exploratory laparotomy

Question 1

what is an exploratory laparotomy (coeliotomy)?

Answer 1

a laparotomy perfomed with the objective of obtaining information that is not avalible via clinical diagnostic methods

once the underlying pathology has been determined the procedure may continue as a theraputic procedure

if no underlying patholgoy can be found then **organ biopsy **should be performed

Question 2

what does the duodenal-colic ligament do in relation to examination of the intestine?

Answer 2

prevents exterization of the last portion of the duodenum

Question 3

what are the 5 regions that the abdomen can be dived into for the purpose of exploration?

Answer 3

• cranial abdomen
• gastrointestinal tract
• right paravertebral region
• left paravertebral region
• caudal abdomen

Question 4

when examining the greater peritioneal cavity what organ/tissue are you assesing?

Answer 4

peritoneal fluid

Question 5

when examining the greater peritioneal cavity what specific manoeuvers can you do to aid examination?

Answer 5

-excision of falciform ligament
examination of right and left paravertebral ‘gutters’

Question 6

when examining the cranial abdomen what organs/tissues are you assesing?

Answer 6

• liver
• gallbladder and bile ducts
• hepatic hilus (portal vein, hepatic artery, caudal vena cava)
• epiploic foramen
• spleen

Question 7

when examining the cranial abdomen what specific manoeuvers can you do to aid examination?

Answer 7

• tiliting surgical table and transection of the triangular ligaments will facilitate exam of diagphragmatic surface of liver. palpate parenchyma caudal retraction of the stomach
• duodenal manoeuvre
• exteriorization of spleen

Question 8

when examining the gastrointestinal tract what organs/tissues are you assesing?

Answer 8

stomach
intestinal tract
pancrease
regional lymph nodes

Question 9

when examining the gastrointestinal tract what specific manoeuvers can you do to aid examination?

Answer 9

exteriorization of intestinal tract
exteriorization of spleen facilitates exam of left limb of pancrease
right limb of pancrease may be examed when assesing descending duodenum. palpate parenchyma

Question 10

when examining the right paravertebral region what organs/tissues are you assesing?

Answer 10

• hepatic portal vein
• caudal vena cava
• coeliac artery
• hepatic lymph nodes
• right adrenal glands
• right kidney and proximal ureter
• right ovary and uterine horn

Question 11

when examining the right paravertebral region what specific manoeuvers can you do to aid examination?

Answer 11

duodenal manoeuvre

Question 12

when examining the left paravertebral region what organs/tissues are you assesing?

Answer 12

• aorta
• left adrenal gland
• left kidney adn proximal ureter
• left ovary and uterine horn

Question 13

when examining the left paravertebral region what specific manoeuvers can you do to aid examination?

Answer 13

colonic manoeuvre

Question 14

when examining the caudal abdomen what organs/tissues are you assesing?

Answer 14

• blader and distal ureters
• proximal urethra
• prostate gland and ductus deferens
• uterine body and proximal vagina
• regional lymph nodes

Question 15

when examining the caudal abdomen what specific manoeuvers can you do to aid examination?

Answer 15

• cranial traction of the small intestine
• caudal reflection of the bladder
• cranial traction of the bladder
• cranial traction on bladder or traction on ductus deferens in neutred males
• caudal reflection of bladder

Question 16

when examining the abdominal wall, peritoneal surface and mesenteries what organs/tissues are you assesing?

Answer 16

• diaphragm
• oesophageal hiatus
• aortic nad caval hiatus
• greater and lesser omentum
• internal inguinal ring

Question 17

when examining the abdominal wall, peritoneal surface and mesenteries what specific manoeuvers can you do to aid examination?

Answer 17

• tilting the surgical table and caudal reetraction of liver loabs will facilitate exam of the visceral surface of the diaphragm
• caudal retration of the stomach
• caudal retraction of the liver lobes and sectioning the triangular ligaments
• caudal retractinoof the stomach (lesser omentum) and exteriorization (greater omentum)

Question 18

how do you differentiate the duodenum from the jejunum?

Answer 18

the jejunum is the intestine after the duodenal-colic ligament

Question 19

what part of the intestine has an unusual blood suply and what is this supply called?

Answer 19

ileum - antimesenteric ileal branch of ileo-colic artery

Question 20

how is the spleen attached to the stomach?

Answer 20

the spleen is attached to the greater curvature of the stomach by ther gastro-splenic ligament

Question 21

what is the colonic manuover?

Answer 21

pulling the descendign colon to the right utilising the mesocolon (mesentery) to view the left kidney

Question 22

where is the left adreal gland found?

Answer 22

cranial to the left kidney sat under the left phreno-abdominal vein