixators?
|
It allows for weight bearing and uninhibited joint motion, less scary looking, the patient is more comfortable and overall the healing is better.
|
|
|
What is something important to remember about cerclage wire and IM pins?
|
They are rarely used by themselves (sometimes you can get away with just cerclage in dental procedures) and they are often combined.
|
|
|
What should the orientation of the clamp be on an external fixator?
|
The bolt should be on the patient side of the connecting bar, because it shortens the effective length of the pin.
|
|
|
What should you have present if you want to use cerclage wire on a fracture to stabilize the pieces?
|
Cerclage wire works best when you can get all of the pieces inside of it, like the bands around a barrel, and you have to get the pieces in direct contact with the bone (no trapping soft tissue in there)
|
|
|
Why should you predrill holes for pins?
|
To reduce thermal and mechanical damage (microfractures) to the bone.
|
|
|
What is the most common complication of external fixators?
|
Pin loosening.
There is likely infection there, but more commonly it is from mechanical (stress) or biological failure (bone damage). |
|
|
Why do you use two pins to stabilize an avulsed piece of bone when you are applying a tension band?
|
Because if you just use one pin the bone fragment can spin around it (a pivot point). The second pin locks it down.
|
|
|
What is an important point when trying to tighten and lock down a cerclage wire?
|
You have to keep tension on the crank the whole time (remember from lab) to keep tension on the wire when it is bent.
|
|
|
Why do you never use one cerclage wire?
|
Because one just creates a ring the pieces can rotate around (like if you tried to tie a bunch of sticks together with just one piece of rope in the middle, versus one at each end...after a little while the sticks will fall out)
|
|
|
What are the three types of knots you can tie with cerclage wire?
|
Twist
Single loop Double loop (Dr. Roe's favorite, because it can take higher yield loads) |
|
|
Say you put in a first cerclage wire around a bone and you do a twist knot. You cut the ends so a couple of twists are left and you want to push the ends over so they are close to the bone. Do you?
|
No...never push down the ends because you will start to weaken the couple of twists. Alternatively, you can leave 6 or so twists and pull it over as you twist the wires.
|
|
|
Retrograde placement =
Normograde placement = |
Retrograde placement = Enter the medullary cavity through the fracture, drive the pin out one end, then reduce the fracture and drive it back through the bone.
Normograde placement = Drive the pin through one end of the bone, all the way through to the other end, passing the fracture along the way. |
|
|
How many screws do you need for a bone plate?
|
6 cortices of contact, which means 3 above and 3 below the fracture, at least.
|
|
|
What is the difference between a lag screw and a position screw?
|
Lag screw = placed perpendicular to the fracture to pull the two ends together, such as for a transverse fracture.
Position screw = (locking screw?) Placed perpendicular to bone, such as to hold a plate in place. |
|
|
How many bones make up the pelvis?
|
8:
Ilium, ischium, pubis, acetabulum, multiplied by two sides. |
|
|
A pelvic fracture usually involves three separate fractures, such as fractures in the _____, ____, and ______.
|
One ilium, one ischium, and one pubis
|
|
|
Why do you in particular have to repair acetabular fractures quickly and perfectly?
What does the step (or gap) of the fracture tell you in this situation? |
Because it is an articular fracture and will lead to a lot of severe chronic pain and degeneration. Unfortunately there is a lot of muscle and the sciatic nerve in the way and the structure is small and hard to reach.
A step or gap > 2mm will result in osteoarthritis of the joint. If < 2m will happen 2/3 of the time. |
|
|
How are pelvic fractures usually corrected surgically?
|
With bone plates and screws.
|
|
|
Which are more common, pelvic fractures or mandibular fractures?
|
Pelvic, dogs tend to try to run from cars when they get hit, instead of face-on.
