Term
| What are the 3 phases of swallowing? |
|
Definition
-oropharyngeal
-esophageal
-gastroesophageal |
|
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Term
| The upper esophageal sphincter opens when? |
|
Definition
| -when food/water bolus passes through |
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|
Term
| Whe lower esophageal sphincter opens when? |
|
Definition
| -only when food/water enters stomach, otherwise remains closed to prevent reflex of gastric contents |
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Term
| What usually causes tonsillitis? |
|
Definition
-rarely primary disease
-secondary to oral, pharyngeal, or URT dz |
|
|
Term
| What is the typical cause of tonsillar neoplasia? |
|
Definition
|
|
Term
| What are the clinical signs of FB or trauma in the pharynx? |
|
Definition
| -abscesses, discomfort, gagging, retching, pawing at mouth, ptyalism |
|
|
Term
| What are the clinical signs of swallowing disorders? |
|
Definition
-dysphagia
-regurge
-gagging
-aspiration |
|
|
Term
| How do we diagnose swallowing disorders? |
|
Definition
|
|
Term
| What is the purpose of the esophagus? What innervates it? |
|
Definition
-moves material from oral cavity to stomch
-all striated m in dogs
-vagus |
|
|
Term
| What are the clinical signs w/ esophageal dz? |
|
Definition
-regurg: most common
-dysphagia
-odynophagia: painful swallowing
-repeated swallowing attemps
-wt loss
-ptyalism
-halitosis
-vomitting
-aspiration pneumonia
-nasal discharge |
|
|
Term
| What sis the typical signalmnet of congential esphageal dz? |
|
Definition
|
|
Term
| Why do we ask if they have recently been under anesthesia w/ esophageal dz? |
|
Definition
| -reflux can cause an esophageal stricture |
|
|
Term
| What is hte most common sign of esophageal dz? |
|
Definition
|
|
Term
|
Definition
-passive retrograde movement of material in esophagus
-material stimulates gag reflex
-can be spit out, swallowed, or aspirated |
|
|
Term
|
Definition
-forceful expulsion of gastric and/or intestinal contents via diaphragmatic adn abdominal muscle contractions
-centrally mediated |
|
|
Term
| Does regurg or vomit have bile? |
|
Definition
|
|
Term
| How does pH change w/ regurge vs vomit? |
|
Definition
-ph>7 is regurg
-pH<5 or >8 is vomit |
|
|
Term
| Why would we look at the neck for megaesophagus? |
|
Definition
|
|
Term
| What do we see on rads w/ esophageal dz? |
|
Definition
|
|
Term
| What do we see on BArium study w/ esophageal dz? |
|
Definition
-avoid sedation!!
-risk of aspiration=-motility
-irregualr mucosa |
|
|
Term
| What is the purpose of esphagoscopy w/ esophageal dz? |
|
Definition
-direct visualization
-biopsy
-take of FB
-dialtion of strictures |
|
|
Term
|
Definition
| -dialtion of the body of esophagus |
|
|
Term
| What is the most common dz thath megaesophagus is secondary to? |
|
Definition
|
|
Term
| What is the most common form of megaesophagus? |
|
Definition
|
|
Term
| What is the primary clinical sign of megaesophagus? |
|
Definition
-regurg +/- aspiration pneumonia
-plus weakness or fatigue w/ MG |
|
|
Term
| How do we treat congenital megaesophagus? |
|
Definition
| -treat symptomatically but DO NOT BREED |
|
|
Term
| What is myasthenia gravis? |
|
Definition
| -d of NMJ w/ Ab directed at ACh rc |
|
|
Term
| What are some other dz that can cause qcquired megaesophagus? |
|
Definition
-canine botulism
-disautonomia
-SLE
-hypoadrenocorticism
-hypothyroidism
-idiopathic |
|
|
Term
| What are some common causes of acquired megaesophagus due to chronic obstruction? |
|
Definition
-vascular irng anomalies
-strictures
-neoplasia
-esophageal compression
-FB |
|
|
Term
| What diagnostics do we run on megaesophagus? |
|
Definition
-ACTH stim testing: Addison's
-Thyroid testing: T4, fT4, TSH
-ACh Rc Ab test: MG |
|
|
Term
| If dog has ability to pass liquids but not solids what is suggested? |
|
Definition
|
|
Term
| How do we treat megaesophagus? |
|
Definition
-feed in upright position
-switch of food consistency
-try prokinets but can make it worse
-gastric tube |
|
|
Term
| What is the prognosis of megaesophagus? |
|
Definition
-variable but generally poor
-aspiration pneumonia makes it way way worse
-most do fine if no asp pneumonia w/ good supportive care |
|
|
Term
| True or FAlse: Megaesophagus is always necessary for esophageal motility disorders. |
