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;
124 Cards in this Set
- Front
- Back
|
Three functions of the spleen
|
Hematopoesis
Filtration Lymphocyte storage |
|
|
The spleen is part of this body system
|
Reticular endothelial system
|
|
|
Animals with splenic issues usually present with these CS.
|
Abdominal distension
+/- Generalized weakness Pale mm Hemoglobinuria |
|
|
Why take thoracic radiographs when you suspect a splenic problem?
|
To rule out metastatic neoplasia
|
|
|
True or false: Dogs with metastatic hemangiosarcoma may not have visible lesions on radiograph or U/S.
|
True
|
|
|
List two problems with doing splenic FNA.
|
Difficult to dx hemangiosarcoma b/c too much blood.
May rupture the mass and seed cells thru the abdomen |
|
|
Primary reason for splenectomy.
|
Neoplasia
|
|
|
Why is splenectomy especially difficult in immune-mediated disease?
|
Possibly thrombocytopenia
|
|
|
True or false: Splenectomy is required in cases of traumatic splenic fracture.
|
False. Most traumatic splenic fractures heal on their own.
|
|
|
Avulsed splenic vessels tend to occur secondary to this disease...
|
GDV
|
|
|
A dog HBC presents for celiotomy and you see little red dots seeded thru the omentum. What are these and why do they occur?
|
Splenoses, where following trauma the splenic fragments seed thru abdomen and re-vascularize
|
|
|
A gauze sponge may hold this much blood.
|
5-10 mL
|
|
|
Usual treatment for a splenic hematoma and the reasoning behind it.
|
Total splenectomy M/C b/c need to be sure there is not a splenic tumor like a hemangiosarcoma.
|
|
|
What determines whether a partial or total splenectomy is required to treat avulsion of splenic vessels?
|
Depends on whether splenic a and v are avulsed or not.
|
|
|
A 4 year old Great Dane presents severely painful, with collapse and signs of GDV, shock, DIC, and splenomegaly. What secondary condition are you concerned about?
|
Splenic torsion
|
|
|
Why in the case of splenic torsion is the spleen not repositioned surgically?
|
Run risk of septicemia and free radical migration
|
|
|
In untreated splenic torsion, death occurs within...
|
24-48 h
|
|
|
A dog presents with chronic anorexia and vomiting, anemia, neutrophilia, hemoglobinuria, and renal disease. These could be clinical signs of a common cause such as...
|
Chronic splenic torsion
|
|
|
Prognosis for acute splenic torsion
|
Guarded
|
|
|
Prognosis for chronic splenic torsion
|
Fair to good
|
|
|
Which surgical case is more urgent based solely on diagnosis: GDV or splenic torsion?
|
Both equally emergent based solely on diagnosis
|
|
|
Why int he event of a splenic mass is it recommended to U/S the right atrium of the heart?
|
Check for metastatic hemangiosarcoma
|
|
|
An older Golden Retriever presents with inappentence, weight loss, pale gums, abdominal distension, hematuria, and syncopic episodes. What is a leading differential diagnosis?
|
Splenic neoplasia (hemangiosarcoma)
|
|
|
Most common splenic tumor in the cat.
|
Mast cell tumor
|
|
|
Most common splenic tumor in the dog.
|
Hemangiosarcoma
|
|
|
What % of splenic masses are neoplastic?
|
50% neoplastic
50% hematoma |
|
|
What % of splenic masses are hemangiosarcomas in the dog?
|
50% of malignant neoplasms in the canine spleen are hemangiosarcoma
|
|
|
If a dog has a splenic mass and concurrent hemoabdomen, is there more likely a tumor or a hematoma?
|
Tumor
|
|
|
Diagnosis of splenic tumor without biopsy made based on:
|
Regenerative anemia
Nucleated RBC's Mitral murmur Abdominocentesis with blood Liver metastasis will cause elevation of liver enzymes |
|
|
During abdominocentesis, you pull out a tubeful of frank blood. It clots in under 1 min. This likely means...
|
You hit a blood vessel during the aspiration
|
|
|
During abdominocentesis, you pull out some bloody fluid. It will not clot. This likely means...
|
Splenic neoplasia and thrombocytopenia
|
|
|
Typical prognosis and survival with splenic hemangiosarcoma.
|
Guarded
6 month survival |
|
|
These two groups of BV need to be preserved when doing a total splenectomy.
|
Left gastroepiploic artery
Short gastric branches |
|
|
Process by which the 40-50 small blood vessels at the level of the spleen are ligated individually
|
Hilar ligation
|
|
|
True or false: Splenic diseases can cause cardiac arrhythmias.
|
True
|
|
|
Lidocaine will not work to treat arrhythmias if these electrolytes are abnormal.
|
Na
K |
|
|
A ligation and dividing stapler decreases... but increases...
|
Decreases surgery times
Increases expense |
|
|
How does a ligation and dividing stapler work?
|
Staple on either side of incision with a single trigger pull
|
|
|
How long does thrombocytosis persist after splenectomy?
|
2 weeks
|
|
|
How long does leukocytosis persist after splenectomy?
