Lecture 9: Small Animal Urogenital Flashcards
(94 cards)
1
Q
What is your landmark for the right gutter
A
Descending duodenum
2
Q
To expose the right kidney, right adrenal, right ovary and right limb of the pancreas what must you move
A
Descending duodenum
3
Q
Does the right kidney sit more cranial or caudal, compared to the left
A
Cranial
4
Q
What structure can the right kidney be hiding under
A
Caudate lobe of liver
5
Q
What structure could the right adrenal gland be sitting under
A
Caudal vena cava
6
Q
___ vein and ___vena cava can be better visualized when the R gutter is retracted
A
Portal vein and caudal vena cava
7
Q
What is the landmark for the left gutter
A
Descending colon
8
Q
To expose left kidney, left adrenal and left ovary what must you retract
A
Descending colon
9
Q
The left kidney is lateral to the ___ and under the left ____vein
A
Lateral to the caudal vena cava and under the left phrenicoabdominal vein
10
Q
The renal vessels and ureter are located on the ___ aspect of the kidney
A
Medial
11
Q
The ureters course ___to the bladder
A
Caudally
12
Q
The adrenal glands sit ___- relative to kidneys
A
Cranial medially
13
Q
What does the renal artery branch off of
A
Aorta
14
Q
what vein does the adrenal vein drain into
A
Phrenicoabdominal vein
15
Q
what is indicated by the black circles
A
Adrenal glands
16
Q
Where do the ureters attach
A
Dorsal aspect of the bladder on the trichone/ ureterovesicular junction
17
Q
The uterus sits ___ to the bladder
A
Dorsal
18
Q
what structure might obscure the urinary trigone in males
A
Prostate
19
Q
The urinary bladder apex is cranial or caudal
A
Cranial
20
Q
What structures are contained within the spermatic cord
A
Testicular artery, vein and nerve, surrounded by vaginal tunic
21
Q
Identify 1-3
A
- Pampiniform plexus
- Ductus deferens
- Vaginal tunic
22
Q
what does the testicular artery branch off of
A
Aorta
23
Q
what does the testicular vein branch off of
A
Caudal vena cava
24
Q
The contents of the spermatic cord pass through what structure to course down towards the testicle
A
Inguinal canal
25
Where does the vasculature that supplies the male and female urogenital system come from
Dorsal aspect off the aorta
26
Do you want to do a cystotomy on the dorsal or ventral aspect and why
Ventral, less vasculature
27
What connects the ovaries to the body wall
Suspensory ligament
28
What ligament do you want to break off during spay to allow for better visualization
Suspensory ligament
29
What vein and artery do you need to ligate during spay
Uterine
30
What structure is a swelling of the caudal uterine body
Cervix
31
What ligament attaches ovary to the uterine horn
Proper ligament
32
During spay where do you you want to place hemostat to hold the ovary in place
Proper ligament
33
If you are unsure whether you grabbed the ureter or the uterine horn how can you differentiate between the two
Tract back Caudally and see if you see the bifurcation of the uterine Horn, if not you have the ureter
34
What is being held by the hemostat
proper ligament
35
identify 1-3
1. Suspensory ligament
2. Vascular pedicle
3. Uterine horn
36
what ligament is this
Broad ligament
37
what does the broad ligament do
Supports the uterus and ovaries. Attaches uterus to body wall
38
What is the red arrow pointing to
Round ligament
39
What ligament provides a tight band of tension that can be broken down to increase exposure during spays
Round ligament
40
What is the black arrow pointing to
uterine artery
41
What is indicated by the asterisks
Mineralized opacity in the urinary bladder, potential stone
42
what is indicated by the white arrows
Urethral stones
43
Where should you make your incision for cystotomy and why
Ventral aspect of bladder to avoid vessels and ureters
44
What do you want to do after you scope out bladder stones
Flush normograde and retrograde
45
What is indicated by the arrow and how should it be approached during cystotomy
Arrow: caudal superficial epigastric vessel
During cystotomy best to make incision on either side but if not possible can cut through it and Lbi ate
46
What is the holding layer for cystotomy closure
Submucosa
47
What is indicated by the yellow arrows
Struvite bladder stones, magnesium stones that appear smooth on rads
48
What is the most common stone type
Struvite
49
___induced stones are more common in dogs
UTI
50
Sterile Struvite stones are more common in what species
Cats
51
What pH do Struvite stones tend to form in
Alkaline urine with pH >6.5-7.1
52
What pH do calcium stones tend to form in
Acidic urine