Pelvic fractures account for about 1/6 of all fractures and about 1 out of 7 pelvic fractures will involve the hip joint (acetabulum) |
|
|
This breed is predisposed to stress fractures of their acetabulum.
|
Greyhounds, particularly those that race
|
|
|
What are the superficial landmarks of the pelvis that you should be able to palpate on a dog?
|
Tuber sacrale
Tuber ischiadicum Greater trochanter (but may not be helpful if the hip has luxated and it may throw you off) |
|
|
Most dogs with pelvic fractures are _______ (ambulatory/non-ambulatory).
|
Non-ambulatory, except some small dogs can get by.
|
|
|
What are some possible complications of a fractured pelvis? (Think about what goes near and through it)
|
Non-ambulatory, limb will shrink from disuse
Urinary or fecal incontinence Obstipation from a narrowed pelvic canal Pain, or neurologic damage Hypovolemic shock Respiratory and CV issues Reproductive issues in intact females Remember the animal may have been HBC, so could have lung contusions, pneumothorax, broken ribs, hernias, ruptured organs, etc. |
|
|
What are three important nerves that run in close proximity to the pelvis?
|
Sciatic: Withdrawal, deep pain distal to the stifle.
Pudendal and Sacral: Continence and anal tone. |
|
|
You are presented with a hobbling spayed yorkie that was bumped by a golf cart a few days ago and radiographs confirm she has a fractured pelvis but the acetabulum is intact and there is little displacement. Would you likely pursue more conservative or more aggressive treatment?
|
More conservative management.
Small lap dog, spayed, not in extreme pain, coxofemoral joint is fine. Compare this two a large flyball-playing lab hit by a truck, who is in a lot of pain, and has urinary incontinence as he is laying down because he cannot rise. |
|
|
What are some postoperative management practices you would want to do for a large dog with a plated pelvic fracture?
|
- Keep them hydrated
- Keep them clean if incontinent and try to get them to urinate and defecate outside with support if possible (slings, etc) - Control activity - Padding in their cage to reduce decubital ulcers and keep them comfortable - |
|
|
Why might you try to leave teeth in a broken jaw, even if they too are fractured and will die?
|
Because they can add some stability while it heals, and you may cause more fractures by trying to remove them.
|
|
|
What causes jaw-locking in cats?
What is a low-tech treatment? |
A subluxation of the TMJ is the common cause.
You can sometimes lever a pencil or straight object behind the caudal aspect of the jaw. |
|
|
What are the three degrees of a sprain?
|
Mild = First degree, only a few ligament fibers have been stretched, probably little pain and no instability.
Moderate = Second degree, more fibers stretched, some may be broken, painful, swollen, but usually still good stability because some is still intact. Severe = Third degree, complete rupture, bony lesions are likely, painful, swollen, palpable instability and the joint is dysfunctional. |
|
|
Luxation =
Subluxation = |
Luxation = Complete displacement of any part (here it is bone)
Subluxation = Partial displacement of one bone in relation to another bone |
|
|
Luxations are described by the position/displacement of the ______ proximal/distal bone.
|
Luxations are described by the displacement of the distal bone.
|
|
|
Most luxations are traumatic/atraumatic.
|
Traumatic...think about how much force it would take to dislocate your hip.
|
|
|
Remember you should treat luxations almost like emergencies and try to reduce the dislocation as soon as possible because it will be ______ and _______.
|
Painful and nonfunctional
|
|
|
Whether you try to repair a luxated joint in a closed or open procedure, your first goal is to ______.
|
reduce the luxation
|
|
|
What are the principles of arthrodesis?
|
1. Remove all of the articular cartilage
2. Get rigid stability in a functional position (hardware: pins, plates, tension wire) 3. Bone grafts may be needed |
|
|
What does a dog with a ruptured gastrocnemius tendon look like?
|
They have hyperflexion of the hock (the dog's heel rests on the ground like a human foot).
|
|
|
What joint is the most common direction for the shoulder to luxate?
|
Medially, usually from trauma, or congenital in Toy Poodles
|
|
|
When treating a luxation, try for a _____ closed/open reduction if possible.
|
Closed, if you can. The hip and the elbow are good candidates if there are no bone chips.
|
|
|
The most common growth deformities in dogs are those of the _____ and _____.
|
Radius and ulna
|
|
|
What happens in chondrodystrophoid dogs that makes their legs short?
