Alimentary System Flashcards
History
Appetite Water intake Prehension Mastication Swallowing Defecation Pain (colic)
Body condition scoring
Scale 1-9
Visual inspection and palpation of regions
Positively related to body fat percentage
No correlation to body weight!
Foals the scale is 1-5
Exam of the oral cavity
Odour Mucus Membranes Saliva Teeth Tongue
Examination of the Salivary Glands
Parotid
Mandibular
Sublingual
Buccal
Examination of the Pharynx
External:
Inspection
Palpation
Internal: Palpation Endoscopy- small nodules of lymphatic tissue especially in young horses Nasogastric tubing Watering and feeding test
Exam of the esophagus
Inspection Palpation Nasogastric tubing Watering and feeding test Endoscopy X-ray- with contrast material US
Exam of the abdomen methods
Inspection Palpation Auscultation Percussion Rectal Palpation Nasogastric intubation Abdominocentesis Endoscopy Radiography US...
Inspection of the abdomen
From all angles! behind, the side, the front, below
Shape, contour, volume, movements
Palpation of the abdomen
Temp Thickness Tenseness Sensitivity Pain Swellings
Auscultation of the abdomen
Gurgling, rumbling
Tinkling, splashing
Physio: +
Decreased: 1/- large colon obstruction and displacement
Increased: ++ borborygmi: early stages of enteritis, colitis, typhlitis
Reduced/absent sounds: atony, impaction, obstruction, shock, poor perfusion, high sympathetic tone
At least 3 areas on each side and spend 1 minute on each area
Percussion of the abdomen
Info regarding gas distension of caecum and large colon
Not used as frequently anymore
Left:
dorsal third: dulled tympanic
Middle third: dulled tympanic
Ventral third: dulled
Right:
Dorsal third: tympanic
Middle third: dulled tympanic
ventral third: dulled
Rectal palpation as an exam of the abdomen
40% of abdomen is palpable in this way
Prep: restraint, spasmolytics, sedation
Inspection: perianal area, anus
Some palpable structures: Bony pelvis, internal inguinal rings, prostate, bladder, abdominal aorta, left kidney, spleen, pelvic flexure etc
Abdominocentesis: patho conditions
Peritonitis Abd neoplasia Abscesses Strangulation Uroperitoneum GI rupture
Abdominocentesis: fluids
Transudate Modified transudate Exudate Blood Urine
Radiography of abdomen indications
Check NG placement in foals
Dignose diseases in neonates
Sand in ventral colon
Enteroliths
US of the abdomen indications
Colic Weight loss, anorexia Pyrexia Leucocytosis or penia Elevated plasma fibrinogen Elevated liver enzymes Elevated kidney values Abnormal peritoneal fluid
US of the stomach
Left
10-15th ICS
Medial to hylus of the spleen
Content, wall thickness and size
US of caecum
Right paralumbar fossa adjacent to the right kidney and descending duodenum
Ultrasound of the large intestine
Wall thickness
Content (gas vs. fluid)
Displacements
US of the peritoneum
Septic peritonitis
Abdominal neoplasia
Hemoperitoneum
Uroperitoneum
Exam of the stomach
Location is deep in the diaphragmatic dome
Nasogastric intubation: Look at gastric content: quantity, quality, colour, smell, pH, components, foreign materials
Gastroscopy
US
Biopsy
Exam of the liver
Location is deep in the diaphragmatic dome, asymmetrically
Phys exam also possible!
Ancillary diagnostic methods: US Biopsy Clinicopathological exam: Serum hepatic enzymes Bile salts Ammonia Glucose Bilirubin Clotting factors Plasma proteins
Exam of the pancreas
Location is behind the stomach and liver, in the dorsal part of the r. epigastrica above the duodenum
No physical exam
No US
Lab diagnostic methods:
Serum amylase and lipase
Peritoneal fluid amylase (this is not specific)
Auscultation regions
Quadrants
Left upper: small colon and small intestines
Left lower: left ventral colon and pelvic flexure
Right upper: head of caecum- ileocaecalis sound which is longer! (sounds like a thunderstorm)
Right lower: right ventral large colon
Abdominal US prep and instruments
Clean hair coat Soak with diluted isopropyl-alcohol Use UH gels for good contact May be necessary to clip hair Macroconvex probe: 3.5MHz- the higher the frequency, the better the image quality but there is less penetration Depth of 25-30cm
Regions of abdominal US
LEFT Left flank area: spleen and kidney Lower colon and spleen Inguinal: bladder and small intestinal loops Cranially: stomach and spleen
RIGHT
16 and 17 ICS is the kidney
ventrally: caecum
cranially: lung, liver, duodenum (from dors to ventral)
Inguinal: small intestine loops and bladder
Ventrally: colon
Gastroscopy
12hr fasting prior 3m long flexible endoscope Decompress stomach at the end Non-glandular: esophageal part Glandular: cardia, fundus and pylorus
Can use nasogastric tube to protect endoscope
Pathological findings of a gastroscopy
Hyperkeratosis
Ulcerations
Bleeding
Fibrin
