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Terms in this set (56)
What are the differentials for neck masses?
thyroid and parathyroid diseases
congenital neck cysts
FB-induced abscess or sinus tract
cervical expanding haematoma
What is the pathogenesis of a oro-pharyngeal stick injury?
penetrates the oropharynx or oesophagus (more dangerous)
can migrate into soft tissue in chronic cases (several months later)
Which dogs are prone to oro-pharyngeal stick injuries?
middle aged dogs
What are acute signs of an oro-pharyngeal stick injury?
hyper salivation - sometimes tinged with blood
What are chronic signs of an oro-pharyngeal stick injury?
draining tract present
How is a oro-pharyngeal stick injury diagnosed?
oral exam. under sedation/GA - key for acute
radiograph/US - to rule out oesophageal perforation
What is the treatment plan for an oro-pharyngeal stick injury?
- IV fluids + antibiotics + analgesia (for acute)
- surgical exploration of neck if chronic or acute with signs of cervical emphysema
- intraoral approach if acute emphysema = flush, clean, debride, close if necessary
What is the aftercare for oro-pharyngeal stick injuries?
antacids (concern of gastric reflux)
poss. feeding tube
What is the prognosis for acute cases of oro-pharyngeal stick injury?
good but if large contamination and oesophageal penetration = guarded
What is the prognosis for chronic cases of oro-pharyngeal stick injury?
good if FB can be found
How many pairs of salivary glands are in dog/cat?
Which is the largest salivary gland?
Which 2 salivary glands share same duct drainage?
mandibular and sublingual
Which salivary glands are most commonly affected by salivary mucoceles?
mandibular and sublingual
Is the parotid salivary gland affected by salivary mucoceles?
What is a salivary mucocele?
collection of saliva that has leaked from a damaged salivary gland/duct and accumulated in tissues
What are the 3 types of salivary mucocele?
cervical (most common)
What are the treatment options for salivary mucoceles?
salivary gland excision i.e. remove duct and drain
marsupialisation of ranula (hole in ranula and suture open to recreate salivary duct - only lasts few days as heals quickly)
List some common oesophageal foreign bodies?
What is used to remove oesophageal FB and assess mucosal damage?
What are the 2 methods of oesophageal FB removal using oesophagoscopy?
- extract orally if can be done (minimal trauma)
- advance FB into stomach (bones dissolve in stomach, or remove via gastrotomy)
only surgery if non-invasive treatment fails
What are complications with oesophagoscopy?
perforation and mediastinitis
What approach is used for oesophageal FB surgery? why?
midline - easy muscle separation (less traumatic)
What are indications for midline approach cervical surgery?
What are the challenges of oesophageal surgery?
- poor blood supply
- lacks serosal layer
- cannot be exteriosed
- difficult to resect
- risk of leakage and strictures
Describe the sutures required for oesophageal surgery?
simple interrupted/continuous/horizontal mattress
monofilament and absorbable
(round body needle)
How may layers of sutures are required for oesophageal surgery?
- 1st = mucosa and submucosa
- 2nd = adventitia and muscularis layer
What is the relevance of the thyroid glands being paired?
they are connected therefore if 1 is affected the other may be also
The thyroid glands are loosely attached to which structure?
The thyroid glands run very close to which nerve?
recurrent laryngeal nerve
How many pairs of parathyroid glands are there?
2 - intra and extra
Is thyroid neoplasia more common in cats or dog?
What is the most common thyroid neoplasia in dogs?
non functional adenocarcinoma (doesn't link to hyperthyroidism)
= large cervical mass
Is thyroid neoplasia bilateral?
yes - both not affected at the same rate i.e. one worse than the other
If the thyroid neoplasia is fixed to the trachea are you able to surgically resect?
(mobile = better prognosis)
How is thyroid neoplasia diagnosed?
palpable mass in neck area
metastasis to lungs - radiography
Can you biopsy thyroid neoplasia?
What is the treatment for a bilateral thyroid neoplasia?
resection if poss. - staged procedure or PTH re-implantation
+ chemo. for recurrence/metastases
Why is the resection for bilateral thyroid neoplasia staged?
to decrease the chances of hypocalcaemia
What is the treatment for a non-mobile thyroid neoplasia?
How many years after thyroid neoplasia surgery do patients survive?
What are the differentials for thyroid neoplasia?
granuloma secondary to wounds/FB
cervical LN metastasis from another cancer (tonsillar SCC)
Is hyperthyroidism more common in cats or dogs?
How is hyperthyroidism diagnosed in cats?
clinical exam. of thyroid
bloods - TSH, T4
imaging - US, scintigraphy
What is the treatment for hyperthyroidism in cats?
oral anti-thyroids e.g. carbimazole, metimazole
radioiodine (if bilateral)
surgery (thyroidectomy)- MOST COMMON
What are the 4 methods of surgery for thyroidectomy?
Which is the most common surgical technique for hyperthyroidism? why?
- dec. risk of hypocalcaemia
- lowest rate of recurrence
What are complications of thyroidectomy surgery NOT RELATED to surgical technique?
GA - cardiomyopathy
What are complications of thyroidectomy surgery RELATED to surgical technique?
How are chances of hypocalcaemia reduced during a thyroidectomy?
Is primary hyperparathyroidism more common in cats or dogs?
Clinical signs of primary hyperparathyroidism?
How is primary hyperparathyroidism diagnosed?
bloods - Ca, PTH, PTHrp
Treatment for primary hyperparathyroidism?
parathyroidectomy (usually 1)
What is seen under histopathology of primary hyperparathyroidism?
Post op patients from parathyroidectomy are assessed for what?
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