|
They have early closure of some of their physes.
|
|
|
What can a specialist do to correct both angular and length deformities in the limbs of growing dogs?
|
External ring fixators with hinges (Ilizarov method). This allows you to adjust the angle and the length over time as the animal grows.
|
|
|
What are some ways to manage a dog with a shearing injury (dragged by a car, etc)
|
CLEAN! (You may never find all of the gravel)
Wet-to-dry bandages Sugar, honey can be used to pack the wound |
|
|
What are some characteristics of young animals in regards to their bones and healing?
|
Young animals heal quickly
They can lose muscle/bone within a couple of weeks They are unforgiving and like to fibrose things, contract things and, lose tissue mass. The bones are small and may be too soft for pins They get overexcited and can break themselves again Repair of physeal or articular fractures needs to be perfect Healing animals will need 24-7 supervision and light activity, otherwise cage rest |
|
|
** With angular limb deformities,
Asymmetrical, think ________ Symmetrical, think ________ |
Asymmetrical = trauma
Symmetrical = genetic |
|
|
*Premature physeal closure is most common in the ________, resulting in a carpus _______. It can be repaired with _________.
|
Distal uLna resulting in carpus vaLgus
A segmental ulnar ostectomy |
|
|
What are some concerns about bandaging fractured limbs in growing dogs?
|
- Don't restrict movement for long
- Don't turn the bandage into a pendulum (big bandage for the leg, heavy on the end) - Avoid immobilization when possible |
|
|
How do we assess deformities in limbs? (Acronym)
|
A Angulation
Le Length R Rotation T Translation |
|
|
What is a greenstick fracture?
|
One cortex is intact, like a young sapling. It happens more in younger animals.
|
|
|
Valgus =
Varus = |
Valgus = knock-kneed, feet point outward (distal outward).
"valGus, knees (wrists, etc) stuck together with Gum" Varus = bowlegged, feet inward (distal inward) "vaRus, knees (wrists, etc) Running away from each other" |
|
|
What is the window of time for an open fracture before you consider it contaminated?
|
The "golden period", of about 6 hours
|
|
|
What are the three classifications of open fractures?
|
1 = Small piercing wound from the inside out, if recent consider it closed and do primary wound closure
2 = Outside-in, with minor trauma 3 = Outside-in with severe trauma |
|
|
About ____% of femoral fractures just treated with an IM pin fail.
|
70%, because no rotational stability
|
|
|
What are some treatments in common with both acute and chronic osteomyelitis?
|
Antibiotic therapy
Debride and lavage Maintain or provide rigid fixation |
|
|
Are fracture-associated sarcomas common or rare?
What are some predisposing factors to developing the neoplasia? |
Rare, 5-10/10,000 fractures, but it jumps to 10-30/10,000 fractures when internal fixation is used, on average about 6 years after the incident.
Comminuted fractures, delayed unions or nonunions, osteomyelitis, and metal-ion induced carcinogenesis (having the plate in there) |
|
|
99% of mechanical complications of fracture repair are from ________.
|
clinician errors
|
|
|
Delayed union means? Cause?
|
The fracture did not heal in the usual amount of time, from inadequate immobilization.
|
|
|
Nonunion means? Cause?
|
A fracture without osteogenic activity. It can come from inadequate immobilization, infection, impaired blood supply, or a loss of bone.
|
|
|
Malunion means? Cause?
|
A fracture healed in an abnormal position. It can come from failed attempts to fix a fracture (or if never treated), and inadequate external coaptation.
|
|
|
List 5 questions you could ask an owner that brings in their lame dog.
|
1. Which leg do you think it is?
2. How long has it been going on? 3. Do you have an idea of what could have caused it? 4. Has it gotten worse or better? 5. Is it there all of the time, or does it come and go? 6. Have you tried to treat it? 7. Does it get better or worse with activity or after rest? |
|
|
CREPI =
|
Crepitus
Range of motion Effusion (?) Pain Instability |
|
|
Common things occur commonly: Your first thought when you see a lame dog is the ______ and ______. Then for the forelimb, start thinking _____, _____, ______.
|
First think non-musculoskeletal problems: footpad, toes/nails.