53
What stones can you use dietary dissolution
Magnesium (not calcium)
54
How long can dietary dissolution of stones take and what should you be doing in meantime
Can take 8 weeks, repeat rads every 4 weeks, monitor for urethral obstruction
55
Up to __% of urine samples in normal dogs have Struvite crystals
50%
56
T or F: crystalluria is always an indicator of stone formation
False! 50% of normal dogs have crystals in their urine so important to ask about urinary behavior and perform rads
57
How does voiding urohydropropulsion work
Fill bladder with saline and express stones out
Only works for stones < 5mm and in dogs >8kg
58
Case example: 9yr, FI KCCS with 1 week lethargy, decrease appetite, PU/PD, febrile, increase HR and RR. Mildly tense on abdominal palpation, abdomen feels distended and doughy. CBC shows marked neutrophilia with left shift, chem shows hyperglobulinemia and hypoalbuminemia. UA=1.010, pH=7, bacteriuria and pyuria. The following x-ray was taken. What is the problem
pyometra
59
When can pregnancy be detected by palpating vesicles
25-35 days
60
In pregnant small animal, uterine swelling can be seen on radiographs when
21-45 days
61
When can calcification of skeletal structures be seen during pregnancy
Day 45
62
When can gestational sacs be seen on ultrasound
As early as 20-22 but easier to see by day 25 with heartbeat
63
What are you looking for in ultrasound of suspected pyometra
Placing prob on ventral aspect, visualize bladder and then look dorsal to bladder to find uterus and note an anechoic fluid filled structures
64
What is the following ultrasound indicative of
Pyometra
65
When does pyometra typically present after estrus
2-4 months
66
At what age is pyometra typically diagnosed
>7
67
What bacteria is commonly cultured in pyometra
E. Coli
68
What type of pyometra has purulent vaginal discharge
Open cervix pyometra
69
What type of pyometra may have no vaginal discharge and are more systemically ill
Closed cervix pyometra
70
What is the survival rate of pyometra with surgery
95%
71
What is the survival rate of pyometra with surgery if there is a uterine rupture
50%
72
What is the survival rate of pyometra with medical management
85% with 30% recurrence
73
When is breeding recommended if pursuing medical management of pyometra
Next cycle
74
What is the treatment for pyometra
Ovariohysterectomy
75
What percent of dogs and cats are cryptochorid
15% dogs and 1% cats
76
When are testicles palpable in scrotum
6-8 weeks
77
What side/testicle descends first
Left
78
What side is cryptorchidism more common on
Right for inguinal and abdominal
79
For large breed dogs is inguinal or abdominal cryptorchidism more common
Abdominal
80
What are cryptorchidism patients at greater risk for
Intrabdominal testicular torsion and neoplasia
81
Neuter before ___yrs old is recommended
5 yrs
82
T or F: cryptorchidism is heritable and therefore breeding is not recommended
True
83
What is a good method to use to find undescended testicle
Find the prostate and then the ductus deferens and trace it
84
When performing a rectal exam, what structures would you mainly feel in an Intact male at the tip of your finger
Prostate, Trigone of bladder (potential stones)
85
During a rectal exam when you flip finger ventrally to palpate dorsally what structures are you examining
LN, aortic pulse, and LS pain
86
When doing a rectal exam and examining ventral aspect what you are examining
Urethra, check for any masses or stones
87
If you are unable to distinguish between an anal gland abscesses and a fistula what can you do
Prescribe antibiotics in both scenarios because that will treat the abscess and temporarily the fistula, but the fistula will come back if just treated with antibiotics because it is immune mediated and therefore needs immunosuppressive drugs
88
What is indicated by the asterisks
sublumbar lymphadenopathy that is compressing colon
89
What is indicated by the arrow
enlarged prostate that is compressing colon
**some mineralization present in the prostate that can be indicative of metastatic neoplasia
90
What is the site of a simple abdominocentesis
On linea alba, 1-2cm caudal to umbilicus
91
If unable to obtain fluid from simple abdominocentesis what can you do
4 quadrant abdominocentesis around umbilicus
92
what is indicated by the red circle
L7/S1 spondylosis
93
During a rectal exam, what surface would you palpate to evaluate sublumbar lymphadenopathy
Dorsal aspect
94
During a rectal exam what surface do you palpate to examine prostomegaly
Ventral/midline