|
2-4 days
|
|
|
Three causes of sudden death after a splenectomy.
|
Hemorrhage
PTE Ventricular tachycardia |
|
|
What is the prognosis of a patient who is splenectomized because of hemangiosarcoma?
|
Not good. Less than 3 mos with surgery only. 4 mos with surgery and chemotherapy
|
|
|
List three congenital defects associated with brachycephalic airway syndrome.
|
Stenotic nares
Elongated soft palate Hypoplastic trachea |
|
|
List two secondary components associated with brachycephalic airway syndrome.
|
Everted saccules
Edema/inflammation |
|
|
Stertorous respiration in a brachycephalic dog may be caused when the elongated soft palate is positioned (above/below) the epiglottis
|
Above the epiglottis
|
|
|
Potential complication of increased respiratory effort and stertorous respiration associated with elongated soft palate.
|
Laryngeal (arytenoid) collapse
|
|
|
Most dogs of this breed in particular should be considered to have brachycephalic airway syndrome.
|
Bulldogs
|
|
|
The diameter of the trachea may compared in a ratio to the width of this structure on radiograph to determine whether or not it is hypoplastic.
|
Thoracic inlet from dorsal T1 to manubrium
|
|
|
These structures can evert themselves in a secondary change associated with brachycephalic airway syndrome.
|
Laryngeal crypts
|
|
|
Everted saccules may also be considered as this stage of laryngeal collapse.
|
Stage I laryngeal collapse
|
|
|
What physiologic process causes everted saccules in BAS?
|
Increased effort
Decreased intraluminal pressure Turbulent airflow Edema Eversion |
|
|
Inspiratory stridor, stertor, exercise intolerance, heat intolerance, and cyanosis are all CS that may be associated with this sequelum to brachycephalic airway disorder.
|
Laryngeal collapse
|
|
|
Is a "snoring" sound stridorous or stertorous?
|
Stertor
|
|
|
Stabilizing therapy for laryngeal collapse and respiratory distress.
|
Cooling
Oxygen supplementation Supportive care |
|
|
How frequently should a tracheostomy tube be changed? Cleaned?
|
Change every 24h
Clean every 6h |
|
|
How should the alar fold be excised in a rhinoplasty?
|
DO not excise alar fold!!!
|
|
|
Describe the preferred wedge resection method for BAS rhinoplasty.
|
Take lateral nasal planum and remove pyramid-shaped wedge to increase airway diameter.
|
|
|
What is the preferred method of hemostasis during a rhinoplasty? Which should be avoided?
|
Use direct pressure
(also may use epinephrine) Avoid cautery |
|
|
Suture material and pattern used for closure of a wedge resection rhinoplasty.
|
Monocryl, simple interrupted
|
|
|
Staphylectomy refers to this surgical procedure
|
Shortening of the soft palate
|
|
|
Normally the soft palate should extend to this landmark.
|
Tip of epiglottis
|
|
|
List some landmarks used to determine the appropriate length of the soft palate during staphylectomy.
|
Palatine tonsil
Tonsilar crypts |
|
|
Where should your three stay sutures be placed during a staphylectomy?
|
One on each caudal tonsil border and one in the uvula.
|
|
|
Three advantages of CO2 laser excision.
|
Decreased blood
Decreased swelling Decreased pain |
|
|
Three disadvantages of CO2 laser excision.
|
Delayed healing
Risks of tissue damage, O2 combustion Cost |
|
|
What should you do when using a CO2 laser in the oral cavity to avoid burning the patient's lungs?
|
Wrap endotracheal tube in aluminum foil
|
|
|
Where are the laryngeal crypts, or "saccules," located in the larynx?
|
Ventrally and at the caudal epiglottis base
|
|
|
Beware during a sacculectomy that you do not remove these nearby laryngeal structures!
|
Vocal folds
|
|
|
How should the endotracheal tube be handled after a sacculectomy to ensure that blood is not aspirated?
|
Remove tube with cuff inflated
|
|
|
Describe the rate of healing when surgery is done for brachycephalic airway syndrome.
|
Rapid healing b/c well vascularized
|
|
|
What is the chance of infection in upper airway surgery to correct BAS?
|
Minimal
|
|
|
Aryepiglottic fold deviation occurs in this stage of laryngeal collapse. (Usually 50% occluded)
|
Stage II
|
|
|
Corniculate process deviation occurs usually in this stage of laryngeal collapse (75% occlusion)
|
Stage III
|
|
|
Prognosis of advanced laryngeal collapse
|
Poor
|
|
|
Overall prognosis when brachycephalic airway syndrome is addressed early
|
Good
|
|
|
List two uses for surgical drain placement
|
Elimination of fluid or air accumilation
Infusion of drugs |
|
|
Benefits of continuous suction drains
|
Can exit in dorsal or lateral position
Less risk of contamination Less frequent bandage changes Less likely to occlude |
|
|
This kind of drain is active with a vacuum reservoir.
|
Continuous suction drain
|
|
|
With peritonitis, fibrin will occlude any drain within...
|
12 hours
|
|
|
How effective are drains at treating generalized peritonitis?
