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287 Cards in this Set
- Front
- Back
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True or False..minor injuries of the cheeks, lips and tongue heal spontaneously
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True
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The use of what type of sutures to repair injuries of the lips, cheek and tongue, will reduce disfigurement and improve function?
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Tension sutures
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Where should cut on the tongue be repaired?
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On the dorsal surface
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What is a sign of a cleft palate?
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Milk runs out of the nostrils of the foal
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Does a cleft palate usually involve the hard palate, soft palate or both?
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Soft palate
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Most foals with a cleft palate develop what other condition?
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-aspiration pneumonia
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Why does a cleft palate become more difficult to repair as the foal grows older?
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Distance between incisors and palate increases
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What sx technique give the best exposure for repair of a cleft palate?
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Mandibular symphyisotomy
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The esophagus is covered by which muscles?
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-cricopharengeus
-thyrophatyngeus |
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What is the position of the esophagus in relationship to the trachea?
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Dorsal to the trachea until the 4th cervical vertebrae, crosses obliquely to the left, reaches the median plane at the 6th c-vert to enter the thoracic inlet
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What are the 4 layers of the esophagus?
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-fibrous
-muscular (striated to base of heart and then smooth) -sub mucosa -mucosa -no serosa |
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What type of vascular supply does the esophagus have?
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Segmental with minimal collateral circulation
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What complications can occur with esphogeal surgery?
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-stricture formation
-incision breakdown -laryngeal hemiplegia |
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What diagnostics are used in the examination of the esophagus?
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-palpation
-stomach tube -endoscope -rads (plain, barium) |
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What are the most common areas for esophageal obstruction?
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-anterior esophagus
-just anterior to the thoracic inlet |
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What are the clinical signs of obstruction?
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-distress, anxiety, sweating
-repeated extension of the head and neck -repeated attempts to swallow and or retching -continuing attempts to eat -food and water at nostrils |
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What are the medical management techniques of esophageal obstruction?
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-many times the bolus will pass in several hours
-in the past horse was tied away form food and water -prolonged presence of a bolus can cause tissue damage and secondary stricture |
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when does a water lavage work well on an obstruction?
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When the bolus is of lush grass
(stomach tube passed to the obstruction) |
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What other methods can be used to remove an obstruction?
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-remove though mouth with hand
-use an endoscope -sx exposure -esophagotomy |
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How is an incision in the esophagus closed?
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-mucosa and submucosa are closed as one
-both interrupted and continuous patterns have been used -knots are tied so they are in the lumen |
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What are the causes of esophageal stricture?
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-external or internal trauma
-previous obstructions or perforation -caustic anthelminitcs |
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How are esophageal strictures classified?
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based on the layers of the wall involved
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What layers does a mural stricture involve?
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adventitia and muscular layers
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What layers does a ring stricture involve?
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mucosa and submucosa
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What layers does an annular stricture involve?
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all layera
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Which sx approach is used if an esophageal stricture is mural?
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Esophagomyotomy
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When closing a Esophagomyotomy which layer is NOT sutured?
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muscularis
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When is a partial resection indicted?
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A stricture the involves the mucosa and submucosa (ring)
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What additional procedure is indicated in the case of a partial resection?
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A cervical esophagostomy distal to the sx site
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What sx approach is indicated in the case of a stricture that involves the entire esophagus (annular)
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Complete resection
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What is the longest length of esophagus that has ever been removed and documented?
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3cm
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What is the cause of an esophageal fistula?
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-secondary to esophageal perforation of sx
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What is the medical management approach to an esophageal fistula?
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waiting several months, many heal in time, all will decrease in size
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What is the sx approach for an esophageal diveticulum?
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-approach as in a partial resection
-excision of the involved mucosa and submucosa |
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When would you perform a cervical esophagostomy?
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-to feed an animal with an esophageal injury
-an animal that cannot swallow |
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What steps are involved in a cervical esophagostomy?
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-pass a stomach tube
-dissect to mucosa of esophagus -place a small stomach tube -attach tube to skin -partial closure to allow drainage |
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What % of horses with acute abdomen will respond to medical tx?
