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ACVS Phase II > Random from Tobias & Johnston > Flashcards

Random from Tobias & Johnston Flashcards

1
Q

Common sites for discospondylitis?

A

Caudal cervical, mid-thoracic and thoracolumbar regions, and lumbosacral space

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2
Q

Most common concurrent condition associated with discospondylitis?

A

UTIs

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3
Q

Most common sites for spinal arachnoid cysts?

A

Cranial cervical and caudal thoracic regions

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4
Q

What radiographic finding is most predictive of atlantoaxial instability?

A

An angle of <162 degrees between the atlas and the axis on lateral radiographs is more predictive of instability than a decrease in AA overlap

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5
Q

With regards to cervical disc disease, what factors are associated with an increased risk of peri-op hypoventilation?

A

Lesions between C2 and C4 and treatment by means of a dorsal decompressive laminectomy are associated with an increased risk of peri-op hypoventilation

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6
Q

For ventral distraction-stabilization of the cervical spine using pins or screws with PMMA, what is the recommended angle of pin/screw insertion in the cervical vertebrae?

A

30-35 degrees dorsolaterally except in C7, which is 45 degrees

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7
Q

With partial injuries of the brachial plexus, which part of the brachial plexus is most commonly affected?

A

Caudal brachial plexus

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8
Q

Name the nerves that are branches of the brachial plexus.

A

Brachiocephalic, suprascapular, subscapular, axillary, musculocutaneous, radial, median, ulnar, dorsal thoracic, lateral thoracic, long thoracic, pectoral, and muscular branches

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9
Q

Which nerves are affected in cranial brachial plexus avulsions?

A

Musculocutaneous, axillary, subscapular, suprascapular

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10
Q

Which nerves are affected in caudal brachial plexus avulsions?

A

Radial, median, ulnar

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11
Q

Clinical signs of cranial brachial plexus avulsions?

A

Loss of shoulder movement, elbow flexion, atrophy of the supraspinatus and infraspinatus muscles

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12
Q

Clinical signs of caudal brachial plexus avulsions?

A

Carrying of the limb in a flexed position because the cranial nerve roots are intact but weight-bearing is impossible without the ability to extend the elbow and carpus due to paralysis of the triceps brachii muscle, partial Horner’s syndrome (miosis), +/- loss of cutaneous trunk reflex ipsilateral to the site of the avulsion

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13
Q

What is the importance of the accessory process as a landmark during spinal surgery?

A

The accessory process is an important landmark for identifying the ventral aspect of the spinal canal

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14
Q

What is removed in a Funkquist A dorsal laminectomy?

A

Spinous process, laminae, articular processes, and approximately half of the pedicles of a vertebra

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15
Q

What is removed in a Funkquist B dorsal laminectomy?

A

Spinous process and laminae, leaving the articular processes and pedicles intact

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16
Q

What T2W length of hyperintensity on MRI to L2 vertebral length ratio is a negative prognostic factor in thoracolumbar IVDD?

A

T2W length of hyperintensity on MRI to L2 vertebral length ratio of 5 or higher is a negative prognostic factor

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17
Q

The ratio of the length of cord swelling to the length of L2 on myelography is a negative prognostic factor in thoracolumbar IVDD. What ratio is associated with development of progressive myelomalacia?

A

Ratio of length of cord swelling to length of L2 on myelography >7.4 is associated with development of progressive myelomalacia

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18
Q

What are common neuro exam findings in animals with significant sciatic deficits?

A

Failure of hock flexion during testing of the withdrawal reflex, loss of antagonistic muscle tone resulting in the appearance of a falsely exaggerated patellar reflex

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19
Q

For diagnosis of lumbosacral disease, CT imaging in what position accentuates foraminal compression and disc protrusion?

A

CT imaging in an extended position accentuates foraminal compression and disc protrusion

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20
Q

List some MRI findings of intracranial meningiomas.

A

Distinct tumor margins, uniform contrast enhancement, broad-based extra-axial mass effect, dural tail sign

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21
Q

List some MRI findings of intracranial gliomas.

