Vomiting/regurgitation Flashcards
(196 cards)
1
Q
4 types of oesophageal disease
A
anatomic, obstruction, oesophagitis, or motlity disorder
2
Q
4 anatomic oesophageal disease causes
A
vascular ring anomoly, circopharyngeal disease, hiatial hernia, or diverticulum
3
Q
oesophageal diverticulum
A
pouch that protrudes outward from weak point in oesophagus
4
Q
3 causes of obstructive oesophageal disease
A
- mural (relating to wall) e.g. stricture
- luminal e.g. foreign body
- exraluminal e.g. mass
5
Q
3 causes of oesophagitis
A
- trauma
- reflux
- irritation
6
Q
3 causes of oesophageal motility disease
A
- megaoesophagus
- neuropathy
- myopathy
7
Q
6 charachteristics of oesophageal disease
A
- hypersalivation
- dysphagia
- odynophagia
- anorexia
- nasal discharge
- coughing
8
Q
dysphagia
A
difficulty swallowing
9
Q
odynophagia
A
pain on eating
10
Q
be aware when radiographing oeasophagus that
A
air in the oesophagus can look like megaoesophagus
11
Q
causes of megaoesophagus
A
- myathenia gravis
- thymoma
- hypoadrenocorticism
12
Q
myathenia gravis
A
an autoimmune neuromuscular disease the weakens muscle
13
Q
thymoma
A
tumour of the epithelial cells of the thymus, associated with myathenia gravis
14
Q
3 treatments of oesophagitis
A
- small meals high in protein and low in fat to minimise acid reflux
- sucralfate liquid to protect mucosa
- inhibit gastric acid secretion
15
Q
complications of oesophagitis
A
if it heals by fibrosis a stricture can form
16
Q
treatment of oesophageal foreign body
A
remove or if cant then push into stomach and remove surgically
17
Q
6 1* GI causes of vomiting
A
- dietary
- infection
- inflammatory disease
- neoplasia
- obstruction
- motility disorders
18
Q
3 acute causes of 1* GI vomiting
A
- obstruction
- dietary
- infection
19
Q
2 chronic causes of 1* GI vomiting
A
- neoplasia
- inflammatory disease
20
Q
3 dietary causes of 1* GI vomiting
A
- intolerance
- indiscretion 9eating crap that shouldnt be eaten)
- hypersensitivity
21
Q
3 inflammatory causes of 1* GI vomiting
A
- gastritis
- IBD
- ulceration
22
Q
6 2* metabolic causes of vomiting
A
- uraemia
- adrenocotical insufficiency
- hepatic disease
- pancreatitis
- toxin ingestion
- drugs
23
Q
coffee ground appearance of vomiting indicates
A
blood
24
Q
sucralfate contains
A
aluminium hydroxide and sucrose octasulfate
25
sucralfate actions
the aluminium hydroxide and sucrose octasulphate dissociate in acid and the sucrose octasulfate reacts with HCl to make a viscous sticky substance that binds to proteinaceous exudate found at ulcer sites
26
sucralfate uses
acts as a protective barrier to stomach ulcer site
27
ranitidine actions
H2 receptor antagonist, which acts as an antihistamine and inhibits gastric acid secretion
28
ranitidine uses
used in any sort of vomiting/regurgitation
29
omeprazole actions
protein pump inhibitor of parietal cell, irreversably stopping H+ secretion into stomach by binding to H+/K+ATPase
30
metoclopramide actions
- para-aminobenzoic acid derivative with central and GI effects
- antagonises D2-dopaminergic and 5-HTs receptors in chemoreceptor trigger zone stopping nausea and vomiting
- peripheral cholinergic effects (parasympatheic effect)
31
metoclopramide uses
anti-emetic
32
ondansetron actions
5-HT3 serotonergic antagonist
33
ondansetron uses
strong anti-emetic, used in chemotherapy
34
macropitant actions
- neurokinin-1 receptor antagonist
| - central and peripheral effects
35
macropitant uses
anti-emetic, stops any kind of vomiting
36
gastric vomiting causes 3 things..
- loss of hydrochloric acid
- dehydration
- decreased feed intake
37
loss of hydrochloric acid causes..
- metabolic alkalosis
| - hypochloraemia (low blood chloride)
38
dehydration causes..