Then for the forelimb think: Osteoarthritis, OCD, elbow dysplasia. |
|
|
Give some common diagnoses of the following kinds of lameness:
Weight bearing Non-weight bearing |
Weight bearing:Osteoarthritis, OCD, Elbow dysplasia
Non-weight bearing: Septic joint, nerve roots, fractures |
|
|
T/F Lame limbs tend to be easier to lift than sound limbs.
|
True...the animal is usually holding it up to some degree.
|
|
|
Choose which diagnosis you think is most likely out of: Shoulder OCD, Elbow dysplasia, cervical disc disease, OSA
3 mo Lab puppy with forelimb lameness. Older beagle with neck pain and lame in front. 6 mo Golden puppy with intermittent lameness in front leg, painful on manipulation and stiff when he gets up. |
Lab: Elbow dysplasia (OCD also possible)
Beagle: Cervical disc disease Golden: Shoulder OCD |
|
|
T/F An old case of OCD in a large breed dog can progress (or be a causative agent) of the dog developing osteoarthritis in that joint later in life.
|
True, or at least thought to be true
|
|
|
Dogs with shoulder OCD tend to be painful when you do what on your physical exam?
|
Extend the shoulder. The lameness may come and go.
|
|
|
Give a brief description of the common surgical correction of OCD of the shoulder.
|
Enter the joint (endoscopy a good option, or an open technique), and remove the joint mice and/or the broken flap of cartilage on the humeral head, debriding the edges. Check the cartilage over the entire surface to assess viability.
|
|
|
What are three things an owner can do to prevent their next large breed puppy from developing OCD?
|
1. Good diet: Not overeating, but getting enough of balanced minerals, and a large breed diet.
2. Exercise: A good amount to manage weight, but not too much and not too strenuous. 3. Get the puppy from parents that do not have OCD in their bloodlines. |
|
|
Suspect these two pathologies when you have a dog that is painful when you manipulate or extend the shoulder.
|
1. Shoulder OCD
2. Biceps and supraspinatus tendonopathies (test by flexing the shoulder and extending the elbow with pressure applied over the medial aspect of the greater tubercle) |
|
|
* What should you remember when radiographing a puppy's forelimb to look for OCD?
|
Radiograph both sides for comparison, and because dogs tend to have it on both sides, but present more on the one worse off.
|
|
|
You take lateral radiographs of the forelimbs of a large breed puppy you suspect has OCD, but you don't see any sclerosis or indications it is the case. What might you see on these radiographs instead if it is a biceps brachii tendonopathy instead?
|
Changes in the bicipital groove, mineralization of the articular surfaces in the joint where the tendon connects.
|
|
|
What kind of dog is most likely to have congenitally lax, unstable shoulders?
|
Toy breeds (poodles, etc)
|
|
|
A dog with shoulder instability from a humeral subluxation should have an increased angle of ______ when you lay the dog on their side and pull their distal forelimb upwards.
|
Abduction
|
|
|
What are some conservative and surgical ways to treat a dog with biceps brachii tenosynovitis.
Medical (conservative) Surgical |
Medical: Control inflammation with meds, intra-lesional Depo steroids, activity restriction for 8 weeks then gradually increase exercise.
Surgical: You can transect the muscle at the tendon and let it dangle, or attach it more distally to the humerus. |
|
|
What is "forage" when it is described in treating OCD?
|
It refers to making lots of small holes in the bone where the cartilage was to encourage healing.
|
|
|
T/F Osteosarcoma only affects old dogs.
The saying for osteosarcoma predilection sites... |
False, but old dogs are typically the ones affected.
"Away from the elbow and towards the knee" = shoulder, carpus, stifle |
|
|
What treatment for OSA carries the best prognosis?
T/F OSA's don't hurt, even when you apply firm pressure. |
Amputation of limb if possible, with chemotherapy.