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90-95%
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What is the preferred sx approach to the abdomen for sx exploration? An why?
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Ventral midline
-allows better visualization |
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What suture pattern is used to close a ventral midline incision?
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Surgeon's preference....continuous or interrupted
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Why do some prefer a paramedian approach to the abdomen?
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-less chance of wound breakdown
-but less exposure and more hemorrhage |
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What is recommended for the closure of the paramedian approach?
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Close the superficial and deep sheath of the rectus muslce
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A flank approach to the abdomen can be performed standing or in lateral recumbency. When is a flank approach used?
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To make a dx, but many times correction of a problem requires a ventral midline approach
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What is meant by a modified grid approach?
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Muscles are divided along the direction of their fibers...not incised
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Why is a suction drain recommended when closing a paramedian incision?
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To reduce the formation of a seroma
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Surgically, how do you locate and evaluate the large colon?
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-palpate the mesenteric attachment of the right dorsal colon and cecum, determine if there is a volvulus
-follow 1 of the ventral bands anterior to the sternal flexure and then caudal to the pelvic flexure |
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Where do you start when you examine the small intestines?
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At the cecum
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How do you locate the cecum?
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-identicy the right ventral colon and follow the cecocolic ligment to the cecum
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Can you start cranially to examine the small intestine?
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Yes but is difficult to do
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What step should you take if you suspect gastric dilation prior to sx?
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pass a stomach tube
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How do you confirm the dx of a gastric rupture surgically?
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ingesta is free in the peritoneal cavity
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What is the only option in the case of gastric rupture and contamination?
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euthanasia
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Gastric ulceration and resulting pyloric stenosis occurs in which age of horse?
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foals
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What conditions can predispose a foal to Gastric ulceration and resulting pyloric stenosis?
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-stress
-NSAIDS |
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What are the signs of Gastric ulceration and resulting pyloric stenosis in a foal?
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-off feed
-abd pain -grinding teethm salivate |
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Where do the ulcers occur?
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in the pylorus or anterior duodenum
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In the case of Gastric ulceration and resulting pyloric stenosis in a foal, what sx correction is taken?
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A gastrojejunostomy
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True or false, removal of a neoplastic area of the equine stomach is normally not performed.
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True
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When is an obstruction of the small intestines considered to be a simple obstruction?
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When it does not compromise blood supply
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What happens in the small intestines as a result of an obstruction?
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Intestinal fluid (100 L/day) cannot move past the obstruction, cause the intestine anterior to the obstruction to dilate excessively
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What are the clinical signs caused by dilation?
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-pain
-decreased perfusion -lactic acid acidosis -reflux of fluid into the stomach -gastric rupture |
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What can cause an impaction of the small intestines in foals and weanlings?
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Ascarids
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An adhesion may occur as a complication to sx, what is the tx for an adhesion?
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-identify and break down the adhesion
-suture the serosa over the damage area -it not possible to cover the defect in the serosa, use heparin, carboxymethylcellusoe -divert the intestinal content around the adhesion |
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What is a pedunculated lipoma?
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Older horses may develop a lipoma on a stalk
-wraps around a segment of bowel causing obstruction |
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What are the suggested causes of impaction of the distal ileum?
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-muscular hypertrophy
-lack of proper motility -character of feedstuff (coastal hay) |
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Abdominal abscess is caused by what?
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An adhesion
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What is the best method of management of an abdominal abscess?
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Divert the flow of ingesta around the adhesion and placing the horse on long term abx
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In the case of anterior enteritis, why might you sx explore the abd?
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For signs of a mechanical obstruction
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In anterior enteritis what procedure should you do with the excessive amount of fluid that is found?
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Force it into the cecum
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Another technique is the remove excessive gas from the cecum. What is the rationale to these techniques?
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Allow the diseased small intestine time to heal
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What is a strangulating obstruction of the small intestines?
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An obstruction in which there is a mechanical blockage and a compromise to blood flow
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True or False....Intussusception of the bowel in more common in older horses.
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False, more common in foals
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What is the definition of an intestinal volvulus?
