L12: LA Surgical Complications (Morton) Flashcards Preview

Surgery (Spring 2015) > L12: LA Surgical Complications (Morton) > Flashcards

Flashcards in L12: LA Surgical Complications (Morton) Deck (30):
1

monitor hemorrhage by:

counting sponges
HR
mm
arterial pressure
bucket

2

prolonged bleeding -->

tachycardia
inc. hypovolemia/hypotension
pale mm
inc. RR
metabolic acidosis

3

what percent of BW does blood compose in horses

8% (~40L)

4

transfusion should be performed when how much blood lost

>10L

5

loss of what percent blood volume --> hypovolemic shock

20-25%

6

rapid loss of >50% -->

death

7

systems affected by hemorrhage

CV
renal
nervous
MS

8

hemorrhage tx

fluids (colloids)
transfusion
hypertonic saline
pain relief
monitor PCV throughout recovery

9

which horses have low blood antigenicity

geldings
quarter horses
-try to do cross-matching, esp. for 2nd transfusion

10

cause of acute airway obstruction

-recovery from anesthesia
-long sx duration, dorsal recumbency
-nasal/pharyngeal/laryngeal edema, nasal bleeding, arytenoid paralysis/spasm

11

CS of acute airway obstruction

-anxiety, strong inhalation against obstruction (stridor/sturdor)
-high negative intrathoracic pressure --> alveolar fluid accumulation and pulmonary edema and hemorrhage
-no evidence of air passage through nostrils
-inc. abdominal effort
-abnormal abdominal movements
-nostril flaring
-panic and strugging

12

Tx of acute airway obstruction

-remove obstruction
-phenylephrine in nostrils
-establish airway
-lasix
-O2 therapy
-Corticosteroids

13

Prevention of acute airway obstruction***

endotracheal/nasotracheal tube during recovery

14

tx of infection

-early recognition
-abx treatment (culture first)
-anti-inflammatories
-removal of infected/necrotic tissue, foreign material
-lavage, bandaging

15

reasons for dehiscence

infection
high motion
excessive tension (esp. a problem in horses)
poor blood supply

16

tx of dehiscence/herniation

-control infection (abx, anti-inflammatories)
-tension suture
-immobilization
-abd. support bandage to prevent hernia
-sx herniorrhaphy after 4-6mo.
-suture/mesh herniorrhaphy

17

CS of post-op colic

-abd. pain
-inappetence
-lack of fecal prod.
-tachycardia
-dehydration
*esp. cecal impactions*

18

tx of post-op colic

NPO
monitoring
fluids
analgesics
laxatives
spasmolytics
electrolytes
anti-endotoxic tx
colic sx

19

laminitis

disruption of blood flow to lamina
-failure of attachments b/w P3 and hoof wall
-can be caused post-op by endotoxemia, or support limb laminitis

20

CS of laminitis

-inc. lameness
-shifting weight b/w front and back feet
-inc. digital pulses
-inc. heat in affected feet
-sensitive to hoof testers
-rotational and/or sinking

21

tx of laminitis

-PREVENTION
-analgesics
-nsaids
-vasodilators
-icing feet
-deep bedding
-corrective shoeing
-dietary changes
-DDF tenotomy

22

predisposition for myopathy

-gen. anesthesia
-ischemia and reperfusion injury
-well-muscled horse
-intra-op hypotension
-sx position, length of sx, padding

23

most common form of myopathy**

triceps myopathy
-char. by dropped elbow stance

24

myopathy sequelae

-local or general swelling and pain
-m. fasiculations
-horse becomes anxious, profusely sweats
-can cause huge delay in recovery and increases risk of fracture
-renal damage
-m. damage

25

tx of myopathy

-bandaging
-fluids
-anti-inflamm.
-m. relaxants
-analgesia

26

sign of radial n. neuropathy

dropped elbow
*most common neuropathy*

27

sign of femoral n. neuropathy

inability to extend stifle

28

sign of facial n. neuropathy

lip drooping

29

neuropathy inc. risk of fracture. May or may not resolve

:)

30

tx of neuropathy

supportive therapy
bandaging/splints
sling
analgesics
anti-inflammatories
acupuncture