Term
| List the Clinical Signs associated with oropharyngeal dysphagias |
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Definition
| salivation, gagging, dropping food, difficulty swallowing |
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Term
| Describe the differences between anatomic and functional oropharyngeal dysphagias |
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Definition
Anatomic: interferes w/ swallowing
Functional: failure to contract/ initiate peristalsis |
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Term
| How do you DIAGNOSE (medically investigate) oropharyngeal dysphagia |
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Definition
| PE, oral exam, survey radiographs, videofluoroscopy |
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Term
| List supportive TREATMENT options for oropharyngeal dysphagia |
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Definition
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Term
| What are oropharyngeal dysphagias? |
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Definition
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Term
| What is cricopharyngeal achalasia? |
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Definition
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Term
| Describe the PATHOGENESIS of cricopharyngeal achalasia |
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Definition
| hypertensive gastroesophageal sphincter, inadequate relaxation |
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Term
| How would you TREAT cricopharyngeal achalasia? |
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Definition
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Term
| Describe Primary vs. Secondary Peristalsis |
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Definition
Primary: food bolus moved down esophagus
Secondary: secondary wave of contractions |
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Term
| List some CLINICAL SIGNS of esophageal motility disorders |
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Definition
| regurgitation, odynophagia, dysphagia, increased salivation, change in appetite, |
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Term
| Describe the SPECIES DIFFERENCES in esophageal anatomy and physiology |
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Definition
Canine: all striated muscle; lacks 5-HT4 receptors
Feline: smooth muscle in distal 1/2 to 1/3 |
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Term
| What is Esophageal Stricture? |
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Definition
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Term
| Describe the PATHOGENESIS of esophageal stricture |
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Definition
| cats: doxycycline can cause esophagitis leading to scarring and subsequent stricture formation |
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Term
| How would you TREAT/MANAGE esophageal strictures? |
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Definition
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Term
| List some CONGENITAL disorders of the esophagus. |
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Definition
| hiatal hernia, vascular ring anomaly, megaesophagus, fistula |
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Term
| List the 4 components of esophagitis THERAPY |
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Definition
1. sucralfate
2. decrease acid in stomach (ie-famotidine)
3. corticosteroids oral
4. +/- local injection of corticosteroids |
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Term
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Definition
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Term
| Compare & Contrast medical vs surgical treatment for hiatal hernias |
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Definition
Medical: start with this; can advance to surgery if necessary
Surgery: usu. necessary in cases involving laryngeal paralysis |
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Term
| What is canine idiopathic megaesophagus? |
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Definition
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Term
| Describe the pathogenesis of canine idiopathic megaesophagus (myasthenia vs afferent neural pathway) |
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Definition
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Term
| How would you treat canine idiopathic megaesophagus? (myasthenia vs. afferent neural pathway) |
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Definition
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Term
| How would you DIAGNOSE esophageal neoplasia? |
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Definition
Survey Radiographs
Ultrasound |
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Term
| How would you TREAT esophageal neoplasia? |
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Definition
Chemo, radiation
Surgery not usually a good option |
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Term
| Describe the general principles of endoscopy- Best Practice Standards |
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Definition
| don't bend/force/torque; don't advance blindly; position centrally; insufflate; biopsy; know landmarks |
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Term
| Describe esophageal endoscopy principles |
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Definition
| withhold food 12hrs; no atropine/opioids; general anesthesia; left lateral recumbency; use bite block |
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Term
| Describe gastric endoscopic principles |
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Definition
| withhold food 12hrs; no atropine/opioids; general anesthesia; left lateral recumbency; use bite block |
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Term
| Describe intestinal endoscopy principles |
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Definition
| can only access duodenum from stomach |
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Term
| Describe colonic endoscopy principles |
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Definition
| withhold food 36-48hrs, warm water enema, oral electrolyte solution (12hrs prior), general anesthesia, left lateral recumbency, can see cecum and distal ileum as well |
