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63 Cards in this Set
- Front
- Back
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Celiotomy
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Surgical incision into the abdominal cavity
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Laparotomy
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Flank approach to the abdominal cavity
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What are the abdominal approaches
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- Ventral midline
- Paramedian - Flank - Paracostal - Combined approaches Ventral midline + paracostal Ventral midline + median sternotomy |
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What is the most common abdominal approach in small animal
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ventral midline incision
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Ventral midline incision incises what tissue
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linea alba
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What are the advantages of a ventral midline incision into the abdomen
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-its the easiest approach
-its the quickest approach -its the quickest closure -minimal bleeding -exposes all abdominal organs |
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What are the advantages of the Paramedian incision
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- increased exposure to organs on one side of the abdominal cavity
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What are the disadvantages of the Paramedian approach
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- increased bleeding
- Increased closure time |
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What is the paramedian incision
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A ventral abdominal incision
parallel to midline can be transrectal- cut muscle or para-rectal- move muscle |
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Flank approach incision is made where
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the flank incision is made laterally between the last rib and the tuber coxae
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What are the advantages of the flank approach
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Excellent exposure of one kidney, one adrenal gland, one ovary
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What is a disadvantage of the flank approach
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limited access to entire abdomen
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Paracostal incision is made where
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Paracostal incision is made caudal and parallel to the last rib
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Disadvantages of Paracostal incision
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-Very limited exposure
- Rarely used alone |
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Combined Approach: Ventral midline + paracostal advantages
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- Increased exposure
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Combined Approach: Ventral midline + paracostal disadvantages
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- "increased" bleeding
- prolonged closure |
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Combined Approach: Ventral midline + median sternotomy disadvantages
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- Opens pleural cavity (need ventilate)
- Sternum must be closed - Thorasic drainage required |
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Combined Approach: Ventral midline + median sternotomy Advantages
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- Increased exposure of cranial abdomen (liver & diaphragm)
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In a ventral midline approach what landmark should be included in the surgical field
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umbilicus
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In exploratory celiotomy the abdomen is opened from where to where
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Xyphoid to Pubis
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In a ventral midline approach where should the skin incision be made
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1cm cranial and caudal to anticipated body wall incision
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where is the Linea alba most easily recognized
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Cranial to umbilicus
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what runs in the area parallel to the linea alba and cranial to the umbilicus
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the cranial superficial epigastric vessels
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When making a ventral midline incision what are the three things that can be done to the Falciform Ligament
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1. Falciform Ligament may be displaced
2. Falciform may be completely ligated cranial to vessels 3. Falciform ligament may be moved to one side |
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What extra things must be done in a ventral midline incision if the patient is a male
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1. preputial orifice must be draped out of the field
2. the skin incision must detour laterally to the prepuce 3. Preputialis mm. must be severed in half and have ends tagged for later reattachment 4. incision returns to midline after branches of ca. superficial epigastric vessels are ligated. |
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What is the holding layer of the ventral body wall
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the external rectus fascia
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why is the internal sheath not usually closed on ventral midline closure
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- it doesn't add any strength to closure
- it may increase adhesion formation |
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why is the rectus muscle layer not closed on ventral midline closure
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- doesn't add any strength to closure
- increases inflammation |
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Where may full thickness bites be placed
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on incisions directly on midline
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if muscle is exposed on ventral midline closure where may the sutures be placed
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external rectus sheath fascia only
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on ventral midline closure where and how can sutures be placed
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sutures are placed 5-10 mm apart & incorporate 5-10mm of tissue.
Simple interrupted (monofilament) or continuous (monofilament synthetic) are exceptable |
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what size suture material should be used in ventral midline closure
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Size 3/0- 0 in dogs; 3/0-4/0 in cats
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What material should you not use in a ventral midline simple continuous closure in LINEA ALBA
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- don't use chromic gut
- don't use stainless |
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Ventral midline approach closure in the subcutaneous tissue
what patterns? what material? |
simple continuous or simple interrupted
use 2/0 -4/0 synthetic absorbable |
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Ventral midline approach closure in the skin
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3/0 or 4/0 nylon
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In closure of the ventral midline approach in the dog the preputialis muscle must be accurately apposed.
