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Small Animal Surgery > Unit 2: 4 - Head & Neck > Flashcards

Unit 2: 4 - Head & Neck Flashcards

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1
Q

What salivary glands do dogs have?

A

Parotid, mandibular, sublingual (mono/polystomatic), zygomatic

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2
Q

What salivary glands do cats have?

A

Parotid, mandibular, sublingual (mono/polystomatic), zygomatic, molar

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3
Q

What are 3 indications for surgery of the salivary glands?

A
  1. Mucoceles
  2. Tumors
  3. Trauma
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4
Q

What SG tumor is common in dogs?

A

parotid

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5
Q

What SG tumor is common in cats?

A

Mandibular

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6
Q

What is a mucocele?

A

Collection of saliva in tissues surrounded by granulation tissue

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7
Q

What are the 5 types of mucoceles?

A

Cervical, sublingual (ranula), pharyngeal, complex, zygomatic/parotid/molar

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8
Q

What are mucoceles caused by?

A

Unknown

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9
Q

What is the most common CS for a mucocele?

A

Asymptomatic

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10
Q

What diagnostics are done when a mucocele is suspected?

A

Cytology, imaging, histopath

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11
Q

How are mandibular and sublingual SGs excised?

A
  1. Incise capsule
  2. Dissect
  3. Ligate and transect duct caudal to lingual nerve
  4. Drain or marsupialize mucocele
  5. Histopath - rule out neoplasia
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12
Q

How is the parotid SG excised?

A

By tedious dissection

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13
Q

How is the zygomatic SG excised?

A

By transecting the arch

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14
Q

What are 3 things that can happen after a SG excision?

A

Recurrence, seroma, infection

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15
Q

What is the prognosis for a SG excision?

A

Good with mucocele but varies with a tumor

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16
Q

What structures make up the external ear?

A

Pinna, auditory meatus (vertical and horizontal canals)

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17
Q

What structures make up the middle ear?

A

Tympanic membrane, auditory ossicles, auditory tube (Eustachian)

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18
Q

What structures make up the inner ear?

A

Semicircular canals, cochlea

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19
Q

What are indications for surgery of the ear?

A

Aural hematomas, otitis, tumors/masses, trauma

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20
Q

What is the cause for an aural hematoma?

A

Trauma, irritation

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21
Q

What is the cause for otitis?

A

Derm-related (allergies, parasites, bacteria, yeast, immune-mediated dz, FB, conformation)

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22
Q

What are CS for aural hematomas?

A

Swollen fluid filled mass, head shaking, scratching

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23
Q

What are CS for otitis?

A

Foul odor, pain, rubbing/scratching ears, discharge, canal narrowing/proliferation, hearing loss, neuro signs

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24
Q

What are the components of an otic exam?

A

+/- sedation, otoscope, swab (cytology, C&S)

