Uvod u kirurgiju i ortopediju doma
ć
ih životinja
1
KIRURŠKA PROPEDEUTIKA .......................................................................................................................... 6
Metode............................................................................................................................................................. 6
Anamneza........................................................................................................................................................ 6
Nacional.......................................................................................................................................................... 6
Status praesens: .............................................................................................................................................. 7
Inspekcija ........................................................................................................................................................ 7
Palpacija ......................................................................................................................................................... 8
Perkusija ......................................................................................................................................................... 9
Askultacija....................................................................................................................................................... 9
Sondiranje ....................................................................................................................................................... 9
Specijalne metode ......................................................................................................................................... 10
ASEPSA I ANTISEPSA ..................................................................................................................................... 11
Antisepsa ....................................................................................................................................................... 11
Asepsa ........................................................................................................................................................... 12
Sterilizacija ................................................................................................................................................... 12
P
RIPREMA RUKU
................................................................................................................................................ 13
Fibringerova priprema.................................................................................................................................. 13
Suvremena metoda:....................................................................................................................................... 13
Priprema materijala...................................................................................................................................... 13
Priprema operacionog polja ......................................................................................................................... 14
ANESTEZIJA ..................................................................................................................................................... 15
Op
ć
a anestezija ............................................................................................................................................. 15
Teorije o nastanku anestezije ........................................................................................................................ 15
Stadiji op
ć
e anestezije ................................................................................................................................... 16
Gubitak refleksa ............................................................................................................................................ 17
Tablica promjena prilikom anestezije ........................................................................................................... 18
E
KSTRAPULMONALNA ANESTEZIJA
.................................................................................................................... 19
O
P
Ć
A ANESTEZIJA ŽIVOTINJA
............................................................................................................................. 21
I
NHALACIONA
(
INTUBACIONA
)
ANESTEZIJA
....................................................................................................... 22
Inhalacioni anestetici .................................................................................................................................... 23
Aparat za inhalacionu anesteziju .................................................................................................................. 23
L
OKALNA ANESTEZIJA
....................................................................................................................................... 26
V
ODILJNA ANESTEZIJA NA GLAVI KONJA
........................................................................................................... 29
Infiltracija n. infraorbitale u canalis infraorbitale-u. ................................................................................... 29
Infiltracija n. infraorbitale na foramen infraorbitale.................................................................................... 29
Infiltracija n. alveolaris inferior ................................................................................................................... 29
Anestezija n. frontalis (anestezija gornjeg o
č
nog kapka i kože na
č
elu po Bolz-u)....................................... 30
V
ODILJNA ANESTEZIJA NA GLAVI GOVEDA
........................................................................................................ 31
Infiltracija n. infraorbitalis ........................................................................................................................... 31
Infiltracija n. cornualis ................................................................................................................................. 31
V
ODILJNA ANESTEZIJA NA EKSTREMITETIMA
..................................................................................................... 32
Infiltracija nn. volares i plantares kod konja ................................................................................................ 32
VODA I ELEKTROLITI ................................................................................................................................... 36
Uzroci šoka ................................................................................................................................................... 38
Patogeneza šoka............................................................................................................................................ 39
Patoanatomski nalaz šoka............................................................................................................................. 39
Klini
č
ka slika šoka ........................................................................................................................................ 39
Infuzione teku
ć
ine ......................................................................................................................................... 39
Korekcija metaboli
č
ke acidoze...................................................................................................................... 41
K
RVARENJA
....................................................................................................................................................... 42
OZLJEDA ILI LESIO........................................................................................................................................ 44
O
TVORENE OZLJEDE
.......................................................................................................................................... 45
Ubodna rana ................................................................................................................................................. 45
L
IJE
Č
ENJE RANA
................................................................................................................................................ 47
Tehnika primarne kirurške obrade rane ....................................................................................................... 48
Uvod u kirurgiju i ortopediju doma
ć
ih životinja
2
Z
ARASTANJE RANE
............................................................................................................................................ 49
Bitni procesi zarastanje rane su: .................................................................................................................. 49
Zarastanje rane per primam ......................................................................................................................... 50
Zarastanje rane per secundam...................................................................................................................... 50
Zarastanje pod krastom................................................................................................................................. 50
Smetnje u zarastanju per primam.................................................................................................................. 50
Smetnje u zarastanju per secundam .............................................................................................................. 50
Patologija ožiljka:......................................................................................................................................... 51
Č
IR
(
LAT
.
ULCUS
,
ENG
.
