DVM Large Animal Surgery 2 — Questions and Answers
Question 1: Which nerve block is most appropriate for standing flank laparotomy in cattle?
- Cornual nerve block
- Paravertebral nerve block (Correct answer)
- Retrobulbar nerve block
- Ring block of the teat
Correct answer: Paravertebral nerve block
Paravertebral nerve block (proximal or distal) desensitizes the flank region by blocking the spinal nerves T13, L1, and L2, providing analgesia and muscle relaxation for standing laparotomy.
Question 2: A horse presents with a large colon displacement that is not correctable via rolling. Which surgical approach is preferred?
- Right flank laparotomy
- Ventral midline celiotomy (Correct answer)
- Left flank laparotomy
- Paramedian approach
Correct answer: Ventral midline celiotomy
Ventral midline celiotomy provides the best access to the entire large colon and allows manual correction of displacements that cannot be resolved non-surgically.
Question 3: What is the primary concern when performing a rumenotomy in cattle?
- Hyperthermia from prolonged anesthesia
- Contamination of the peritoneal cavity with rumen contents (Correct answer)
- Damage to the reticulum during incision
- Excessive blood loss from the rumen wall
Correct answer: Contamination of the peritoneal cavity with rumen contents
Spillage of rumen contents during rumenotomy can cause severe peritonitis; meticulous isolation of the surgical field and careful incision technique are essential to prevent contamination.
Question 4: Which suture pattern is classically used to close the equine linea alba after celiotomy?
- Simple interrupted with chromic gut
- Simple continuous with 2-0 PDS
- Large-bite simple continuous with #2 or #3 polyglactin 910 (Correct answer)
- Mattress pattern with stainless steel wire
Correct answer: Large-bite simple continuous with #2 or #3 polyglactin 910
Large-bite simple continuous suture with large-gauge absorbable monofilament or polyglactin incorporates adequate fascial tissue to resist the significant intra-abdominal pressure in horses.
Question 5: In small ruminants, what is the most common site for urethral obstruction by uroliths?
- Renal pelvis
- Ureterovesicular junction
- Urethral process (vermiform appendage) (Correct answer)
- Neck of the bladder
Correct answer: Urethral process (vermiform appendage)
The urethral process is the narrowest point of the small ruminant urethra and is the most frequent site of urolith lodgment, making amputation of this structure the first-line treatment.
Question 6: Which technique is used to correct a right-sided displacement of the abomasum (RDA) with volvulus in cattle?
- Standing right flank omentopexy
- Right paramedian abomasopexy
- Rolling followed by left flank laparotomy
- Right flank laparotomy with abomasopexy or omentopey (Correct answer)
Correct answer: Right flank laparotomy with abomasopexy or omentopey
RDA with volvulus requires a right flank laparotomy to decompress the abomasum, correct the volvulus, and perform abomasopexy or omentopexy to prevent recurrence.
Question 7: What is the recommended management of a sequestrum following a long-bone fracture in cattle?
- Systemic antibiotics alone until resolution
- Surgical removal of the necrotic bone fragment (Correct answer)
- Hyperbaric oxygen therapy
- Intramedullary pinning to stabilize the fragment
Correct answer: Surgical removal of the necrotic bone fragment
A bone sequestrum is avascular necrotic bone that cannot be reached by antibiotics; surgical debridement and removal of the sequestrum is required for resolution of the infection.
DVM Large Animal Surgery 2
Which nerve block is most appropriate for standing flank laparotomy in cattle?