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Twisting of a segment of bowel on its mesentary so as to obstruct blood flow and passage of intestinal contents
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In order to potentially correct the volvulus and leave the bowel in place sx must take place how quickly after occurrence?
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6 hours
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Internal hernias of the epiploic foramen occur more often in older horses. Sx how do you located the foramen?
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-horse in dorsal recumbency
-feel along the right medial surface of the liver at 9 0'clock position, finger will enter the foramen |
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Commonly the jejunum passes in which direction into the omental bursa?
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From left to right
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Prior to pulling the bowel back from the foramen is it sometimes necessary to do what?
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Perform an enterotomy and drain the bowel
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Why are mesenteric defects a dx problem?
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The hole can be anywhere and difficult to locate
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What is a Meckel's Diverticulum?
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A persistance of the omphalomesenteric duct
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Where is Meckel's Diverticulum located?
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A finger like diverticulum 2cm in diameter and 6cm long connecting the antimesenteric surface of the ileum to the body wall in the area of the umbilicus
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Meckel's diverticulum can become impacted and rupture or can serve as an axis for what condition?
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Volvulus
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What structure forms a mesodiverticular band?
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Persistance of the distal vitelline artery and associated mesentary
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Is there greater potential for a saml or a large umbilical hernia to cause an acute abdomen?
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A small hernia
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A hernia clamp is applied to an animal of what age?
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1 1/2 years old
-sx closure is done at weaning...6 months) |
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An umbilical hernia in a foal could correct itself in time if it is what size?
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If the ring is less than 3cm diameter
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What other techniques have been suggested for umbilical hernias?
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-time
-application of external pressure -injection of mild irritant -hernia clamp |
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In the sx closure of an umbilical hernia, what type of incision is made?
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Elliptical skin incision
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Why aren't ventral hernias associated with an acute abdomen?
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The ring is too large to cause strangulation of the bowel
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A large ventral hernia may require the use of what sx supply?
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Polypropylene mesh
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Where is the mesh placed?
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-close the peritoneum
-place mesh between peritoneum and the abdominal wall.,,suture in place |
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What other current method has be used to repair hernias?
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Laporoscope
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In the case of a diaphragmatic hernia, the diaphragm often shows evidence of chronic damage...such as from what?
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parasites
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If a repair of a diaphragmatic hernia is attempted what type of breathing assistance is needed?
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Positive pressure
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When would you consider sx for a simple obstruction of the colon?
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Abdominal pain for more than 24 hours
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Where do most impactions of the colon occur?
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At the pelvic flexure of the right dorsal colon
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Most impactions are handled medically, surgically how would an impaction be treated?
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-ventral midline lap
-deliver pelvic flexure from abdomen -enterotomy of the pelvic flexure -use a hose to flush -close |
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Impaction sof the cecum are usually a result of a motility problem. If handled surgically, a better prognosis is from performing what additional procedure (along with the lap and enterotomy)
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-cecocolostomy
-jejunocolostomy to bypass the cecum |
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What is the usual location to find an enterolith?
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Right dorsal colon
(transverse or small also) |
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Which portion of the colon can get trapped over the nephrosplenic ligament?
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the left
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True or False..horses with nephropslenic ligament entrapment don't show much pain.
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True
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How can a nephropslenic ligament entrapment be managed medically?
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-short acting general anesthesia
-pick horse up by its legs allow the colon to move dorsally -put horse on right side rol to dorsal recumbency and then to left lat and sternal -check with U/S |
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How is a nephropslenic ligament entrapment corrected surgically?
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-ventral midline lap
-force colon dorsal and lat to free it from the ligament |
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Torsion and volvulus of the large colon typically occur at what sites?
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diaphragmatic and sternal flexures
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In repairing a volvulus of the colon or cecum surgically, it is best to do what during the repair?
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enterotomy and empty the contents
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How much of the large intestine can be removed from a horse and they still do well?
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90%
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Rectal prolapse occur more often in which species?
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Pigs
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What are the potential causes of rectal prolapse?
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-estrogens in feed relax anal sphincter
-high protein diets -abx feeding irritates anal region -limited exercise -multiple bull housing |
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What are the 2 types of rectal prolapse that can occur?