ULCER
) .......................................................................................................................... 52
I
NFEKCIJA RANE
................................................................................................................................................. 53
Gnojna rana .................................................................................................................................................. 53
F
LEGMONA
........................................................................................................................................................ 54
A
PSCES
.............................................................................................................................................................. 56
E
DEM
................................................................................................................................................................. 57
Oblici edema ................................................................................................................................................. 57
E
MPIJEM
............................................................................................................................................................ 58
F
ISTULA
............................................................................................................................................................. 58
O
P
Ć
A PIOGENA INFEKCIJA
.................................................................................................................................. 58
O
PEKLINE
.......................................................................................................................................................... 59
Lokalni klini
č
ki simptomi opeklina ............................................................................................................... 59
Op
ć
i simptomi opeklina................................................................................................................................. 60
Lije
č
enje opeklina ......................................................................................................................................... 60
S
MRZAVANJE
..................................................................................................................................................... 61
L
YMPHANGITIS
.................................................................................................................................................. 61
F
LEBITIS
............................................................................................................................................................ 62
Tromboza arterije axillaris i arterije brachialis ........................................................................................... 63
C
ISTE
................................................................................................................................................................. 64
T
UMORI
............................................................................................................................................................. 65
Papillomatosis............................................................................................................................................... 67
Prenosivi veneri
č
ni tumor pasa..................................................................................................................... 69
BOLESTI ROGOVA .......................................................................................................................................... 70
P
UKOTINE
.......................................................................................................................................................... 70
O
TPADANJE ROŽNE
Č
AHURE
(
EXCORNUATIO
).................................................................................................... 70
P
RIJELOM ROŽNOG NASTAVKA
........................................................................................................................... 70
O
DROŽNJAVANJE
(D
ECORNUATIO
) .................................................................................................................... 71
BOLESTI UŠKE ................................................................................................................................................. 72
Hematom ....................................................................................................................................................... 72
Hematom uške ............................................................................................................................................... 72
Nekroza ......................................................................................................................................................... 74
Otitis externa................................................................................................................................................. 74
Fistula uha .................................................................................................................................................... 74
B
OLESTI NOSA
................................................................................................................................................... 76
Kroni
č
ni nosni katar ..................................................................................................................................... 76
Epistaxis (rhinorrhagia)................................................................................................................................ 76
Empijem sinusa ............................................................................................................................................. 77
Bolesti zra
č
nog mjehura ............................................................................................................................... 77
Z
VIŽDA
(
HEMIPLEGIA LARYNGIS
) ...................................................................................................................... 78
Uzroci zvižde................................................................................................................................................. 78
K
UPIRANJE UŠKI
................................................................................................................................................ 79
Kupiranje repa .............................................................................................................................................. 79
KASTRACIJA..................................................................................................................................................... 80
K
ASTRACIJA PASTUHA
....................................................................................................................................... 81
Kastracija magaraca..................................................................................................................................... 82
K
ASTRACIJA BIKOVA
,
OVNOVA I JAR
Č
EVA
......................................................................................................... 83
Kastracija nerasta......................................................................................................................................... 83
Kastracija pasa ............................................................................................................................................. 84
Kastracija ma
č
aka ........................................................................................................................................ 84
Uvod u kirurgiju i ortopediju doma
ć
ih životinja
4
Dijagnosti
č
ke injekcije/anestezije:.............................................................................................................. 162
U
TVR
Đ
IVANJE UZROKA HROMOSTI
.................................................................................................................. 163
Utvr
đ
ivanje hromosti .................................................................................................................................. 163
Adspekcija ................................................................................................................................................... 163
Palpacija ..................................................................................................................................................... 166
Pretraga krune ............................................................................................................................................ 167
Pretraga putice ........................................................................................................................................... 168
Pretraga metakarpusa odnosno metatarzusa.............................................................................................. 168
Pretraga carpus-a ....................................................................................................................................... 169
Pretraga podlaktice..................................................................................................................................... 169
Pretraga ple
ć
ke ........................................................................................................................................... 169
Pretraga tarsus-a ........................................................................................................................................ 169
Pretraga metakarpusa odnosno metatarzusa?............................................................................................ 169
PRIKRIVENE BOLESTI................................................................................................................................. 170
B
OLESTI MIŠI
Ć
A
............................................................................................................................................... 170
Upala miši
ć
a – myositis .............................................................................................................................. 170
Akutni myositis-i.......................................................................................................................................... 170
Kroni
č
ni myositis-i...................................................................................................................................... 170
R
UPTURA MIŠI
Ć
A
............................................................................................................................................. 172
Rupture miši
ć
a ............................................................................................................................................ 173
B
OLESTI TETIVA
............................................................................................................................................... 175
Prekid kontinuiteta tetiva ............................................................................................................................ 175
T
ETIVNE OVOJNICE
.......................................................................................................................................... 181
Upala tetivnih ovojnica – tendovaginitis – tenosynovitis............................................................................ 181
Akutne upale tetivnih ovojnica – tendovaginitis acuta................................................................................ 181
2.