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Term
| Give some examples of endoscopic interventional procedures |
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Definition
PEG tube (percutaneous endoscopic tube gastrotomy) placement
- indicated in anorectic,
malnourished, or dysphagic
animals |
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Term
| List the Advantages & Disadvantages of endoscopy vs exploratory surgery |
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Definition
Endoscopy:
Pros: less invasive, direct
visualization, need multiple
biopsies
Cons: only duodenum; small biopsies
Surgery:
Pros: full thickness biopsy,
inspect other organs
Cons: increased risk, longer
recovery |
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Term
| Describe patient positioning for upper and lower GI endoscopy |
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Definition
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Term
| Describe appropriate patient PREPARATION (ie- pre-op meds) |
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Definition
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Term
| What are the differences b/w fiberoptic and digital image endoscopy? |
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Definition
fiberoptic: fiber bundles-> image-> eyepiece; cheaper; less clear picture
Digital: computer microchip-> image-> TV; expensive; clearer picture |
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Term
| Compare & Contrast anatomic (outflow obstruction) vs. functional (delayed gastric emptying) disorders |
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Definition
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Term
| List the CLINICAL SIGNS assoc. w/ gastric disease |
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Definition
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Term
| How would you DIAGNOSE (or medically investigate) gastric disease? |
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Definition
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Term
| How would you TREAT anatomic outflow obstruction? |
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Definition
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Term
| Describe how you would nutritionally manage delayed gastric emptying disorders |
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Definition
| low fat, low protein, neutral pH, low osmolality, liquid |
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Term
| List the categories (or where the various drugs act) for GI prokinetic therapy |
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Definition
- Dopamine D2 antagonists
- 5-HT4 serotonergic agonists
- motilin agonists
- acetylcholinesterase inhibitors |
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Term
| Give an example of Dopamine D2 antagonists |
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Definition
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Term
| Give an example of 5-HT4 serotonergic agonists |
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Definition
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Term
| Give an example of motilin agonists |
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Definition
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Term
| Give an example of acetylcholinesterase inhibitors |
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Definition
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Term
| Name the Salivary glands (dog & cat) |
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Definition
Parotid salivary gland (serous)
Mandibular salivary gland (seromucus)
Sublingual salivary gland (seromucus)
zygomatic salivary gland (seromucus)
molar salivary gland (cats only)(seromucus) |
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Term
| List some differentials for maxillofacial and cervical swellings |
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Definition
| edema (hypersensitivity rxn, lymphatic obstruction, vasculitis, cardiovascular abnormalities), salivary pathology, trauma, infection (abscess), FB, autoimmune conditions (masticatory myositis), developmental anomalies (brachial cyst), neoplasia, periostitis ossificans, cranial mandibular osteopathy, subcutaneous emphysema (tracheal rupture, pneumothorax/ pneumomediastinum) |
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Term
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Definition
accumulations of saliva in the regional soft tissue; most common salivary pathology in the dog and cat
Parotid gland -> sialocele
other salivary glands-> mucocele
Types: ranulas (sublingual mucocele), pharyngeal mucocele, cervical mucocele |
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Term
| Describe the pathogenesis of sialoceles |
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Definition
secondary to trauma, anatomical defec, iatrogenic trauma, obstruction
non-painful and soft, but firm
swelling size may increase or decrease over time |
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Term
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Definition
NO
cysts: epithelial lining
sialocele: lined by granulation tissue |
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Term
| How would you diagnose sialoceles? |
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Definition
clinical suspicion, rule out other diseases/abscesses/FB/draining tracts
aspirating a yellow-blood tinged thick fluid
periodic-acid schiff stain
Sialography
advanced imaging |
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Term
| How would you treat sialoceles? |
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Definition
remove the offending salivary gland and duct
trx of the fluid accumulation: benign neglect, aspiration, surgical resection, marsupialization |
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Term
| Contrast retrobulbar abscess/cellulitis vs masticatory myositis |
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Definition
Key point:
first thing to do is give
analgesia/sedation and try to open
mouth
if mouth opens...then think retrobulbar abscess/cellulitis
if mouth does not open...masticatory myosistis
- auto-imune dz (type 2M myofibers)
Treatment:
masticatory myositis: immunosuppressive steroids
retrobulbar abscess: antibiotics |
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