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Large Animal Surgery Amy Fayette November 2005 Equine Respiratory Sx Guttural Pouch Diseases
What are the indications for surgery Exercise intolerance Poor performance Abnormal resp noise Mucopurulent nasal discharge Serosanguineous nasal discharge External distortion of facial region
What is the most common respiratory tract diagnostic technique Endoscopy
What is your diagnosis for this soft fluctuant mass Epidermal inclusion cyst
How can you treat an epidermal inclusion cyst Aspiration or surgery
What is the problem with using aspiration Recurrence
What kind of noise is expected with redundant alar folds Expiratory
How do you diagnose redundant alar folds Place large temporary mattress sutures and see if the noise disappears
What is the treatment for redundant alar folds Surgery
What is the most common complication of surgery for redundant alar folds Highly vascular-> hemorrhage
How can you help to decrease the hemorrhage produced by this procedure Large carmalts Ice cold saline
What is your diagnosis Wry nose
What are the clinical signs of diseases of the nasal septum Decreased or complete obstruction Stridor Discharge Facial distortion
What are the preop considerations before operating on the nasal septum Collect 4-8 L of blood Tracheotomy
What is the aftercare required for surgery of the nasal septum 5-6 days systemic ATBs 10 days NSAIDS Remove packing 2 days post op Remove tracheostomy tube Clean and flush with saline
What is your diagnosis Ethmoid hematoma
What are the CS of progressive ethmoid hematomas Epistaxis Serosanguinous nasal exudate Stridor
What is the suspected cause of ethmoid hematomas Nasal gastric tubing
What is this instrument Funnel screw
What is this instrument Trephine
What is the main post op complication for surgical removal of ethmoid hematomas Hemorrhage
What is an ethmoid hematoma made up of on histopath Outer: resp epithelium Central: hemosiderin-filled macrophages
What is an alternative treatment for ethmoid hematomas Chemical ablation with formalin
What is the cause of primary sinusitis UR tract infection
What is the causes of secondary sinusitis Dental disease Facial fx Cysts Neoplasia
What are the CS of sinusitis Nasal discharge: serosanguineous Coughing Facial deformity
What is the treatment for sinusitis Sinusotomy (trephination)
What is the aftercare instructions for sinusotomy Leave open and flush daily ATB and NSAIDS
What is the prognosis for sinusitis after sinusotomy Good-excellent
What is this instrument Cribbing strap
What is cribbing Grasp object with incisors Contract neck muscles Pull backward
What is another name for cribbing Windsucker
What are the causes of cribbing Boredom Confinement Isolation Lack of roughage Learn from others?? Genetic??
What are the consequences of cribbing Colic ?? Abnormal wear of incisors Weight loss
What are some non surgical treatments for cribbing Remove fixed objects Bitter tasting substances Cribbing straps Acupuncture Shock- aversion Naloxon
What is the possible surgical treatments for cribbing Removal of sternomandibularis, sternothyroideus, omohyoideus Neurectomy of the ventral branch of accessory nerve
What aftercare should be followed after surgery for cribbing ATB and NSAIDS Change the environment
What dose of NSAIDS should be given Should be a bit painful if they try to repeat the behavior so low doses
What is the most common cause of noise Recurrent laryngeal hemiplegia
What is Recurrent laryngeal hemiplegia Progresive neurogenic atrophy of the recurrent laryngeal nerve
What is the signalment for Recurrent laryngeal hemiplegia 1-10 years old Large breed horses Hereditary
What causes Recurrent laryngeal hemiplegia Perivascular injection Guttural pouch mycosis Trauma Strangles OP toxicity Plant poisoning Lead toxicity CNS disease
What is the typical history for Recurrent laryngeal hemiplegia Noise Exercise intolerance
How is Recurrent laryngeal hemiplegia diagnosed Palpation Slap test Endoscopy during treadmill exercise
What is the slap test Slap withers during endoscopy Observe adduction of the contralateral arytenoid cartilage
What is the most common surgical treatment for recurrent laryngeal hemiplegia Laryngoplasty (Tie back)
What are some potential complications with the tie back procedure Seroma Cough Dysphagia
What should be done if an animal is coughing following tieback Remove sutures
How can you decrease dysphagia after tie back Feed off the ground
What other surgical procedures can be performed for recurrent laryngeal hemiplegia Ventriculectomy Reinervation of cricoarytenoid muscle Arytenoidectomy
What instrument is this Roaring burr
What are the complications of ventriculectomy Granuloma formation Mucocele Laryngeal web
How do you know that you excised enough of the ventricle Place on the finger tip---should be as big as your distal phalanx
What is arytenoid chondritis Inflammation and thickening of the arytenoid cartilage
What is the treatment for arytenoid chondritis Arytenoidectomy
What is a partial arytenoidectomy Arytenoid body and corniculate process removed
What is a total arytenoidectomy Arytenoid body, corniculate and muscular process
What is the px for a partial arytenoidectomy 50% of racehorses return to racing
Is partial or total arytenoidectomy recommended Partial
What is the colloquial term for DDSP Choking up
What is DDSP The soft palate is displaced over the epiglottis
What are some treatments of DDSP Tongue tie Staphylectomy Myectomy Epiglottic augmentation Laser cauterization
What is a staphylectomy Cutting part of the soft palate
Is epiglottic augmentation commonly done No because the epiglottis is often normal in size
What is your diagnosis Guttural pouch tympany
What is guttural pouch tympany Air filled guttural pouch
What are the causes of guttural pouch tympany Idiopathic Upper airway infection Persistent coughing Muscle dysfunction
What are the clinical signs of GP tympany Nonpainful Dyspnea Dysphagia Inhalation pneumonia Secondary empyema
What are the treatments for GP tympany Needle aspiration Indwelling catheter Surgery for recurrent problems
Which approach to the guttural pouch is illustrated below hyovertebrotomy
What are the problems with the hyovertebrotomy approach No ventral drainage
Which approach to the guttural pouch is illustrated below Viborgs triangle
What are the borders of viborgs triangle Sternomandibular muscle Linguofacial vein Caudal border of vertical ramus of the mandible
Which approach to the guttural pouch is illustrated below Whitehouse
Which approach to the guttural pouch is illustrated below Modified Whitehouse
Why might it be a bad idea to use a laser in the guttural pouch Less control than a scalpel and there are a lot of vessels and nerves in it
What are the causes of GP empyema Upper resp tract infection Abscessation of the retropharyngeal lnn Fx of the stylohyoid bone
Is GP empyema usually uni or bilateral Unilateral
What is the treatment for GP empyema Indwelling catheter Sx
What makes treatment of GP empyema difficult The presence of chondroids
What is the most common complication following GP sx Dysphagia
What is your diagnosis GP mycosis
What are the CS of GP mycosis Epistaxis Dysphagia
Which structure in the GP is most commonly affected by mycosis Internal carotid artery
Why can you not ligate the carotid artery to stop bleeding Blood will still come from the other side via the circle of willis
Can you ligate both carotid arteries Hypothetically yes if the animal has a really good supply from the basilar artery but often will kill the animal
What are the treatments for GP mycosis Arterial ligation Flush guttural pouch with antifungals with horse under GA
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