Kataralna - zahva
ć
a sinoviju* - tenosynovitis ................................................................................... 181
Kroni
č
ne upale tetivnih ovojnica T chronica .............................................................................................. 181
Hygroma – žu
ć
i tetivnih ovojnica................................................................................................................ 183
BOLESTI ZGLOBOVA – ARTHROPATHY................................................................................................ 184
D
ISPLAZIJA KUKA
–
D
ISPLASIO FEMORIS
......................................................................................................... 184
L
EGG
–
P
ERTHERS
-
OVA BOLEST
....................................................................................................................... 187
U
GANU
Ć
A
–
D
ISTORTION
................................................................................................................................. 189
I
Š
Č
AŠENJE
–
L
UXATION
–
D
ISLOCATION
.......................................................................................................... 191
Reparacija plantarne subluksacije proksimalnog me
đ
ufalangealnog zgloba............................................. 193
Iš
č
ašenje ivera............................................................................................................................................. 195
Dorzalna luksacija patele konja.................................................................................................................. 198
UPALA KOSTI I PERIOSTA ......................................................................................................................... 199
Periostitis .................................................................................................................................................... 199
Obru
č
.......................................................................................................................................................... 200
Acropachia.................................................................................................................................................. 201
O
STEITISI
......................................................................................................................................................... 202
Ostemyelitis................................................................................................................................................. 203
LOM KOSTI ..................................................................................................................................................... 204
Oblici i priroda koštanih lomova ................................................................................................................ 205
Svijanje kosti ............................................................................................................................................... 207
Koštani lom s pomakom .............................................................................................................................. 208
Simptomi frakture kosti ............................................................................................................................... 208
L
IJE
Č
ENJE LOMA KOSTI
.................................................................................................................................... 210
T
EMELJNI NA
Č
INI TERAPIJE LOMA KOSTI
.......................................................................................................... 210
Repozicije koštanih ulomaka....................................................................................................................... 211
U
č
vrš
ć
ivanje koštanih ulomaka u ispravnom položaju ............................................................................... 213
O
PERACIJSKO LIJE
Č
ENJE FRAKTURE
................................................................................................................. 219
Plo
č
ice za aplikaciju na površinu kosti....................................................................................................... 222
O
STEOSINTEZA S PLO
Č
ICOM U PSA
................................................................................................................... 224
LAKATNA DISPLAZIJA................................................................................................................................ 225
Uvod u kirurgiju i ortopediju doma
ć
ih životinja
5
ONICHOLOGY ................................................................................................................................................ 230
N
EPRAVILNA KOPITA
....................................................................................................................................... 233
I
ZOBLI
Č
ENA KOPITA
......................................................................................................................................... 235
PAPAK............................................................................................................................................................... 238
P
ODOARTHRITIS
–
UPALA KOPITNOG ZGLOBA
.................................................................................................. 241
Gnojno - ihorozna* upala ........................................................................................................................... 242
N
AGAZ NA
Č
AVAO
........................................................................................................................................... 243
UBODNE RANE KOPITA............................................................................................................................... 244
U
KOV
............................................................................................................................................................... 244
Simptomi ..................................................................................................................................................... 244
N
AGAZ NA
Č
AVAO
........................................................................................................................................... 245
K
OPITNI RAK
.................................................................................................................................................... 247
G
NJILOGRIZ ŽABICE I MEKUŠA
......................................................................................................................... 250
L
OM KOPITNICE
............................................................................................................................................... 252
L
OM ŽABI
Č
NE KOSTI
........................................................................................................................................ 255
K
ARAKUŠ
........................................................................................................................................................ 256
U
PALA KOPITNOG DERMISA
–
PODODERMATITIS
.............................................................................................. 259
L
AMINITIS
,
KLASI
Č
NO OBJAŠNJENJE
................................................................................................................ 260
P
ODODERMATITIS SUPPURATIVA
..................................................................................................................... 262
L
AMINITIS
........................................................................................................................................................ 264
Tredicionalna definicija laminitis-a............................................................................................................ 268
S
UBKLINI
Č
KI LAMINITIS GOVEDA
.................................................................................................................... 269
P
ODODERMATITIS CIRCUMSCIRIPTA
................................................................................................................. 270
PAREZE I PARALIZE .................................................................................................................................... 274
PODSJETNIK ANATOMIJE.......................................................................................................................... 278
ZDJELICE I UDOVA ...................................................................................................................................... 278
KONJA I PSA ................................................................................................................................................... 278
RJE
Č
NIK........................................................................................................................................................... 305
Uvod u kirurgiju i ortopediju doma
ć
ih životinja
7
3.
Boja i znakovi
životinje su bitni radi identifikacije životinje, te odre
đ
enih predispozicija. Stari sivci su
skloni melanomu, kao i dalmatineri. Albino jedinke su prijemljive za mnoge bolesti.