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25
What is the preferred imaging for the ear?
CT
26
What are 6 procedures that can be done surgically to the ear?
1. Pinna drainage 2. Pinnectomy 3. Lateral ear canal resection 4. Vertical ear canal resection 5. Total ear canal resection (with lateral bulla osteotomy) 6. Ventral bulla osteotomy
27
How is an aural hematoma treated?
Treat cause --\> remove clots & fibrin, lavage --\> place a teat cannula, active drain, "S" incision, and/or bandage
28
What are complications that can happen from an aural hematoma?
Can recur, cauliflower
29
T/F: No bandage is needed for an aural hematoma when a teat cannula is placed
True
30
Which way are sutures oriented around an "S" incision?
vertically, parallelling major vessels and obliterating dead space
31
What tumors are common in the ear?
SCC, melanoma, mast cell
32
What are 3 things that can be done to mitigate trauma?
1. Repair (appose epith edges and exclude cartilage) 2. Partial pinnectomy (cosmetically contour and appose epith edges) 3. Bandage (primary, concurrent)
33
What are 2 benefits to doing a lateral ear canal resection?
1. Improves drainage and ventilation 2. Facilitates topical treatment
34
Lateral ear canal resections should be done before _____ and \_\_\_\_\_.
proliferation, calcification
35
What are 3 indications for a total ear canal resection?
Irreversible hyperplasia, stenosis, calcification
36
What are indications for a ventral bulla osteotomy?
Polyps, otitis media (w/o externa), problems post TECA
37
What part of a cat's bulla is the largest?
ventromedial compartment
38
What is the promontory part of the cat's bulla?
Plexus of postganglionic sympathetic nerves
39
What is the purpose of a ventral bulla osteotomy?
Increased exposure and drainage
40
What are 3 complications associated with the lateral and vertical ear canal resections?
1. Inadequate drainage 2. Persistent otitis and progression 3. Dirty tumor margins
41
What are 7 complications that can happen after total ear canal resection and ventral bulla osteotomy?
1. Hemorrhage 2. Infection/abscess 3. Facial n. paralysis 4. Deafness 5. Vestibular dysfunction 6. Horner's syndrome (cats) 7. Fistula/otitis media - remnants
42
What are 3 indications for surgery of the thyroid/parathyroid glands?
Tumors, adenomatous hyperplasia, cysts
43
What CS are associated with thyroid carcinomas in dogs?
**Cervical mass**, dysphagia, laryngeal dysfunction, cough, dyspnea, exercise intolerance, hemorrhage
44
What CS are associated with parathyroid tumors?
PU/PD, vomiting, weakness, constipation, lethargy, inappetance, cystic calculi, bone and joint pain
45
What CS are associated with adenomatous hyperplasia in cats?
Unthrifty, weakness, muscle tremors, ataxia, incoordination, muscle atrophy, breathless, collapse
46
Where does the thyroid get its blood supply?
Common carotid and brachiocephalic trunk
47
Where do the parathyroid glands get their blood supply?
Cranial thyroid artery
48
What should be done in a thyroidectomy?
It is a bilateral procedure but should preserve one parathyroid
49
What are 6 complications that can arise from surgery of the thyroid/parathyroid?
1. Hypothyroidism 2. Hypocalcemia (rare if unilateral) 3. Hemorrhage 4. Laryngeal paralysis 5. Dysphagia 6. Recurrence
50
What is the most common thyroid tumor and what is the prevalence?
Thyroid carcinoma - 90%
51
How often are thyroid carcinomas metastatic and how often are they functional?
Metastatic = 40-80% Functional = 10%
52
What is the risk to taking a thyroid biopsy?
High risk of severe or fatal hemorrhage
53
What is the prognosis for surgical removal of thyroid adenomas?
Excellent - curative
54
What is the prognosis for surgical removal of carcinomas?
Depends on mobility, size, and stage 3 years if movable 6-12 months if invasive 3 months if untreated
55
Bilateral thyroid tumors are ___ times more likely to metastasize.
16
56
What are adjunct treatments for thyroid tumors?
I131 = cats Radiation Chemo
57
What is primary hyperparathyroidism caused by?
Excess excretion of PTH
58
What is secondary hyperparathyroidism caused by?
Chronic renal failure, diet imbalance
59
What does excess PTH result in?
Increased Ca and P release from bone --\> Ca resorption and P excretion by kidneys & Ca and P absorption in the intestines
60
How hoes hypercalcemia cause PU/PD?
Elevated Ca levels interfere with proper functioning of the renal tubule cells that normally respond to ADH --\> increased urination --\> increased thirst and dehydration
61
How can hyperparathyroidism be diagnosed?
Measure persistent ionized hypercalcemia, inappropriate or high PTH, no PTHrp
62
What % of patients have hypocalcemia after parathyroid surgery?
33%
63
When do we treat for post op hypocalcemia?
1. Total Ca \<8.0 mg/dL 2. iCa \<0.8 - 0.9 mmol/L 3. CS = face rubbing, muscle tremors, convulsions
64
How can we treat acute hypocalcemia?
10% Ca gluconate
65
How can we treat long term hypocalcemia?
Calcitriol, Ca, maintain serum Ca at low/low normal
66
What are the LNs of the head and neck?
Mandibular, parotid, retropharyngeal, superficial cervical (prescapular)
67
Branchial and pharyngeal cysts have an _____ lining.
epithelial
68
Where are branchial cysts?
Lateral or dorsolateral neck
69
Where are Rathke's cleft cysts?
Nasopharyngeal obstruction
70
Where are thymic cysts?
Mediastinal or SQ neck
71
Where are thyroglossal duct cysts?
Ventral midline

Small Animal Surgery (17 decks)

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