- low tissue perfusion
| - metabolic acidosis which causes decreased Na+
39
insufficient food intake due to vomiting causes..
hypokalaemia (low potassium)
40
given to stabalise vomiting patient prior to surgery
- i/v isotonic crystaloid or colloid fluids
| - i/v potassium supplements
41
lower small intestinal obstruction vomiting causes
- decreased pancreatic na+ and HCO3-
- metabolic acidosis casusing low Na+
- dehydration
- decreased food intake
42
higher intestinal obstruction vomiting causes..
signs similar to gastric vomiting
43
anaemia types
regenerative and non-regenerative
44
antibiotic indication post surgery in GIT
small intestine and colon
45
number of bacteria in GIT
increases as you go down the GIT, and so do % of anaerobes
46
antibiotics to be used post small intestinal surgery
1 broard spectrum antibiotic that covers anaerobes
47
antibiotics to be used post colonic surgery
2 antibiotics, 1 with specific anaerobic cover
48
3 ways you can reduce contamination in GI surgery
- pack area off with saline soaked swabs
- use different instruments and gloves for contaminated part of surgery
- lavage wound after closure
49
2 ways to reduce amount of poo in small intestine
- feed a low residue diet
| - starve for 12 - 24 hours pre surgery
50
strongest layer of stomach lining
sub mucosa
51
sub mucosa is the strongest layer in GIT because..
it has a high collagen content
52
day 1-4 post surgery in GIT wound (4)
- clot formation
- no change to strength
- inflammation
- possible wound debridement
53
day 3-14 post GIT surgery wound (1)
increase in wound strength
54
day 3-14 post GIT surgery wound (1)
increase in wound strength
55
day 14 of small intestinal wound
regained 75-80% original strength
56
day 14 of colonic wound
regained 50% original strength
57
hypoproteinemia
low blood protein
58
effect of hypoproteinemia on wound healing
negative effect
59
time after surgery have to wait before starting chemo/radiotherapy
3 weeks
60
effect of steroids on wound healing
negative
61
where cut for ex lap
from xiphisternum to pubis
| in the male cut through the preputial muscle
62
where cut for ex lap
from xiphisternum to pubis
| in the male cut through the preputial muscle
63
think when cutting through preputial muscle
large skin blood vessel near it that need to tie off
64
stomach blood vessels and surgery
you can tie a few off as the stomach has a large collateral blood supply
65
suturing of the stomach layers
do mucosa and submucosa together then muscularis and serosa together
66
3 things to think when cutting the intestine
- make sure the section is empty of contents
- clamp of section with atraumatic bowel clamps or fingers
- cut along antimesenteric border
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how to biopsy liver
- clamp a triangle off and use a skin biopsy punch
68
3 things to promote GIT healing
- feed soon after surgery
- omentalise it
- if its small intestine then you can tack healthy intestine to the wound
69
define intussuception
where a section of intestine has invaginated into the lumen of its adjoining intestine
70
intussuception on radiograph
intestine will be distended with gas
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intussuception treatment
surgery - push the invaginated bit out. do not pull
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prevention of intussuception reoccurance
- enteroplication - sex neighbouring bits of intestine together to prevent movement. look for an underlying cause first though
73
5 stages of septic peritonitis
- inflammatory cells enter the peritoneal cavity and release endotoxins and cytokines.
- vasodilation and increased capillary permeability
- diaphragmatic lymphatics blocked due to fibrosis
- increased fluid and protein in peritoneal cavity
- hypovolemia, decreased oncotic pressure and hypovolaemic shock
74
clinical signs of septic peritonitis show on..
day 3-5
75
mortality of septic peritonitis
50%
76
treatment of septic peritonitis 3 stages
- stabalise patient and give antibiotics
- surgery to find and correct leak, then lavage and drain cavity
- intensive post op care
77
diagnosis of septic peritonitis
abdominocentesis showing neutrophils containing bacteria
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define salivary mucocoeles
cyst of the salivary gland
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cause of salivary mucocoeles
disruption of gland and duct anatomy causing saliva to leak into tissues
80
most common gland for mucocoele formation
sublingual salivary gland
81
salivary mucocoeles 3 clinical signs
- painless swelling
- difficulty eating
- dyspnoea
82
ranula
a mucocoele that is formed independently (away from) salivary gland
83
treatment for salivary mucocoeles
- complete surgical removal of the salivary chain
| - avoid draining for tx as they will reoccur and you can introduce infection
84
large foreing bodies lodge in 3 sites
- thoracic inlet
- heart base
- caudal oesophagus
85
dyspnoea
difficulty breathing
86
diagnosing oesophageal foreign bodies radiograph
- lateral cervical and thoracic views
| - orthagonal view (90*) to confirm location
87
3 layers of the oesophagus wall
- mucosa
- submucosa
- muscularis
88
oesophagus blood supply
- arteries are segmented with few anastomising branches
| - veins drain into the azygous and the jugular veins
89
oesophagus lymphatics
drain to thoracic and abdominal lymph nodes
90
cervical tissues are continuous with...
cranial mediastinum
91
infection in the neck can travel to..
