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Thrall > Esophagus > Flashcards

Esophagus Flashcards

1
Q

What are other names for the upper esophageal sphincter?

A

Cranial esophageal sphincter Cricopharyngeal sphincter

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2
Q

What muscles is the UES made from…2 of them?

A

Cricopharyngeus m Thropharyngeus m

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3
Q

The esophagus is to what side of the trachea?

A

left thus enters the diaphragm on the left

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4
Q

What are the four walls of the esophagus?

A
  1. Fibrous 2. Muscular 3. Submucosa 4. Mucosa
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5
Q

What percentage of the esophagus is straited in the dog? Cat?

A

Dog: 100% Cat: Cranial 2/3.. the caudal 1/3 is smooth muscle

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6
Q

What arteries supply the esophagus? Cervical vs cranial thorax vs caudal thorax.

A

Cervical - Thyroid arteries Cranial thorax - Bronchoesophageal a. Caudal thorax - Esohageal branches of the aorta

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7
Q

What veins drain the esophagus?

A

Azygos Left gastric

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8
Q

What nerves are involved in swallowing?

A

5 - Trigeminal 7 - Facial 9 - Glossopharyngeal 10 - Vagus 12 - Hypoglossal

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9
Q

Why does this look this way and what is it called?

A

This is a normal appearance of the caudal esophagus of a cat.

Herringbone look.

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10
Q

What is this? Is this a problem?

A

This is a redundant esophagus. It is commonly incidental though can have reduction of motility thus fluoroscopic evaluation is warranted.

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11
Q

Who commonly has redundant esophaguses?

A

Brachycephalic dogs

Young dogs

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12
Q

What is not recommended for contrast in patients with greater risks for aspiration?

A

Barium paste because it can cause plugging of the lower airways

Iodinated contrast due to edema

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13
Q

Where can you see barium after barium is aspirated?

A

Thoracic lymph nodes (mediastinal and tracheobronchial)

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14
Q

What are the three phases of swallowing before the esophagus?

A
  1. Oral
  2. Pharyngeal
  3. Cricopharyngeal

Each one can have problems causing dysphagia

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15
Q

What is the difference between cricopharyngeal achalasia and cricopharyngeal chalasia?

A
  1. Cricopharyngeal achalasia is the inability for the UES to open
  2. Cricopharyngeal chalasia is that the UES is open between swallows
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16
Q

Do cats get dysphagia?

A

Rarely… mostly esophageal problems.

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17
Q

Dyspagia secondary to cricopharyngeal dysfunction can cause what?

A

Misdirection of food bolus into the trachea

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18
Q

What is the normal time in seconds does it take for the cricopharyngeal phase?

A

0.1s

Delayed is considered 0.3s

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19
Q

What type of dysphagia is most rare and usually does not happen without other types of dysphagia?

A

Pharyngeal… it is rare.

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20
Q

What type of esophageal disease is LarPar associated with?

A

Esophageal dismotility. Geriatric onset laryngeal paralysis polyneuropathy (GOLPP)

21
Q

What does laying a dog in lateral recumbancy do to esophageal transit time? Time for oral, pharyngeal and cricopharyngeal phases? and percentage of swallows that need a secondary perstalsis wave?

A

Increases them all.

22
Q

How many seconds is considered a prolonged esophageal time?

A

>5 sec

23
Q

What are three criteria for diagnosis of esophageal dismotility?

A
  1. Esophageal time >5
  2. Retrograde flow >10cm
  3. Bolus staying in the esophagus after two secondary peristaltic waves.
24
Q

Esophageal dysmotility can normally be seen in younger dogs….T/F?

A

True… wait til 1 year of age and it may resolve.

25
Q

What types of aortic anomolies cause external esophageal stricture?

A

All of them

26
Q

What is normal development of the aorta?

A

Aorta comes from the left 4th aortic arch

The right 4th should regress

27
Q

What is the difference in the clinical signs from the aberrant right subclavin artery and the aortic anomalies?

A

Aberrant right subclavin artery (coming from the aorta and not the brachycephalic trunk) usually has less compression and is sometimes more cranial.

28
Q

Granulomas from spirocera lupi can turn into what type of neoplasia?

A

Osteosarcoma

Fibrosarcoma

29
Q

What are the two early signs for spirocera lupi?

A

Aortic mineralization

Spondylitis

30
Q

On CT… what is the way to tell if neoplastic transformation has occured in nodules created by spirocera lupi?

A

Granulomas will enhance

Neoplastic nodules will not!

31
Q

What breed gets redundant esophagus?

A

Brachycephalic breeds

32
Q

What frame rate should you look at a fluroscopic esophagram?

A

30-60fps

33
Q

Bolus size can significantly alter what in a swallowing study?

A

Pharyngeal contraction

Opening of the UES

Thoracic esophageal transit time

34
Q

Pharyngeal dysphagia can look like what with clinical signs and fluoroscopic findings?

A

Cricopharyngeal dysphagia

35
Q

What are the fluoroscopic abnormalities seen with pharygneal dysphagia?

A

Slow contraction of the larynx

Incomplete enclosure of the bolus

Incomplete rostral and dorsal movement off the larynx

Absence of forceful contraction of the phargynx to propel bolus to UES

36
Q

Why is it important to differentiate between cricopharyngeal disorders and pharyngeal disorders?

A

Cricopharyngeal disorders (achalaisa) can be helped with a myotomy while pharyngeal disorders with worsen with a myotomy.

37
Q

What is the discerning factor between pharyngeal dysphagia and cricopharyngeal dysphagia?

A

Time of opening of the UES

38
Q

Cricopharyngeal achalasia is associated with what breed type?

A

Toy breeds

39
Q

How do you calculation pharyngeal constriction ratio?

A

Dividing pharyngeal area at max contraction by the pharyngeal area at rest

40
Q

What is the normal time (avg) between beginning of swallow (closure of epiglottis) to opening of the UES? Achalasia of the UES average time?

A
  1. 1s Normal.
  2. 3-0.4s Achalasia
41
Q

What disease process is cricopharyngeal chalasia commonly seen with?

A

Myasthenia gravis

42
Q

What is the most common type of dysphagia in a cat?

A

Esophageal - hiatal hernia, dysmotility and stricture being the most common

43
Q

What disease process is esophageal dysfunction commonly associated with?

A

Lar Par

44
Q

The percentage of primary waves are affected how in sternal recumbancy vs lateral?

A

Sternal recumbancy has significantly greater primary waves than in lateral.

45
Q

Fluoroscopic signs of esophageal dysfunction?

A

Abnormal primary wave moves bolus 5 cm and abnormal secondary waves allow bolus retention in the esophagus after two subsequent swallows

Retrograde flow of more than 10 cm

Prolonged esophageal transit time (>5s)

46
Q

Can esphageal dysmotility be caused by delayed maturation?

A

Yes.. can spontaneously impove after 1 year of age

47
Q

What breed of dogs is seen to have reduced pharyngeal contraction secondary to myopathy?

A

Boxers

48
Q

What disease can look identical to esophageal and paraesophageal varices in dogs?

A

Bronchoesophageal artery hypertrophy secondary to chronic pulmonary disease or thromboembolic disease.

49
Q
A

Thrall (19 decks)

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