surgery of the perineum, rectum, anus II

Question 1

inflammation of anal sacs

Answer 1

anal saculitis

Question 2

infection of anal sacs

Answer 2

anal sac abscess

Question 3

obstruction of anal duct

Answer 3

impaction

Question 4

anal sacs are sometimes erroneously referred to as what

Answer 4

anal glands

Question 5

signalment of dogs with anal sacculitis

Answer 5

most common in small and toy breed dogs, rare in cats

Question 6

normal secretions of anal sacs

Answer 6

serous slightly viscid, granular, pale-yellow liquid

Question 7

abnormal anal sac expressions

Answer 7

whitish gray, brown, yellow, green, bloody, purulent, gritty, turbid, opaque

Question 8

what may allow for early detection of anal sac disease

Answer 8

routine palpation and expression of the anal sacs during physical examination

Question 9

what is recommended if neoplasia is suspected in anal sacs

Answer 9

survey rads, CT, MRI

Question 10

how do you diagnose anal sac impaction

Answer 10

sac is distended and mildly painful and cannot be readily expressed

Question 11

how do you diagnose anal sacculitis

Answer 11

mod or severe pain is elicited on palpation, secretions are liquid, yellowish, bloody, purulent

Question 12

how do you dx anal sac abscessation

Answer 12

marked distention of the sac with purulent exudate, cellulitis of surrounding tissues, erythema of overlying skin, pain and fever

Question 13

how do you dx anal sac rupture

Answer 13

draining tract associated with anal sac

Question 14

name bacteria associated with diseased anal sac

Answer 14

C. perfringens, Proteus spp, micrococci, diphtheroids

Question 15

how are anal sac problems medically managed

Answer 15

manual expression, lavage, topical abx, dietary change

Question 16

which treatment is not recommended for anal sacculitis

Answer 16

chemical cauterization due to extensive perineal sloughing

Question 17

what is required to prevent fecal incontinence during anal saculectomy

Answer 17

meticulous dissection to preserve anal sphincter muscle and nerves

Question 18

what should owners always be warned of after anal saculectomy

Answer 18

incontinence risk

Question 19

describe the lining of the anal sac

Answer 19

graying and glistening, easy to distinguish from surrounding tissue

Question 20

how can anal sacs be packed to facilitate dissection

Answer 20

pack with iodoform umbilical tape

Question 21

why should histopath exam of removed tissue be performed

Answer 21

r/o anal sac tumors

Question 22

which technique is preferred for anal saculectomy

Answer 22

closed technique - external anal sphincter m is not transected and lumen of the sac remains closed

Question 23

when do perineal hernias occur

Answer 23

when the perineal muscles separate allowing rectum, pelvic, and/or abdominal contents to displace perineal skin

Question 24

is the pelvic diaphragm stronger in female dogs or male dogs?

Answer 24

female dogs

Question 25

how does the pelvic diaphragm get stressed

Answer 25

any condition that causes straining

Question 26

conditions that cause straining and may predispose to perineal herniation

Answer 26

urinary tract obstruction, colorectal obstruction, rectal deviation, perianal inflammation, prostatitis, cystitis, anal sacculitis, diarrhea, constipation

Question 27

what does the hernial sac contain

Answer 27

pelvic or retroperitoneal fat, serous fluid, deviated or dilated rectum, rectal diverticulum, prostate, urinary bladder, or small intestine

Question 28

what do cats have within their hernial sac

Answer 28

rectum

Question 29

what is postrenal uremia associated with

Answer 29

bladder entrapment

Question 30

what is shock associated with regarding perineal hernias

Answer 30

intestinal strangulation

Question 31

what is the concern with perineal hernias?

Answer 31

visceral obstruction associated with rapid deterioration - life threatening

Question 32

signalment for perineal hernias

Answer 32

almost always intact male dogs (93%)

Question 33

what is the risk of occurrence for perineal hernias in intact male dogs

Answer 33

increases with age until 14 years with intact males

Question 34

PE findings for perineal hernais

Answer 34

+/- perineal swelling lateral to anus (not all dogs with perineal hernias have perineal swelling), some reports indicate right-sided predominance

Question 35

if ballottement suggests liquid is present and the animal is dysuric, what should be performed?

Answer 35

perform US or perineal centesis to determine if fluid is present

Question 36

what should always be recommended for urinary bladder entrapment?

Answer 36

herniorrhaphy

Question 37

what does retroflexion of the urinary bladder and visceral entrapment require

Answer 37

emergency surgery

Question 38

two most common techniques for perineal hernia repair

Answer 38

traditional or anatomy reapposition, internal obturator roll up or transposition technique

Question 39

which urinary entrapment technique is it more difficult to close the ventral aspect of the hernia?

Answer 39

traditional technique

Question 40

is a bilateral herniorraphy possible?

Answer 40

yes, but postop discomfort and tenesmus may be greater than after unilateral procedures

Question 41

when should an enlarged prostate be biopsied?

Answer 41

if accessible during repair

Question 42

which castration techniques can be performed during perineal hernia repair

Answer 42

caudal or prescrotal castration

Question 43

if the urinary bladder is retroflexed into the hernia, what can be done?

Answer 43

urinary cath should be placed or a cystocentesis performed via perineum to relieve distress and prevent further deterioration

Question 44

how may perineal vessels and nerves be placed with perineal hernias?

Answer 44

may be displaced from their normal anatomic location

Question 45

do not mistake the prostate for a mass and attempt to excise it

Answer 45

just know this

Question 46

how can most postop complications of hernia repairs be prevented

Answer 46

meticulous surgical technique

Question 47

what is believed to reduce hernia recurrence or contralateral herniation

Answer 47

castration during herniorrhaphy

Question 48

what is recurrence of hernias related to

Answer 48

expertise of the surgeon

Question 49

what can be prevented by appropriate abx prophylaxis

Answer 49

infection and dehiscence

Question 50

what are post op complications of perineal hernia repairs

Answer 50

sciatic nerve entrapment - marked pain, NWB lameness, knuckling