GI system → oropharynx, esophagus, oral neoplsia (test 1) Flashcards Preview

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Flashcards in GI system → oropharynx, esophagus, oral neoplsia (test 1) Deck (86):
1

what are the 5 stages of deglutition?

•Oral stage

•Pharyngeal stage

•Cricopharyngeal stage

•Esophageal stage

•Gastroesophageal stage

2

what are some signs of dysfunction inf the Oral stage of deglutition?

•dysphagia

•salivation

•retching

•regurgitation

•inappetence

•halitosis

•weight loss

•ptyalism (drooling, salivation)

3

The oral mucosa can be an indicator of systemic Dz, what does this color tell us? Yellow

Jaundice

discoloration of tissue due to bilirubin

4

The oral mucosa can be an indicator of systemic Dz, what does this color tell us? Pale (Pallor)

Anemia

5

The oral mucosa can be an indicator of systemic Dz, what does this color tell us? Blue

Cyanosis

deoxyhemoglobin (e.g. R to L cardiac shunts; anoxia)

6

The oral mucosa can be an indicator of systemic Dz, what does this color tell us? Bright red

Carbon monoxide intoxication

7

The oral mucosa can be an indicator of systemic Dz, what does this tell us? Prolonged CRT

hypoperfusion (shock)

8

The oral mucosa can be an indicator of systemic Dz, what does this tell us? Ulceration

  • phenylbutazone in horses some
  • viral diseases (e.g. Bovine Viral Diarrhea, Calicivirus in cats)
  • renal failure / uremic stomatitis

9

The oral mucosa can be an indicator of systemic Dz, what does this tell us? Petechiae

Thrombocytopenia and/or vasculitis

10

The oral mucosa can be an indicator of systemic Dz, what does this tell us? Moisture or lack there of

Hydration status (dehydration)

11

What makes up the oral stage of deglutition? and what CN are utilized

Food is prehended, masticatd and formed into a bolus

  • CN V (trigeminal)
  • VII (Facial), XII (hypoglossal)

12

What is involved in the pharyngeal stage of deglutition, and what CN are utilized

Involuntary, initiated when bolus is propelled into pharynx by the base of tongue (larynx and internal nares sealed)

  • CN IX (glossopharyngeal)
  • X (Vagus)

13

what is palatoschisis?

Cleft palate

14

what is cheiloschisis

Cleft lip

15

what is heterotopic polyodontia? and give an example

extra tooth outside the dental arcades

  • "ear teeth" in horses, the tooth cyst usually found in parotid area which my fistulate to the exterior

16

what is brachygnathism

mandible is shorter then the maxilla (collies and dachshunds)

17

what is prognathism

mandible is longer then maxilla (pekingese and other brachycephalic breeds)

18

what are some of the consequences of malocclusions?

{a} traumatize soft tissues of the oral cavity

{b} cause abnormal wear and accelerated tooth attrition

{c} contribute to and accelerate periodontal disease

19

Anomalies of tooth wear = .......

Degenerative Conditions

20

define stomatitis

Inflammation of the mouth (i.e. of oral mucous membranes)

21

define glossitis

inflammation of the tongue

22

define gingivitis

inflammation of the gums (gingiva)

23

define cheilitis

inflammation of the lips

24

define vesicle

blister - fluid filled raised area

25

define bulla

fluid filled raised area >5 mm (large blister)

26

define erosion

discontinuity of the mucosa, exhibiting incomplete loss of the epithelium

27

define ulcer

discontinuity of the mucosa with complete loss of epithelium, often excavative extending deep into the submucosa and possibly muscularis

28

what is dental plaque

= accumulated bacterial mass that becomes adherent to tooth surfaces

also includes

  • food particles
  • exfoliated cells
  • saliva & mucus

29

what is dental calculus?

can be called "tartar" = mineralization of plaque an indicator of serious plaque build-up

30

what is periodontal Dz

peridontitis = bacterial plaque and calculus leading to

  • progressive destruction of gingiva and supporting adjacent tissue

31

what is a common outcome of chronic inflammation of the gingiva

Gingival hyperplasia

32

what are dental caries?

Decay...

bacterial induced decalcification of the inorganic portions of the tooth, accompanied or followed by dissolution of the organic components this may account for 20% of the tooth loss among cats and 10% among dogs

33

Actinobacillus Lingnieresii the causative agent in "wooden tongue", is an example of.......

Bacterial stomatitis

34

what is the pathogenesis of Bacterial stomatitis

Pathogenesis

- deep glossitis / stomatitis → normal oral flora →begins with traumatic lesions in mouth (feed?) →organisms access submucosa and deep soft tissue →pyogranulomatous host inflammatory response →“sulfur granules” and fibrosis

35

T or F Bacterial stomatitis is a great example of a primary pathogen causing pathology

False

Bacterial stomatitis is generally secondary

  • typically follows mucosal injury or systemic Dz

36

Vesicular stomatitis is caused by a group of viruses that produce vesicles in the oral cavity, how are they differentiated?

(1) lesions

- (nature & location)

(2) host species affected

(3) PCR, virus isolation**, serology

37

what are some examples of virus associated vesicular stomatitides?