A

Intraxial mass growing toward the periphery of the brain, highly infiltrative and invading normal brain parenchyma, lack of distinct tumor margins, poor non-uniform contrast enhancement

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22
Q

How are pituitary microadenomas differentiated from macroadenomas?

A

Pituitary microadenomas can be differentiated from macroadenomas on the basis of pituitary height-to-brain ratio - a height-to-brain ratio <0.31 is consistent with a microadenoma

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23
Q

Hypophysectomy via transsphenoidal or ventral paramedian approaches for pituitary tumors has been associated with excellent outcomes - is it useful for microadenomas or macroadenomas?

A

Hypophysectomy via transsphenoidal or ventral paramedian approaches is useful for microadenomas; radiation therapy is recommended for macroadenomas

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24
Q

With MRI, name a fat suppression technique and a fluid suppression technique.

A

Fat suppression technique: Short tau inversion recovery (STIR)
Fluid suppression technique: Fluid-attenuated inversion recovery (FLAIR)

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25
Q

Reported delayed union and nonunion rates for each type of open fractures?

A

Delayed union and nonunion rates: 0-5% for type I, 1-14% for type II, 2-37% for type III open fractures

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26
Q

Femoral torsion is assessed with what angle and what is the value of this angle in normal dogs?

A

Angle of anterversion - normally 27-40 degrees

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27
Q

Describe coxa vara and coxa valga in terms of the angle of inclination of the femur.

A

Coxa vara is a decreased angle of inclination and coxa valga is an increased angle of inclination; angle of inclination in normal dogs is 130-145 degrees

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28
Q

Where is the scapular spine thickest and how does this affect screw placement for bone plating of scapular body fractures?

A

The scapular spine is thickest caudally in the dorsal half and cranially in the ventral half, therefore fractures in the dorsal half of the scapula should be plated caudally and fractures in the ventral half of the scapula should be plated cranially; angling of screws at 45 degrees to the scapular spine also provides better screw purchase

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29
Q

Name the muscles that make up the rotator cuff of the shoulder.

A

Subscapularis and coracobrachialis muscles medially, supraspinatus, infraspinatus and teres minor muscles laterally

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30
Q

What % of dogs with OCD of the shoulder have bilateral lesions?

A

27-68% of dogs have bilateral shoulder OCD lesions, but lameness is often unilateral

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31
Q

In the cat humerus, the ____ nerve and a branch of the _____ artery pass through the ________________.

A

In the cat humerus, the median nerve and a branch of the brachial artery pass through the supracondylar foramen

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32
Q

Name the tension side of the humerus and how this affects plate placement for fracture fixation.

A

The tension side of the proximal humerus is the convex craniolateral surface, and the tension side of the distal humerus is the caudomedial surface; plates are usually positioned cranially or laterally for fractures of the proximal and mid-diaphysis, and medially for distal diaphysial, supracondylar and intracondylar fractures

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33
Q

Is incomplete ossification of the humeral condyle often unilateral or bilateral?

A

IOHC is often bilateral

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34
Q

What % of dogs with incomplete ossification of the humeral condyle have concurrent elbow lesions?

A

23-25% of dogs with IOHC have concurrent elbow lesions

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35
Q

Extension of the elbow is dependent upon innervation by which nerve?

A

Radial nerve

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36
Q

Flexion of the elbow is dependent upon innervation by which nerve?

A

Musculocutaneous nerve

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37
Q

Describe the 3 types of elbow luxation. Which is the most common type of chronic elbow luxation?

A

Type I: Lateral or caudolateral luxation of the radial head
Type II: Lateral rotation and subluxation/luxation of the ulna
Type III: Luxation of the radius and ulna
Type II is the most common type of chronic elbow luxation

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38
Q

What sized scope is preferred for arthroscopy of the elbow, and what intra-articular pressure needs to be achieved by fluid irrigation?

