Shared Flashcard Set

Details

Surgery Exam II
Kraus and Toombs
37
Veterinary Medicine
Graduate
03/07/2011

Additional Veterinary Medicine Flashcards

 


 

Cards

Term

 

 

 

What is the focus of the physical examination?

Definition

 

 

Concentrate on the bladder, distal limb, neurologic examination, then pelvis

Term

 

 

 

What should you note with abdominal radiographs in regards to a ruptured bladder?

Definition

 

 

Fluid in the abdomen

 

Distinct bladder margins

 

Sublumbar streaking

Term

 

 

 

What else is involved in the physcial exam of the urinary tract?

Definition

Palpation

 

Serum Creatine and BUN

 

Abdominocentesis

 

Cystogram with isotonic IV contrast and CO2

 

Intravenous pyelogram for ureteral or kidney damage

Term

 

 

 

What is the order of the physical exam for a hit by car?

Definition

 

1) Urinary tract

 

2) Distal limb

 

3) Physical examination

 

4) Pelvis

Term

 

 

What neurological components are you testing in the back leg?

Definition

 

 

Lack of sensation in lateral digit indicates disfunctionality of sciatic nerve and a lesion in vertebral disks L4 and L5 (L6,7,S1,2 segs) or disruption at the acetabulum

 

Lack of sensation in the medial digit indicates disfunctionality of femoral nerve and a lesion in vertebral disks L3 - L4 (L4,5 segs) or disruption cranial to pelvis

Term

 

 

 

How should the pelvis be examined for trauma?

Definition

 

Symmetry

 

Ability to stand

 

Pain on palpation of hip

 

Instability of sacroiliac joint

 

Rectal examination

Term

 

 

What radiographic views should be taken?

Definition

 

 

Lateral and Ventral dorsal views

Term

 

 

 

When should a pelvic fracture be treated conservatively?

Definition

1) Fracture is not greatly displaced

 

2) Dose not involve acetabulum

 

3) Pelvic canal is maintained

 

4) Acetabulum covers femoral head

 

5) Sacroiliac joint displaced less than 50% and is stable

Term

 

 

 

What are the surgical treatments for acetabular fractures?

Definition

 

Open reduction internal fixation - DCP

Reconstruction

Acetabular plates

 

Screws, pins wires, methylmethacrylate

 

Femoral head and neck excision

 

Trochanteric osteotomy

Term

 

 

 

How is a trochonteric osteotomy performed

Definition

 

The acetabulum is exposed, allowing retraction of middle and deep gluteal muscles.

 

Tension band repairs the issue by converting tensile forces of gluteal mm into compressive forces

Term

 

 

 

What are common mistakes made in a trochanteric osteotomy tension band repair?

Definition

1) Too small an epiphysis

 

2) Only one K-wire used

 

3) Too small of a wire gauge

 

4) Its not done in a figure 8

 

5) The distal hole is insufficient

 

6) K-wires are not seated

Term

 

 

 

 

What are the surgical treatments for an iliace shaft fracture?

Definition

 

 

ORIF plate fixation with at least 4, if not 6 cortexes and use of ventral lag screws

Term

 

 

 

What's the surgical treatment for a sacroiliac luxation?

Definition

 

 

Reduction and use of lag screw fixation. Screw's must engage 60% of the sacrum

Term

 

 

 

 

What are the components of an external skeletal fixation device?

Definition

Fixation pins

Pin-gripping clamps

Connecting rods

Fixation frame

+/- IM pin

 

Prefered devices:

K-E splint

IMEX-SK

Securos

APEF (acrylic frame)

Term

 

 

 

What supplements are used for the ESF?

Definition

 

 

 

Lag screws, cerclage wires, and K-wires

Term

 

 

 

 

What are the advantages of the ESF system?

Definition

1) Minimally invasive application

 

2) Adjustable - to ensure fracture alignment and fixation rigidity

 

3) Implants can be removed without general anesthesia and surgery

 

4) Clamps & rods can be reused (NOT fixation pins)

 

5) Good for fractures with significant injury to overlying soft tissues

Term

 

 

 

What are disadvantages to the ESF system?

Definition

 

1) Pins penetrate soft tissues - impairing muscles, vessels, and nerves, while potentially seeding bacteria

 

2) Mechanical disadvantage - due to the greater distance from the bone

 

3) Greater post-op care necessary

Term

 

 

 

What's the difference between a half and full pin?

Definition

 

 

 

A half pin doesn't pass all the way through the limb

Term

 

 

 

 

What are the types of ESF structures and which bones are they good for?

Definition

Type 1-a: unilateral and uniplanar: tibia, radius, femur, and humerus

 

Type 1-b: unilateral and biplantar: tibia, radius, femur*, humerus* (*modification required)

 

Type II: bilateral and uniplanar: Tibia, sometimes radius

 

Type III: bilateral and biplanar: Tibia, sometimes radius

 

 

Term

 

 

 

What are the advantages of using a IM tie-in configuration?

 

Definition

 

Adds strength when fixation frame is a great distance from the bone

 

Especially on femur and humerus

 

For antebrachium, radius is fixated and ulna gets IM pin (un-tied)

Term

 

 

 

What are the biomechanics of ESF?

Definition

Rod diameter

 

Construct geometry

 

Pins/segment

 

Pin diameter

 

Pin type

 

Working length - Frame and pin lengths

Term

 

 

 

What is the proper pin diameter?

Definition

 

 

 

Thread diameter should be 25% of the bone diameter

Term

 

 

 

What is the appropriate pin number?

Definition

 

 

 

Minimum of 3 pins per segment

Term

 

 

 

How should pins be placed?

Definition

 

 

 

In the center of mechanically intact bone with pre-drilling and slow speed power insertion.

Term

 

 

 

 

How should the ESF be managed?

Definition

 

 

 

There should be adequate soft tissue release around all pins.  Proper pin-tract hygiene must be high until granulation tissue develops.  There is typically protective bandaging of the frame

Term

 

 

 

 

What radiographic projection should pin diameter and target spots be determined?

Definition

 

 

 

Lateral

Term

 

 

 

When should the hanging limb technique be used to provide approximate fracture alignment?

Definition

 

 

 

Radius and tibia

Term

 

 

 

 

What should be the drill bit

Definition

 

 

 

0.1 mm smaller than the core diameter of the pin

Term

 

 

 

What is the appropriate drill bit diameter?

Definition

 

 

 

0.1 mm smaller than the core diameter of the pin

Term

 

 

 

 

Why is fixation pin centering so important?

Definition

 

 

 

Proper centering ensures maximum distance between points of near and far cortical engagement and will increase pin-bone longevity and decrease likelihood of iatrogenic fracture

Term

 

 

 

How much space should there be between clamps and skin surface and how long should release incisions be.

Definition

 

 

 

1cm

Term

 

 

 

 

What's the order of pin placement?

Definition

 

 

 

Far, far, near,near, middle, middle

Term

 

 

 

 

How far from fracture should the near pins be?

Definition

 

 

 

about 1 bone diameter

Term

 

 

 

How should the ESF be bandaged?

Definition

 

 

Pack gauze sponges between fixator and skin and apply a Robbert Jones bandage

 

After granulation tissue, simplify to a bumper bandage

Term

 

 

 

 

How far from the fracture should the near positions be?

Definition

 

 

 

 

Should be about 1 bone diameter

Term

 

 

 

 

When should you cut fixation pins?

Definition

 

 

 

 

After alignment of the fractures in post-op radiographs

Term

 

 

 

 

How long should you wait before doing a staged disassemly of the frame?

Definition

 

 

 

 

6 weeks post-op

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