Gastric Pathophysiology

Question 1

What is the true stomach of the ruminant?

Answer 1

Abomasum (glandular)

Question 2

How many compartments does the camelid stomach have?

Answer 2

3

Question 3

What is the true stomach of camelids?

Answer 3

C3

Question 4

What types of stomachs to carnivores have?

Answer 4

Monogastric

Question 5

What are the layers of the slide from top to bottom

Answer 5

Mucosa
Muscularis mucosae
Submucosa
Muscularis
Serosa

Question 6

What portions of the stomach are non-galnduar mucosa?

Answer 6

Esophagus
Esophageal region (horse, pig)
Forestomach (ruminant, camelid)

Question 7

What part of the stomach is the tru glandular stomach?

Answer 7

Cardiac gland region

Question 8

What types of cells are in the cardiac gland region/

Answer 8

Surface foveolar cells
glands

Question 9

Whare are the gastric glands located?

Answer 9

Deep within the mucosa of the stomach

Question 10

What are isthmus cells?

Answer 10

Stem cells

Question 11

What do parietal cells secrete?

Answer 11

HCl

Question 12

What do chief cells secrete?

Answer 12

Pepsinogen; helpful for digestion of protein

Question 13

What do mucous neck cells secrete?

Answer 13

mucus

Question 14

What is located in the pyloric region of the stomach?

Answer 14

luminal surface and foveolar cells
Glands – G cells (gastrin), D cells (somatostatin), mucus

Question 15

What animal did this stomach come from?

Answer 15

Horse

Question 16

What is this structure and what is the significance?

Answer 16

Margo plicatus; it separates the glandular and non-glandular (squamous) regions of the horse’s stomach

Question 17

What makes up the gastric mucosal barrier?

Answer 17

1. Mucus layer
2. Epithelial cell tight junctions
3. Epithelial cell turnover
4. Adequate blood flow

Question 18

What does the mucus layer do in the gastric mucosal barrier?

Answer 18

lubricate and protect from autodigestion
mucins
bicarbonate
phospholipids

Question 19

What aids in adequate blood flow?

Answer 19

oxygen, growth factors, nutrients

Question 20

What type of control is the gastric mucosal barrier under?

Answer 20

prostiglandin control

Question 21

Where are prostiglandins made?

Answer 21

lamina propria

Question 22

What does Prostaglandin do?

Answer 22

-Stimulates HCO3- and mucus secretion and foveolar cell stimulation
-Inhibits histamine-stimulated HCl secretion from parietal cells
-Promotes vasodilation and increased blood flow

Question 23

What are some types of gastric injury?

Answer 23

Dilation
Displacement
Foreign Bodies
Impaction
Rupture
Vascular (hemorrhage, edema, infarct)
Ulcers
Gastritis
Neoplasia

Question 24

What is an erosion?

Answer 24

Suerficial mucosal defect; necrosis of the mucosa above the basement membrane

Question 25

What is an ulcer?

Answer 25

deep mucosal defect; necrosis of the mucosa through the basement membrane

Question 26

What are the gastric responses to injury?

Answer 26

Acute Ulcer/Gastritis: Return to normal function Chronic Ulcer: Re-epithelialization with granulation tissue/ scar tissue & fibrosis Chronic Gastritis Chronic Gastritis + anorexia

Question 27

Where do horses get ulcers?

Answer 27

Squamous mucosa

Question 28

What are some characteristics of acute ulcers?

Answer 28

Superficial depression, soft, indistinct edges, red to red/brown, tan (necrosis) luminal blood/fibrin may be abundant, +/- inflammation

Question 29

What are some characteristics of chronic ulcers?

Answer 29

Deep depression, firm, raised edges, whit to tan (granulation tissue/fibrosis), red/red brown. yellow hyperkeratosis (squamous mucosa), +/- inflammation & fibrin

Question 30

What are some causes of Gastric Ulcers?

Answer 30

Traumatic/toxic Nutritional Vascular Inflammatory/infectious Neoplasia Iatrogenic (NSAIDS)

Question 31

List some examples of ulcers caused by trauma

Answer 31

Foreign body, impaction, surgery/biopsy

Question 32

List some examples of ulcers caused by toxicity

Answer 32

Endogenous (uremia, bile) Exogenous (corrosives, blister beetles)

Question 33

What are some vascular causes of ulcers and erosions?

Answer 33

GDV, abomasal displacement in cattle, gastric dilation in horses, stress in all species

Question 34

What do NSAIDs do?

Answer 34

Inhibit Cox enzymes

Question 35

What is the pathogenesis of gastric ulcers due to NSAIDs?

Answer 35

NSAIDs inhibit cox enzymes with decreases the production of prostaglandin in the gastric lamina propria. Stimulation of HCO3- and mucus secretion; inhibition of histamine stimulated HCl secretion from parietal cells; epithelial cell turnover, foveolar cell proliferation, localized ischemia

Question 36

What are some issues that can be seen secondary to gastric ulcers?

Answer 36

Bleeding-- Anemia/exsanguination Healing with granulation tissue/fibrosis -- Stricture Perforated ulcer -- Rupture, septic perotinitis

Question 37

What is the gastric response to an acute ulcer/gastritis?

Answer 37

1. Re-epithelializationation (mucosal repair) 2. Return to normal function

Question 38

What is the gastric response to a chronic ulcer?

Answer 38

Re-epithelialization with granulation tissue Scar tissue/fibrosis

Question 39

What are nutritional factors that can cause stomach ulcers for pigs?

Answer 39

finely ground rations

Question 40

What are nutritional factors that can cause gastric ulcers in ruminants?

Answer 40

- Calves: dietary changes -Adults: high concentrates

Question 41

What are nutritional factors that can cause gastric ulcers in horses?

Answer 41

- Feeding intervals -Feed type

Question 42

What are some vascular causes of gastric ucleration?

Answer 42

systemic hypotension local vascular compromise

Question 43

What is the main iatrogenic cause of gastric ulcers?

Answer 43

NSAIDS Corticosteroids

Question 44

Define gastritis

Answer 44

Inflammation of the stomach

Question 45

What is the main cause of bacterial gastritis?

Answer 45

Clostridium

Question 46

What can you see with clostridial infection?

Answer 46

Hemorrhage, edema, necrosis, erosions/ulcers, +/- emphysema

Question 47

What is the main parasitic cause of gastritis in ruminants?

Answer 47

Haemonchus contortus

Question 48

What are some types of neoplasia you can get in the stomach?

Answer 48

SSC (horses) Gastric adenocarcinoma Lymphoma

Question 49

What ate some general characteristics of gastric neoplasms?

Answer 49

- Locally infiltrative - Desmoplasia (firm) - Carcinomatosis