A

A 1.9mm short 30 degree oblique scope is preferred; fluid irrigation should maintain an intra-articular pressure of 70mmHg at a rate of 1-1.4L/min

39
Q

List 3 contraindications for total elbow replacement.

A

Chronic elbow luxation, neurologic dysfunction, skeletally immature dogs

40
Q

What is the amount of radial shortening required to achieve a 90% diagnostic sensitivity with radiographs?

A

1.5-4.0mm of radial shortening

41
Q

What are the typical changes seen in the radius as a result of premature closure of the distal ulnar physis?

A

Radial shortening, procurvatum, distal valgus, and torsion

42
Q

What is the difference in treatment of ulnar shortening between skeletally immature animals and skeletally mature animals?

A

In skeletally immature animals, dynamic ulnar ostectomy is preferred to prevent the ulna from completing osseous union before cessation of radial growth; in skeletally mature animals, dynamic ulnar osteotomy is preferred as early osseous union is encouraged in mature animals

43
Q

Describe the 4 types of Monteggia fractures and specify which type is most common.

A

Type I: Cranial luxation of the radial head and cranioproximal angulation of the ulnar fracture
Type II: Caudal luxation of the radial head and caudal angulation of the ulnar fracture
Type III: Lateral luxation of the radial head
Type IV: Fracture of the proximal radius and ulnar diaphysis with cranial luxation of the radial head
Type I Monteggia fractures are most common

44
Q

What amount of gap strain results in lamellar bone formation vs woven bone formation vs bone resorption?

A

Gap strains of 2% facilitate lamellar bone formation, gap strains of up to 10% facilitate woven bone formation, and gap strains of 10-30% result in bone resorption

45
Q

Incomplete rings in circular ESFs decrease construct stiffness by how much in axial compression, bending and torsion?

A

Incomplete rings in CESF decrease construct stiffness by 25-30%

46
Q

When using circular ESFs, what is the effect of decreasing the ring diameter?

A

Decreasing ring diameter enhances axial stability, torsional stiffness and bending rigidity of the construct

47
Q

Which of the 5 types of accessory carpal bone fracture is most common? Describe it.

A

Type I accessory carpal bone fracture is the most common - avulsion fracture of the distal margin of the articular surface at the attachment of the ligament from the accessory carpal bone to the ulnar carpal bone

48
Q

Which of the 5 types of accessory carpal bone fracture is considered non-surgical?

A

Type V accessory carpal bone fractures (comminuted) are considered non-surgical because of the small fragments and inability to reconstruct the articular surface

49
Q

What is the ideal angle for a pancarpal arthrodesis?

A

10-12 degrees of extension

50
Q

For lag screw fixation of sacroiliac luxations, the screw should be placed to a depth of what % of the sacral width?

A

60% of the sacral width

51
Q

Describe the 5 types of sacral fractures.

A 
Type I: Alar fracture
Type II: Foraminal fracture
Type III: Transverse fracture
Type IV: Avulsion fracture
Type V: Comminuted fracture
52
Q

What is considered a normal Norberg angle (NA)?

A

NA 105 degrees or greater is considered normal

53
Q

What is the generally accepted distraction index (DI) cut-off value for OA susceptibility?

A

DI >0.3 indicates increased risk of OA

54
Q

What is considered normal percentage of femoral head coverage (%FHC)?

A

%FHC of 50% or more is considered normal

55
Q

What are the 2 early radiographic osteophytic signs that predict later development of the characteristic radiographic signs of hip dysplasia?

A

The caudolateral curvilinear osteophyte line or Morgan’s line, and the circumferential femoral head osteophyte

56
Q

What is the earliest age that the PennHIP method of hip screening can be performed accurately?

A

16 weeks of age

57
Q

What is the maximum age at which juvenile pubic symphysiodesis (JPS) should be performed?

A

JPS is more effective if performed before 18 weeks of age (recommended age for JPS is 12-16 weeks of age)

58
Q

What are the advantages and disadvantages of cementless total hip arthroplasty compared to cemented total hip arthroplasty?

