VCM Exam Flashcards

esophageal foreign bodies
Terms Definitions
Pylorectomy with end-to-end anastomosis between duodenum and remainder of stomach
GDVClinical signs
Acute depressionAbdominal distensionLethargy, weaknessMucous membranes pale to congestedPtyalismVomiting and/or retching which may be unproductiveCardiac dysrhythmias - weak pulsesFast, shallow respirations
Normal gestational length
330-340 days
Aseptic peritonitisCommon causes
Bile peritonitisUrine peritonitisLeakage of gastric or pancreatic juicesMechanical peritonitis
Open peritoneal drainageContinual patient monitoring …
Is important
Esophageal foreign bodiesThe prognosis is … if the foreign body can be removed without esophageal surgery
Difficulty or discomfort in swallowing
Surgical procedure involving an incision through the abdominal wall to gain access into the abdominal cavity
Principles of esophageal surgeryA … closure should be performed
Diseases of the pharynx
Retropharyngeal abscessCricopharyngeal achalasiaPharyngeal neoplasia
GDVBroad-spectrum antibiotics
Good initial choices include cephazolin, or a combination of enrofloxacin and ampicillin
Surgical operation in which the stomach is sutured to the abdominal wall
Esophageal foreign bodies… is critical in reducing the risk of severe esophageal damage and death of the patient
Early detection
Splenic arteryCeliac
Parasympathetic innervation to the stomach is supplied by the …
GastrotomyPerioperative antibiotics should be started at induction and continued for …
Up to 24 hours
Esophageal strictureDamage severe enough to involve the … is needed for stricture development
Submucosa and muscularis
Esophageal foreign bodiesIf the object has been advanced into the stomach, a … is performed to remove it
Localized peritonitis
Regional peritonitis limited to a specific anatomical area
Retropharyngal abscess usually occur secondary to … or a …
Trauma, foreign body
Hiatal herniasMale Shar peis and … are also predisposed
English bulldogs
Peritonitis is an inflammation of the peritoneumIt does not infer bacterial contamination or sepsis
Urine peritonitis
From disruption of continuity of urinary tractUsually causes mild peritonitis
There are 3 major phases of swallowing
Outcome of insultDisease process contained
Resolution of disease
EsophagraphyIf esophageal performation is suspected, a … should be used and food should be avoided
Water soluble contrast material
Esophageal foreign bodies are seen … more commonly in the dog than in the cat due to the more indiscriminate eating habits of dogs
6 times
Anatomy of the esophagusThe muscularis is … for the entire length of the esophagus in the dog
Striated muscle
Anatomy of the pharynxThe portion that lies above the epiglottis is the …
Hypertrophic gastropathiesFour types have been recognized in dogs
Focal cystic hypertrophic gastropathyHypertrophic gastritis of Basenji dogsHypertrophic glandular gastritisChronic hypertrophic pyloric gastropathy
Puppies than in adults
The stomach secretes …
Pyloric stenosisAn acquired form is also seen in …
Adult dogs
Second stage laborChorioallantois ruptures
Bag of water breaks
Anatomy of the esophagusIt has no …
Digestive functions
Diagnosis of esophageal disorderClinical signs
Common signs include regurgitation, dysphagia, repeated swallowing movements, profuse salivation, coughing, respiratory distress, and depression
Anatomy of the esophagusThere is an incomplete … which covers the muscularis
Adventitial layer
Surgical treatment of gastric neoplasia
Partial gastrectomyDistal gastrectomy with gastrointestinal anastomosis
Intraperitoneal antibiotics are …
Not recommended because adequate intraperitoneal concentrations of antibiotics are reached when they are given intravenously and they may damage the peritoneal surface when they come into direct contact with it
Hiatal herniasTreatment by replacing the abdominal contents into the abdomen and surgically decreasing the size of the esophageal hiatus has …
Not been uniformly successful
Tension relieving, reinforcing, or substitution procedure
Esophageal resection and anastomosisPrevent contamination by …
Physiology of swallowingDisruptionClinical signs
Regurgitation through the mouth or nose, dysphagia, coughing, gagging, excessive salivation, or aspiration pneumonia
Gastroesophageal phase
The bolus passes through the lower esophageal sphincter into the stomach
Cricopharyngeal achalasia
Condition where there is an inability to relax the cricopharyngeus muscle resulting in the animal being unable to pass solid food boluses from the mouth into the exophagus
