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57 Cards in this Set

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Ovariohysterectomy
(OHR,spay,spayed OVH)
major abdominal surgery. Most common surgical procdure performed in small animal clinic
Indications: Elective
prevent heat cycles
decreased risk of mammary tumors
no risk of pyometra, no risk of uterine cancer
fewer behavioral problems
no risk of pregnancy
pregnancy termination
Non-Elective; Emergency
Pyometra
Uterine/ovarian cancer
Mammary cancer
Contraindications
Breeding animal
too young
anesthetic risk
late pregnancy
combining with non-sterile surgery
age
prior to 1st heat is ideal: 5 months in cats and 6 months in dogs
pre-puberal gonadectomy - soaying at 6-8 wks of age
Technique:
Pre-op
preanesthetic work up
general anesthesia
express the bladder
Surgical prep:
#40 blade clipper
clip fom the xiphoid process to pubis lateral to nipples or beyone
Routine surgical scrub and rinse
Proceedure
Ventral midline incision through linea alba(white line where muscles connect)
isolate right or left uterine horn with spay hook
Double ligate and transect ovarian artery and cein
Isolate uterine body - Ligate uterine arteries and transect uterus
check stump for bleeding
close linea alba
close subcuticular layer
close skin
Complications
Abdominal hemorrhage:
Ligature slips off uterine or ovarian vessels
Von Willebrands Disease - clotting disorder in several dog breeds:
Dobermans G. Shepards, Welsh Corgies
monitor patient 3-6 hrs post-op
hemorrhaging
Bladder irritation from uterine stump
Peritonitis
Infection
Dehiscence _incision opening up
Client instruction
restrict activity for 48 hrs
surture removal 10-14 days
check incision for redness swelling discharge or if animal is licking excessively at incision
do not bathe until sutures removed
Role of CVT
may manipulate the ovarian pedicle clamps to ease placement of ligatures
retract tissue
load hemoclip forceps (blade)
swab surgery site
Cut sutures as directed by surgon
Cesarian section (C-section)
dystocia: difficulty birthing, large fetus, small pelvis, fractured pelvis, uterine inertia, certain breeds (bulldogs big heads)
technique
be prepared want anesthetic period to be as short as possible
light plane, adjust dosage to pre pg weight - Ketamine/Isoflurane not atropine (thickens mucus in neonates)
Neonatal care -
be prepared rub with towel to dry and stimulate respiration
reverse narcotic with naloxone
aspirate mouth
keep warm
use drugs as needed (doxopram)
check and tie umbilicus
check for abnormalities
place with momma asap
send home together
complications
infection pups chewing on sutures
respiratory depression
Pyometra
signs
Pus in the Uterus
anorexia, lethargy, PU/PD vomoting, discharge
treatment
fluids, antibiotics,supportive care monitoring
prostaglandin available for open pyometra but spat treatment of choice
Castration(canine)
prevent breeding decrease undesirable male behavior
prevent some prostativ disease
prevent testicular disease
decrease roaming, fighting
age
pre-op
6-9 months can be 6-8 weeks
clip from prepuce to margin not on scrotum
Cryptorchid
more common in dogs than cars
castration recommended due to increased risk of testicular cancer and it is an inheritable trait
Onychectomy(declaw)
amputation of P3, 3-6 months of age
procedure
pain mgmt - fentanyl patch
apply tourniquet proximal to elbow remove P3 with Rescoe nail trimmer of scalpel dissection
laser dissection
leave open surgical adhesive or suture +- bandage
complications
Neuritis from tourniquet, pain, bleeding , infection, nail regrowth, behavior changes abnormal stance on feet
chronic pain referred pain phantom pain
use yesterday's news instead of litter 5-7 days
Otoplasty - Ear Cropping
age 8wks to 6 mths
AVMA - cosmetic reasons are not medically indicated or of benifit to animal - cause pain and distress Bet should consel dog owners before agreeing to perform surgeries
Caudectomy (tail docking)
age - puppies 1-5 days old
pups cut tail off with mayo sissors
hematoma or seroma if dead space
Feline Perineal Urethrostomy (PU)
recurrent urethral obstruction in male cats
make it so cat will pea like a girl - incise urethra suture skin to urethral mucoa
Anal Gland Abalation(removal)
recurent inpactions or infections - ferret descenting
put plaster of paris in parts so dr can cut around
Abscess
establish ventral frainage(lowest spot) lance drain flush wound
Aural Hematoma (ear)
check ear for ear infection - drain seroma- have ears heal together prevent dead space
incisional - s-shaped incision and suture
teat cannula - drain placed on hairless surface of pinna suture
needle aspiration - high incidence of recurrence- may use steroids
bandage ear to head
Tumors
benign - remove mass itself
malignant - wide margins of normal tissue removed with tumor
Common tumors seen in SA practice
Mammory
Limpoma
Mast cell tumor
Squamous cell carcinoma
Thyroid adenoma
Perianal gland adenoma
Mammary Neoplasia
Usually seen inolder, intact dogs/cats or animals spayed late in life - 50% malignant in dogs 90% malignant in cats protective bendfit if animal is spayed prior to 1st or 2nd heat
frequently matestazes to lungs
Limpoma Removal
usually occur in older, overweight animals. SQ soft moveable masses. When aspirated droplets of oil form - handle all the way around and move- behind front leg - lots of dead space
Mast Cells
Malignant - grade I II or III based on likelihood to metastasize(basofil granules)- do not squeeze will release histamine give benedryl prior to surgery (boxers known for this)
Opthalmic Surgery(eye)
do not use chlorhexidine or alchol use dilute betadine solution or steril saline.