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-prolapse of the mucosa only
-evagination of the rectum |
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What route of anesthesia is used in pigs during sx repair of a rectal prolapse?
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Lumbosacral epidural- the head down position
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EWhat sx technique is used in the case of a mucosa prolapse?
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replace and put in a purse string suture
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When is amputation of the rectum, performed?
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When there is evagination of the rectum
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How are sutures placed for amputation of the rectum?
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mattress sutures place in a transverse plane
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What sx device can be used that is sturured tightly into place causing a portion of the rectum to slough off?
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A rectal ring
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Rectal rupture is a problem seen in which species?
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Horses
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What are the causes of rectal rupture?
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-misdirection of the penis
-iatrogenic during a rectal exam |
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During a rectal exam what should you so as the horse strains?
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allow the hand to be pushed caudally
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What is considered a grade 1 rectal tear?
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through the mucosa and submucosa
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What is considered a grade 2 rectal tear?
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through the muscularis...muscosa intact
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What is considered a grade 3 rectal tear?
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through the mucosa and muscularis
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What is considered a grade 4 rectal tear?
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Through mucosa, muscularis and serosa
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What is the tx for a grade 1 - 2 tear?
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-mineral oil
-antibiotics -limited hay -careful observation |
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How can a grade 3 rectal tear be managed?
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-suture
-colostomy -inserting a ring with a rectal sleeve to protect the area of the rectum |
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In a left flank approach n the bovine, what benefit does the rumen give the surgeon?
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Is space occupying, holds the intestines out of the way
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When might you choose a paramedian abdominal incision in a bovine?
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for specific conditions such as LDA, RDA
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What types of anesthesia are used in bovine GI sx?
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-local: line block, inverted L
-regional: paravert, distal -general |
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What is a common cause of LDA in bovine?
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dietary changes immediately prepartum or in the early post partum period
-too little fiber -subclinical hypocalcemia -mechanical factors |
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What is the approach in sx correction of a LDA?
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Left flank lap and abomasopexy
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How is the abosmasopexy performed?
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-fixation sutures on the greater curve of abomasum
-passed out between xiphoid and right milk well -tied together |
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Which approach is taken if an abomasal ulcer is suspected?
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Right flank laparotomy and pylorplasty or omentopexy
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What are the advantages to the Right flank laparotomy and pylorplasty or omentopexy?
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-does not require an assistant
-care be performed by a shorter armed surgeon |
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What is the sx approach if the ping is located on the left side very low?
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Right paramedian lap and abomasopexy
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What is the disadvantage to a blind suturing technique?
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Can miss the abomasum and entrap other organs
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When facing a cow from the right, what is the appearnce of a RDA?
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90 degree clockwise rotation
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When facing a cow from the right what is the position of a abomasal volvulus/torsion?
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180-270 degree counter clockwise rotation
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What are the only hallow organs on the right side of a bovine that cannot routinely result in a ping on the right side?
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-reticulum
-omasum -bladder |
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What procedure will help determine which organ is pinging?
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Rectal palpation
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What e'lyte and acid base abnormalities are associated with RDA?
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-metabolic alkalosis
-hypochloremia -hypokalemia |
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In the repair of a volvulus/torsion is fluid decompression performed?
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No, risk of contamination
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Cecal dilation or torsion will cause a ping on which side?
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Right
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What might you feel on rectal palpation of a cecal dilation/torsion?
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6-10" diameter blind ended pouch or several loops of bowel that size
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True or False....cecal dilation/torsion is one of the few conditions in the bovine that results in colicky pain
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True
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How is a cecal dilation/torsion repaired surgically?
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exteriorize the apex of the cecum, perform cecotomy and empty contents
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What will rectal palpation reveal in the case of intussusception in a cow?
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6-12" long sausage shaped mass
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What type of feces will be seen with an intussusception?
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Dark. tarry
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why is the intussusception in an adult bovine short in length?
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Due to short mesentary and large amount of mesenteric fat
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Where is an intussusception usually located in the adult bovine?
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Jejuno-ileum portion of the small intestine..also called the flange
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what sx correction is used to tx intussusception?
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resection and anastomosis
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What are the post op care steps needed in sx tx of intussusception?