GDVSeverity of clinical signs
Duration of dilatation and/or volvulusAmount of dilatation or malpositioning of the stomachAbility to vomit and relieve intragastric pressureSeverity of gastric and/or splenic vascular compromise
Heineke-Mikulicz pyloroplastyClose the incision transversely using one layer of …
Simple continuous or simple interrupted sutures of a synthetic monofilament absorbable suture material
Gastric dilatation volvulusSignalmentSex
There is no apparent sex predisposition, but the incidence may be lower in neutered dogs than in intact dogs
Second stage laborPoint of frequent dystocia (difficult birth)
Passage of shoulders
Sarcomas and squamous cell carcinoma
The esophagus lacks a …
Procedure for pharyngostomy tube placementA … is placed on the tube and the tube is sutured to the skin or a … suture may be used instead
Tape butterfly, Chinese finger trap
Anatomy of the esophagusIn the cat the terminal portion of the esophagus is …
Smooth muscle
Bilroth-IIThis procedure is reserved for situations where a …
Bilroth-I resection is not adequate
7th or 8th intercostal space
Esophagostomy tube placementThe tube should be filled with a small amount of …
Indications for ovariectomy or ovariohysterectomy
Prevent reproductionMinimize risk of mammary cancerTreat pyometra
Fredet Ramstedt pyloromyotomyA longitudinal incision is made in a relatively avascular area along the ventral aspect of the …
Pyloric antrum, pyloric canal and proximal duodenum, extending through the serosa and muscularis
Mucosa and submucosa
Layers of the stomach wallThe … is the holding layer for sutures
Cricopharyngeus muscle forms
The majority of the upper esophageal sphincter
GDVThe primary goal initially is …
To stabilize the patient
Fredet Ramstedt pyloromyotomy
For very mild cases of pyloric stenosisIn most cases, this procedure is not adequate to relieve clinical signs long term
Bile peritonitis
From rupture of the biliary tract or leakage after biliary tract surgeryIs usually not fatal unless there is concurrent peritoneal infectionIrritant nature of bile salts can alter bowel wall permeability with subsequent leakage of bacteria
Partial gastrectomyIf the lesion is on the dorsal or ventral aspect of the stomach and does not involve the greater or lesser curvature, excise the lesion and a margin of normal tissue with a …
Full-thickness elliptical incision
Third stage laborUmbilicus
Foal lays quietly near mare's vulva with umbilicus intact for 5-10 minUp to 30% of normal foal's blood volume may pass through placenta to foal during that first 5 min after birthEarly rupture of cord deprives foal of its normal blood volume
Full thickness surgical biopsies may be a better choice
LaparoscopyThis technique would be most useful for diagnosis of gastric disease if the lesion involves the …
The esophagus is a tubular, muscular organ that transmits boluses of materials from the …
Pharynx to the stomach
The largest region of the stomach, located between the fundus and the antrum
Anatomy of the stomachAntrum
Pharyngostomy tubes are contraindicated in …
Animals with healing wounds of the pharynx or esophagus where the tube itself may interfere with healing
Gastric dilatation volvulusSignalmentBreeds
Large and giant breed dogs are most commonly affected, but the disease can occur in any breed or size dog
GastrotomyA one-layer closure consists of a …
Simple interrupted or simple continuos pattern through all layers of the stomach wall
Esophageal foreign bodiesPrognosis
The prognosis is good if an early diagnosis has been made before esophageal necrosis and/or perforation have occurred
Partial gastrectomyIf the lesion involves the greater or lesser curvature, double ligate and divide the branches of the …
Gastric or gastroepiploic vessels that supply the area that is to be removed
Cytology of peritoneal tapsLarge numbers of neutrophils
Often toxic in appearance, will contain intracellular bacteria in septic peritonitis
GastrotomyUse a different sterile suction tip if the first suction tip …
Entered the lumen of the stomach
Goals of surgery are
To correct the underlying cause of peritonitisTo remove peritoneal exudatesTo provide some method for postoperative enteral nutrition in most casesTo establish continued postoperative drainage in most cases
Cricopharyngeal achalasiaPrognosis is …
Good if there are no other abnormalities of esophageal motility and if aspiration pneumonia is not present
Surgical incision into the chest wall