|
Definition
|
|
Term
| What are the clinical signs of esophageal motility disorders? Diagnosis? |
|
Definition
-same as megaesphgus
-barium |
|
|
Term
|
Definition
| -inflammation fo esophageal mucosa |
|
|
Term
| What is the most common cause of esophagitis? |
|
Definition
|
|
Term
| What are the clinical signs of esophagitis? |
|
Definition
-may be asymptomatic
-anorexia, dysphagia, odynophagia, ptyalism, regurg
-blood tinged saliva |
|
|
Term
| How do we diagnose esophagitis? |
|
Definition
-contrast rads or fluorscopy
-endoscopy: hyperemia, erisions |
|
|
Term
| How do we treat esophagitis? |
|
Definition
-soft or liquid food
-severe cases: gastroprotectants, prokinetics (metoclopramide or cisapride), acid reducers (ranitidine, famotidine, omeprazole), feeding tube |
|
|
Term
| What is the prognosis of esophagitis? |
|
Definition
-good if mild
-guarded if severe ulcerations (could cause stricture formation) |
|
|
Term
| Are esophageal FB more common in dogs or cats? |
|
Definition
|
|
Term
| TEST QUESTION: What are the 4 most common locations of esophageal FB? |
|
Definition
-dorsal to larynx
-thoracic inlet
-base of heart
-diaphragmatic hiatus |
|
|
Term
| What are the most common FB in odgs? |
|
Definition
|
|
Term
| True or False: 60% of FB are found in the proximal esophagus. |
|
Definition
|
|
Term
| What are the clinical signs of esophageal FB? |
|
Definition
-regurg, dysphagia, odynophagia, gagging, ptyalism
-severe pain
-rarely also see dyspnea |
|
|
Term
| What is the best way to remove an esophageal FB? |
|
Definition
|
|
Term
| What causes esopagheal strictures? |
|
Definition
| -damage in muscle layers that heal by fibroblasts/collagen 1-3 weeks after injry |
|
|
Term
| What are the common causes of benign esophageal stricture? |
|
Definition
-acid reflux under anesthesia: most common
-meds: doxy in cats
-FB |
|
|
Term
| What are the clinical signs of benign esophageal stricture? |
|
Definition
-regurg
-dysphagia
-odynophagia
-ptyalism
-wt loss |
|
|
Term
| How do we treat esophageal strictures? |
|
Definition
| -repeated ballonings or stents |
|
|
Term
| What are vascualr irng anomalies? |
|
Definition
| -congenital malformations of major aa of the heart which entrap and obstruct the esophagus |
|
|
Term
| What is the most ocmmon vascular ring anomaly? |
|
Definition
|
|
Term
| What is the common history of vascular ring anomalies? |
|
Definition
| -regurg at time of weaning w/ failure to thrive |
|
|
Term
| How do we diagnose vascualr ring anomalies? |
|
Definition
| -Barium rads: dilation of cranial esophagus w/ narrowing at base of heart |
|
|
Term
|
Definition
| -surgical ligation and transection of ligamentum arteriosum |
|
|
Term
| What is the prognosis of vascular ring anomalies? |
|
Definition
-usually good after surgery
-worse of regurge continues after surgery |
|
|
Term
|
Definition
| -nematode infects the wall of esphagus |
|
|
Term
| What are the clinical signs of Spirocerca lupi? |
|
Definition
-regurge
-gagging
-wt loss
-hematemesis |
|
|
Term
| How do we diagnose Spirocerca lupi? |
|
Definition
| -ID eggs in feces/vomitus OR seen on endozcopy |
|
|
Term
| How do we treat Spirocerca lupi? |
|
Definition
|
|
Term
| What is the most common esophageal neoplasm in dogs? Cats? |
|
Definition
-Dogs: fibrosarcoma
-Cats: SCC |
|
|
Term
|
Definition
| -herniation of distal esophagus, gastroesophageal junction, stomach, and/or other agdominal organs witno thoracic cavity |
|
|
Term
| What are the clinical signs of hiatal hernia? |
|
Definition
-GER
-regurg
-vomiting
-dysphagia
-dyspnea
-ptyalism |
|
|
Term
| How do we diagnose hiatal hernia? |
|
Definition
|
|
Term
| How do we treat hiatal hernia? |
|
Definition
-feed in inclined position
-surgery |
|
|
Term
| What are some of the common causes of extraluminal obstruction? |
|
Definition
-enalrged bronchial or mediastinal LN
-thoracic cavity tumors
- |
|
|
Term
| What is an esophageal diverticula? HOw is it diagnosed? |
|
Definition
-pouch-like dilation of esophageal wall
-congenital or acquired
-dx contrast rads |
|
|
Term
| What is an esophageal fistula? Tx? |
|
Definition
-communication b/n esophagus and either trachea or carina
-congenital or acquried
-tx = surgery |
|
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