19

Question 1

vessels that can be permanently ligated

Answer 1

BOTH common carotid arteries (NOT IN CATS)BOTH jugular veins (NOT IN CATS)Brachiocephalic v.Brachial arteriesHepatic veinfemoral arteriesBoth external iliac arteriesBoth common iliac veinsabdominal vena cava caudal to liver

Question 2

why can’t both common carotid arteries and jugular veins be ligated in cats

Answer 2

less collateral circulation vs Circle of Willis and vertebral artery

Question 3

three main principles that can be used to augment hemostasis

Answer 3

1. reduce blood flow to affected areas 2. topical hemostatic agents3. anti-fibrinolytics

Question 4

list methods to reduce blood flow to affected areas

Answer 4

1. digital P/tamponade2. topical vasoconstrictors3. induce hypotension/hypothermia4. distant occlusion of blood flow

Question 5

length of time it takes to form a platelet plug and cross link fibrin for clot

Answer 5

platelet plug 30 scross link fibrin for clot 2-3 minutes

Question 6

types of topical vasoconstrictors

Answer 6

1. epinephrine2. ephedrine3. adrenaline

Question 7

ways to control distal blood flow

Answer 7

1. vascular clamps (bull dogs, statinsky)2. tourniquets (rumel, esmarch-limbs)3. fingers

Question 8

times in normothermic patients to temporary ligatehepatic arterypringle maneuverthoracic aortaabdominal aortarenal artery/vein

Answer 8

hepatic artery 30 minutespringle maneuver 10-15 minutesthoracic aorta 5-10 minutesabdominal aorta 30 minutesrenal artery/ vein 30 minutes

Question 9

what pressure applied to distal limb tourniquet can be associated with neurogenic degeneration

Answer 9

1000 mm Hgdegeneration of myelin of compressed nerveddeficit ~ 6 months

Question 10

pneumatic tourniquets

Answer 10

used in human surgerydeliver controlled pressure–100 mm Hg above patients systolic pressuremay reduce complicationsocclusion time is measured

Question 11

equation used for tourniquet pressure

Answer 11

pressure = T (bandage tension)/R(radius)Width(bandage)P = T/RWPressure is inversely proportional to bandage width

Question 12

most recommendations for length of duration of bandage tourniquets

Answer 12

MAX 1.5-2 hours (corresponds with muscle depletion of ATP stores)release for 10-15 minutes before reapplication

Question 13

complications of hemostatic agents

Answer 13

volumetric swellingexothermic reactionsimmunogenic reactionsFB reactionsinhibition of normal healing

Question 14

types of mechanical hemostatic agents

Answer 14

1. porcine gelatin (gelfoam)2. bovine collagen II (ultrafoam)3. cellulose (surgicel)4. wax (bone wax)

Question 15

MOA of mechanical hemostatics

Answer 15

Absorb bloodprovide a mechanical barrier or tamponadecreate a matrix for clot formation/stabilization

Question 16

difference in MOA of collagen vs gelatin

Answer 16

collagen promotes platelet aggregation

Question 17

suspected MOA of silver hemostatic agent

Answer 17

Ionization of the product with direct activation of vessel contraction and the clotting cascade

Question 18

types/categories of hemostatic agents

Answer 18

1. Mechanical hemostatic agent→gelatins (gelfoam), collagens (ultrafoam), Cellulose (surgical), Wax (bone wax) 2. Active hemostatic agent→Thrombin (II), alginates3. Hemostatic sealants→fibrin (Tisseel), synthetic (duraseal)

Question 19

list two absolute contraindications for hemostatic agents

Answer 19

1. DO NOT GO INTRAVASCULAR2. AVOID WITH AUTOTRANFUSIONS

Question 20

Regarding in vitro mechanical hemostatic agents, rank the following in order of best to least (collagen sponge, cellulose, microfibrillar collagen, cellulose)

Answer 20

Microfibrillar collagen>collagen sponge>gelatin sponge>cellulose

Question 21

How can gelatin be distinguished from cancer or an abscess with advanced imaging modalities?

Answer 21

The foam should have pockets of air before complete absorption

Question 22

types of antifibrinolytics

Answer 22

delay fibrinolysis1. serine protease inhibitors (aprotin)2. lysine analgoes (EACA, tranexamic acid)–more potent