4.
Starost
se uzima radi identifikacije kao i boja i znakovi životinje. Uz to, životinje razli
č
ite dobi razli
č
ito
reagiraju na terapiju i operacijske zahvate. Tako su kod npr. starih pasa znatno
č
eš
ć
e sr
č
ane mane, a u
mladih pasa nikada nemamo panostitis. Nadalje, anestetik u mladih životinja djeluje duže…
5.
Veli
č
inu
je nužno uzeti radi to
č
nog i pravilnog doziranja lijekova. Nadalje, radi kontrole mase prije i
poslije operacije/terapije. Npr. penicilin se daje 20.000IJ/kg tjelesne mase. No, kada ra
č
unamo tjelesnu
masu valja oduzeti masno tkivo – to je posebno zna
č
ajno za svinje.
6.
Procjena vrijednosti ovisi o upotrebi životinje.
Status praesens:
Status praesens (lat. stanje trenutno) je stanje pacijenta tijekom pregleda.
Lat. habitus – držanje tijela, spoljašnjost, narav
1.
Op
ć
e stanje:
o
Habitus; anatomska gra
đ
a i držanje tijela, gojno stanje, konstitucija, karakter i temperament
životinje. Temperamentne životinje teže anesteziramo
Æ
bitno za izvo
đ
enje operacije.
Agresivan/zlo
ć
udan karakter pasa i konja predstavlja opasnost za veterinara.
o
Trijas; bilo, disanje, temperatura tijela i promijenjenog dijela tijela, kontrakcije buraga.
o
Vidljive sluznice.
o
Limfni
č
vorovi.
2.
Stanje pojedinih sustava i organa
Inspekcija
Inspekcija je bitna za ustanovljavanje op
ć
ih i lokalnih promjena. To je osnovna metoda prema kojoj
usmjeravamo cjelokupnu daljnju pretragu oboljelog podru
č
ja. Kako bismo procijenili jesu li neke promjene
zna
č
ajne, potrebno je usporediti simetri
č
ne dijelove tijela. Posredna inspekcija, za razliku od neposredne koristi
pomagala; zrcala, svjetiljke, ensodkope. Inspekcijom oboljelog mjesta odre
đ
ujemo:
1.
Položaj
– anatomska pozicija promjene
2.
Veli
č
inu
– mjerenje 'od oka' ili instrumentima; vrpca, menzure…
3.
Oblik
– sli
č
nost s nekim predmetom. Oblik je uglavnom nepravilan. Može biti ovalan, elipti
č
an,
okrugao... Otekline su mahom oblika valjka, kobasice, kruške. Bursitis precarpalis (upala prekarpalne
burze – ta burza leži subkutano) daje kuglastu oteklinu. Tendovaginitis ekstanzora prsta
ć
e se
manifestirat kao valjkasta oteklina. Tumori
ć
e biti poput jagode, maline, karfiola…
4.
Boja.
Boja je bitna kod gnoja jer ona varira ovisno o vrsti uzro
č
nika. Bitna je i prozirnost. Npr.
sinovijalna teku
ć
ina mora biti prozirna, odnosno mutna sinovijlna teku
ć
ina upu
ć
uje na patološki proces.
Zbog izrazite prokrvljenosti zdravi kopitni korijum je crvene boje. Naprotiv, siva boja kopitnog
korijuma upu
ć
uje na nekrozu. Boja je važna i prilikom upotreba medikamenata; žuta boja
Æ
upotreba
joda, crno-siva
Æ
srebro nitrat, crna
Æ
katran
5.
Površina.
Na površini ocjenjujemo stupanj vlažnosti, hrapavost, kvaliteta sekreta, prekrivana gnojem,
ljutkasto prekrivena. krasta, mogu
ć
i ožiljak. Ošišana dlaka upu
ć
uje da je netko ve
ć
vršio zahvat. Mutna
dlaka sugerira prisustvo parazita. Ožiljak (lat.cicatrix, eng. scar) upu
ć
uje na spontanu ozljedu ili
operacijski zahvat. Lažne kastracije na kriptorhidima su kriptorhidi koji imaju ožiljak od 'reza za
kastraciju', ali kastracija nije izvedena nego je testis, jedan ili oba, zaostao u utrobi. Rez na pupku
ukazuje na umbilikalnu herniju. Rezovi na bijeloj liniji mladih životinja ukazuju na laparotomiju, kao i
rez u slabinskom podru
č
ju goveda. Rez u podru
č
ju grkljana konja ukazuje na larnigotomiju.
Laringotomija konja se vrši prvenstveno radi lije
č
enja zvižde – hemiplegia laryngis
Cicatririx, pl, cicartices, ožiljak, novo tkivo koje se formira u rani koja zacjeljuje.
