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SAM 2 TEST 2- intro + esophagus Flashcards

1
Q

dysphagia

A

difficulty swallowing and or chewing

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2
Q

ptyalism

A

excessive production of saliva, hypersalivation

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3
Q

regurigatation

A

passive explosion of material from pharynx or esophagus

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4
Q

vomiting

A

forceful explosion of stomach contents through the mouth

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5
Q

hematemesis

A

blood in vomitus

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6
Q

borborygmi

A

bowel sounds

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7
Q

diarrhea

A

steatorrhea

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8
Q

tenesmus

A

straining to defecate

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9
Q

hematochezia

A

frank blood in or around stool

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10
Q

obstipation

A

severe or complete (inability to pass stools) constipation

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11
Q

dyschezia

A

painful defecation

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12
Q

Canine Oral Papillomatosis

A

Papillomavirus in dogs

Transmission via saliva, grooming, playing1-2 month’s incubation Mucosal surface – pale, smooth growths at first then rough and irregular

with fronds “Cauliflower Like”

Will go away as pup’s immune system matures

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13
Q

EPULIDES

A

EPULIDES – ODONTOGENIC NEOPLASM

From periodontal ligament – seen mostly in dogs BENIGN – do not metastasize
On gingiva, near teeth, especially incisor
Firm & Irregular

+/- symptomatic
Older Dogs, rarely cats
Breed: ANY, Shetland Sheepdogs, Old English Sheepdogs

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14
Q

Peripheral Odontogenic Fibromaa

A

(Fibromatous & Ossifying Epulis)

Non invasive, solitary, +/- pedunculated, non ulcerated Surgery Curative

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15
Q

Acanthomatous Ameloblastoma

A

Invasive +/- bone destruction Often needs large resection including bone to be curative +/- RT

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16
Q

What is the number one oral maligant neoplasm in the dog?

A

Maligant melanoma - #1 in DOG 2/3 pigmented

1/3 unpigmented
Metastasis not uncommon – LNs, Lung

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17
Q

What is the number one malignant oral neoplasm in the cat?

A

Squamous cell carcinoma - #1 in Cat, #2 in Dog Ulcerated, erosive lesions

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18
Q

EOSINOPHILIC GRANULOMA COMPLEX

A

Feline – any age

‘Rodent Ulcer’

Suspect hypersensitivity reaction Fleas/other insects, environment, diet

Can occur together or separately & range in size Eosinophilic Plaque – not on face Eosinophilic Granuloma – lip or chin swelling Indolent Ulcer – ulcers of mouth

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19
Q

What’s the treatment for eosinophilic granuloma complex?

What about the prognosis?

A

Minimum data base i.e. CBC, Chemistry, UA Evaluate lesions for infection
Impression smear and biopsy

Tx can include:
Food trial
Steroid – tapering course pending response Flea control
Pain management
Treat secondary infection

Prognosis is good Recurrence is common

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20
Q

GINGIVOSTOMATITIS

A

Severe chronic inflammation of gingiva and oral mucosa FELINE > CANINE
Abnormal immune response to plaque
Starts around a tooth; extends

Can be associated with: FIV

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21
Q

What’s the treatment for gingivostomatitis?

A

Medical management with oral hygiene control

 Routine periodontal treatments

 Brushing

 Immune mod medications such as prednisone or other immune mod meds

_* Full mouth extractions * +/- medications after_

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22
Q

PHARYNGEAL DISEASE

A

Foreign Body

Inflammation or Infection
Primary or secondary to neoplasia or foreign body Abscess

Obstruction/Compression Salivary Gland disease

Neoplasia (i.e. salivary, thyroid, tonsilar) Lymphadenopathy

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23
Q

Odynophagia

A

painful swallowing

24
Q

What is one of the key things about pharyngeal disease?

