Critical Care, Toxicology, and Wound Management

For Chapter 25

Diagnosis of _________ is made when the patient meets physiologic criteria including tachycardia, tachypnea, fever, and marked increases or decreases in white blood cell count.

Systemic Inflammatory Response Syndrome (SIRS)

Cattle are at risk for _______, or inflammation of the uterus. 

Matritis

Clinical signs of ______ include gagging, retching, and excessive drooling.

Choke

__________ is often secondary to external trauma to the chest cavity that allows an influx of air into the pleural space, which collapses the lung and prevents re-expansion.

Pneumothorax

________ is complete cessation of all mechanical and electrical activity in the heart. 

Asystole

The term ________ refers to any condition that causes abdominal pain. 

Colic

If gas fails to be expelled from the rumen, bloat, or __________, may occur.

Ruman Tympany

_________ is the clinical term for a functional disorder of the small intestines in which motility is lost.

Ileus

_________ is a rapid, irregularly irregular rhythm with supraventricular morphology QRS complexes, no identifiable P waves, and the presence of fibrillatory waves (f waves).

Mertial Fibrillation

_________ results from excess acid in the blood caused by abnormal metabolism, excessive acid intake, renal retention, or excessive loss of bicarbonate.

Metabolic Acidosis

If the SIRS response progresses to microvascular clotting, it can lead to permanent failure of the kidneys, liver, lungs, brain, and heart, a condition called ____________.

Multiple organ dysfunction syndrome (MODS)

The inflammatory response associated with _______ causes increased vasodilatation, which often presents as bright red mucous membranes and bounding pulses.

Sepsis

The clinical term for difficult birth is _______.

Dystocia

The pattern of concurrent thrombosis and bleeding is called __________, and is among the most serious complications of shock.

Disseminated intravascular coagulation (DIC)

APCs are differentiated from ______________ by their wide and bizarre QRS shape and by the presence or absence of a P wave.

Ventricular Premature Complexes (VPCs)

A _______ is a device that uses obstetric wire to cut a dead fetus into smaller parts that can be extracted more easily.

Fetatome

Cyanotic (blue) membranes provide a tremendous amount of insight into a patient’s degree of ________.

Hypoxia

Ventricular fibrillation is often preceded by a rapid pulseless __________ 

Ventricular Tachycardia

The clinical term for restriction of blood supply is ________.

Ischemia

During patient assessment, it is important to differentiate a dehydrated patient from a ___________ patient, a condition marked by a loss of intravascular volume commonly occurring with shock, trauma, hemorrhage, or profuse vomiting and diarrhea.

Hypovolemic

Animals that cannot stand are referred to as ___________. 

Down Animals

Abnormal impulses originating from the atrial myocardium instead of the SA node are called ________________.

Atrial Premature Complexes (APCs)

If endotoxins are absorbed from septic secretions within the udder, endotoxemia can result, and the condition is termed _________.

Toxic Mastitis

Patients with _______________ are suffering from a stomach that becomes twisted because it is full of gas. The animal presents with acute signs ranging from abdominal distention, agitation, repeated retching, lateral recumbency, and shock.

Gastric Dilatation-Volvulus (GDV)

If the patient is in severe respiratory distress because of an upper airway obstruction, a temporary ________ should be performed immediately before the physical examination.

Tracheotomy

_______ anesthesia can be useful for reducing the pain associated with vaginal manipulation and for decreasing the force of uterine contractions so that vaginal manipulation of the fetus can be accomplished.

Epidural

The condition of increased nitrogenous wastes in the blood is _______. 

Azotemia

Urethral obstruction due to ________ (urinary calculi or stones) is common in male ruminants.

Urolithiasis

Borborygmi

Sounds caused by large intestinal mobility

Capillary refill time

Time required for blood to refill the small capillary beds of the mucous membranes after digital blanching 

Eructation

The periodic expulsion of gas through the esophagus of ruminants

Stridor

A harsh, high-pitched respiratory sound usually caused by obstruction to airflow at the pharynx or larynx

Syncope

Fainting

Tachycardia

Abnormally fast heart rate

Tachypnea

Increased respiratory rate

Tympany

Rumen distention with air; commonly referred to as bloat

Toxin

A poisonous substance

Urethral process

A small, curved extension of the urethra located at the distal end of the penis in sheep and goats

Uterine prolapse

Folding of the uterus inside-our through the open cervix and the vulvar lips

Uterine torsion

Twisting of the uterus in relation to the maternal pelvis 

Endometrial

Pertaining to the lining of the uterus 

Jugular vein

Consists of paired veins running in the neck that drain the brain, and neck 

Perineal area

The area between the anus and the dorsal part of the external genitalia

Abdominocentesis

Aspiration of fluid by inserting a needle in the peritoneal cavity

Cardiopulmonary Resuscitation

A response to cardiac arest

Chest Tube

A tube inserted into the pleural space

Defibrillation

The treatment for ventricular fibrillation

Electrocardiogram

A visual representation of the electrical activity of the heart

Fetatome

A device that is used to cut a fetus into smaller parts that can be extracted vaginally more easily

Fetotomy

A procedure in which a dead fetus is cut into smaller pieces so that it can be extracted vaginally

Primary Survey

The brief, targeted exam performed to deterime the most importent aspects of the patient’s condition