A branch of the vagus nerve innervates the eye
Manipulation of the eye can activate this nerve resulting in activation of the parasympathetic nervous system and bradycardia may result. Premeditate with atropine of glycopyrrolate to avoid bradycardia
Nictitating Membrane flap placement (3rd eyelid flap)
pulling the 3rd eyelid to cover the corneal surface
indicatrions: Corneal ulcers - Proptosis(eye pops out)
a horizontal mattress suture is placed through the 3rd eyelid and uper lid
Conjunctival membrane Flap
Pulling the conjunctiva over part of the cornea
Indication- Sever corneal ulcers
antibiotics without steroids steroids make ulcers worse
Prolapsed Gland of 3rd eye lid (cherry eye)
Cocker Spaniels.
Replacement of the gland of 3rd eyelid by sutureing to periosteu of ventral orbit - a pocket is created in 3rd eyelid and gland is inverted into pocket may happen in other eye also
Entropion
lid rolls inward eyelashes touch eyes
surgery on lids to pull them in opposite direction of defect
Ectropion
lid rolls outward - dry eye
Distichiasis
abnormal eyelashes - need to remove with electrolysys or cryosurgery
Enucleation
Removal of the eye- Glaucoma, trauma, Neoplasia, Refractory infections
complcations- swelling hemorrhage infections dehiscence draining tracts sunken appearance Optic nerve damage to remaining eye
Proptosis
protrusion of the globe from the orbit with associated muscle and nerve damage . Is an Emergency situation tarsorrhapy involves suturing the eyelids shut - enucleation is an option if wont go in- epeniphrin - reduces swelling
may end up with strabismus(eye shooting off in odd direction) Atrophy of eye bilndness chronic pain
Gastrointestinal Surgery
-otomy - to open cut into
-ectomy - to remove
Resection: to remove
anastomosis: to reattach fre ends
stenosis: narrowing or stricture of a canal or lumen
Volvulus: twisting of organ abound blood supply (GVD)
Types of GI surgery
Foreign Body Removal - cats string look under toung gets caught at base intestinse bunch up (plicate)- do not u=pull string can saw through intestional wall= foreign bodies are easiest to remove from stomach - intestine-colon and lastely esophagus
Gastric Dilation and Volvulus (GVD or bloat)
Life Threatening Emergency!
Challenge for technicians: must be fast at catherers, anesthesia and surgery set up and prep. may need to pass stomach tube
surgery incolces large cranial abdominal incision repositioning the spleen and stomach and fixing stomach to body wall - may have cardiac arrhythmais and may rebloat
Feeding tube placement
Esophgastomy
Gastrostomy
Duodenostomy
Jejunostomy-bypass pancreas diet must be broken down
Intervertebral Disk Disease
Weakness in the outer capsule of the disk leads to bulging or rupture and pressure on the spinal cord
Ovvurs most commonlu in the cervical vertebrae(beagles, dassets) or in the T-L junction (dachshunds, cockers) leads to pain, ataxia(out of balance) with loss of conscious proprioception, paralysis loss of dep pain. One of the more common neurological diseases in dogs - treatment - strict cage rest - steroids or NSAIDS - surgery laminectomy - fenestratrion of adjacent disks
Orthorpedic Surgery
Luxation - dislocation of a joint
Subluxation - partial dislocation
Articular: a fracture through a joint
Comminuted: 3 or more fx lines which interconnect
Open(or compact) fx which penetrates the skin
Epiphyseal(psalter): fracture line involves a growth plate
Greenstick: an incomplete fx
Tranverse: fx line is perpendicular to long axis bone
Oblique: fx line is at an angle to long axis of bone
Spiral: fx line twists up bone shaft
Multiple: 3 or more dx lines that do not interconnect
Inpacted: fx due to compressive forces
Aculsion: fx at a point where ligament or tendon atach to bone
Stable: does not displace under force(tranverse)
Unstabel: displaces easily under force(oblique)
External fixation devices
Kirschner apparatus
Cast
Splint
Internal fixation devices
Intramedullary pins
Rush pins
K-wire
Plates
Screws
Cerclage wire
Osteolyelitis
Infection of bone and marryo cavity
Callus
a collar of new bone which bridges the fx to repaif the fx formed by periosteum
Cancellous bone- soft lattive like bone at the end of long bone good for frafting trabecular bone
Cortical bone - compact hard bone which makes up the shaft of a bone
Luxations
Sunovial joints are most frequently involved (hips, shoulder) if hip pops out it goes dorsal cranial leg that is shorter is the one that is out
Luxation and dislocation - separtation or change in the relationship of the articular surfaces of bone
Articular separation:luxations
Incomplete dislocations subluxations
Complete dislocation: total luxation
Acute luxation: result of direct or indirect force of a simple recent occurrence
Chronic or recurrent luxation: long standing luxation or a recurrence following a reduction from degeneration of restraining structures of joing(joint capsule and ligaments)
Cranial Cruciate Ligament Repair(ACL)
Actual ligament cannot be repaired (wire installed)
fragments of tissue in joint removed to minimize post op degenerative joint disease - will most likely happen to other leg
Hip Displasia
Proceedure
Triple pelvic osteotomy - young animals with out degenerative joint changes - 3 cuts made into pelvis to restructure acetabulum
Femoral head and neck resection (osteotomy)
older animals with joint changes removal of femoral head
proximal remainder of fenur creates false joint salvage provedure
totla him replacement artifical hip replaces bone
Elbow
Ununited Anconeal Process