A

Advantages: Longer potential implant life, decreased risk of post-op or later infection, better implant stability
Disadvantages: Greater risk of femoral fracture during reaming, more critical need for precise acetabular and femoral reaming to allow for good implant fit

59
Q

Which muscles insert on the greater trochanter, lesser trochanter and third trochanter of the femur?

A

Greater trochanter: Middle and deep gluteal, piriformis
Lesser trochanter: Iliopsoas
Third trochanter: Superficial gluteal

60
Q

Which muscles insert on the trochanteric fossa of the femur?

A

Internal and external obturator, gemelli

61
Q

What is the recommended number of pins for repair of capital physeal fractures?

A

Minimum of 2 pins, no more than 3 pins

62
Q

When using pins to repair capital physeal fractures, how should the pins be oriented (parallel or divergent) and why?

A

Pins placed in a parallel fashion offer biological and mechanical advantages compared to divergent pins as they allow for continued physeal growth, and mechanically, forces applied to pins inserted in a parallel fashion are distributed equally between the pins, whereas with divergent pins, uneven distribution of loads between the pins renders the technique significantly weaker and thus predisposed to failure

63
Q

What are 2 indications for distal femoral corrective osteotomy in dogs with MPL?

A

Distal femoral varus >10-12 degrees or aLDFA >102 degrees

64
Q

What are the advantages of nylon leader line compared to other types of nylon line for extracapsular stabilization of the stifle?

A

Nylon leader line is biologically inert, has low bacterial adherence, and is minimally affected by steam or ethylene oxide sterilization

65
Q

What are the functions of the long digital extensor muscle?

A

Flex the tarsocrural joint and extend the digits

66
Q

What clinical exam finding would suggest rupture of the lateral collateral ligament of the stifle in combination with rupture of one or both cruciates, rather than an isolated rupture of the lateral collateral ligament?

A

Marked varus angulation of the stifle during the varus test suggests rupture of the lateral collateral in combination with rupture of one or both cruciate ligaments, whereas isolated rupture of the lateral collateral would only result in mild increase in varus angulation

67
Q

What are the normal angles of the tarsal joint in cats and dogs?

A

Cats: 115-125 degrees
Dogs: 135-145 degrees

68
Q

In racing Greyhounds, what other fracture commonly occurs concurrently with calcaneal fractures?

A

In racing Greyhounds, calcaneal fractures are commonly associated with a concurrent central tarsal bone fracture

69
Q

Describe the 5 types of central tarsal bone fractures and indicate which type is the most common.

A

Type I: Non-displaced dorsal slab fracture
Type II: Displaced dorsal slab fracture
Type III: Large displaced medial fragment
Type IV: Medial slab fracture + dorsal slab fracture
Type V: Comminuted fracture
Type IV central tarsal bone fractures are the most common

70
Q

List the 3 main parts that comprise the common calcanean tendon.

A

Paired tendons of the gastrocnemius muscle, combined tendon of the gracilis, semitendinosus and biceps femoris muscles, and tendon of the superficial digital flexor muscle

71
Q

In a atraumatic partial rupture of the common calcanean tendon, which component of the common calcanean tendon is usually ruptured?

A

The tendon of the gastrocnemius muscle is often ruptured (avulsed from the calcaneus), leaving the superficial digital flexor tendon intact

72
Q

Which suture patterns are designed for use in flat tendons, and which suture pattern is best for round tendons?

A

The locking loop and Krackow patterns were designed for flat tendons, and the three loop pulley pattern works best in round tendons

73
Q

What is a reasonable starting intra-articular pressure for most joints during arthroscopy?

A

60mmHg

74
Q

What is the threshold size of pulmonary metastatic nodules that can be detected on CT vs radiographs?

A

CT: 1mm
Radiographs: 7mm

75
Q

What is an important difference in anatomic location between naturally occurring osteosarcoma and implant-associated osteosarcoma?

A

Naturally occurring OSA has a predilection for the metaphyseal region of long bones, whereas implant-associated OSA typically develops in the diaphysis

76
Q

Name the 4 zones of a growth plate.