the chest causing septic mediastinitis
92
ligamentum arteriosum
ligament connecting the aorta to the pulmonary artery
93
persistent right aortic arch
the right aortic arch remains and so the ligamentum arteriosum forms a circle around the oesophagus and the trachea
94
4 medical treatments for persistent right aortic arch
- feed from a height
- feed a slurry diet
- remain upright for 20 mins post feeding
- possible treatment needed for aspiration pneumonia
95
4 treatments for aspiration pneumonia
- antibiotics
- O2
- nebulised drugs (made into a mist)
- coupage (hitting chest wall to break up crap)
96
prognosis persistent right aortic arch
- guarded as surgical tx does not fix oesophageal dilation or motility disturbances
97
rumen holds
180-200 litres
98
rumen pH
6.2-7
99
volatile fatty acid produced at normal rumenal pH
acetate
100
if cow eats starch or sugar
pH will drop
101
3 VFAs produced if rumen pH drops
- butyrate
- propionate
- lactate
102
ruminal acidosis can cause.
ruminal stasis
103
amount of saliva cow makes in a day
100-150 litres
104
amount of bicarbinate in cow saliva per day
3.5kg
105
function of bicarbinate in cow saliva
to maintain a neutral pH
106
time a cow needs lying down per day
14 hours
107
normal cause of ruminal acidosis
eating a large amount of concentrate (fermentable carbohydrate)
108
12 acute ruminal acidosis clinical signs
- dull
- recumbent
- uncoordinated
- ataxia
- blindness
- anorexia
- dehydration
- laminitis
- ruminal stasis
- abdominal distension
- increased pulse
- sunken eyes
109
acute ruminal acidosis prognosis
guarded
110
4 treatments acute ruminal acidosis
- i/v sodium bicarbonate slow over 30 minutes
- i/v fluinds NaCl over 6-12 hours
- oral magnesium hydroxide
- rumenotomy/rumen lavage
111
SARA
sub acute ruminal acidosis
112
define SARA
an ill defined herd syndrome
113
8 SARA clinical signs
- low milk fat
- decreased milk yields
- long term laminitis
- increased herd culling rates
- decreased appetite
- liver abscesses
- haemoptysis
- epistaxis
114
haemoptysis
coughing up blood due to bleeding in lungs
115
how SARA causes haemoptysis
bacteria leaks through wall and sets up abscess in liver. abscess breaks of and forms septic thrombosis in vena cava, this can spread to lungs, eroding blood vessels and causing bleeding
116
5 clinical signs ruminal bloat
- distended abdomen on left
- recumbent
- distressed
- dyspnoea (due to pressure on lungs#)
- sudden death (due to pressure on lungs)
117
bloat types
frothy and gaseous
118
frothy bloat causes
foaming properties of soluble leaf proteins in
- legumes
- clovers
- alfalfa
- rich lush pasture
119
frothy bloat treatment
sit in sternal if recumbent and give surfactant like
- cooking oil
- poloxalene
120
causes of gaseous bloat
- excessive carbohydrate intake
| - oesophageal blockage
121
treatment gaseous bloat
stomach tube or trocar
| - put local anaesthetic in paralumbar fossa, cut a small hole and then screw in trocar to rumen. then remove the canula
122
define traumatic reticula peritonitis
where metal ruptures through reticulum causing local or diffuse peritonitis, pericarditis, or liver abscess
123
6 clinical signs traumatic reticulo peritonitis
vague
- decreased milk yield
- pyrexia
- decreased ruminal movement
- arching back
- increased jugular pulse or corded jugular vein
- splashing sounds over heart
124
3 tests for cow abdominal pain
- withers pinch
- pole test
- eric williams test
125
pole test
put pole under chest behind legs and pull up, should grunt if painful
126
eric williams test
hear a grunt before rumen reticulum cycle
127
3 treatments traumatic reticulo peritonitis
- raise animal up on front legs for a few days, give antibiotics and pain relief
- rumenotomy to remove object
- cull
128
prevent traumatic reticulo peritonitis
magnet in rumen
129
LDA usually occurs
6 weeks post calving
130
LDA 4 clinical signs
- reduced milk yield
- increased blood and urine ketones
- decreased body condition
- reduced rumen contractions
131
diagnosis LDA
listen for pings or tinkles (move gut with fist) over left side
132
3 treatments for LDA
- roll
- omentopexy
- right paramedian abomasopexy
133
omentopexy
organ is sutured in place to greater omentum
134
RDA causes 3 things
- acute intestinal obstruction
- reduced blood supply
- necrosis
135
3 RDA clinical signs
- sick
- dehydrated
- painful
136
caecal dilation rectal exam presentation
- caecal apex palpable coming into pelvic inlet
| - can twist forming volvulus
137
3 caecal dilation treatment
- medical fluids
- high fibre diet
- surgery if persists
138
4 differential diagnosis for right side ping
- RDA
- gas in spiral colon
- uterine tear at calving
- ruptured abomasal ulcer
139
horse canines
usually only seen in males
