Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Horse Medicine > Rectal tears > Flashcards

Rectal tears Flashcards

1
Q

what are common causes of rectal tears?

A

palpation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are less common causes of rectal tears

A 
enema administration
dystocia
chronic impaction (dry) and stricture--impaction causes lesions at mucosa of rectum
breeding injuries
spontaneous rupture
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

how do you avoid a rectal tear?

A

do not force against straining or peristaltic wave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what animals do you have to take special precautions with with rectal tears?

A 
arabian horse
ponies
small breeds
fractious horses
horses with colic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how can you appropriately restrain horses?/what other precaution to take?

A
  1. stocks
  2. twitch
  3. sedation
  4. lubrication
  5. lidocaine–IV set
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the grades of rectal tears?

A
  1. grade 1
  2. grade 2
  3. grade 3a
  4. grade 3b
  5. grade 4
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is a grade 1 rectal tear

A

only mucosa and submucosa are torn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is a grade 2 rectal tear

A

only the muscular layer is disrupted and causes mucosa and submucosa to prolapse through defect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is a consequence of a a grade 2 rectal tear?

A

creates a site for feces impaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is a grade 3A rectal tear?

A

the serosal area is intact but the tear causes formatino of a serosal diverticulum.
This serosal diverticulum is li kely to be larger than defect cause by grade 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a grade 3B rectal tear?

A

a tear that enters the mesentery–enters retroperitoneal space. occurs dorsally. That only leaves fat-filled mesocolon as a barrier preventing fecal contamination of abdominal cavity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is a grade 4 rectal tear?

A

disrupts all layers of rectum. allows direct palpaton of abdominal organs and gross fecal contamination of abdominal cavity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

where do rectal tears usually occur?

A

dorsal aspect of the rectum. located 15-55cm from anus and parallel to the longitudinal axis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what do you feel with a grade 4 rectal tear?

A

sudden release pressure

able to directly palpate abdominal organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are the clinical signs of a rectal tear?

A 
within 2 hours see signs of peritonitis and endotoxic shock:
tachycardia
intestinal ileus
pyrexia
sweating
depression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How do you diagnose rectal tears?

A
  1. avoid straining–epidural, sedation (xylazine, butorphanol)
  2. digital palpation
  3. endoscopy
  4. abdominocentesis
17
Q

differentiate feeling of grade 1 vs grade 3 rectal tear

A

grade 1–feels like a flap of mucosa

grade 3-there are thick rigid and seperated edges that are packed by feces

18
Q

why would you do abdomiocentesis with a rectal tear?

A

to rule out septic peritonitis. good diagnostic test

19
Q

What are the initial treatments for rectal tears?

A
  1. reduce activity of rectum–epidural etc
  2. remove feces from rectum and tear
  3. treat shock and peritonitis
  4. rectal packing
  5. broad spectrum peritonitis
  6. flunixin meglumine
  7. mineral oil–lube rectum,
  8. diet changes–cow pie feces
20
Q

what antibiotics should be used with a suspected rectal tear

A
  1. penicillin, gentamicin, metronidazole
21
Q

What are the benefits of flunixin meglumine?

A

antiinflammatory

anti-endotoxin

22
Q

what is the benefit of mineral oil?

A

coat feces, don’t break it down so there aren’t small pieces–don’t want small pieces because could go through tear

23
Q

beyond initial treatment, what steps should be taken with grade 3-4 tears?

A
  1. aggressive intravenous fluid therapy, hypertonic saline, isotonic crystalloids
24
Q

How do you protect tears from conversion to another grade?

A
  1. rectal packing (stokinet with cotton, povidone iodine, lubricated gel)
  2. anus closed using purse-string suture
  3. epidural anesthesia
25
Q

what is the surgical treatment for rectal tears?

A

divert feces away form tear–prevents contamination, impaction, enlargement, progression of peritoniti

26
Q

What are the general steps of surgical treatment of rectal tears?

A
  1. procedure to form stoma

2. procedure to reverse stoma

27
Q

What is a loop colostomy?

A

make a loop of small colon–suture together, then make an incision in tenia–large surgery probe, and take loop down to lower incision. Cut and fold back and suture to body wall.

28
Q

What is the after care for loop colostomy?

A 
broad spectum  (pen, gen, metronidazole)
laxatives
pretrolatum based ointment around stoma!
29
Q

How do you reverse the stoma? (colostomy)

A

do anastomosis of the small colon.

30
Q

What are complications of colostomy?

A 
dehiscence
abscessation
peristma herniation
prolapse
rupture colostomy
spontaneous closure
anastomic impaction
dehiscence after reversal
31
Q

What is an alternative to colostomy?

A
  1. incise rectum where tear is, then staple, and oversew mucosa
  2. suture the defect–deschamps needle
    can be used as adjuncts to colostomy
32
Q

What is the survival rate for grade 1?

A

93%

33
Q

What is the survival rate for grade 3 tearA? B?

A

74%
44%
(60% overall)

34
Q

What is the prognosis for grade 4 tear?

A

grave!

Horse Medicine (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions