Quiz Question

In Latifi 2024 et al., on fascial mapping in the canine hindlimb, which major nerve was highlighted as at risk during dissection in the medial thigh region?

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Correct. The obturator nerve was located superficial to adductors and could be damaged in fascial dissection.
Incorrect. The correct answer is Obturator nerve.
The obturator nerve was located superficial to adductors and could be damaged in fascial dissection.

🔍 Key Findings

  • This anatomical study mapped fascial planes of the canine hindlimb and pelvis to aid superficial tumor resection.
  • Type I fascia (discrete sheets) was suitable for deep margins in fascia lata, lateral crus, and gluteal regions.
  • Areas with poor or absent fascia included the ischiorectal fossa, femoral triangle, stifle extensor mechanism, and pes.
  • Type IV fascia associated with periosteum (e.g., patella, tibial tuberosity) required partial ostectomy for inclusion in surgical margins.
  • Nerves at risk during deep dissection included obturator, superficial peroneal, and tibial nerves, particularly in regions with weak fascia.
  • In males, bulbospongiosus muscle could act as a fascial plane but dissection was challenging and potentially hemorrhagic.
  • In females, constrictor vulvae/vestibulae muscles were tightly associated with mucosa, limiting clean resection options.
  • Distal hindlimb resections often lacked a usable fascial plane, suggesting that amputation or adjuvant therapy may be more appropriate.

Latifi

Veterinary Surgery

3

2024

Fascial plane mapping for superficial tumor resection in dogs: Part III – Hindlimb and pelvis

2024-3-VS-latifi-3

Article Title: Fascial plane mapping for superficial tumor resection in dogs: Part III – Hindlimb and pelvis

Journal: Veterinary Surgery

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In Latifi 2024 et al., on fascial mapping in the canine hindlimb, which fascial structure was most suitable as a consistent surgical deep margin in the lateral thigh?

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Correct. The fascia lata was a robust type I sheet suitable for pseudocompartmental resection.
Incorrect. The correct answer is Fascia lata.
The fascia lata was a robust type I sheet suitable for pseudocompartmental resection.

🔍 Key Findings

  • This anatomical study mapped fascial planes of the canine hindlimb and pelvis to aid superficial tumor resection.
  • Type I fascia (discrete sheets) was suitable for deep margins in fascia lata, lateral crus, and gluteal regions.
  • Areas with poor or absent fascia included the ischiorectal fossa, femoral triangle, stifle extensor mechanism, and pes.
  • Type IV fascia associated with periosteum (e.g., patella, tibial tuberosity) required partial ostectomy for inclusion in surgical margins.
  • Nerves at risk during deep dissection included obturator, superficial peroneal, and tibial nerves, particularly in regions with weak fascia.
  • In males, bulbospongiosus muscle could act as a fascial plane but dissection was challenging and potentially hemorrhagic.
  • In females, constrictor vulvae/vestibulae muscles were tightly associated with mucosa, limiting clean resection options.
  • Distal hindlimb resections often lacked a usable fascial plane, suggesting that amputation or adjuvant therapy may be more appropriate.

Latifi

Veterinary Surgery

3

2024

Fascial plane mapping for superficial tumor resection in dogs: Part III – Hindlimb and pelvis

2024-3-VS-latifi-4

Article Title: Fascial plane mapping for superficial tumor resection in dogs: Part III – Hindlimb and pelvis

Journal: Veterinary Surgery

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In Price 2024 et al., on left-sided TD ligation in dogs, what percentage of cadavers showed successful thoracic duct ligation at the fourth intercostal space?

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Correct. Ligation success was confirmed via CT in 9 out of 10 cadavers.
Incorrect. The correct answer is 90%.
Ligation success was confirmed via CT in 9 out of 10 cadavers.

🔍 Key Findings

  • Left fourth intercostal thoracotomy allowed successful thoracic duct (TD) ligation in 9/10 canine cadavers.
  • 10/13 clinical cases had a single TD branch at the left fourth intercostal space, indicating lower anatomical complexity.
  • All TD branches at this site were lateral to the esophagus, simplifying surgical access.
  • Unilateral subphrenic pericardiectomy was successfully performed via the same incision in 10/10 cadavers.
  • Fewer TD branches at the fourth intercostal space than traditional caudal sites may reduce the risk of missed collaterals.
  • In contrast, traditional caudal TD ligation sites had up to 5 branches, requiring broader dissection.
  • No cadaver had right-sided TD branches, reducing surgical complexity at the studied location.
  • Contrast-confirmed ligation was effective in 90% (9/10) cadavers on CT imaging.

Price

Veterinary Surgery

3

2024

Evaluation of thoracic duct ligation and unilateral subphrenic pericardiectomy via a left fourth intercostal approach in normal canine cadavers

2024-3-VS-price-1

Article Title: Evaluation of thoracic duct ligation and unilateral subphrenic pericardiectomy via a left fourth intercostal approach in normal canine cadavers

Journal: Veterinary Surgery

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In Thibault 2023 et al., on DPO for THR luxation, what was the median change in angle of lateral opening (ALO) following DPO?

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Correct. The median reduction in ALO achieved with DPO was 11°, which is lower than TPO-reported values.
Incorrect. The correct answer is 11°.
The median reduction in ALO achieved with DPO was 11°, which is lower than TPO-reported values.

🔍 Key Findings

  • Double pelvic osteotomy (DPO) reduced angle of lateral opening (ALO) by a median of 11° (p ≤ .001).
  • Despite ALO correction, THR reluxation occurred in 5/11 dogs, often within 7 days post-DPO.
  • Post-DPO ALO remained elevated (median 56°), with only 2 dogs achieving the recommended 35–45° range.
  • Explantation was required in 7/11 dogs (5 aseptic loosenings, 2 infections), suggesting poor long-term implant survival.
  • Dogs with luxoid hips were more likely to fail, even with corrected ALO, emphasizing soft tissue instability as a risk factor.
  • Compared to TPO (23° correction), DPO yielded a smaller ALO correction, possibly due to older dog population and less elastic pelvis.
  • No ventral luxation occurred post-DPO, unlike in TPO studies, likely due to more conservative ALO reduction.
  • Authors do not recommend routine DPO for THR luxation due to high complication and failure rates.

Thibault

Veterinary Surgery

8

2023

Poor success rates with double pelvic osteotomy for craniodorsal luxation of total hip prosthesis in 11 dogs

2023-8-VS-thibault-2

Article Title: Poor success rates with double pelvic osteotomy for craniodorsal luxation of total hip prosthesis in 11 dogs

Journal: Veterinary Surgery

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In Larose 2024 et al., on fluorescence cholangiography, what timing of fluorescence onset was typical after ICG administration?

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Correct. Regardless of dose, biliary fluorescence began within 10–20 minutes.
Incorrect. The correct answer is 10–20 minutes post-injection.
Regardless of dose, biliary fluorescence began within 10–20 minutes.

🔍 Key Findings

  • Near-infrared fluorescence cholangiography (NIRFC) was feasible and safe in all healthy dogs studied, with no major adverse effects noted.
  • Low-dose ICG (0.05 mg/kg) at 3 h pre-op achieved the highest target-to-background (cystic duct-to-liver) contrast ratio, reaching nearly 4:1 at 280 minutes.
  • Early imaging (time 0) favored low-dose ICG for optimal cystic duct visualization; high-dose ICG led to excessive liver fluorescence and reduced contrast.
  • Visualization of biliary tree occurred within 10–20 min post-injection regardless of dose, but longer delays improved background clearance and contrast.
  • No significant cardiovascular or histamine-related side effects were observed with either dose of ICG.
  • Repeated ICG injections showed minimal residual fluorescence when using a >72 h washout period; shorter intervals caused mild carryover in high-dose groups.
  • Surgeon scoring matched contrast ratios, confirming clinical relevance of imaging outcomes.
  • Recommended dose for laparoscopic imaging: 0.05 mg/kg ICG given 3–5 h before surgery, or at premedication for urgent cases.

Larose

Veterinary Surgery

4

2024

Near-infrared fluorescence cholangiography in dogs: A pilot study

2024-4-VS-larose2-3

Article Title: Near-infrared fluorescence cholangiography in dogs: A pilot study

Journal: Veterinary Surgery

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In Moreira 2024 et al., on predictive equations for TPA correction, which technique demonstrated the **highest TLA shift** after cranial cortical alignment?

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Correct. Frederick and Cross mCCWO showed significantly higher TLA shifts at high wedge angles.
Incorrect. The correct answer is Frederick and Cross.
Frederick and Cross mCCWO showed significantly higher TLA shifts at high wedge angles.

