5.Examination of the Alimentary System of the Horse Flashcards
What is important to check when doing the history?
- Appetite
- Water intake
- Prehension
- Mastication
- Swallowing
- Defecation
- Pain (colic)
How is the body scoring system?
- Scale 1-9 most widely accepted
- Based on visual inspection and palpation of certain regions
- Positively related to body fat percentage
- No correlation to body weight
- Modified scale for foals (1-5)
What do you examine in the oral cavity?
- Odour
- Mucous membranes
- Saliva
- Teeth
- Tongue
Which salivary glands do you examine?
- Parotid gland
- Mandibular gland
- Sublingual gland
- Buccal gland
How do you examine the Pharynx:
External examination:
• Inspection
• Palpation
Internal examination: • Palpation • Endoscopy • Nasogastric tubing • Watering and feeding test
How do you examine the Esophagus?
- Inspection
- Palpation
- Nasogastric Tubing
- Watering and Feeding test
- Endoscopy
- X-ray (contrast)
- Ultrasound
What are the regions of the abdomen?
- Epigastric region
- Mesogastric region
- Hypogastric region
What are the specific examination methods of the abdomen?
- Rectal palpation
- Nasogastric intubation
- Abdominocentesis
- Endoscopy
- Radiography
- Ultrasonography
- Laparoscopy
- Laparotomy
- CT (foals)
Explain the inspection and palpation of the abdomen:
Inspection:
• From behind, the side, the front, below
• Shape, contour, volume, movements
Palpation:
• Temperature, thickness, tenseness, sensitivity, pain, swellings
Explain the auscultation of the abdomen:
Aim: detecting normal and abnormal sounds
• Gurgling, murmuring, rumbling sounds
• Tinkling, splashing sounds
• Increased borborygmi: early stages of enteritis
• Reduced or absent sounds: atony, impaction, obstruction, shock, poor perfusion, high sympathetic tone
• At least 3 areas on each side
• 1 minute at 1 area
Explain the percussion of the abdomen:
Historically important part of colic work-up
• Provides information regarding gas distention of caecum and large colon
• Usefullness is limited due to size of the abdomen
• More sensitive and specific diagnostic methods are available
What are the normal finding on the left side of the abdomen?
Leftside:
• Dorsal third: dulled tympanic
• Medium third: dulled tympanic
• Ventral third: dulled
What are the normal finding on the right side of the abdomen?
Right side:
• Dorsal third: tympanic
• Medium third: dulled tympanic
• Ventral third: dulled
What are the parameteres you check for the gastric content?
Gastriccontent: quantity, quality, colour, smell, pH, components, foreign materials
Examination of the Liver:
Location: deep in the diaphragmatic dome, asymmetrically.
• Physical examination is impossible
Ancillary diagnostic methods of the liver examination:
- Ultrasonography
- Biopsy
- Clinicopathological examination
What are the Clinicopathological examination methods of the liver?
o Serum levels of hepatic enzymes o Bile salts o Ammonia o Glucose o Bilirubin o Clotting factors o Plasma proteins
Examination of the Pancreas
- Location: behind the stomach and the liver, in the dorsal part of the r. epigastrica, above the duodenum
- Physical examination is impossible
- Not imageable with ultrasound
- Difficult to see during laparotomy
Laboratory diagnostic methods:
- Serum amylase and lipase activity,
- Peritoneal fluid amylase activity (notspecific)
Rectal Palpation
-Only 40% of the abdomen is palpable
Preparation: restraint, spasmolytics, sedation
Inspection: perianal area, anus
Introducing the hand: long sleeved plastic glove, lubricant, cone-shaped hand, gentle gliding, drilling movement
What can you palpate with rectal palpation?
- Mucous membrane
- Rectum
- Bony pelvis
- Internal inguinal rings
- Prostate
- Vagina, uterus, ovaries
- Urinary bladder
- Small colon
- Abdominal aorta
- Cranial root of mesentery
- Left kidney
- Spleen
- Nephrosplenic ligament
- Nephrosplenic space
- Peritoneum
- Left ventral and dorsal colon
- Pelvic flexure
- Ampulla of the colon
- Head of the caecum
- Ventral/medial taenia of the caecum
- (Small intestines)
Abdominocentesis: What can you evaluate and how could the sample look?
Evaluation of numerous pathological conditions – Peritonitis – Abdominal neoplasia – Abscesses – Strangulating obstructions – Uroperitoneum – GI rupture
Sample: • Transsudate • Modified transsudate • Exsudate • Blood • Urine
what are the indications of abdominal ultrasound?
Indications • Colic • Weight loss, anorexia • Pyrexia • Leucocytosis, leucopenia • Elevated plasma fibrinogen • Abnormal X-ray findings • Elevated liver enzymes • Elevated kidney values • Abnormal peritoneal fluid
What do you see on the ultrasound of the stomach?
- Left side 10th-15th ICS
- Medial to the hylus of the spleen
- Content
- Wall thickness
- Size
What do you see on the ultrasound of the small intestine?
- Duodenum
* Jejunum, ileum
What do you see on the ultrasound of the caecum?
- Right paralumbar fossa adjacent to the right kidney and descending duodenum
- Wall thickness
- Content
What do you see on the ultrasound of the large intestine?
- Wall thickness
- Content ( gas vs. fluid)
- Displacements
What are some of the conditions that we could look for on an ultrasound of the peritoneum?
- Septic peritonitis
- Abdominal neoplasia
- Hemoperitoneum
- Uroperitoneum
Why do we do radiography of abdomen?
- Check NG tube placement in neonatal foals
- Diagnose certain diseases in neonates
- Detect sand in the ventral colon
- Detect enteroliths