False, they hurt quite a bit when you do that, and the dog may be lame in that leg when you see them. |
|
|
What ligament in the shoulder region is most likely to have problems from soft tissue injury and result in a subluxated shoulder?
What surgical treatment may be done to correct the problem? |
The medial glenohumeral ligament...the leg will be able to be abducted more.
Scarification of the soft tissues of the medial aspect of the shoulder so they constrict a little in healing and keep the leg tighter against the body. Arthrodesis in severe cases. |
|
|
What is an Ortolani sign?
|
The palpable sensation of the femoral head sliding in and out of the acetabulum, and you may feel it passing over a ridge of cartilage as it moves in and out (according to a human ortho book)
|
|
|
T/F While you expect OSA to have a gradual onset of lameness and other signs, it can also present acutely.
|
True. It may have been going on a long while, weakening the bones before something acute happened. You will rarely feel or see the mass unless it is advanced.
|
|
|
D
Thought to happen more in puppies after vaccination, radiographs may show cloudy medullary cavities with loss of definition, and though it is often self-limiting, puppies are sometimes euthanized. |
Panosteitis. Apply pressure over the bones and see if it is painful.
|
|
|
D
An older dog has severe muscle atrophy in one forelimb, and is non-weightbearing lame but it does not appear to be an orthopedic problem on radiographs. The owners say the dog cries out from time to time in severe pain. |
Nerve root issues, it may be a nerve root tumor in the brachial plexus, or cervical, arising from IVDD.
|
|
|
* What is the most common cause of elbow dysplasia?
|
Fractured/fragmented coronoid process
|
|
|
Give the basic traits common to dogs with brachycephalic syndrome.
|
1. Stenotic Nares
2. Elongated soft palate 3. Everted laryngeal saccules 4. Hypoplastic trachea (Redundent pharyngeal mucosa and laryngeal collapse are also common) |
|
|
When removing the redundant tissue of an elongated soft palate in a brachycephalic dog, where should the end of the soft palate be when you are finished?
What happens if you overshoot it and take too much tissue? |
The edge of the soft palate should lay just caudal to the tip of the epiglottis.
The animal may have nasopharyngitis/rhinitis because material will be able to get up in there. |
|
|
If you decide not to do a temporary tracheostomy when correcting an elongated soft palate, what should you be ready for after surgery/have on hand?
|
The area may swell after surgery, closing the airway. You will either have to do an emergency tracheostomy or try to get them reanesthetized with an endotracheal tube and on oxygen quickly. Steroids can help reduce the inflammation.
|
|
|
What are some things you should have if doing laser surgery in the oral cavity?
|
Wet gauze
Water bucket Eye protection Fire extinguisher A laser-specific or (real) aluminum foil-wrapped endotracheal tube (or else you will have a blowtorch) |
|
|
Why are brachycephalic (and other) dogs predisposed to laryngeal collapse?
|
Long-term strenuous breathing (negative pressure) has stressed the tissues, and they have been running into each other, causing inflammation.
|
|
|
* This muscle is the only one that opens your airway
|
Cricoarytenoideus dorsalis muscle
|
|
|
* What is the most common cause of laryngeal paralysis?
|
Idiopathic is the most common
(Also a congenital and seasonal form, or the result of trauma, neoplasia, and possibly hypothyroidism) |
|
|
Dogs with laryngeal paralysis also usually have trouble with what?
|
Swallowing. They may aspirate liquids.
Owners may also notice a voice change. |
|
|
What is the typical surgical treatment for laryngeal paralysis?
What is the #1 complication for this procedure? |
A "tie-back" procedure, very similar to what is done in horses.