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-postop abx
-low fiber diet 5-7 post op -monitor hydration |
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What are the indications for a rumenotomy?
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-traumatic reticuloperitonitis
-grain overload -ingested toxins |
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What is the only acceptabel sx positon for a rumenotomy?
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Left flank lap with patient standing
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How do you affix the rumen so it doesn't move during sx?
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-suture to skin
-rumenotomy shroud -Weingart's apparatus -position with towel clamps |
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What are the potential complicatiosn to rumen sx?
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-peritonitis
-rumen fistula formation |
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What the clinical signs/finding that help you to dx a small intestine or mesenteric volvulus?
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-acute abdomen
-significant abdominal distention in all quadrants -rectal palpation: multiple distended loops of small bowel |
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Upon laparotomy what will you find in the case of a small intestine/mesenteric volvulius?
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Torsion at or near the root of the mesentary
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Why is it best to repair a small intestine/mesenteric volvulius in lateral recumbency?
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A standing patient will become recumbent from the pain of mesenteric traction
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What are the laparotomy findings in a calf with atresia ani? (a heritable condition)
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-distended intestines proximal to the rectum and descending colon
-proximal end of the artetic bowel may be difficult to identify |
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In which segment of the bowel does atresia coli usually affect?
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spiral colon
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True or False...intussusception in the bovine neonate is not as acute of a condition as in the adult.
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False- IS an acute condition in the neonate
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What is the most common presenting sign of LDA in a calf?
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Chronic bloat
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What is the urachus?
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Vestigial part of the bladder
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The 2 umbilical arteries become what structures in the neonate?
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Lateral or round ligaments of the bladder
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Te round ligament of the bladder is which neonatal remnant?
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Umbilical vein
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What is the most common congenital defect in cattle?
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Uncomplicated umbilical hernia
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In which breed is it more common?
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Holstein
is a heritable conditon |
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What are the physical findings of a Uncomplicated umbilical hernia?
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-completely reducible with a palpable ring
-usually no systemic illness (strangulation may occur) |
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A Uncomplicated umbilical hernia can cause obstruction of outflow and result in what e'lyte condition?
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-hypochloremic, hypokalemix metabolic alkalosis
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What is another name for a parietal hernia?
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Richter's hernia
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Which species is more likely to have an umbilical hernia with a fibrous core or abscess?
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Calves more than foals
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Plapation of the umbilical hernia with a fibrous core or abscess reveals what?
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A reducible dorsal hernia and a firm nonreducible ventral portion to the skin
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Which organisms are most commonly involved in an umbilical hernia infection?
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-corynebacterium pyogenes
-E coli, proteus, enterococcus, staph, strep |
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What is the condition of the calf with an umbilical infection?
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Unthrifty, may have concurrent dz
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What is the management appraoch for an umbilical abscess?
|
lance, drain, flush
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An enlarged umbilical stump is secondary to what conditions?
|
-omphalitis
-persistent patent urachus -tx of the umbilicus with harsh antiseptics |
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What dx techniques are used to define an umbilical hernia?
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-palpation
-U/S -contrast rads -aspiration -culture -CBC |
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If sx for an umbilical hernia is performed, what type of incision is made?
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-intial finger size to diagnose the problem
-elliptical or half moon (for males) |
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Can the umbilical veins or arteries be removed if they are involved in the problem?
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Yes
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Dehorning of young goats is achieved with what device?
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Electric dehorner
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Post dehorning and/or tail docking, what drug should be given?
|
tetanus antitoxin
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What tx options are available for uroliths obstructing the distal bend of the sigmoid flexure of the urethra?
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-urethrostomy
-penile amputation -tube cystotomy |
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What is "balling"?
|
A breeding male pig ejaculates into the preputial diverticulum
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Why is castration of a pot bellied pig handled in the same manner as a dog castration (pre scrotal incision)?
|
Evisceration may occur
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Why are llama fighting teeth removed?
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-prevent injury during fighting
-treat root abscesses |
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What technique can be used if you don't want to remove the teeth in a llama?