- Foot and mouth disease

- Vesicular stomatitis

- Vesicular exanthema of swine

- Swine vesicular disease

38

what is the etiology of foot and mouth Dz, and what species is it found in

Picornavirus

  • Ruminant
  • pigs

39

what is the etiology of Vesicular stomatitis, and what species is it found in

Rhabdovirus

  • Ruminant > pig = horses

40

what is the etiology of vesicular exanthema, and what species is it found in

Calicivirus

  • Pigs

41

What is the etiology of swine vesicular Dz

Enterovirus

42

BVD is an example of what type of oral Dz?

this Dz has varied affects on an individual animal, what are some of those factors that contribute to that?

erosive / ulcerative stomatitides (viral)

Outcome of infection with BVD depends on

  • Strain/virulence of virus
  • Immune status
  • Age that animal is affected
  • Pregnancy and state of pregnancy

43

Oral inflammation and ulcers is characteristic of Felid Dz. what is it?

oral inflammation is THE most comon clinical abnormality recognized. also some association with the feline gingivitis stomatitis complex

44

what are the 4 causes of ulcerative stomatitis and cheilitis in bovine

  1. Bovine viral diarrhea 
  2. Vesicular stomatitis
  3. Malignant catarrhal fever
  4. Foot and Mouth Dz

 

45

how would you characterize BVD mucosal Dz

Acute: Pyrexia, depression, weakness, anorexia with dehydration, hypersalivation, mucopurulent nasal discharge, corneal edema, profuse watery diarrhea with tenesmus

46

what is the pathogenesis of BVD mucosal Dz?

Pathogenesis: calf infected by noncytopathic strain in utero (before 125 days) becomes immunotolerant, then infection by cytopathic strain after birth => mucosal disease

47

what lesions are found in BVD

Lesions: erosions and ulcers in oral cavity, esophagus, intestine…any mucosa Peyer’s patch necrosis

48

what are the 4 main causes of Stomatitis (non infectious)

  1. Physical
  2. Chemical
  3. Autoimmune
  4. Metabolic & Systemic Disorders

49

what is uremic stomatitis

Uremic stomatitis is caused by Renal failure results in uremia, which can cause stomatitis, oral ulcers & halitosis

50

what is the pathogenesis of Uremic stomatitis

Renal failure → urea secretion by salivary glands → conversion of salivary urea to ammonia by oral bacteria + vascular necrosis → oral/lingual ulcers → halitosis

51

what is feline gingivitis - stomatitis - pharyngitis complex, and how is it caused?

• chronic progressive inflammation – may be ulcerative and/or proliferative

• very common & important → inappetance, weight loss

Many think this condition is an example of a host response, which is normally protective, resulting instead in tissue destruction and chronic inflammation. An aberrant immune response to normal flora/plaque

52

seeing as how Feline Gingivitis - Stomatitis - Pharyngitis Complex is very difficult to to pin point how it is caused, how might it be classified?

  • clinical appearance
  • microscopic appearance (cell types)
  • response to treatment

53

what is meant by Gingivitis - Stomatitis - Pharyngitis Complex is multifactorial?

it is poorly understood.

  • most common form is associated with plaque & calculus
  • plasmacytic-lymphocytic gingivitis/stomatitis
  • can be associated with FIV and calicivirus infection (about 23% are FIV+ and 70 to 90% calicivirus +)
  • opportunistic oral bacteria can also be involved (response of oral tissue to normal flora ???)

54

A serology survey of the herd indicates that approximately 40% of the animals are seropositive for BLV What is the most likely meaning of the seropositive state in these animals?

A. These animals have been exposed to BLV.

B. These animals have been exposed to BLV and may have successfully cleared the virus.

C. These animals are currently INFECTED with BLV virus.

C. These animals are currently INFECTED with BLV virus.

55

A serology survey of the herd indicates that approximately 40% of the animals are seropositive for BLV.

Based on the biology of this Virus/disease, approximately how many cases of bovine lymphoma might you expect in this herd of 1000 animals?

A. 400 (40%)

B. 70 (30%)

C. 50 (5%)

D. 20 (2%)

E. Impossible to predict

D. 20 (2%) • 40% of 1000 are infected = 400 • 30% of 400 will have asymptomatic PL = 120 • Approx. 5% of 400 will develop lymphoma = 20

56

what are the most common effects seen resulting from oral tumors?

  • dysphagia
  • salivation
  • oral hemorrhage
  • weight loss
  • halitosis
  • facial deformity

57

what is the most common benign oral tumor in a dog?

Epulis

58

what is an Epulis?

this is tumor of peridontal ligament origin or dental lamina epithelium, it is very common in dogs (most common benign oral neoplasm)

59

what are the subclassification of an epulis.

  • Fibromatous epulis (peripheral odontogenic fibroma)
    • Benign behavior
  • Ossifying epulis (peripheral odontogenic fibroma)
    • Benign behavior
  • Acanthomatous epulis (peripheral ameloblastoma or acanthomatous ameloblastoma)
    • Locally invasive

60

what are the 7 most common types of neoplastic disorders of the oral cavity?