It is also called Unilateral Arytenoid Stabilization, and has an 80-100% success rate. Aspiration is the #1 complication. |
|
|
** A Bulldog treated for brachycephalic syndrome 2 years ago is now dyspnec. Possible cause?
|
Recurrence
|
|
|
What are some guidelines for post-op and home care for animals that have just had upper airway surgery, such as a tie-back procedure?
|
- Watch out for dyspnea, and give steroids and oxygen post-op as they need it
- Not allowed to wear a collar for at least a month - House rest and a cool environment |
|
|
* Any dog with a permanent tracheostomy should never be allowed to do what?
|
Go swimming
|
|
|
What group of dogs are more likely to develop tracheal collapse and why?
|
Toy breeds, esp. Yorkies and Poodles
Their trachea is abnormal from birth, with defective tracheal rings that have lower than normal cell numbers and fewer GAGs, which helps the cartilage hold water and stay rigid. As the trachea collapses on itself it causes inflammation, and add in asthma, heart disease, etc... |
|
|
Describe medical management options for a Yorkie with tracheal collapse.
|
Antibiotics if an infection
Cough suppressants (Hycodan, Butorphanol) Bronchodilators (Aminopylline) Corticosteroids (Pred) |
|
|
An older Poodle is in your clinic for an intermittent cough. As you palpate the dog's throat a goosehonking sort of cough starts. What is a likely diagnosis?
|
Tracheal collapse. The honking is from a narrowing airway on exhalation.
|
|
|
Because of the anatomy, surgical correction for tracheal collapse is limited to locations cranial to the _________.
|
2nd rib
|
|
|
What is the old school technique to open a collapsed trachea in a dog?
What is done commonly these days? |
An external spiral ring prosthesis (fashioned syringe containers, etc...now you can buy them.) Watch out for the recurrent laryngeal nerve as you do it.
Now we use stents. It is important to get the sizing right to reduce the chance of complications. |
|
|
What is the location for a temporary tracheostomy?
|
Ventral midline along the neck down to the cartilage, a horizontal slice between the rings 2-3 rings below the larynx.
The horizontal opening is preferred because it heals faster and you can run stay sutures around the rings to pull on. |
|
|
**Why do cats tend to not do well with temporary tracheostomies?
|
They produce a lot of mucus and they have tiny tracheas that plug easily.
|
|
|
**A dog with a permanent tracheostomy is being sent home. What do you tell the owner to do as far as initial care?
|
Daily: Clean the site, nebulize the dog/shower with them/humidifier, flush with sterile saline several times a day initially, coupage.
Owners should not smoke near the dog. Dog cannot go swimming. |
|
|
**Feline tracheal tears are a complication of this action at the vet.
|
Overinflating the cuff and turning the animal, such as during a dental. The cat puffs up like a marshmallow after surgery.
|
|
|
Salivary mucoceles are most often caused by these salivary glands...
Treatment is usually to... What should you always do before surgery? |
The mandibular and sublingual glands, often surgically removed from inside their capsules.
FNA, since it could also be an abscess, tumor, etc. |
|
|
Of the oral tumors that occur in dogs, this is a bad one to get because 60-70% of the time it will have metastasized by the time of diagnosis.
|
Melanoma, and it is the most common oral tumor in dogs.
|
|
|
Describe what a dog with a malignant melanoma in its mouth may present with.
|
Bad breath (necrotic center of the melanoma), bleeding (biting the tumor)
|
|
|
What is the most common oral tumor in cats?
|
SCC, it is more locally invasive and you may "cure" it with surgical excision and radiation.
|
|
|
Guidelines for removing an epulis.
|
- Stay at least one healthy tooth away from the radiographic changes, 1 cm margins.
- Don't go for small margins or hack it off, or else it will come back angrier. |
|
|
What are three options (general) for treating end-stage joints?
|
1. Ostectomy
2. Joint replacement 3. Arthrodesis (good at carpal and intertarsal joints) |
|
|
What are three main complications of oral surgery to be concerned with, say if you removed a large SCC from a cat.
|
#1 Dehiscence
#2 Recurrence #3 Deformity |
|
|
What percent of fractures are physeal fractures (in growing animals)?
|
30%
|
|
|
Doctor word for soft palate resection.
|
Staphylectomy
|
|
|
A cyanotic lab is carried into your practice. He was out enjoying the spring air and playing fetch and then started having trouble breathing.