A

Resting zone, proliferative zone, hypertrophic zone, mineralization zone

77
Q

Describe the pathophysiology of acute coagulopathy of trauma-shock.

A

Tissue injury results in enhanced fibrinolysis (hyperfibrinolysis), fluid resuscitation and RBC transfusion lead to dilutional coagulopathy, hypothermia resulting from hypoperfusion aggravates coagulopathy because platelets are extremely temperature-sensitive, and acidemia resulting from hypoperfusion increases fibrinogen degradation and impairs coagulation protein activity

78
Q

What are some of the purported benefits of negative pressure wound therapy?

A

Improved wound perfusion, reduced edema, stimulates granulation tissue formation, decreased bacterial colonization, and removal of exudate from the wound

79
Q

What pressure for negative pressure wound therapy is recommended when used over skin grafts?

A

-75mmHg

80
Q

With respect to axial pattern flaps, which artery is the most difficult to identify consistently, and which is the easiest to identify?

A

The superficial cervical artery (omocervical flap) is most difficult to identify consistently and the caudal superficial epigastric is the easiest to identify

81
Q

What are the differences in skin wound healing between cats and dogs?

A

Cats have lower rates of granulation, epithelialization and contraction; granulation tissue takes twice as long to form in cats and begins at the wound edges rather than across the entire wound bed simultaneously

82
Q

What marks the caudal border of the latissimus dorsi myocutaneous flap?

A

The 13th rib

83
Q

What are the 4 stages of skin graft engraftment (“take”)?

A

Adherence, plasmatic imbibition, inosculation, vascular ingrowth

84
Q

What are the 3 mechanisms by which carbon monoxide exerts its toxic effects during smoke inhalation?

A
  1. Preferential binding to hemoglobin to form carboxyhemoglobin, thereby reducing the oxygen-carrying capacity of blood
  2. Carboxyhemoglobin formation results in a left-ward shift of the oxyhemoglobin dissociation curve and reduces oxygen delivery to the tissues
  3. Carbon monoxide binds to myoglobin and reduces oxygen availability to muscles, particularly cardiac and skeletal muscles
85
Q

What orientation of tears in the costal muscle are usually seen with diaphragmatic hernias in dogs?

A

40% circumferential, 40% radial and 20% combination

86
Q

What orientation of tears in the costal muscle are usually seen with diaphragmatic hernias in cats?

A

59% circumferential, 18% radial

87
Q

What are alternative options for closure of a diaphragmatic defect that is too big to close primarily?

A

Omentum, muscle, liver, fascia, polypropylene mesh or silicone rubber sheeting can be used

88
Q

What are the physiologic effects of increased abdominal pressure caused by loss of domain and abdominal compartment syndrome?

A

Decreased renal function, hypotension from decreased cardiac output, hypoxia from reduced ventilation and lung compliance, visceral hypoperfusion, acidosis, and increased intracranial pressure

89
Q

What peritoneal fluid glucose concentration is 100% specific for bacterial peritonitis in dogs?

A

Peritoneal fluid glucose concentration <50mg/dL or <2.78mmol/L

90
Q

What blood-to-peritoneal fluid glucose difference is 100% sensitive and 100% specific for the diagnosis of septic peritoneal effusion in dogs?

A

Blood-to-fluid glucose difference of >20mg/dL or >1.12mmol/L

91
Q

What blood-to-peritoneal fluid lactate difference is 100% sensitive and 100% specific for the diagnosis of septic peritonitis in dogs?

A

Blood-to-fluid lactate difference of below -2.0mmol/L

92
Q

Hemostatic clips are appropriate for vessels up to what diameter?

A

3mm

93
Q

Bipolar vessel sealing devices are appropriate for vessels up to what diameter?

A

7mm

94
Q

Which type of hiatal hernia is most commonly reported with severe upper respiratory disease such as BOAS or laryngeal paralysis?

A

Type I hiatal hernia (sliding hiatal hernia)

ACVS Phase II (53 decks)

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