🔍 Key Findings

  • A linear relationship was observed between wedge angle and tibial plateau angle (TPA) correction across all four CCWO techniques.
  • All techniques produced predictable TPA corrections using linear regression-derived equations, allowing wedge angle extrapolation to achieve a target postoperative TPA of 5°.
  • TLA shift (tibial long axis) increased with wedge angle and influenced final TPA; greatest in Frederick & Cross method.
  • Tibial shortening (mTL%) varied by technique, being most severe (up to 40.9%) in traditional Slocum & Devine CCWO and least in newer techniques (7.5–12%).
  • The Oxley mCCWO technique showed lower TLA shift compared to the Frederick & Cross and Christ techniques, though similar to Slocum & Devine; tibial shortening was more pronounced than other modified techniques at wedge angles ≤40°.
  • Techniques varied in craniocaudal translation and wedge apex positioning, influencing planning accuracy and mechanical axis alignment.
  • The corrective wedge angle equations reliably predicted TPA within 4–6° across varied tibial conformations.
  • The study supports equation-based planning over static TPA–5° subtraction to reduce risk of under- or over-correction.

Moreira

Veterinary Surgery

8

2024

Predicting tibial plateau angles following four different types of cranial closing wedge ostectomy

2024-8-VS-moreira-3

Article Title: Predicting tibial plateau angles following four different types of cranial closing wedge ostectomy

Journal: Veterinary Surgery

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In Duvieusart 2025 et al., on lung lobectomy approaches, which technique provided the greatest surgical exposure?

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Correct. TDCM had the largest median exposure area (193.5 cm²), significantly more than ICT and MS.
Incorrect. The correct answer is Transdiaphragmatic with caudal sternotomy (TDCM).
TDCM had the largest median exposure area (193.5 cm²), significantly more than ICT and MS.

🔍 Key Findings

  • Study Design: Canine cadaveric study comparing intercostal thoracotomy (ICT), median sternotomy (MS), and transdiaphragmatic with caudal median sternotomy (TDCM) for accessory lung lobectomy (ALL).
  • Main Outcomes:
    • Exposure Area: TDCM (193.5 cm²) > MS (106.5 cm²) > ICT (73.5 cm²) (p = .01).
    • TDCM provided significantly greater exposure than MS (p = .02) and ICT (p = .02); MS > ICT (p = .04).
    • Surgical Time: No significant difference (p = .06).
    • Lobe Excision (% by weight/surface area): No significant difference between groups (p = .4).
    • Staple Line Leak: Leak at ≤40 cmHâ‚‚O in 2/4 ICT, 0/4 MS, 0/4 TDCM (p = .09).
  • Complications:
    • 1/4 MS cases had iatrogenic damage to an adjacent lobe.
  • Technical Insights:
    • TDCM approach allowed immediate visualization of all three parts of the right pulmonary ligament.
    • The TDCM approach offers improved access without requiring en bloc removal with the right caudal lobe.
  • Conclusion: The TDCM approach provides improved exposure for ALL lobectomy with no increase in surgical time or complications relative to other approaches.

Duvieusart

Veterinary Surgery

1

2025

Comparison of three approaches for accessory lung lobectomy in the canine cadaveric model: Intercostal thoracotomy, median sternotomy, and a transdiaphragmatic approach combined with caudal median sternotomy

2025-1-VS-duvieusart-1

Article Title: Comparison of three approaches for accessory lung lobectomy in the canine cadaveric model: Intercostal thoracotomy, median sternotomy, and a transdiaphragmatic approach combined with caudal median sternotomy

Journal: Veterinary Surgery

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In Bounds 2023 et al., on feline hip arthroscopy, what was the optimal limb position to maximize joint distraction?

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Correct. This positioning, combined with traction, maximized working space and joint distraction.
Incorrect. The correct answer is Neutral duction and 90° extension.
This positioning, combined with traction, maximized working space and joint distraction.

🔍 Key Findings

  • Feline hip arthroscopy using a supratrochanteric lateral portal was feasible in all cadaveric hips studied.
  • All relevant intra-articular structures (femoral head, acetabulum, round ligament, joint capsule, transverse acetabular ligament, dorsal acetabular rim) were consistently visualized.
  • Optimal limb positioning (neutral abduction, 90° extension) significantly aided joint distraction and visualization.
  • Minor iatrogenic cartilage injury (ICI) occurred in all hips, typically partial-thickness abrasions; one hip had a full-thickness lesion.
  • Portal placement did not damage the sciatic nerve or caudal gluteal artery, with a mean distance of 4.3 ± 2 mm between the cannula and nerve.
  • Probe use improved visualization of the dorsal joint capsule and dorsal acetabular rim, though not essential.
  • Joint evaluation was also successful in hips with DJD, suggesting technique feasibility even in diseased joints.
  • Muscle trauma was minimal, with only mild impingement in a few specimens and no gross nerve or vessel injury.

Bounds

Veterinary Surgery

8

2023

Feasibility of feline coxofemoral arthroscopy using a supratrochanteric lateral portal: A cadaveric study

2023-8-VS-bounds-3

Article Title: Feasibility of feline coxofemoral arthroscopy using a supratrochanteric lateral portal: A cadaveric study

Journal: Veterinary Surgery

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In Lin 2025 et al., on surgical approaches to the radius, which measurement was significantly greater for CLA at the P2 site?

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Correct. CLA had wider exposure proximally (P2), supporting easier plate placement.
Incorrect. The correct answer is Width of exposure.
CLA had wider exposure proximally (P2), supporting easier plate placement.

🔍 Key Findings

  • Craniolateral approach (CLA) exposed significantly more radial surface area than craniomedial approach (CMA) (19.4 cm² vs. 13.8 cm²; p = 0.01).
  • Proximal width of exposure was greater in CLA, especially at 12.5% length (P2 level, p = 0.016), aiding plate placement.
  • No significant difference in exposed bone length between approaches.
  • CLA avoided major neurovascular structures, making dissection cleaner and safer proximally.
  • CMA consistently encountered median nerve/artery/vein, complicating proximal exposure.
  • CLA allowed better access to proximal radius for locking plate application, which may benefit MIPO techniques.
  • CLA also enables ulna fixation via the same incision, whereas CMA requires a separate skin incision.
  • Anatomical tilt of the proximal cranial surface favored CLA, requiring less plate contouring than CMA for proper fit.

Lin

Veterinary and Comparative Orthopaedics and Traumatology

3

2025

Does the Craniolateral Approach Provide Better Exposure to the Radius than the Craniomedial Approach for Internal Fracture Fixation in Dogs?

2025-3-VCOT-lin-3

Article Title: Does the Craniolateral Approach Provide Better Exposure to the Radius than the Craniomedial Approach for Internal Fracture Fixation in Dogs?

Journal: Veterinary and Comparative Orthopaedics and Traumatology

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In Chik 2024 et al., on cholangioscopy feasibility, which factor most limited advancement of the 3.8 mm disposable endoscope into the common bile duct?

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Correct. Anatomical flexure and endoscope diameter prevented deeper passage beyond the junction.
Incorrect. The correct answer is Flexure between the cystic and common bile duct.
Anatomical flexure and endoscope diameter prevented deeper passage beyond the junction.

🔍 Key Findings

  • Open transcholecystic cholangioscopy was feasible using a 3.8 mm disposable flexible endoscope in all 8 canine cadavers.
  • Visualization was consistently achieved up to the junction of the hepatic ducts, common bile duct, and cystic duct.
  • Advancement past the junction was limited by the endoscope diameter (3.8 mm) and anatomical flexure.
  • The 1.9 mm flexible ureteroscope could visualize the entire biliary tree, including the major duodenal papilla, in a large dog (43.8 kg).
  • Endoscopic tools (e.g., 3 Fr grasping forceps) could be passed through the working channel only after removing the irrigation line.
  • Standard biopsy forceps were incompatible with the disposable endoscope's 1.2 mm working channel.
  • Cadaver study showed no rupture, but clinical extrapolation is limited due to lack of diseased tissue.
  • Disposable endoscope setup cost (~$6,100) was significantly lower than traditional endoscopy systems (~$75,000–100,000), improving accessibility.

Chik

Veterinary Surgery

7

2024

Feasibility of open cholangioscopy with disposable flexible endoscopes

2024-7-VS-chik-2

Article Title: Feasibility of open cholangioscopy with disposable flexible endoscopes

Journal: Veterinary Surgery

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Topic: Anatomy & Surgical Approach
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