A

Voice change

25
If nothing seen on oral exam OR history lead you elsewhere ...
Endoscopy: Assess caudal pharynx and soft palate Fluoroscopy: Assess function CT scan of head, pharynx, cervical region, chest
26
Difficulty swallowing Upper respiratory signs Nasal discharge Stertor = ‘snore sound’
NASOPHARYNGEAL POLYP
27
If you are worried about polyps, what should you do?
SEDATED EAR EXAM Inflammatory response – possibly to viral organisms Arises from middle ear Penetrates into nasopharunx OR Penetrates eardrum
28
What is the treatment for a nasopolyp?
GENTLE TRACTION removal for Nasopharyngeal https://www.youtube.com/watch?v=VKz7pF4IkAI Ventral Bullae Osteotomy Excellent prognosis with removal Possible Recurrence
29
What is the number one salivary disease in dogs?
Sialocele - ‘salivary mucocele’ #1 salivary gland disorder in dogs
30
SIALOCELE
Accumulation of saliva in submucosal or subcutaneous tissues Trauma Inflammation Location Cervical # 1 Ranula (under tongue) Pharyngeal & Zygomatic – rare Small to large swelling +/- resp distress Usually non-painful with chronicity Mobile, soft, flocculent
31
What are the swelling locations for a siocele?
Parotid: Below Ear Mandibular: Angle of Jaw Zygomatic: Caudal to eye+/- retrobulbar swelling
32
What is the dx and treatment for siocele?
Systemic Evaluation Aspirate for cytology and culture Straw to light brown colored Viscous, non-odiferous fluid No bacteria +/- if drained before CT pending involvement Treatment Surgical removal WITH BIOPSY ! Excellent prognosis
33
SIALADENITIS
Inflammation of the salivary gland Trauma Systemic infection Secondary infection not uncommon – needs more aggressive therapy Painful, carrying head down Ptyalism Fever, lethargy Mild cases without infection self-resolved
34
PHARYNGEAL TRAUMA
Penetrating stick OR other cause wound Secondary Infection Remaining splinters or piece of foreign material Draining tracts, abscess, swelling Bloody saliva ACUTE: Dysphagia & oral pain **_+/- resp signs_** CHRONIC: Anorexia, pyrexia, retrobulbar swelling History of playing with sticks, active or no known cause
35
pharygeneal trauma treatment and prognosis
Removal of foreign material Treatment for secondary infection Surgical repair of injured tissues PROGNOSIS: Best if airway or esophagus not injured & ACUTE cases Recurrence occurs if no FB found, esp. difficult with inflammation Failed treatment with retained or migrating FBs, too short duraiton of antibiotics, permanent damage to oral or pharyngeal structures
36
Oral Swallowing phase
Oral (CN 5, 7, 12)  Prehend food and form bolus which moves to end of tongue
37
Pharyngeal- swallowing phase
Pharyngeal (CN 9, 11)  Propel bolus along pharynx  Closure of the larynx by epiglottis & inhibition of breathing  UES sphincter opens (cricopharyngeal muscle)
38
Esophageal- swallowing phases
Esophageal (CN 9, 10, SNS)  Bolus moves along into stomach
39
what are the clinical signs for oral swallowing phase issues?
ORAL: Dropping food and water; difficult to pick up
40
What are the CS for pharyngeal swallowing phase issues?
PHARYNGEAL: Retch, cough, gag, food expelled rapidly after attempting to swallow, repeated attempts to swallow
41
What are the CS for esophageal phase issues?
ESOPHAGEAL: Retch, gag, expel food quickly after eating or some time later
42
CRICOPHARYNGEAL ACHALASIA/DYSPHAGIA
Rare Genetic disorder in dog Breeds: Cocker and Springer Spaniels Acquired in adults associated with NM disorders CxS: repeat attempt to swallow, followed by gag and regurgitation
43
Cricopharyngeal muscle
- Involved in swallowing reflex - Inability to relax muscle leads to inability to swallow food or liquid - Prevents propulsion of food bolus from caudal pharynx into esophagus
44
What are treatment options for cricopharyngeal dysphagia?
SURGERY: Cricopharyngeal Myotomy or Cricopharyngeal & Thyropharyngeal Myectomy 65 % success rate Failure = lack of improvement, worsening, aspiration pneumonia Pets with NM disorders – treat underlying disease Treat aspiration pneumonia
45
Esophagus in dog vs cat
Striated muscle entire length – DOG Distal smooth muscle – CAT
46
ESOPHAGITIS
Inflammation of the esophageal mucosa – can affect motility Secondary to medications, foreign bodies, caustic toxins, gastrointestinal reflux from GA or GI dz RADS: Unremarkable or transient dilation Endoscopy: Erythemic +/- edematous mucosa
47
how do we treat esophagitis?
TREATMENT Pain management Buprenorphine, Tramadol, Fentanyl patch Sucralfate/Carafate 250 – 1 gram PO as slurry Q 6-8 hours Antacid  PPI Omeprazole 0.7=1.0 mg/kg PO BID Monitor for strictures Look for underlying disease (i.e. GERD)
48
treatment/managment of FB
GOAL Remove per OS with FB retrieval RISK Perforationeffusion, pyothorax, surgery Stricture Fistulae or Diverticulae No H2 blockers if pushed into stomach +/- Sucralfate +/- Pain management Feed small frequent meals Monitor for stricture and esophagitis signs
49
ESOPHAGEAL DIVERTICULAE
Small lesions do not cause overt clinical signs Larger lesions associated with impactions, esophagitis, rarely rupture and pyothorax Diagnosis with radiographs with contrast or fluoroscopy with contrast Secondary to trauma or congenital Tx: Surgery
50
What is the most common type of megaesophagus?
Idiopathic aquired
51
Congenital megaesphagus
CONGENITAL Abnormal NM innervation \< 6 months old Breeds: SharPei, Fox Terrier, German Sheperd, Labs, Danes, Irish Setter, Mini Schnauzer, Newfie Siamese cats May improve with time No genetic test
52
VASCULAR RING ANOMALY
Development abnormality 3rd, 4th, or 6th aortic arch and others Abnormal vessel entraps the thoracic esophagus #1 = Persistent right aortic arch DOG \> CAT Breeds: Boston, Irish Setter, German Shepard, Persian, Siamese
53
SPIROCERCA LUPI
Cystic nodules (larva) in esophageal wall – also gastric wall and aorta Fistula to lumen allows eggs to pass into alimentary tract NO fistula = no eggs = cannot detect in fecal evaluation Cystgranulomasarcoma with mets Not always, more in Hounds Can be incidental finding at necropsy WHERE Southern US; tropical and subtropical regions (Greece, India, Japan, SA, Israel)
54
What is the treatment for spiraceri lupi?
TREATMENT Keep dogs from eating things Monthly preventatives in edemic regions (moxidectin/imidacloprod in Europe) Often too advanced to treat Meds: Doramectin (0.4 mg/kg, SQ) every 2 weeks for 6 weeks then monthly until granuloma resolves Ivermectin (0.6 mg/kg, SQ, two doses 2 wk apart) combined with prednisolone (0.5 mg/kg, PO, bid for 2 wk and then tapered)
55
HIATAL HERNIA
Movement of abdominal contents through esophageal hiatus in diaphragm Congenital Acquired TYPE 1: Sliding – intermittent displacement of LES and gastric fundus into thorax TYPE 2: Gastric fundus displacement only BREEDS: Shar Pei, Bull Dogs – English & French
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