Abomasal Fistula and Abomasal Volvulus, Fractures of the Skull

Question 1

Surgical options for Left Displaced Abomasum:

1.
2.
3.
4.

Answer 1

1. Right flank omentopexy
2. Left flank abomasopexy
3. Right paramedian abomasopexy
4. Closed suture or bar techniques

Question 2

How does a fistula prevent wound healing?

Answer 2

enzymes in the fistula

Question 3

First thing to do when treating an abomasal fistula?

Answer 3

do a CBC to identify potential electrolyte issues, and treat them.

Question 4

T/F: Repair of abomasal fistulas are difficult to treat in the field?

Answer 4

T. Usually refer them because of the labor and equipment required

Question 5

Closure after removal of abomasal fistula removal:

1. Suture size to use?
2. Can also place additional sutures after closure, using what material? Why that material?

Answer 5

1. large sizes like 2-3-4

2. Steel, because it is the least tissue reactive suture

Question 6

What is the most likely cause of a simple abomasal displacement?

Answer 6

gas accumulation causes the abomasum to rise dorsally within the abdomen, and it begins to twist and turn

Question 7

Abomasal volvulus twists (clockwise/counterclockwise) from behind, and (clockwise/counterclockwise) from the right side?

Answer 7

counterclockwise

counterclockwise

Question 8

Surgical Options for Treatment of Abomasal Volvulus:

1. _____ = preferred

2.

Answer 8

1. Right flank omentopexy

2. Right paramedian abomasopexy

Question 9

When using a right flank omentopexy approach for abomasal volvulus, what should you find on the serosa of the abomasum?

Answer 9

descending duodenum and omentum congestion

Question 10

In what direction is the liver displaced during abomasal volvulus?

Answer 10

It is displaced medially

Question 11

Before placing a stomach the in the abomasum for fluid decompresssion, you should….

Answer 11

preplace a purse string suture in the seromuscular layer of the abomasum

Question 12

Describe the technique for correcting the abomasal volvlus manually:

Answer 12

place left forearm medial to the abomasum and push laterally-ventrally-caudally, to free the duodenum from its site of entrapment ventral to the abo-omaso junction

Question 13

What do you do once the volvulus has been manually corrected?

Answer 13

pull the omentum until you see the pylorus to confirm correction

Question 14

Good prongostic indicators after abomasal volvulus surgery:

1.
2.
3.

Answer 14

1. Sternal
2. good appetitie
3. Feces on wall

Question 15

Cecal dilatiation, cecal displacement, and cecal volvulus all share what clinical symptom?

Answer 15

ping on the right paralumbar fossa

Question 16

What will a rectal exam in a cecal dilatation or volvulus reveal?

Answer 16

distended viscus 4 inchs in diameter at the brim of the pelvis

Question 17

When decompressing a cecal dilatation, you (do/do not) want to put the needle in at an angle?

Answer 17

do, so when you remove the needle you avoid contamination

Question 18

1 cause of fractures in the skull?

Answer 18

Trauma

Question 19

4 Aspects of the skull fracture emergency protocol in order of most important to least important:

1. 2.
   3.
   4.

Answer 19

1. A - Airway
2. B - Breathing, Bleeding
3. C - CV, circulation
4. D - Drugs

Question 20

T/F: In patients with suspected head trauma and increased intracranial pressure, the use of ketamine is CONTRAindicated

Answer 20

True

Question 21

T/F: Clipping for an emergency tracheostomy is ALWAYS required

Answer 21

False

Question 22

Anesthetic for a tracheostomy?

Answer 22

Local infiltration

Question 23

T/F: It is easier to remove a tracheal ring in an older horse due to the decreased calcification

Answer 23

F, it’s harder due to increased calcification

Question 24

How often should you clean a tracheostomy tube?

What should you clean it with?

Answer 24

twice a day

rinse with water and parahydroxide

Question 25

Calvaria fractures are (easy/difficult) to diagnose with radiographs

Answer 25

Difficult.

Question 26

Hyphaema definition

Answer 26

Blood in the eye

Question 27

What imaging technique provides a radiographic contrast evaluation of the nasolacrimal duct?

Answer 27

Dacryocysto-rhinography

Question 28

Equine: What is the name of the opening to the nasolacrimal duct, and where do you find it?