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Blunt the canine teeth with a gigli wire and a rasp
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Which is the most common angular limb deformity of llamas?
|
Carpal valgus
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When performing periosteal stripping for limb deformity, which side is stripped?
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Strip the concave side, bridge the convex side
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At a canter, when does a horse expire the air in his lungs?
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When the front feet hit the ground
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At what location is a tracheal wash performed?
|
Junction between the upper and middle 1/3 where the sternomandibularis muscle bifurcates
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When is a thoracocentesis performed?
|
To evaluate the fluid in the pleural space in the case of lower respiratory tract dz
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What is an atheroma?
|
An epidermal inclusion cyst located in the posterior dorsal aspect of the false nostril- interferes with air passage
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What 3 methods can be used to tx an atheroma?
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-extirpation through the skin: incise the skin and remove it
-Drain from within the false nostril -extirpation through the mucosa: use a burr to remove lining of cyst |
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How can a fluttering alae fold be tx?
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Can be removed under general anesthesia (dx first by suturong the fold to the false nostril to see if its the cause of the exercise intolerance)
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Resection of the nasal septum proceudre is associated with conisderable blood loss, so the nostrils as packed during the procedure. because of this, what other procedure is necessary?
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A tracheotomy
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when cutting the nasal septum, how much do you leave?
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5cm to support the nostrils
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What technique can be used to remove the nasal septum that results in less blood loss?
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use a gigli wire
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What is a nasal polyp?
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pedunculated inflammatory grwoths arising from the nasal mucosa
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True or false...a nasal polyp that is not completely removed will recur.
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True
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What are the usual clinical signs of sinusitis?
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-unilateral mucopurulent discharge
-usually no systemic involvement |
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Sinusitis can be secondary to what conditions?
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-dieseased teeth
-fractures -neoplasia |
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True or false.... primary sinusitis will usually improve with parenteral abx?
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True
|
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Which teeth are usually the cause of sinusitis?
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Diseases upper 4th premolars and molars--remove by repulsion
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What is a clinical sign of ethmoid hematoma?
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Epistaxis (intermittent)
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Endiscopic evaluation of an ethmoid hematoma will show what?
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-a dark green lesion involving the ethmoid turbinate
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Which methoda can be used to tx an ethmoid hematoma?
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-remove with laser sx
-remove through a frontal sinusostomy -Injection of 10% formalin controls but does not cure the condition |
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What is the etiology of pharyngeal lymphoid hyperplasia?
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Chronic respiratory infection usually secondary to viral infection
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In which horses is pharyngeal lymphoid hyperplasia seen most often?
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2 year old racing horses
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Do horses with pharyngeal lymphoid hyperplasia show signs of systemic dz?
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No
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How is pharyngeal lymphoid hyperplasia dx?
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Endoscopic exam
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How is pharyngeal lymphoid hyperplasia treated medically/
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-rest for 60-90 days
-abx and corticosteroids -topical tx |
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What is the sx tx fro pharyngeal lymphoid hyperplasia ?
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-chemical cuatery of the follicles
-50% trichloroacetate or phenol - cryo tx -electrocautery |
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What happens during the dorsal displacement of the soft palate?
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The larynx slips out of the hole in the palate so that the soft palate is dorsal to the epiglottis- causing an airway obstruction
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Dorsal displacement can by caused by what?
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-hyperexcitability
-increased activity of the sternothyroideus muscles |
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What is the primary clinical sign of dorsal displacement?
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Expiratory dyspnea and noise
("choking up") |
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During endoscopic exam, how might you cause the displacement to occur?
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Occlusion of the nostrils
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What other condition must you differentiate dorsal displacement from?
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Epiglottic entrapment
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What type of device can you try to manage the displacement without sx?
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-tongue tie and a straight
-cornell collar |
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What sx techniques have been used for dorsal displacement?
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Section of of the sternohyoideus muscle removed
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What is a stphylectomy?
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partial soft palate resection- prevents epiglottis from "hanging up" on the soft palate
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What sx technique is used for dorsal displacement that includes suturing to the basihyoid?
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Tie forward
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Congential hypoplasia of the epiglottis is seen in which breed and when?
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SB, when training starts
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What are the arytenoepiglottic folds?