Pulse Oximeter

A monitor used to measure oxygen saturation of hemoglobin

Regional Nerve Block

A procedure in which a relatively small amount of local anesthetic is injected near a nerve causing desensitization of a larger area of the body

Rumenostomy

Creation of the permanent opening from the skin to the rumen

Thoracocentesis

Aspiration of fluid by inserting a needle in the pleural space

Tracheostomy

Creation of a permanent opening from the skin to the trachea

Tracheotomy

Creation of a temporary opening from the skin to the trachea

Transfaunation

The transfer of beneficial microorganisms from the rumen of one individual to another

Triage

Sorting patients according to the severity of an injury

Tube Cystostomy

Placement of catheter through the abdominal wall and into the bladder

Urethrostomy

Creation of permanent opening from the skin into the urethra

Restrictive Breathing

Fast, short, and shallow breaths

Bradypnea

Decreased respiratory rate

Labored Breathing

Prolonged and deep respirations

Orthopnea

Condition of maintaining a specific posture to ease breathing

Tachypnea

Increased respiratory rate

Normal

Interacts with the environment and is alert

Dull

Not eager to interact with the environment

Obtunded

Reacts to stimuli more slowly than normal

Stuporous

Only reacts to noxious stimuli

Comatose

Unresponsive to any stimuli

Fixed and Dilated pupils

Irreversible midbrain lesion

Rigid forelimbs and flexed hindlimbs with normal mentation

Injury of the cerebellum

Anisocoria

Injury of the cerebrum

Rigid forelimbs and flaccid hindlimbs when in lateral recumbency is typical

Schiff-Sherrington, associated with a T3 or L3 spinal lesion

Unresponsive midrange pupils

Lesion in the medulla

Extreme rigidity of all four limbs with arching of the neck and back

A lack of connection between the forebrain and brainstem

Septic Shock

Severe infection

Distributive Shock

Vasodilation and pooling of blood in the capillaries

Hypovolemic Shock

Decreased circulating blood volume

Cardiogenic Shock

Decreased cardiac output

Obstructive Shock

Impaired venous retrun to the heart

Ventricular Trachycardia

Lidocaine

Asystole

Epinephrine and Vasopressin

PEA

Epinephrine and Vasopression

Bradycardia

Atropine

Vagally mediated arrest or AV block

Atropine

Hypotension

Vasopressin and Dopamine

Pulmonary Edema

Furosemide

Cerebral Edema

Mannitol

Low Cardiac Output

Dobutamine

Hyperkalemia

Calcium Gluconate

P Wave

Atrial depolarization

PR Interval

Time it takes or the impulse to conduct through the AV node

QRS Complex

Ventricular depolarization

ST Segment

Time interval from ventricular depolarization to repolarization

T Wave

Vetricular repolarization

Name, reading summary, and significance of this rhythm:

Atrial Standstill

Flat baseline, absence of P wave, supraventricular appearing QRS complexes and tented T waves. The average heart rate is slow (50 beats per minute [bpm]).

The most common cause of atrial standstill is hyperkalemia associated with systemic disease, because high extracellular potassium concentration impairs the ability of the atrial myocardium to conduct an impulse. Prominent, tented T waves are also noted with hyperkalemia. The sinus node may continue to control the rhythm through the interatrial tracts without atrial myocardial depolarization (and therefore without P waves) until hyperkalemia is very severe, which is called a sinoventricular rhythm. Treatment is directed at restoring nomokalemia.

Atrial standstill that occurs with normal serum potassium concentration is most commonly a result of replacement fibrosis of the atrial muscle and is called persistent atrial standstill (or silent atrium). Because the sinus node cannot conduct impulses to the atria or the AV node, the AV node supports heart rhythm with a junctional escape rhythm at 40 to 60 bpm. Underlying etiologies of persistent atrial standstill may include atrial myocarditis or genetic predispositions (e.g., English Springer Spaniels appear predisposed). Pacemaker implantation is necessary for treatment of atrial standstill not caused by electrolyte disturbances.

Name, reading summary, and significance of this rhythm:

Normal Sinus Rhythm (NSR)

This is a 6-lead electrocardiogram with a lead II rhythm strip at the bottom. The rhythm is a sinus with a heart rate (HR) of 100 beats per minute (bpm).

Sinus rhythm refers to normal rhythm in dogs and cats, in which each beat is initiated by SA nodal discharge. It is characterized by a regular rhythm, normal HR, and consistent association between P waves and QRS complexes.

Name, reading summary, and significance of this rhythm:

Second-degree AV Block

Lead II ECG showing second-degree atrioventricular block. The second, fourth, and seventh P waves are not conducted to a QRS complex while the remaining P waves are associated with QRS complexes. Paper speed is 50 mm/second.

Second-degree AV block is a rhythm characterized by intermittent disruption of AV nodal conduction. On an ECG tracing, soma P waves are seem to be followed by QRS complexes, while others are not. Second-degree AV block is further subdivided into Monitz type I and Mobitz type II second-degree AV block. Mobitz type I (Wenchebach periodicity) is caused by high vagal tone and is characterized by progressive prolongation of the PR interval until AV node conduction is blocked. Mobitz type II is considered more serious and is characterized by a consistent PR interval before AV block.