One differential. |
Laryngeal paralysis...tends to affect big dogs like labs in the spring when the weather warms up.
|
|
|
What is the most common laryngeal mass?
|
SCC, always look for it
|
|
|
* How effective is a unilateral tie-back procedure for laryngeal paralysis and which side do you typically do first and why?
|
80-100% success rate
Start on the Left, because easier to access, and because the left is usually the side most/first affected. |
|
|
As far as radiographing tracheal collapse:
|
For intrathoracic collapse, expiratory rads
For extrathoracic collapse, inspiratory rads |
|
|
* What will happen if you place an intraluminal tracheal stent that is:
1. Too big 2. Too small |
To big will cause pressure necrosis
To small and it will migrate |
|
|
What is the prognosis of using an intraluminal stent for tracheal collapse?
|
Pretty good. The animal should be able to breathe if no complications, but will probably always have a cough like they did because now they have a foreign body in their trachea.
|
|
|
Before placing a temporary tracheostomy tube, what should you try to do?
|
See if the procedure is actually needed and try to intubate the animal under sedation.
|
|
|
In a permanent tracheostomy where you are resecting 3-4 tracheal rings, why do you take all of the time and care to preserve the mucosal lining inside?
|
So that you can suture it to the skin, because gaps will lead to the formation of granulation tissue, which will work to try and close over your hole = stenosis.
|
|
|
You have removed the main body of a salivary gland (sublingual or mandibular) that was causing a sialocele. How far do you need to follow the remaining "tail" so you can remove it?
|
Follow the structures until the gland runs under the digastricus muscle
|
|
|
T/F Epulides are common in dogs but rare in cats.
#1 malignant oral tumor in dogs? Cats? |
True
Dogs: Melanoma Cats: SCC |
|
|
What do dogs with elbow dysplasia tend to look like?
|
They swing their forelimb out (circumduct) it so they don't have to bend their elbow, shift weight to the back, abduct their elbows, shorter stance phase.
|
|
|
What does the asynchronous growth concept have to do with developing elbow dysplasia.
|
The idea that the radius tends to grow slower than the ulna, which can shift over time and put pressure on the coronoid process and break it = FCP -> Elbow dysplasia
|
|
|
What age and breeds of dog tend to develop an ununited anconeal process?
|
Before 5 months old
German shepherds, Great Danes, Mastiffs, Bassets Usually bilateral, and more of the idea if the radius grows fast or the ulna grows slow (reverse of FCP) |
|
|
You are presented with a German Shepherd puppy with carpal hyperextension.
What do you do/not do? |
Do NOT bandage or splint...will make it worse
Encourage exercise to build up strength in those legs |
|
|
* What is the most sensitive test to see if hips are abnormal?
|
Extension test
|
|
|
How old do puppies need to be to have PennHIP radiographs taken?
|
16 weeks
|
|
|
* As far as a distraction index (DI) from PennHIP, what are generally good and bad values to have?
|
Under 0.3 DI is pretty safe in general
Over 0.7 is almost guaranteed to have hip problems |
|
|
If the PennHIP information comes back for a dog and it gives them a very high likelihood of developing hip problems, why would it be a good idea to suggest spay/neuter with a Juvenile Pubic Symphysiodesis (JPS)?
|
Puppies that get PennHIP are sometimes intended to be breeding stock, and it will take them out of the gene pool.
|
|
|
* What is the age cutoff for doing a Juvenile Pubic Symphysiodesis (JPS)?
|
20 weeks of age, after that too old.
|
|
|
TPO =
What does it do? When is the cutoff age? |
Triple Pelvic Osteotomy
Cutting pelvis at pubis, ischium, ilium, and rotating the hip joint 20° This serves to increase the coverage of the femoral head by the acetabulum. 9 months is the cutoff age. |
|
|
What are two options for treating hip dysplasia in dogs over 9 months old?
|
Femoral head ostectomy
Total hip replacement |
|
|
What are two differentials in a small dog with stifle problems?
|
Medial patellar luxation
Avascular necrosis of the femoral head (Legg-Perthes disease) |
|
|
** What are the landmarks to perform a cranial drawer test?
|
Finger on patella, thumb behind fabella; finger on tibial crest, thumb behind head of fibula
|
