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ECVS Tobias > 91. Stomach > Flashcards

91. Stomach Flashcards

1
Q

What are the four regions of the stomach?

A

Cardia, Fundus, Body, Pyloric

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2
Q

What is the incisura angularis?

A

Intraluminal protrusion of tissue at the midpoint of the lesser curvature

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3
Q

What does the incisura angularis separate?

A

Antrum and body

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4
Q

Where does the papillary process of the liver lie?

A

In the angular notch

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5
Q

What are the parts of the greater omentum?

A

Bursal, splenic, and veil portions

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6
Q

What does the lesser omentum attach to?

A

The liver and the stomach

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7
Q

What artery supplies the greater curvature of the stomach?

A

Gastroepiploic artery

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8
Q

What are the three main branches of the celiac artery?

A

Splenic, hepatic, and left gastric arteries

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9
Q

What artery supplies the pylorus and pyloric antrum?

A

Right gastric artery

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10
Q

What does the hepatic artery continue as after branching to the liver and gallbladder?

A

Gastroduodenal artery

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11
Q

What does the gastroduodenal artery supply?

A

Right pancreatic limb and greater curvature of the stomach

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12
Q

What artery supplies the fundus of the stomach?

A

Left gastric artery

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13
Q

Where does the venous drainage of the stomach occur?

A

Portal vein through the splenic vein and gastroduodenal vein

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14
Q

Which lymph nodes are involved in the lymphatic drainage of the stomach?

A

Gastric, splenic, and hepatic lymph nodes

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15
Q

What nerves innervate the stomach?

A

Vagus nerves and sympathetic fibers of the celiac plexus

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16
Q

How many muscle layers does the stomach have?

A

Three layers: longitudinal, circular, and oblique

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17
Q

What are the four layers of the gastric wall?

A

Serosa, muscle, submucosa, and mucosa

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18
Q

Which muscle layer of the stomach is not present in the fundus?

A

Circular layer

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19
Q

Where do the oblique muscle fibers of the stomach primarily lie?

A

Body and fundic areas

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20
Q

What type of tissue is found in the submucosa of the stomach?

A

Elastic areolar tissue

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21
Q

What are the three types of glands in the stomach?

A

Cardiac, pyloric, and gastric glands proper

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22
Q

Where are the cardiac glands primarily located?

A

Around the cardia and antrum

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23
Q

What do the pyloric glands primarily produce?

A

Mucus

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24
Q

What cells are found in the gastric glands of the fundus and body?

A

Parietal, chief, mucous neck, and endocrine cells

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25
Q

What is the primary function of parietal (oxyntic) cells?

A

Maintain gastric acidic pH and produce intrinsic factor

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26
Q

What do chief cells secrete?

A

Pepsinogen

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27
Q

What do mucous neck cells secrete?

A

Mucus

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28
Q

What hormones do gastric endocrine cells produce?

A

Gastrin, histamine, and serotonin

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29
Q

What initiates the process of swallowing?

A

Receptive relaxation

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30
Q

What is the result of gastric accommodation?

A

Further relaxation of the fundus

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31
Q

What is contractile retropulsion?

A

Process that reduces food particles to an appropriate size for gastric emptying

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32
Q

How does the gastric mucosa repair superficial epithelial injuries?

A

Epithelial migration without proliferation

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33
Q

What type of injury is considered an ulcer in the stomach?

A

Injury extending into the submucosal layer

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34
Q

What enhances healing in the stomach?

A

Extensive and redundant blood supply

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35
Q

How long should food be withheld before surgery?

A

8 to 12 hours

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36
Q

What effect does longer fasting times have on gastric pH in dogs?

A

Decreases gastric pH

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37
Q

What is gastroesophageal reflux and its occurrence rate in dogs undergoing anesthesia for orthopedic procedures?

A

Reflux of stomach contents into the esophagus; 57% occurrence rate

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38
Q

What medications can be given to increase gastric pH before surgery?

A

Proton pump inhibitors or histamine2 (H2) receptor blockers

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39
Q

What is the purpose of incisional gastropexy?

A

To attach the stomach to the abdominal wall

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40
Q

What is a belt-loop gastropexy?

A

Seromuscular flap passed through a tunnel created in the abdominal wall

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41
Q

What is a circumcostal gastropexy?

A

Seromuscular flap wrapped around a rib

42
Q

What surgical approach is used for a minimally invasive prophylactic gastropexy?

A

Grid approach minilaparotomy

43
Q

What is the Y-U pyloroplasty technique used for?

A

Increase pyloric outflow tract diameter

44
Q

What is the purpose of a Fredet-Ramstedt pyloromyotomy?

A

Relieve pyloric outflow obstruction without penetrating the gastric mucosa

45
Q

What type of incision is made in a Heineke-Mikulicz pyloroplasty?

A

Longitudinal full-thickness incision closed transversely

46
Q

What is the Billroth I procedure?

A

Pylorectomy with gastroduodenal anastomosis

47
Q

What is the primary goal of pyloroplasty procedures?

A

To remove outflow obstruction and normalize gastric outflow

48
Q

What is a possible complication after pylorectomy and gastroduodenostomy?

A

Hypoalbuminemia and anemia

49
Q

What is the prognosis after pylorectomy and gastroduodenostomy?

A

Depends on the underlying disease

50
Q

What is the function of the ventral vagal trunk in the stomach?

A

Sends small branches to the pylorus, liver, and lesser curvature

51
Q

What does the dorsal vagal trunk supply in the stomach?

A

Lesser curvature and ventral wall

52
Q

What do sympathetic fibers of the celiacomesenteric plexus follow?

