Female Repro Flashcards by Meleah McMillen

Anatomy of the female repro tract is supplied by the ______ from the ______ artery

Vaginal from the internal pudendal artery

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What are the 3 types of Vestibulovaginal stenosis? What type of abnormality is Vestibulovaginal stenosis?

Vestibulovaginal stenosis is a congenital abnormality

Septal stenosis
Annular stenosis
Vaginal hypoplasia

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What are the clinical signs of Vestibulovaginal stenosis?

Vaginitis
UTI
Painful breeding
Hydrocolpos

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_______:

distension of the vagina caused by accumulation of fluid due to congenital vaginal obstruction

Hydrocolpos

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_____ ______:

Connection between the rectum and vagina. Describe what type of abnormality it is?

Rectovaginal fistula (congenital abnormality)

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With use of contrast rads and sterile iodinated contrast media, Vestibulovaginal stenosis is confirmed as severe when it is this value or less

<0.2

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What is the BEST diagnostic modality to determine Stenosis?

Vaginoscopy (bc direct visualisation, and can eval the entire urogenital tract and repro. tracts and look for ectopic ureters and neoplasia

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You can treat stenosis with a _____

scope

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What are the indications of treating Vestibulovaginal stenosis? what do you always do to the urethra?

Breeding dogs
Spayed dogs with CS

Always catheterise the urethra

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Can digital breakdown of Vestibulovaginal stenosis to break up the narrowing with your finger work??

It’s ineffective!!!

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Describe how the tissue band is oriented in a septal stenosis?

Dorsoventrally

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What is the common name for septal stenosis?

Double vagina

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How do you treat septal stenosis?

perform episiotomy
Mucosal resection at the attachments
Suture mucosa
LASER ABLATION

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________:

a surgical cut made at the opening of the vagina during childbirth, to aid a difficult delivery and prevent rupture of tissues.

Episiotomy

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_______:

Incision of vulvar orifice to all access to the vestibule and vagina

Episiotomy

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Why would you do a Episiotomy?

Explore the vagina
Excise vaginal masses
Repair lacerations
Modify strictures

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When you perform a Episiotomy they animal is in the ______ position and you place the instrument in the _____ ______. You incise from _____ _____ to the limits of the _______

perineal position

place the instrument in the vulvar fissure

Incise from dorsal commissure to limits of vestibule

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What do you do to control the hemorrhage with an episiotomy (2)? and you close in ____ layers

Electrocautery; Doyen forceps

Close in 3 layers (mucosa, muscle, skin)

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Describe the shaped lesion for annular stenosis?

V-v junction ring shaped lesion

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Annular stenosis includes the _____ and +/- ______

mucosa and submucosa and +/- muscularis

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Annular stenosis is manifested with an _____ ______, a congenital disorder where a hymen without an opening completely obstructs the vagina. It is caused by a failure of the hymen to perforate during fetal development.

Imperforate hymen

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Describe the sx apporach to annular stenosis if caudal to the pelvis?

Dorsal approach (vaginal resection and anastomosis)

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Describe the sx apporach to annular stenosis if intrapelvic to the pelvis?

Transpelvic approach (vaginectomy)

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_______:

often used with annular stenosis, this is a surgery to remove all or part of the vagina. It is usually used as a treatment for vaginal cancer.

Vaginectomy

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Vaginal Hypoplasia causes _____ of the _____ _____

narrowing of the vaginal vault

Where does vaginal hypoplasia occur between?

Occurs B/w the vestibulovaginal junction and cervix

Vaginal hypoplasia requires _____ along with ____ and may require a ____ approach

vaginectomy along with OHE; pubic

What are the indications for a vaginectomy? (3)

More extensive lesions Intrapelvic annular stenosis Vaginal hypoplasia

When performing a vaginectomy you may also perform a ______ ______ approach and ____

ventral abdominal; OHE

What is the conformational abnormality where the vulva is engulfed by skin and what sized breeds are predisposed

Recessed Vulva (hooded vulva) medium to large breeds, overweight

Does early spaying cause hooded vulvas??

Study proved no!!! so tell your clients its okay!!

What are the clinical signs of hooded vulvas? (4)

1. Skin fold dermatitis 2. Vaginitis 3. Recurrent UTI 4. Incontinence

What treatment options are there for recessed vulva?

1. Cleansing regularly (prevent skin fold dermatits) 2. Weightloss 3. Episioplasty (vulvoplasty)

_______: (also known as vulvoplasty) is a surgical procedure to remove excess folds of skin which form a curtain around or over the vulva

Episioplasty

Vaginal edema / hyperplasia occurs during _____ ____ and is due to high _____ levels. Seen most commonly in _____ ( < ___ years old) _____ breed dogs.

proestrus / estrus high estrogen levels <2 years old large breed

Vaginal edema / hyperplasia happens during this time and what do we see?

one of first 3 estrus cycles Mucosa protrudes from the vulva

Where does the tissue arise from with Vaginal edema / hyperplasia and subject to _____ and _____

ventral vaginal floor subject to dessication and self trauma

What is the general medical treatment for Vaginal edema / hyperplasia

conservative management and use of lubricants and e collars - reduce the exposed tissue - recommend OHE to prevent reoccurrence