suture pattern? |
any cross stitch or horizontal mattress.
don't use a vertical mattress as it leads to fraying |
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What are three words that imply the surgical removal of both testes
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Castration
Orchiectomy Orchidectomy |
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what are the indications for K9 castration
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- sterilization
- elimination of male characteristics - Tx other disease (prostatitis, prostatic cyst/abscess, prostatic hypertrophy) - Chryptorchidism - perineal hernia (w/o castration 2-3x more likely recur) - testicular torsion/abscess - urethral obstruction - scrotal/ testicular trauma - endocrine disorders - scrotal/ inguinal hernis - neoplasia (testicular, scrotal, perianal gland adenoma) |
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Surgical approaches to k9 castration
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- prescrotal
- scrotal ablation - perineal (caudal) NOT Scrotal (bladder infections) |
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Surgical Approaches to Cat castration
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- Scrotal
- Scrotal ablation done w/ perineal urethrostomy |
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When would you do a scrotal ablation approach to a k9 castration
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- scrotal/ testicular neoplasia or trauma
- scrotal urethrostomy - pendulous scrotum |
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When would you do an inguinal or abdominal approach to castration
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when patient is a chryptorchid
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When would you do a perineal or scrotal approach to a castration
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to avoid repositioning when a patient is in perineal position
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pluck hair from the scrotum in cat and use scissors in a dog.
True or False |
True
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Closed castration doesn't incise the parietal vaginal tunic. what are the advantages
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- less time
- less risk of abdominal infection |
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Open castration involves incision of the parietal vaginal tunic what are the concerns to this approach
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- requires more secure ligations
- communicates with the abdominal wall |
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Step one in castration
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bluntly disrupt scrotal ligament with a gauze sponge to release testicle
*try to break adhesions by stroking down |
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Step 2 in castration
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continue to strip fat & subcutaneous tissue until spermatic cord is completely isolated
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Closed castration simply apply 3 clamps.around the parietal tunic and cremastor muscle.
the first ligation around the proximal (near the body) clamp is ? |
circumfrential ligation. Tight tight to squeeze the tissue.
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Where is the second ligation placed? what type? and where does the surgeon cut
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second ligation is a transfixing placed around the middle clamp. Don't forget to flash.
Cut is between the middle and distal clamp |
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What is different in an open castration?
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in an open castration the parietal tunic is incised with scalpel or scissors. Then a window is made in the mesorchium which is the thin transparent tissue between the parietal tunic/cremastor muscle and the vas deferens/ testicular artery & vein.
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tags should be no longer than
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5mm
(cat gut can leave longer b/c absorb water) |
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What should be done post-op for a castration
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-Cold packs should be applied to site for 10-15 min. (careful not to cause freezer burn or further damage)
- E-collar - Restrict exercise for one week |
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what are the possible complications of castration
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- hemorrhage/ bleeder
- scrotal irritation, bruising (scrubbing, allergy, sensitivity) - scrotal hematoma - infection - complications more common in dogs, rare in cats. |
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Scrotal castration is good for what kind of problems
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Good for urethral problems because at scrotum urethra is wider
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Retained testicle increases the chance of a sertoli cell testicular tumor from 14% to what?
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23%
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what are the 4 degrees of contamination
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1. clean
2.clean contaminated 3. contaminated 4. dirty |
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what are the three types of tumors in the testicle ?
* All cause testicular enlargement, are malignant but have a low rate of metastasis, and are often cured by castration |
- Sertoli cell tumor
- Seminoma - Interstitial cell tumor |
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what testicular tumor may secrete estrogen
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sertoli cell
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Is testicular neoplasia common or rare in cats
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Rare
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Can multiple tumors occur in one testis
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Yes
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How can you diagnose testicular neoplasia
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- palpation
- ultrasonography/ radiology - presence of paraneoplastic syndrome (hyperestrogenism associated with sertoli cell tumor) |
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What are the signs of hyperestrogenism
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- Alopecia
- Gynecomastia - Testicular atrophy - penile atrophy - pendulous atrophy - prostatic atrophy - prostatic cysts - reduced male behavior, may attract males |