A

Gastric branches of the celiac artery

53
Q

What are the common clinical signs of gastric disorders?

A

Vomiting and regurgitation

54
Q

What medications may be administered to reduce gastric secretions before surgery?

A

Anticholinergics such as atropine or glycopyrrolate

55
Q

What surgical principle is followed for visualizing the dorsal surface of the stomach?

A

Transection of hepatogastric and hepatoduodenal ligaments

56
Q

What is used to determine tissue viability in the stomach?

A

Serosal surface color, thickness, capillary perfusion, and peristalsis

57
Q

What dye can be used to assess tissue viability in the stomach?

A

Fluorescein dye

58
Q

What surgical technique is used for gastric wall invagination?

A

Inverting suture pattern

59
Q

What is the result of gastric wall invagination?

A

Devitalized area is sloughed into the gastric lumen

60
Q

What are the methods of gastropexy?

A

Incisional, belt-loop, circumcostal, endoscopically assisted, laparoscopic

61
Q

What is the purpose of laparoscopic-assisted gastropexy?

A

To prevent recurrence of gastric dilation

62
Q

What is the Fredet-Ramstedt pyloromyotomy procedure used for?

A

Relieve pyloric outflow obstruction without penetrating the gastric mucosa

63
Q

What is the purpose of a Heineke-Mikulicz pyloroplasty?

A

Increase pyloric outflow tract diameter

64
Q

What is a Y-U pyloroplasty?

A

Advance a portion of the pyloric antrum into the pyloric sphincter

65
Q

What is the Billroth II procedure?

A

Partial gastrectomy with gastrojejunal anastomosis

66
Q

What is the prognosis for patients with gastric neoplasia?

A

Poor, especially with metastasis

67
Q

What is the most common malignant epithelial tumor in dogs?

A

Gastric adenocarcinoma

68
Q

What breed is commonly affected by gastric adenocarcinoma?

A

Belgian Shepherd Dogs, rough-coated Collies, Staffordshire Bull Terriers

69
Q

What is the typical age range for dogs affected by gastric adenocarcinoma?

A

8 to 10 years

70
Q

What is the main cause of gastric ulceration in dogs?

A

NSAID administration, renal and hepatic disease

71
Q

What is the primary effect of NSAIDs on the gastric mucosa?

A

Decrease prostaglandin production, decrease blood flow, increase acid secretion

72
Q

What is the clinical sign of gastric ulceration?

A

Vomiting, anorexia, melena

73
Q

What medication can be used to block histamine H2 receptors?

A

Cimetidine, ranitidine, famotidine

74
Q

What is the function of proton pump inhibitors in treating gastric ulcers?

A

Block secretion of hydrogen ions into the gastric lumen

75
Q

What is the role of sucralfate in treating gastric ulcers?

A

Forms a protective barrier on ulcers

76
Q

What is misoprostol used for in gastric ulcer treatment?

A

Increase bicarbonate secretion, mucus production, and blood flow

77
Q

What is the surgical treatment for life-threatening gastric ulceration?

A

Surgical resection of the ulcerated area

78
Q

What is the common cause of gastric perforation in dogs?

A

NSAID administration, neoplasia

79
Q

What is the typical treatment for gastric dilatation volvulus (GDV)?

A

Surgical decompression, gastropexy

80
Q

What breed is at higher risk for GDV?

A

Large breed dogs such as Great Danes and German Shepherds

81
Q

What is the pathophysiology of GDV?

A

Rotation of the stomach causing obstruction and compression

82
Q

What are the clinical signs of GDV?

A

Abdominal distention, unproductive retching

83
Q

What radiographic finding is indicative of GDV?

A

Right lateral radiograph showing a double bubble

84
Q

What laboratory finding is often associated with GDV?

A

Increased plasma lactate concentration

85
Q

What is the preferred method for fluid resuscitation in GDV?

A

Crystalloids, colloids, hypertonic saline

86
Q

What is the purpose of gastric decompression in GDV?

A

Relieve pressure on the stomach and allow for repositioning

87
Q

What anesthetic agents are used for GDV surgery?

A

Propofol, isoflurane, fentanyl

88
Q

What is the significance of plasma lactate concentration in GDV?

A

Higher concentrations indicate poor prognosis

89
Q

What are common postoperative complications of GDV surgery?

A

Peritonitis, sepsis, disseminated intravascular coagulation

90
Q

What is the recurrence rate of GDV after gastropexy?

A

Low with proper surgical technique

91
Q

What is the prognosis for GDV patients with plasma lactate concentration below 6.0 mmol/L?

A

Good with early intervention and proper treatment

92
Q

What is the function of a prophylactic gastropexy?

A

Prevent recurrence of GDV

93
Q

What are the four types of hiatal hernia?

A

Sliding, paraesophageal, mixed, organoaxial

94
Q

What breed is commonly affected by congenital hiatal hernia?

A

Chinese Shar-Peis and English Bulldogs

95
Q

What is the primary clinical sign of hiatal hernia?

A

Regurgitation and vomiting

96
Q

What is the preferred diagnostic method for hiatal hernia?

A

Positive-contrast esophagram

97
Q

What surgical techniques are used for hiatal hernia correction?

A

Phrenoplasty, esophagopexy, gastropexy

98
Q

What is the typical postoperative care for hiatal hernia surgery?

A

Monitor for regurgitation, provide analgesia

99
Q

What is gastroesophageal intussusception?

A

Stomach invaginates into the esophagus

100
Q

What is the primary clinical finding in gastroesophageal intussusception?

A

Vomiting and regurgitation

ECVS Tobias (16 decks)

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