140
wolf teeth are
vestigial premolar teeth
141
temporomandibular joint allows
occlusal contact with all cheek teeth
142
2 features of horse teeth
- hypsodont
| - irregular enamel ridges
143
hypsodont
constantly emerging teeth
144
irregular enamel ridges in horse teeth allows
increased grinding ability
145
how teeth are examined on dental chart
clockwise starting at the horses top right
146
equine teeth 05
wolf teeth
147
horse teeth 01-03 on dental chart
incisors
148
horse teeth 04
canines
149
horse teeth 06-08
premolars
150
horse teeth 09-11
molars
151
significance of horse tooth 09
most commonly affected tooth
152
angisognathism
maxillary arcade is wider than the mandibular arcade
153
5 components of teeth
- dentine
- enamel
- cementum
- secondary dentine
- pulp
154
where is dentine
inside the bulk of the tooth
155
pulp
blood and nerve supply of tooth, in horses ends 5-10mm from surface
156
infundibulum
cup shaped dips made by enamel infolding on occlusal surface of tooth, usually filled with black decaying matter
157
maxillary cheek teeth number of infundibulum
2
158
number of infundibulum in incisor
1
159
how you get linguinal edge points on mandibular arcade
decreased lateral movement of jaw. encouraged by foraging
160
enamel overgrowth causes
- the jaw to stop moving freely
- causing oral pain
- which causes quidding, weight loss, headshaking, and shear mouth
161
shear mouth
where occlusal angle is over 15*
| animal will eventually adapt to it
162
treatment of shear mouth
- remove sharp lingual or buccal points
- ongoing treatment to correct
- find underlying problem
163
quidding
food dropping from mouth
164
cheapest rasping blade
carbide chip blade
165
blest blade for rasping
tungsten carbide blade
166
4 types rasping handle
- straight head long length
- obtuse angle long length
- angled offset with medium length
- s float
167
straight head long length rasping handle use
all lower and some upper cheek teeth
168
obtuse angled head with long length rasping handle uses
caudal upper cheek teeth and curve of spee
169
define curve of spee
curve in upper caudal cheek teeth
170
s float rasping handle uses
smooth of 1st cheek teeth and 6th mavillary cheek teeth, bit seat, and angle of curve of spee
171
angled offset head of medium length rasping handle use
upper 1st - 4th cheek teeth
172
bit seat define
where edges of first upper and lower cheeck teeth are rounded so that it is not painful when skin gets trapped there when horse pulls on the bit
173
blood vessle that may bleed during equine dentistry
palantine artery found inside upper arcade
174
caps on equine teeth
retained deciduous teeth
175
when equine caps are shed
2.5, 3, and 4 years
176
equine caps cause 3 things
- anorexia
- poor performance
- malocclusion
177
equine caps removal
with forceps or screwdriver
178
equine parrot mouth
rostral displacement of the maxillary arcade causing overgrowth of rostral and caudal teeth
179
overgrown teeth can cause 4 things
- diastema
| - displaced/fractured/lost teeth
180
wave mouth
multiple overgrown teeth
181
effect of wave mouth on 2* dentine
as does not have complete contact with occlusal surface 2* dentine may not form leaving pulp exposed
182
define infundibular caries
a cavity in the infundibulum
183
infundibular caries can cause formation of
septic pulpitis
184
treatment of excessive transverse ridges
dont remove them as ridging is normal, you can reduce the larger ones
185
stages of peridontal disease
- localised gingivitis and pocket formation
- trapped debris stagnate and food is compressed widening pocket
- alveolar bone is destroyed
- bacteria enter the pulp cavity through the root canals
186
define diastema
a gap between teeth, can be normal
187
if food packs into the diastema
- food will also pack into peridontal spaces
- pressure of food compaction causes pain
- bone becomes infected
188
treatment of abnormal diastema
- widen it
- extraction
- monitoring and removing food when necessary
189
define apical tooth infections
infection in the root of tooth
190
5 clinical signs apical tooth infection
- asymmetrical jaw swelling
- ventral discharge tract
- quidding
- halitosis
- submandibular lymph node enlargement
191
diagnosis of apical tooth infections
radiography showing; gas in bulging root area, root fragmentation, increased pulp volume, abnormal pulp morphology
192
significance equine teeth 06, 07
can burst into nasal cavity as in maxillary bone
193
significance equine teeth 08-11 apical tooth infection
in rostral and caudal sinuses so can cause sinusitis
194
clinical sign of sinusitis
unilateral nasal discharge
195
diagnosis sinusitis
imaging
196
3 treatment of apical tooth infection
- anitibiotics
- removal
- endodontic treatment