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bands of mucous membranes under th epiglottis which are attached to the later aspect- entrapment may be caused by excess tissue or hypoplastic epiglottis
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What are the clinical signs of epiglottic entrapment?
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-inspiratory and expiratory dyspnea and noise
-exercise intolerance -coughing |
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What sx is preferred for epiglottic entrapment for a horse in training?
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Slit the fold
(recurrence rate of 60%) |
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Where do epiglottic cysts develop
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A congenital condition they develop on the ventral aspect of the epiglottis
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What are the clinical signs of an epiglottic cyst?
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-cyst can become displaced dorsally and partially occlude the airway
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How is an epiglottic cyst removed?
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-appraoch the pharynx through the cricocartilage membrane and remove
-use a snare and electrocautery |
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Right laryngeal hemiplagia is usually a result of what complication?
|
IV injection
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Left laryngeal hemiplagia is a dysfunction of which nereve?
|
left recurrent laryngeal nerve
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Horses of what physical attribute all have some lack of innervation causing subclinical involvement.
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Over 15 1/2 hands
large TB males |
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What effect does the lack of innervation have?
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Causes atrophy of the circoarytenoideus dorsalis muscle
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What are the clinical signs of left laryngeal hemiplagia?
|
Inspiratory noise and exercise intolerance
-horse fades at the end of a race |
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The noise is made during inspiration, how do you know when a horse is inhaling?
|
Nostrils flare
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What should you feel on palpation of the cricoarytenoideus dorsalis muscle?
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Atrophy makes the muscular process more apparent
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|
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What other methods have been used to dx laryngeal hemiplagia?
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-grunt to the stick
-endoscope -slap test |
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What is a ventriculectomy?
|
Sx removal of the laryngeal saccules
-reduces inspiratory noise, 60% will be sound |
|
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How is the lining of the saccule removed?
|
with a burr
|
|
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What procedure for laryngeal hemiplagia improves performance?
|
Arytenoidpexy (tie back)
|
|
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What is the overall goal of an arytenoidpexy?
|
To tie the arytenoid out of the airway
|
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What sx procedure is used when an arytenoidpexy and removal of the laryngeal ventricle have not been successful?
|
Subtotal aryetnoidectomy
|
|
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What is a neuromuscular pedicle graft?
|
Nerve ends and muscle pedicles of the first cervical nerve are implanted onto the atrophied cricoarytenoideus dorsalis muscle for innervation
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|
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The 1st cervial nerve innervates which muscle?
|
Omohyoideus---accessory muscle of inspiration
|
|
|
Which bacterial organism is chondritis of the arytenoid cartiage most commonly associated?
|
Strep
|
|
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How is chondritis of the arytenoid cartiage dx?
|
With an endoscope...can be confused with laryngeal hemiplagia
|
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What is a Type II partial arytenoidectomy?
|
Removal of protruberances which project into the airway
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What is a Type I partial arytenoidectomy?
|
removal of the body of the arytenoid and leave the muscular and corniculate processes
|
|
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What is a Type II Corniculoarytenoidectomy?
|
Remove the body leave the muscular process
|
|
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What is a Type 1 Corniculoarytenoidectomy?
|
remove the entire arytenoid cartilage
|
|
|
Empyema of the guttural pouch is most commonly secondary to what type of infection?
|
beta hemolytic streptococci
|
|
|
What are the clinial signs of GP empyema?
|
-unilateral mucopurulent nasal discharge
-marked swelling of the throat latch |
|
|
How do you confirm a Dx of GP empyema?
|
-endoscopic exam
-catheterize the pouch to confrim presence of exudate -rads |
|
|
Medical management of GP empyema includes flushing the pouch daily. What fluids do you NOT flush with?
|
never flush with anything you wouldn't put in your eye...irritation of the pouch may cause extreme pharyngeal dysfunction
|
|
|
is sx management of GP empyema needed?
|
rarely--is so use the Viborg's or modified White House approach
|
|
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What are the boundaries of Viborg's triangle?
|
dorsally: tendon of the sternomandibularis
ventral: linguofacial vein rostral: ramus of the mandible |
|
|
What is the advantage to the White House technique?
