SA Sx, Q2, I

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HLW
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180539
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SA Sx, Q2, I
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2012-10-29 10:14:58
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SA Sx Q2
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SA Sx, Q2, I
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  1. What is the protrusion of the abdominal content included in a peritoneal sac through a natural or acquired opening?
    hernia
  2. What is the protrustion of the abdominal content through a debilitated area of the abdominal wall due to a surgical or traumatic origin with an intact skin?
    eventration
  3. What is the rupture of all the structures constituent of the abdominal wall with the protrusion of the visceral content, through a wound or surgical incision?
    evisceration
  4. What are the 2 types of reducible hernias?
    coercible or incoercible
  5. With what type of hernia can the hernial content be reduced manually and is retained inside the abdominal cavity?
    coercible reducible hernia
  6. What type of reducible hernia can the hernial content be manually reduced but is NOT retained inside the abdominal cavity?
    incoercible
  7. What type of irreducible hernia is impossible reduction fo the hernia into the abdominal cavity, with no alteration yet in the blood supply to the hernial content?
    incarcerated
  8. What type of irreducible hernia is impossible reduction of the hernia into the abdominal cavity, with vascular compromise to the protruded viscera?
    strangulated
  9. What are some congenital defects that can be associated hernias?
    PSS, cardiac defects, hypospadia, imperforated anus, cryptorchidism, PPDH
  10. What are the four herniorrhaphy principles?
    return all viable content to the abdominal cavity, close the hernial ring to prevent recurrences, obliteration of redundant tissue in the hernial sac, use the patients own tissues whenever possible
  11. What are differential diagnosis of inguinal hernias?
    abscess, mammary neoplasia, neoplasia from another origin, hematoma, inguinal lymph node, fat, eventration
  12. What is the content of inguinal hernias?
    omentum, spleen, intestine, fat, uterus, bladder
  13. What is it called when the continuity is disrupted leading to protrusion of the abdominal viscera through the diaphragm into the thoracic cavity?
    diaphragmatic hernia
  14. What are signs of traumatic diaphragmatic hernia?
    dyspnea, tachypnea, cyanosis, orthopnea, muffled heart sounds, borborygmus, vomiting, chronic cough, exercise intolerance, tucked up abdomen, anorexia
  15. What are some radiographic signs of diaphragmatic hernia?
    interruption of diaphragmatic outline, soft tissue density in thorax, gas-filled viscera in thorax, loss of cardiac sihouette
  16. When you are auscultating a traumatic diaphragmatic hernia and you hear muffled heart and respiratory sounds, what could this mean?
    fluid or viscera in pleural space
  17. When you are auscultating a traumatic diaphragmatic hernia and you hear borborygmus, what could this mean?
    intestines in the pleural space
  18. When you ausculate a traumatic diaphragmatic hernia and you hear tympany on left side of thorax, what could this mean?
    stomach in pleural space
  19. When is the mortality rate of hernias higher when surgery is done?
    higher when hernias are repaired < 24 hours, or > 1 year after the occurence
  20. When you delay hernia repair 1-2 weeks, what is the success rate?
    90%
  21. What type of herniation needs immediate repair?
    if the stomach has herniated into the thoracic cavity
  22. In repairing a traumatic diaphragmatic hernia where should you begin suturing the radial tear?
    at most dorsal margin
  23. In repairing a traumatic diaphragmatic hernia, where should you anchor circumferential tears?
    by suturing around ribs
  24. In closing a traumatic diaphragmatic hernia, what should you do when primary closure is not possible?
    use autogenous or synthetic graft or advance the diaphragm
  25. What is a congenital hernia in dogs and cats that is thought to be result of faulty development or prenatal injury of septum transversum, often associated with cardiac abnormalities and sternal deformities?
    peritoneo-pericardial hernia
  26. In peritoneo-pericardial hernia where are the abdominal organs?
    inside pericardial cavity
  27. What are radiographic signs of peritoneo-pericardial hernia?
    enlarged cardiac silhouette, discontinued ventral diaphragm, structures with gas in pericardial sac, sternum defects, and tracheal elevation
  28. What type of hernia is more common in adult non-castrated males, 2/3 unilateral usually on the right side?
    perineal hernia
  29. In repairing a diaphragmatic hernia, what approach should you use, the thoracic approach, or the abdominal approach and why?
    abdominal approach, more familiarized, provides bilateral access, can be extended by sternotomy or paracostal incision, requires ventilatory support of patient.
  30. When repairing a diaphragmatic hernia what type of suture and what pattern should you use?
    non-absorbable suture, and simple continuous or simple interrupted.
  31. In closing a diaphragmatic hernia, why does the anesthetist slowly expand lungs while the last suture is placed?
    force air out of pleural space
  32. In repair of traumatic diaphragmatic hernia, why should you insuflate lungs gradually?
    reperfusion injuries can lead to pulmonary edema
  33. How long is the prognosis of traumatic diaphragmatic hernia guarded?
    until the patient has survived 24 hours following surgery
  34. What are congenital associated defects with peritoneo-pericardial hernia?
    ventral/umbilical hernia, cardiac defects, lack of union of the last sternebra, associated with ventral hernia in 4 out of 13 dogs
  35. What is the breed incidence of perineal hernia?
    GSD, collie, boxer, pekingese, dachshund, mongrel
  36. What is the best way to diagnose perineal hernia?
    radiography
  37. What are the surgical approaches for perineal hernia?
    perineal or lateral
  38. What are postop complications of perineal hernia repair?
    rectal prolapse, incontinence, dehiscence, sciatic nerve lesion
  39. What is the recurrence rate of perineal hernia?
    10-46%
  40. What is the rate of sciatic nerve lesion in perineal hernia repair?
    5%
  41. In fixing a sciatic nerve lesion, from where should you NOT approach?
    via herniorrhaphy
  42. What perianal neoplasia is most common in intact male dogs, and does not occur in cats because no perianal or circumanal glands?
    perianal gland adenoma
  43. What perianal neoplasia is most common in female dogs, and associated with hypercalcemia?
    apocrine cell adenocarcinoma of the anal sac or apocrine gland adenocarcinoma
  44. In vertical ear canal resection, what is the clock face analogy involved with suturing?
    place stay suture at 3,6,9, and 12

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