Approaches to the esophagusThoracic esophagus over the heart baseIf approaching the esophagus for persistent right aortic arch,
Surgical operation in which the stomach is sutured to the abdominal wall
Esophageal neoplasia… are the most common primary tumor types
Gastric dilatation volvulusSignalmentAge
GDV can occur at any ageHowever, this disease tends to be seen most frequently in middle aged to older dogs with the mean reported age at diagnosis varying from 6.5 to 8 years
Pyloric stenosisA congenital form is seen in …
Young brachycephalic dogs and Siamese cats
Chronic hypertrophic pyloric gastropathyIt is seen primarily in small breed dogs …
Such as lhasa apsos, Shih tzus and dachshunds, that are middle aged to older dogs
EsophagraphyTo evaluate swallowing and esophageal motility, … can all be used
Liquid barium, barium paste, or barium impregnanted food
GDVVascular insult results in …
Ischemia to the mucosa first followed by the submucosa, muscularis and serosa
Comes out of the mouth and/or nose simultaneously with eating
Cricopharyngeal achalasiaDiagnosis is confirmed by a …
Retropharyngal abscessThe abscess cavity should be …
Left open to heal by second intention, partially closed over a penrose drain, or a flushing system and penrose drain left in place for several days
Factors which have been associated with GDVEffect of diet and feeding patterns
Several studies have investigated the effect of diet type and feeding patterns on the development of GDV
Chest tube before closure
A length of esophagus equal to … can usually be resected without excessive tension on the suture line
Right lateral recumbency to allow the tube to be placed on the left side preferentially
Esophagostomy tube placementThe tube should extend from the midcervical region to the …
Use a left lateral thoracotomy because the great vessels are to the right of the esophagus
Approaches to the esophagusThoracic esophagus over the heart baseFor all other lesions in this area use a …
Greater curvature of the stomach
The lesser omentum is located between the …
Partial gastrectomyClosure can be done in …
Two layers with a simple continuous pattern in the mucosa/submucosa and a simple continuos or interrupted pattern in the muscularis/serosa layer
Serosa, muscularis, submucosa, and mucosa
When an incision is made into the stomach wall, the … separate from the muscularis and serosa
Gastrostomy tube placed endoscopically at the time of esophageal surgery, parenteral nutrition, or nasogastric intubation with a very small diameter tube
An esophagostomy tube is one that is placed in the …
Cricopharyngeal achalasiaIt is seen as a congenital lesion, most commonly in the …
Cocker and springer spaniel breeds or mixes
Right and left gastric arteriesRight and left gastroepiploic arteries
The left gastroepiploic is a direct branch off of the … , while the other three are branches of the …
Some patients require sedation for manipulation of an oral-gastric tube
If sedation is necessary, choose drugs wisely to avoid hypotension
GDVThe unstable patient is at a much greater risk due to
Dehydration and hypovolemic shockThe hypotensive properties of anesthetic agents compounding a shock situationPossible sepsis, endotoxemia and/or DICAlterations in acid-base and electrolyte statusPositioning the animal in dorsal recumbency with the weight of the distended stomach on the vena cava further reduces venous return to the heart
Y-U pyloroplastyMake the tip of the flap …
Round, rather than pointed, to help insure adequate blood supply
GDVIf the initial assessment deems that the patient is critical, only …
Take a brief history at this timeTreat the patient first
Cytology of peritoneal tapsAmber to serosanguinous fluid in urine peritonitis
Check BUN and creatinine of fluid and compare to that of serum
Submucosa as in the rest of the gastrointestinal tract
… should be administered when doing esophageal surgery
Storage of food after a mealGastric secretionRegulation of the delivery of chyme to the small intestine
Storage of food after a mealThe stomach capacity ranges from 45 to 115 ml/pound of body weight and is more variable in …
Pylorus and goes down into the small intestine
Large objects and objects which are likely to traumatize the esophagus during removal via the endoscope should be removed by …
OPD is more expensive than some drainage methods, but …
The results may be better in some types of septic peritonitis
It is concave and is the shortest distance from the cardia to the pylorus
The greater omentum arises mostly from the …
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