|
Both pouches are drained with 1 incision
|
|
|
When is a hyovertebrotomy procedure indicated?
|
Only when there are extremely large hard chondroids in the pouch
|
|
|
Tympany of the guttural pouches is due to a malfunction of what?
|
Pharyngeal orifice- common in Arabs
|
|
|
What are the clinical signs of tympany of the GP?
|
-marked swelling in the parotid area in the young animal
|
|
|
What procedure is used to determine if tympany is uni or bilateral?
|
Unilateral catheterization of the pharyngeal orifice--if distention resolves the problem is unilateral
-contrats rads are helpful |
|
|
What is the sx procedure is GP tympany in unilateral?
|
fenestrate the median septum so that air can exit through the normal pharyngeal orifice
|
|
|
What is the approach if both pouches are involved?
|
Sx remove or modify the medial side of the pharyngeal opening to the GP on both sides or modify one and fenstrate the septum
|
|
|
Which organism is seen most often as a cause of GP mycosis?
|
Aspergillus
|
|
|
What is the clinical sign of GP mycosis?
|
Intermittent spontaneous epistaxis
|
|
|
What is the cause of the epistaxis?
|
damage to the internal carotid artery
|
|
|
What is the medical management approach to GP mycosis?
|
DAily topical application of enilconazole
|
|
|
What sx technique is considered in the tx of GP mycosis?
|
Occulsion of the carotid artery
|
|
|
What are the indications for a short term tracheotomy in a horse?
|
-obstructions of the upper airway
-administration of gas anesthesia |
|
|
What is another term form cribbing?
|
Wind Sucking
|
|
|
What is cribbing?
|
A vice that is associated with a horse grasping a fixed object with the incisors and then flexing the neck pulling backwards and swallowing air
|
|
|
What sx procedures have been attempted to stop a horse from cribbing?
|
Forsell's procedure: removal of a 4 inch section of all muscles between the jugulars
|
|
|
In the modified Forsell's technique, it is important to identify which 2 muscled of the neck?
|
Combined sternohyoid and omohyoid just ventral to the larynx
|
|
|
How are obstructions to the flow of milk dx?
|
-palpation
-use of a graduated rod -culture -imaging -theloscopy |
|
|
Teat lacerations that are how old respond well to primary closure?
|
less than 12 hours
|
|
|
What is the disadvantage to using a longitudinal or transverse incision for closure of a teal laceration?
|
-more damage to blood vessels, more edema
-greater wound breakdown |
|
|
What preop care is needed for teat lacerations?
|
-all lacs should be considered contaminated
-preop abx are indicated |
|
|
Which abx is typically used?
|
Procaine Pen G
|
|
|
What sedation protocol is used for repair of teat lacs?
|
xylazine
ketamine butorphanol |
|
|
What position is used for teat lac repair?
|
right lateral recumbency is preferred
|
|
|
The mucosa and submuscosa and opposed using what type of suture material?
|
Synthetic absorbable
|
|
|
True or false...post repair for teat laceration, hand milking is preferred?
|
False---hand milking is contraindicated
|
|
|
When might a teat fistula develop?
|
When a laceration heals by 2nd intention
|
|
|
How long does it take for a fistula to heal?
|
4 months
|
|
|
What is the most frequent congenital teat anomaly in cows?
|
Supernumary teats
|
|
|
When are Supernumary teats a problem?
|
-when the suprenumery teat is close to the normal teats
-when the produce milk |
|
|
What is the usual procedure for Supernumary teats?
|
Removed when heifers are 6 months old
|
|
|
What is the typical cause of blunt end trauma to a teat?
|
Cow steps on her own teat
|
|
|
If no mastitis is present with a blunt end trauma, what is the course of tx?
|
a period or rest
|
|
|
What is the tx for a tight streak canal that has not responded to rest?
|
Cut with a Hug knife
|
|
|
What is the usual cause of an obstruction in the rosette of Furstenberg?
|
Tissue flaps
|
|
|
What is the approach for the removal of milk stones?
|
-forced or by hand milking
-may need to crush with foceps prior to removal |
