Chapter 65 Amputations

Question 1

In which cases can partial limb amp be considered?

Answer 1

If prosthesis will be used.

Question 2

What intra-op analgesia can be provided prior to nerve transection

Answer 2

0.5% ropi or bupi, up to 2 mg/kg total.

Question 3

How many heads does the triceps muscle have in dogs?

And in cats?

Answer 3

Four in dogs: Long, lateral, medial, accessory

Three in cats: Medial and accessory are fused

Question 4

List the extrinsic muscles of the thoracic limb (7):

i.e. those that need to be cut for a TL amputation (inc scapula)

Answer 4

1. Trapezius
2. Omotranversarius
3. Rhomboideus
4. Serrratus ventralis
5. Latissimus dorsi
6. Brachiocephalicus
7. Pectorals

Question 5

Between which muscles does radial nerve move from medial to lateral?

Answer 5

Between long and medial heads, then along brachialis muscle

Question 6

what muscles make up brachiocephalicus muscle?

Answer 6

Coracobrachialis + Cleidocephalicus

(Cleidocephalicus = cleidomastoid + cleidocervival parts)

Question 7

What is the proper name for prescapular LN?

What muscle does it sit under?

Answer 7

Superficial cervical.

Beneath brachiocephalicus

Question 8

Under which (2) muscles does axillary LN sit?

Answer 8

Lat dorsi + deep pectoral

Question 9

List 3 pelvic limb amputation techniques

Answer 9

• Mid femoral
• Coxofemoral disarticulation
• Acetabulectomy

Question 10

When is acetabulectomy indicated?

Answer 10

Neoplasia of femoral head/neck

Question 11

What muscles lie cranial and caudal to the femoral triangle?

Answer 11

Sartorius cranially, pectineus caudally.

Question 12

The femoral artery should be ligated proximal to two branches - which two branches?

Which additional (more proximal still) branch usually needs to be ligated individually?

Answer 12

Ligate femoral artery proximal to:

• Superficial circumflex iliac
• Lateral circumflex femoral

Medial circumflex femoral usually needs to be ligated individually.

Question 13

List the muscles that need to be cut during plevic limb coxofemoral amputation (15)

Name an extra muscle in cats

And name 3 extra when performing acetabulectomy

Answer 13

1. Sartorius
2. Pectineus
3. Adductor longus
4. Adductor magnus et brevis
5. Semi-memb
6. Semi-tend
7. Biceps femoris
8. Tensor fascia lata
9. Quads
10. Iliopsoas
11. Gemelli
12. Internal + external obturator
13. Piriformis
14. Articularis coxae
15. Glutes

+ Caudofemoralis in cats. N.B. = abductor cruris!

In acetabulectomy;

+ intertransversarius dorsalis caudalis

+ levator ani

+ iliocaudalis

And can elevate muscles from pelvis instead of mid/distal body transection.

Question 14

What factor is associated with worse outcome in amputations?

Answer 14

Obesity

(N.b. not size of animal)

Question 15

Name 3 less common complications of amputation (on top of the usuals)

Answer 15

• Neuroma
• IVDD (w TL amp –> increased head bobbing –> poss increased IVDD risk)
• Phantom pain

Question 16

What two options are there for prostehses?

Answer 16

Stump pocket prosthesis or ITAP

Question 17

What does ITAP stand for?

Answer 17

Intraosseous Transcutaneous Amputation Prosthesis

Question 18

At least, how much radius/ulna or tibia/fibula should remian to allow for stump socket prosthesis?

Answer 18

>30%

Question 19

name 2 ITAP complications

Answer 19

Aseptic loosening and prostehsis fracture

Question 20

What is a partial foot amp?

Answer 20

2 or more adjacent toe amputations

Question 21

At the metatarsal/metacarpal level, what arteries are encountered dorsally?

And ventrally?

Answer 21

Dorsally:

• Dorsal common digital arteries

Ventrally:

• Palmar/plantar common digital arteries
• Palmar/plantar metacarpal/metatarsal arteries

Question 22

name the seven arteries encounted when performing high tail amp.

Answer 22

(only the two lateral caudal and medial continue caudally)