What is the surgical treatment of Vaginal edema / hyperplasia

Significant mucosal injury, OHE of the breeding animal, mucosal resection through EPISIOTOMY

Vaginal edema / hyperplasia resolves with this?

termination of estrus

______ ______: very rare, often mistake for edema, the entire circumference prolapses and appears DONUT SHAPED

Vaginal prolapse

How do you treat vaginal prolapse?

manual reduction and OHE

_____ _____ ______: takes place with recurrence of estrus cycle following OHE/OVE and is caused by these etiologies (3)?

Ovarian Remnant Syndrome - Decreased visualisation - Improper surgical technique - Dropped ovarian tissue revascularizes

Ovarian Remnant Syndrome is more common in ____

cats

What are the clinical signs of Ovarian Remnant Syndrome (3)?

Vulvar enlargement (dog) Attraction to males Willingness to breed

Upon vaginal cytology in dogs with Ovarian Remnant Syndrome what does it mimic?

normal heat cycles

Ovarian Remnant Syndrome treatment is often _____ removal during _____ by a _____ surgeon. The remnant is usually at this location and why do you need to be carefuL?

1. Surgical removal during estrus by referral surgean | 2. Remnant usually at the caudal pole of the kidney careful to avoid the ureter

Ovarian Remnant Syndrome hormones are elevated (3)?

- estrogen - progesterone - Cats require lutinization to evaluate progesterone

______: Inability to expel a fetus through the birth canal and _____ causes responsible for 75% and are these 3 reasons?

Dystocia; maternal 1. Primary uterine inertia 2. Secondary uterine inertia 3. Birth canal obstruction (small pelvic canal, malunion fracture)

Dystocia due to fetal causes are from these 4 things?

1. Malposition 2. Malformation 3. Oversized 4. Fetal etiology can cause secondary uterine inertia

______ _____ ______: os where parturition fails to proceed and the birth canal/ fetal size present normal?

Primary uterine Inertia

With Primary uterine Inertia are neonates born?

No neonates born

what is the etiology of Primary uterine Inertia

Oversized litters (uterine stretching) Undersized litters (uterine stimulation)

What are the clinical signs of Primary uterine Inertia? (3)

- No signs of parturition - Prolonged gestation > 68 days - ***No puppies 36 hours after temp is <100 degrees F

Describe the 2 main components of Secondary uterine Inertia

Normal delivery of part of the litter develops uterine fatigue!!!

What are the 4 etiologies of Secondary uterine Inertia

1. Fetal obstruction 2. Pelvic obstruction 3. Fetal malposition 4. Fetal size

What are the 2 clinical signs of Secondary uterine Inertia

1. prolonged interval between neonates > 4 hours | 2. Weak or absent uterine contractions from fatigue

_______: the normal discharge from the uterus after childbirth.

Lochia

With a dystocia physical exam you will often see _____ without delivery and feel an obstructed canal on palpation from abnormal fetal presentation characterized by lack of _____ _____ in response to ______ ______

Lochia; uterine contractions; Fergusons reflex

Which type of uterine inertia can be treated medically?

Primary (NEVER secondary)

How do you medically treat primary uterine inertia? (4)

1. Oxytocin and repeat in 30 min if necessary 2. If positive results can contine to repeat oxytocic 3. manual manipulation of fetus if in vaginal vaulta if obstructed 4. Perform c section if no results?

Why would you do a C section? (5)

Secondary to uterine inertia primary uterine inertia refractory to treatment Systemic signs of bitch fetal distress diagnosed by ultrasound planned for high risk patients

WHere is the incision for C section compared to hysterotomy?

Be careful!!! Midway between xiphoid and umbilicus to cranial pubis Hysterotomy Ventral midline into uterine body

With C sections what must you do carefully?

Exteriorize the uterus (vascular and friable)

What do you need todo during a c section and avoid? (3)

Avoid incison over fetus milk fetus to incision pull placenta releases

C section patients are packed off with these?

Pack off with laparotomy sponges

With C sections you first engage the _____ layer, and clamp the umbilical cord _____ cm from abdominal and then pass the fetus to assistant. Placent can pass naturally if....

Sub Q; 2-6; firmly attached

Describe the closure for c section and suture (check for?) (what type suture) (layers?) (what dont you penetrate)

Check uterus for more fetus 3/0 monofilament absorbable single layer or double layer with inverting holding layer do not penetrate lumen

With c sections, if visible involution has not started or excessive hemorrhage what can you give?

Oxytocin IM

With c section, if you are finishing with a OHE there is no need for ______. (enbloc resection)

closure

What are the advantages of enbloc resection? (5)

1. OHE 2. Dystocia Tx 3. Decreased anesthesia time 4. Decreased abdominal contamination 5. No increased fetal mortality

Describe the basic procedure for enblock resection? (5)

- Break down SUSPENSORY ligament********** - Triple clamp pedicles - Transect - Hand uterus to assitant - Remove puppies < 60 seconds after clamps

______ a congenital condition in males in which the opening of the urethra is on the underside of the penis.

Hypospadius

Female Repro Flashcards

(73 cards)