LA Sx, Q2, IV

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LA Sx, Q2, IV
2012-10-29 10:09:18

LA Sx, Q2, IV
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  1. most inguinal hernias are usually what type of hernia?
    • Indirect
    • peritoneum intact
  2. What is a direct hernia?
    bowel goes thru break in peritoneum
  3. Post-breeding hernias in stallions are usually what type?
    acute irreducible inguinal hernias
  4. Should a foal that has a congenital scrotal hernia be castrated?
    yes- it is an inherited trait we dont want to pass along
  5. If a foal had a congenital scrotal hernia at birth and then it later corrected on its own, what problem can still arive at the time of castration?
    hernias are more likely to occur post-castration
  6. Does a chronic redicuible inguinal hernia have to be repaired?
    no- repair is elective
  7. What is a problem with stallions and bulls that have chronic redicible inguinal hernias?
    reduced fertility because testicle temp increased
  8. In what species are chronic reducible inguinal hernias genetic? Which do we surgically correct?
    • genetic in horses and swine- dont correct, castrate!
    • cattle- not genetic, can sx repair and keep breeding
  9. In a bull is the right or left inguinal ring usually bigger? and why?
    • left ring usually larger
    • b/c they usually lie down on right leg with left extended out
  10. Is the resection and anastamosis of dead intestine usually done thru the same incision as the hernia repair?
    no- fix hernia and then do ventral midline incision for resection and anastamosis
  11. in stallions with unilateral inguinal hernia what do we usually close? and do we castrate?
    • close external inguinal ring
    • unilateral castration
  12. The scrotum of a bull with a chronic hernia has what shape?
  13. Can stallions with chronic inguinal hernias show slight rear limb lameness
  14. When performing an ischial urethrotomy is the horse standing or in dorsal recumbancy?
  15. Where is the incision made in an ischial urethrotomy?
    midline just below anal sphincter
  16. T or F: passing a catheter makes an ischial urethrotomy procedure ALOT easier
    true- otherwise its very hard to find urethra
  17. The urethra is very distendable in what area of the male urinary system?
    pelvic urethra is very distendable
  18. Do we usually close an ischial urethrotomy incision?
    no- left to close by second intention
  19. What special post-op management do we need after a stallion with an ischial urethrotomy?
    none- simple procedure with few post op complications
  20. If calculi are too large to remove by an ischial urethrotomy, what procedure can be performed?
    pararectal cystotomy
  21. In a horse is the neck of the bladder in the peritoneal cavity?
    no- neck is outside peritoneal cavity
  22. In a pararectal cystotomy with an abdominal approach what is the biggest risk?
    abdominal comtamination
  23. Is the incision for a pararectal cystotomy closed with suture?
    no- left to heal as an open wound
  24. What are the 4 ways stallions/geldings commonly injure their penis?
    • 1. kicks- esp in breeding
    • 2. mare not ready to breed and moves
    • 3. jumping and not making it over a fence or partition
    • 4. poorly managed stallion ring
  25. Paraphimosis happens more in stallions or bulls? what is it?
    • stallions
    • distended penis ouside prepuce
  26. Paraphimosis can be caused by what 2 growths/enlargements?
    • 1. cutaneous habronemiasis
    • 2. other masses/tumors/neoplasia
  27. What is the most helpful thing an owner can do for a horse with paraphimosis?
    massage- rubbing emollient into penis until gone, about 20 mins
  28. What is one method of correcting paraphimosis that is no longer recommended and why?
    • purse string suture on external prepuce to help penis in
    • dont use because suture will rip- not we have open wound!
  29. What is the "humburg method"/best way of treating paraphimosis?
    hollow plastic jug with padded edges shoved up prepuce holding penis in, tape this to the patient securely
  30. With treatment paraphimosis will probobly resolve when?
    24 hours
  31. Phimosis is more common in stallions or bulls? what is it?
    • Bulls
    • swelling of penis/prepuce that holds penis inside
  32. What are 2 things that cause penile paralysis?
    • 1. Phenothiazine tranquilizers
    • 2. failure to treat paraphimosis
  33. What is priapism?
    an erection that wont go away
  34. What is the surgical correction for priapsm?
    • communication made b/w c.cavernosum and c. spingiosum so blood can drain
    • (erection not possible after this)
  35. What is reefing?
    circumcision in stallion
  36. What kind of growths on penis do i treat with reefing?
    ones that do NOT extend deeper than dermis
  37. Do we need a torniquet and catheter for reefing surgery?
    no- not necessary
  38. How do we close a reefing surgery?
    2 layers- superficial fascia and skin
  39. What is a post-op complication from a reefing surgery?
    hematoma- make drainage now
  40. What must we prevent post-op reefing sx?
    masturbation and erections
  41. When do we amputate the penis?
    • carcinomas- going deeper than dermis
    • penile paralysis
  42. When preparing to amputate the penis what MUST(!!!) we do?
    catheterize- always have to be able to locate urethra!
  43. When suturing the urethra mucosa to the skin what are we trying to prevent? and how?
    • strictures
    • leaving a LARGE ventral opening of urethra after amputation
  44. In penile amputation of stallion if I cut too much off what is the problem?
    patient urinates inside the prepuce- urine calding
  45. Is it normal for a bull to urinate inside the prepuce?
    yes- long hairs at end of prepuce help urine drain away and prevent urine scalding
  46. What is the Vinsot technique for partial phallectomy?
    • using a bander distal to the urethrotomy site
    • distal penis is sloughed off
    • wound healed by second intention
  47. When do we use the Boltz Technique for penis retraction?
    paralysis of penis
  48. For penis retraction sx- what happens if we leave the penis too short? too long?
    • too short- urine scalding
    • too long- injury/cuts/sunburn (SCC)
  49. What is a key structure to identify when performing a penile retraction surgery?
    must find the preputial reflection- we suture thru this bilaterally
  50. At the end of penile retraction surgery where do we want the glans penis to be?
    right at the prepucial orifice
  51. What is the best way to make sure the penis is properly placed in a penile retraction sx?
    using suture thru large tubing- adjust the tightness of suture and therefore placement of penis once animal is standing after surgery
  52. What adhesion do we WANT to happen in penile retraction surgery?
    adhesion between prepuce and skin- to maintain this retracted position