Answer 28

Nasal punctum at the edge of the pigmented/non-pigmented mucosa

Question 29

Three BROAD steps to surgically repair a facial fracture in a foal: 1. 2. 3.

Answer 29

1. Elevate the bone depression using periosteal elevator 2. Drill holes for cerclage fixation 3. Tighten cerclage wire

Question 30

Technique to drain a sinus in a horse:

Answer 30

place a foley catheter into the sinus.

Question 31

Treatment options for a fracture in the incisive region in a horse: ``` 1. 2. 3. 4. 5 ```

Answer 31

1. Conservative 2 Cerclage 3. Screws 4. Plates 5. Fixateur extern

Question 32

What is the best way to anchor the cerclage wire when using the cerclage technique to repair an incisive fracture in a horse?

Answer 32

cut a small grove with a saw into a nearby tooth

Question 33

What would you add if you wanted to create additional compressive forces during the surgical repair of a fracture in the inter-dental space of a horse?

Answer 33

A tension band. It transforms tension forces into compression forces. Has better fracture healing.

Question 34

T/F: Wires, screws, and plates are one time use only, but you can use them twice with minimal loss of efficiency

Answer 34

FALSE. ONLY USE THEM ONCE. they have micro-fractures! You can re-use clamps and bars though

Question 35

What type of external fixator for the equine skull has sharp tips that clamp onto the bone?

Answer 35

Pinless External Fixator System

Question 36

The prognosis of using Cerclage wire to repair the upper incisive region in a horse is (poor/good)?

Answer 36

good! GREAT even

Question 37

What is the regarded tool to cut bone during an osteotomy of the equine skull?

Answer 37

Oscillating Saw

Question 38

what kind of screws do you use to attach a fixator to the bone in a equine "parrot mouth" repair?

Answer 38

distraction screws

Question 39

One complete turn of a distraction screw (used in equine skull fracture repair) inserts the screw by how much?

Answer 39

1mm per turn

Question 40

Two most common cause of vertebrae fractures in a horse?

Answer 40

Trauma and Electrocution

Question 41

In a horse with suspected vertebrae fracture, what diagnostic imaging method is contraindicated? Why?

Answer 41

Myelogram - may increase deficits

Question 42

4 Broad treatment options for equine vertebrae fracture: 1. 2. 3. 4.

Answer 42

1. Conservative 2. Screws 3. Plates 4. Fixateur extern

Question 43

How would you repair a fracture of the dens of the axis in a horse?

Answer 43

Lag-Screw fixation

Question 44

How to treat a communuted fracture of C5 in a recumbent horse?

Answer 44

Stabilization with a plate + basket

Question 45

What is the cause of static compressive spinal cord lesions in horses?

Answer 45

Degenerative joint disease of diarthrodial articulations of caudal cervical vertebrae

Question 46

What qualifies a lesion found in a myelogram as a "clinically relevant compressive lesion"?

Answer 46

If BOTH dorsal and ventral contrast columns narrow at the same level

Question 47

What are the three options to treat a static compressive spinal cord lesion in horses

Answer 47

1. Rest 2. Dorsal laminectomy 3. Cervical ventral interbody fusion

Question 48

Laminectomy for static compressive SC lesion in horses: 1. What position should horse be in?

Answer 48

lateral recumbancy, "hanging" over the surgery table

Question 49

Laminectomy for static compressive SC lesion in horses: Incision length and location? consider use of what other tool for incision?

Answer 49

30-40 cm incision on dorsal midline, consider using large self-retaining retractors

Question 50

Cervical ventral interbody fusion for static compressive SC lesion in horses: What position should the horse be in?

Answer 50

Dorsal recumbancy, with an "over-stretching" of the neck

Question 51

Cervical ventral interbody fusion for static compressive SC lesion in horses: After identifying the vertebrae, what do you do? How?

Answer 51

Remove the ventral spinous process, than use 16 mm pilot hole + overdrilled with 25 mm core saw

Question 52

Cervical ventral interbody fusion for static compressive SC lesion in horses: After drilling hole, do what?

Answer 52

Insert basket, smooth hole with osteotome

Question 53

Cervical ventral interbody fusion for static compressive SC lesion in horses: What is the goal of placing a basket?

Answer 53

arthrodesis of joint