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Module 16 > Diagnostic Techniques of Equine Abdominal Cavity > Flashcards

Diagnostic Techniques of Equine Abdominal Cavity Flashcards

1
Q

what is ultrasonography best for (7)

A
  1. small intestinal abnormalities
  2. imaging the liver/spleen/kidneys
  3. gastric distention
  4. left dorsal displacement
  5. colitis
  6. large colon volvulus
  7. right dorsal displacements
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2
Q

how should you assess the full abdomen (where do you start and what direction)

A

start caudally on the right and work cranially assessing each ICS

repeat on the left side

ventral abdomen

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3
Q

what is the targeted emergency assessment using US (5)

A
  1. inguinal left and right (less hair)
  2. left flank (nephrosplenic space)
  3. gastric window (left)
  4. duodenal window (right)
  5. ventral
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4
Q

where is the small intestine mostly found on US

A

inguinal area

but can be anywhere

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5
Q

what should you assess when looking at small intestines (3)

A
  1. motility
  2. distention
  3. wall thickness
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6
Q

what should the width of the small intestine lumen be on US

A

<4cm is normal

>4cm is distended

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7
Q

how thick should the small intestine wall be on US

A

<4mm is normal

>4mm is abnormal

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8
Q

what can be seen here

A

multiple loops of dilated small intestine

>4cm diameter

no motility

contents separates

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9
Q

what are mechanical obstructions of the small intestine

A
  1. simple luminal obstructions
  2. strangulating obstructions
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10
Q

what are functional obstructions of the small intestine

A
  1. enteritis
  2. ileus
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11
Q

where is the duodenal window

A

right side

14th-15th ICS in the dorsal/middle third

from cranial pole of right kidney tracking cranioventrally beneath liver

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12
Q

what would a normal duodenum window look like

A

non distended

motile

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13
Q

what should the wall thickness of the duodenum be

A

<4mm

>4mm distended

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14
Q

what should the duodenum lumen width be

A

<4cm

>4cm distended

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15
Q

what is shown here

A

liver

duodenum

right dorsal colon

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16
Q

where is the gastric window

A

left side

8-12th ICS in middle third

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17
Q

where can you find the stomach

A

the gastric window

seen in 4 ICS

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18
Q

how do you assess distention of the stomach on US (2)

A
  1. how far back/how many ICS –> does it go back to the 14th or 15th ICS
  2. height of the stomach
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19
Q

what is seen here

A

stomach

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20
Q

where can you find the nephrospenic space

A

splenorenal window

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21
Q

where is the splenorenal window

A

left, dorsal behind last rib or 17th ICS

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22
Q

what is the normal appearance of the kidney and spleen on US

A

kidney should be deep to spleen

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23
Q

what would be abnormal in the splenorenal window

A

colon obscures kidney –> may displace the spleen ventrally

left dorsal displacement (nephrosplenic entrapement)

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24
Q

what is shown here

A

spleen and the left kidney

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25
Q

what breed of horses are more predisposed to nephrosplenic entrapment

A

warmbloods

large breed horses

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26
Q

will abdominocentesis be normal with a nephrosplenic entrapment

A

yes

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27
Q

would can you feel on rectal with a nephrosplenic entrapment

A

medial displacement of spleen, cannot palpate kidney

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28
Q

where is the colon on US

A

seen variably throughout abdomen

RDC deep to the liver

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29
Q

what is the normal wall thickness of the colon

A

<4mm

30
Q

what would an increased thickness of the colon wall be due to (2)

A
  1. colitis
  2. volvulus
31
Q

what would blood vessels seen on the colon indicate

A

displacement or volvulus

32
Q

what is seen here

A

colitis

ventral colon

1.7cm thick

should be less than 4mm

33
Q

what would be seen with volvulus of the colon (3)

