Veterinary Surgical Principles Flashcards

A 7-year-old Labrador undergoes a splenectomy. Intraoperatively, the surgeon notices the short gastric vessels are under significant tension after ligation of the splenic hilum. Which of the following best describes the anatomical basis for this tension and the most appropriate corrective action?

Answer: The short gastric vessels arise from the left gastroepiploic artery and require individual ligation close to the greater curvature of the stomach

The short gastric vessels are branches of the left gastroepiploic (gastro-omental) artery, which itself originates from the splenic artery. During splenectomy, they must be individually identified and ligated close to the greater curvature of the stomach to avoid gastric wall ischemia or inadvertent traction injury. Ligation en masse risks incorporating the gastric wall, and avulsion risks significant hemorrhage.

Which of the following suture patterns provides the greatest resistance to leakage in a low-tension enterotomy closure in small animals, while minimizing luminal narrowing compared to a single-layer interrupted appositional pattern?

Answer: Gambee pattern using a full-thickness monofilament absorbable suture

The Gambee pattern (full-thickness interrupted suture that incorporates mucosa, submucosa, and muscularis but everts slightly to appose mucosa-to-mucosa) provides excellent leak resistance comparable to double-layer inverting techniques, with significantly less luminal narrowing. Double-layer inverting patterns (Cushing over Connell) invert considerable tissue and reduce lumen diameter. Simple interrupted appositional is acceptable but the Gambee pattern is specifically validated for superior burst strength and minimal stenosis in intestinal surgery.

During a feline perineal urethrostomy (Wilson-Harrison technique), which of the following intraoperative complications most specifically results from failure to adequately dissect and retract the ischiocavernosus muscles bilaterally before completing the urethral spatulation?

Answer: Postoperative urethral stricture at the anastomotic site due to tension and inadequate caliber

Failure to fully retract the ischiocavernosus muscles limits the surgeon's ability to spatulate the urethra sufficiently proximal to the pelvic urethra's widest point. This results in anastomosis at a narrower segment under tension, which is the primary cause of postoperative stricture—the most common serious long-term complication of feline PU. The rectum is dorsal and protected by careful dorsal dissection. The internal pudendal artery is a known risk but is not specifically caused by inadequate ischiocavernosus muscle retraction.

A surgeon is performing a total ear canal ablation and lateral bulla osteotomy (TECA-LBO) in a dog with end-stage otitis. Postoperatively, the patient shows an ipsilateral facial nerve paralysis and Horner syndrome. Which of the following statements most accurately characterizes the expected prognosis and underlying anatomical explanation?

Answer: Horner syndrome resolves if caused by middle ear inflammation rather than nerve transection; facial nerve deficits resolve in 6–8 weeks if neuropraxia rather than axonotmesis

Both deficits can be neuropraxic (traction or thermal injury) or result from more severe axonotmesis/neurotmesis. If Horner syndrome arises from perioperative middle ear inflammation compressing the postganglionic sympathetic fibers (which traverse the tympanic bulla), it is more likely to resolve as inflammation subsides. Facial nerve paralysis prognosis depends on severity—neuropraxia recovers in weeks, while axonotmesis may take months or may not fully recover. Neither deficit is invariably permanent. This nuanced prognosis distinguishes it from the other options that overstate permanence or simplify recovery timelines.

In performing a diaphragmatic herniorrhaphy in a cat with a chronic (>2 week) traumatic diaphragmatic hernia, which of the following physiological phenomena presents the greatest anesthetic risk specific to the re-expansion phase of the repair?

Answer: Re-expansion pulmonary edema due to rapid inflation of chronically atelectatic lung lobes

Re-expansion pulmonary edema (RPE) is a well-documented complication when chronically atelectatic lung lobes are rapidly re-expanded. In chronic diaphragmatic hernias, the displaced lung has been collapsed for weeks; sudden re-expansion causes increased vascular permeability from mechanical stress and reperfusion injury to the alveolar-capillary membrane, leading to non-cardiogenic pulmonary edema. This is the anesthetic/surgical risk most specific to the re-expansion phase. Tension pneumothorax is managed by routine thoracic drainage. Hyperkalemia from bowel reperfusion is possible but not as specifically tied to the re-expansion phase itself.

A modified Robert Jones bandage is applied to a dog's distal forelimb following surgical repair of a distal radial fracture. Three days postoperatively, the owner reports the dog is excessively licking at the bandage and the toes appear swollen. Upon removal, a pressure sore is found over the accessory carpal bone. Which of the following best explains the biomechanical reason this specific site is most vulnerable in a Robert Jones bandage?

Answer: The accessory carpal bone is a bony prominence that creates a focal high-pressure zone when circumferential bandage compression is applied over a non-planar surface

Pressure sores develop most frequently over bony prominences because circumferential compression forces concentrate at these points of reduced surface area. The pressure equation (P = F/A) dictates that the same compressive force applied over a smaller area (the apex of a bony prominence) generates dramatically higher local pressures than over flat tissue. The accessory carpal bone protrudes laterally, creating exactly this condition. While poor vascularity and thin skin contribute, the primary biomechanical explanation is focal high-pressure concentration at the bony apex—the principle underlying all pressure ulcer formation.