|
Ineffective
|
|
|
Anytime there is a large amount of dead space in an incision closure, use of this will help reduce fluid buildup
|
Drain
|
|
|
List 3 ways in which drains should be monitored.
|
Monitor fluid volume of drainage
Measure PCV, TP, and electrolytes bid-tid Monitor fluid character by removing fresh sample |
|
|
When should a drain be removed from a wound?
|
Improvement in peripheral WBC count and bloodwork
Change in fluid character (clearer, no toxic PMN, no intracellular bacteria) |
|
|
True or false: Removal of a drain is based on the amount of fluid that is draining.
|
False
|
|
|
Drains should be removed when the fluid...
|
Looks clearer, has no toxic neutrophils, and has no intracellular bacteria
|
|
|
Placement of continuous suction drains in the abdomen in peritonitis will decrease these three things.
|
Hospitalization time
Cost Professional time investment |
|
|
Primarily used for drainage of air or fluid from the chest
|
Thoracostomy tube
|
|
|
Complications of thoracostomy tube include...
|
Dislodgement, discomfort, obstruction, ascending infection
|
|
|
How should a thoracostomy tube be secured?
|
Purse-string around tube, and finger-trap suture through skin-- at least 5 throws with nonabsorbable suture.
|
|
|
Type of end on a thoracostomy tube
|
Three-way stopcock
|
|
|
What should be done about 20 mins before drain removal?
|
Infuse area with bupivicaine
|
|
|
Which end of a thoracostomy tube is wider: The internal part or external?
|
Internal
|
|
|
Follow-up care after removing a thoracostomy tube.
|
Bandage
Antibiotics for 7-10 days |
|
|
A continuous suction drain may be made from scratch using these two items.
|
Butterfly catheter
Vacutainer |
|
|
Three kinds of drugs delivered by drain.
|
Antibiotics
Analgesics Chemotherapy |
|
|
Complications of drain placement
|
Infection
Foreign body reaction Tissue trauma Malfunction SQ emphysema Discomfort Increased drainage |
|
|
Are drain materials typically radiopaque or radiolucent?
|
Radiopaque
|
|
|
True or false: Penrose drains require both an entrance site and exit site.
|
FALSE. Exit site only!
|
|
|
Should a Penrose drain be fenestrated?
|
No--> works on principle of outside surface area!
|
|
|
3 classifications of hernia.
|
Reducible
Incarcerated Strangulated |
|
|
When a hernia becomes...there is a risk of vascular compromise and tissue necrosis.
|
Strangulated
|
|
|
This kind of hernia is enclosed in peritoneal sac.
|
True hernias
|
|
|
These hernias occur when there is a protrusion of organs outside abdominal opening without peritoneal sac.
|
False
|
|
|
Henia type more likely to be traumatic in nature: True or false hernia?
|
False
|
|
|
This kind of hernia (true/false) is more likely to be congenital or spontaneous in nature.
|
True
|
|
|
3 parts of a hernia
|
Ring/neck
Hernial sac Contents of hernia |
|
|
Is a diaphragmatic hernia a true hernia or false hernia more typically?
|
False
|
|
|
If an umbilical hernia is repaired, is it okay to condone breeding of the animal?
|
No due to heritability
|
|
|
Defect that may form when the umbilical ring fails to close normally or the cord is transected too close to the body wall.
|
Umbilical hernia
|
|
|
How important is it to repair an umilical hernia?
|
Not very unless large enough to allow bowel strangulation
|
|
|
Large umbilical hernias may coexist along with a defect in...
|
Diaphragm
|
|
|
Congenital inguinal hernias are more common in this gender.
|
Male
|
|
|
Acquired inguinal hernias most frequently occur in this signalment.
|
Older intact females
|
|
|
A painless, soft mass in the inguinal area is likely this...
|
Inguinal hernia
|
|
|
Is the inguinal approach or a midline approach more appropriate for a beginner who is repairing an inguinal hernia?
|
Midline
|
|
|
This inguinal hernia repair approach is made from the inside out and allows visualization of both inguinal rings.
|
Midline approach
|
|
|
Major structures of concern when repairing an inguinal hernia from the inguinal region.
|
External iliac artery
Deep femoral artery and vein Obturator nerve Genitofemoral nerve Caudal superficial epigastric artery and vein |
|
|
Abdominal fat is usualy associated with these structures of surgical concern...
|
Blood vessels
|
|
|
Are scrotal hernias more common in intact or castrated males?
|
Intact
|
|
|
If you are repairing a scrotal hernia without castration, the neck should be left partially open to allow room for...
|
Cremaster muscle
Spermatic cord |
|
|
Four reasons cats scratch
|
Scent marking
Visual marking Muscle stretching (flexor muscles) Claw conditioning |
|
|
These locations are most attractive scratching places for cats.
|
Prominent location
Stable surface Longitudinal texture Vertical or horizontal preference |
|
|
Short term complications of declawing.
|
Pain and lameness
Bleeding Infection Swelling Dehiscence Behavior change |
|
|
The risk of post-op hemorrhage after declaw means that we should keep cats this long after surgery.
|
3 days
|