A
  1. thick colon wall
  2. abnormal sacculations
  3. abnormal blood vessels
34
Q

what would be seen with a right dorsal displacement on US

A

abnormal blood vessels tracking along right abdomen

35
Q

what would be seen with a right dorsal displacement with rectal palpation

A

tight bands horizontally across the abdomen

36
Q

what is a normal PCV range

A

30-40%

37
Q

what does the PCV increase with

A

dehydration

38
Q

what does the PCV decrease with

A

anemia

39
Q

what is a normal protein range

A

55-70 g/L

40
Q

when does total protein increase

A

dehydration

41
Q

when does total protein decrease (2)

A

colitis

peritonitis

42
Q

what should lactate levels be less than

A

<2mmol/L

43
Q

what is lactate a product of

A

anaerobic metabolism

44
Q

what does lactate increase with (6)

A
  1. hypoxia
  2. anemia
  3. dehydration
  4. obstruction of blood supply (strangulating lesion)
  5. bacterial production
  6. other
45
Q

what does an increased lactate indicate in regards to prognosis

A

poor prognosis as lactate increases

46
Q

what does a neutropenia indicate

A

colitis (salmonella!)

47
Q

what does increased creatine indicate

A

dehydration or renal injury

48
Q

why would Na, Cl, bicarb and K be decreased

A

loss in diarrhea or reflux

K with inappetance

49
Q

why would there be an increase in bilirubin

A

inappetance

50
Q

why would liver parameters be elevated

A

bile obstruction

RDD

distention of duodenum

51
Q

what is the earliest indicator of strangulating lesion

A

abdominocentesis

52
Q

what are the risks with performing an abdominocentesis

A
  1. enterocentesis
  2. peritonitis
53
Q

how is abdominocentesis performed (5)

A
  1. US used to identify site (or just right of midline at lowest point of abdomen)
  2. aseptic prep of site
  3. insertion of 18g needle
  4. or local anesthesia, stab incision and teat cannula
  5. sample collected in plain tube and EDTA
54
Q

what should normal peritoneal fluid look like

A
  1. clear
  2. colourless or light yellow
55
Q

what should the total protein be of peritoneal fluid

A

<20 g/L

56
Q

what should the WBC count of peritoneal fluid be

A

< 5 x 10^9/L

57
Q

what should the lactate level be of peritoneal fluid

A

<2mmol/L

58
Q

how do strangulating lesions result in serosanginous peritoneal fluid

A
  1. hemorrhagic infarction and inflammation
  2. increased capillary permeability
  3. movement of protein, then red blood cells, then white blood cells into abdominal cavity
59
Q

what does strangulating lesion peritoneal fluid look like

A

red, serosanginous, turbid appearance

60
Q

if lactate is higher in the abdominal fluid than the blood what does this indicate

A

that the lactate is coming from the abdomen

61
Q

if lactate is 2x blood lactate what does this indicate

A

strangulating lesion is highly likely

62
Q

what does peritoneal glucose decrease with

A

septic peritonitis

bacterial consumption of glucose

will also see increased protein and WBC

63
Q

what are strangulating lesions of the small intestine (6)

A
  1. pedunculated strangulating lipoma
  2. epiploic foramen entrapment
  3. mesenteric rent
  4. small intestinal volvulus
  5. intussusception
  6. inguinal hernia
64
Q

what are strangulating lesions of the colon

A

large colon volvulus

65
Q

what are strangulating lesions of the cecum

A

cecal torsion

66
Q

what are small intestine non strangulating lesions (3)

A
  1. ascarid impaction
  2. ileal impaction
  3. anterior enteritis (proximal enteritis, duodenitis-proximal jejunitis)
67
Q

what are non strangulating lesions of the colon (6)

A
  1. left dorsal displacement/right dorsal displacement
  2. impaction
  3. colitis
  4. large colon typmany, gas colic, spasmodic colic
  5. pelvic flexure impaction
  6. enterolithiasis
68
Q

what should you assess cytology of peritoneal sample (3)

A
  1. number of WBC
  2. presence of bacteria
  3. presence of feed material
69
Q

what is shown here

A

bacteria in peritoneal fluid

70
Q

what is shown here

A

feed material

perforation/rupture

71
Q

what can be diagnosed on radiograph of the abdomen (3)

A
  1. meconium impaction in foals
  2. enteroliths
  3. sand impaction

Module 16 (26 decks)

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