  1. Malignant melanoma
  2. Squamous cell carcinoma
  3. Fibrosarcoma
  4. Epulis
  5. Osteosarcoma
  6. Dental (odontogenic tumors)
  7. Oral papilloma (viral and self limiting)

61

T or F

an Acanthomatous Ameloblastoma is not invasive but will commonly metastize

False

  • very commonly invasive → bone
  • NOT metastatic

62

what is the most common oral neoplasm in cats?

  1. SCC
  2. Fibrosarcoma

63

What oral neoplasm in dogs is characterized by.....

  • rapid growth
  • local invasion
  • early metastasis
  • usually to the lungs

Oral Melanoma

64

Characterized the behavior of an oral melanoma in a dog.

characterized by.....

  • rapid growth
  • local invasion
  • early metastasis
  • usually to the lungs

65

What oral neoplasm in dogs is characterized by.....

  • rapid growth
  • local invasion
  • including bone
  • common recurrence
  • late to metastasis
    • usually to Lymph Nodes

SCC

66

This form of SCC is VERY aggressive and has generally metastasized by the time of diagnosis

Tonsillar SCC

67

Characterized the behavior of an oral SCC in a dog.

Squamous Cell Ca

  • rapid growth
  • local invasion
  • including bone
  • common recurrence
  • late to metastasis
    • usually to Lymph Nodes

68

what oral neoplasm is dogs is characterized by...

  • locally invasive 
  • common recurrence
  • intermediate metastatic potential

Fibrosarcoma

69

Characterize the behavior of an oral Fibrocarcoma in a dog

characterized by...

  • locally invasive
  • common recurrence
  • intermediate metastatic potential

70

although rare, what are the most common disorders of the salivary glands?

  • Sialoadenitis
  • Sialocele/ranula
  • Salivary gland infarction
  • Neoplasia

71

What is a Salivary Mucocele or sialocele

extraductal accumulation of salivary secretion in adjacent soft tissue -most often at angle of mandible Results from trauma to a salivary gland or rupture of ranula

72

what is a ranula? and how is it caused

Definition = cystically distended salivary duct in floor of mouth

  • due to salivary duct obstruction

73

what are come potential pathological consequences of a Cleft palate

  • nasal regurgitation
  • aspiration pneumonia

74

compare and contrast regurgitation and vomiting

  • Vomiting = forceful ejection of food or fluid through the mouth from the stomach and, sometimes, the duodenum
  • Regurgitation = more passive • results in expulsion of food or fluid from the oral or pharyngeal cavity or the esophagus

75

what are the 4 steps in "filling in" a deep esophageal ulcer? and what is the primary goal

1) inflammatory cells enter first (scavengers)

2) granulation tissue will fill the defect

3) epithelial covering

4) contraction of scar (myofibroblasts) GOAL = ↓ damaged surface area

76

what are two potential pathological consequences of esophageal ulcer healing?

WOUND CONTRACTURE may:

a) decrease lumen diameter (stricture) and/or

b) decrease distensibility

77

what are some consquences or clinical signs of Choke

  • anorexia
  • dysphagia 
  • regurgitation 
  • palpable lesion in esophagus (mass/food bolus) 
  • secondary aspiration pneumonia

78

what potential neoplasm's can occur in the esophogus, and which cell line to they belong to?

  • smooth muscle → leiomyoma
  • skeletal muscle → rhabdomyoma
  • epithelium (stratified squamous) → SCCa, papilloma
  • fibroblasts → fibroma, fibrosarcoma

79

what are your 3 DfDx for peri-esophageal obstruction (extramural)

{a} Congenital - persistent right aortic arch AKA: vascular ring anomaly → constriction of esophagus

{b} Neoplastic - intrathoracic tumors

{c} Inflammation - e.g. fungal granuloma

80

what is the defination of megaesophagus, and what are some of the consequences and signs?

  • Definition = flaccid, dilated esophagus
    • Can be diffuse or segmental (focal)
  • Consequences / Signs:
    • regurgitate - after eating (minutes to hours)
      • client complaint is commonly “vomiting”
    • +/- aspiration pneumonia
    • failure to thrive / weight loss

 

81

There are 6 primary etiologies of megaesophagus...... what are they?

  1. Congenital
  2. Primary degeneration of muscle
  3. Obstruction e.g. PRAA, tumor, etc.
  4. Denervation
  5. Secondary to certain systemic diseases
    • e.g. hypoadrenocorticism
    • lead poisoning
  6. Idiopathic

82

what are the 3 primary causes of esophagitis

  1. Trauma / foreign body
  2. Chemical
    • exogenous vs endogenous
  3. Infectious (uncommon)
    • Viral
      • BVD
    • Candida
      • avain crop infections
    • Parasitic
      • Spirocerca lupi

83

84

What is the lesion this is showing?

Q image thumb

Persistent right aortic arch (PRAR)

85

Write a Morphological Dx:

Possible etiologic agent?

Q image thumb

Chronic, Multifocal, severe, ulcerative glossitis 

Actinobacillus Lignieressii (Wooden Tongue) 

86

What appears to be wrong? Diagnosis this photo

Q image thumb

Megaesophagus