GI system → oropharynx, esophagus, oral neoplsia (test 1) Flashcards
1
Q
what are the 5 stages of deglutition?
A
- Oral stage
- Pharyngeal stage
- Cricopharyngeal stage
- Esophageal stage
- Gastroesophageal stage
2
Q
what are some signs of dysfunction inf the Oral stage of deglutition?
A
- dysphagia
- salivation
- retching
- regurgitation
- inappetence
- halitosis
- weight loss
- ptyalism (drooling, salivation)
3
Q
The oral mucosa can be an indicator of systemic Dz, what does this color tell us? Yellow
A
Jaundice
discoloration of tissue due to bilirubin
4
Q
The oral mucosa can be an indicator of systemic Dz, what does this color tell us? Pale (Pallor)
A
Anemia
5
Q
The oral mucosa can be an indicator of systemic Dz, what does this color tell us? Blue
A
Cyanosis
deoxyhemoglobin (e.g. R to L cardiac shunts; anoxia)
6
Q
The oral mucosa can be an indicator of systemic Dz, what does this color tell us? Bright red
A
Carbon monoxide intoxication
7
Q
The oral mucosa can be an indicator of systemic Dz, what does this tell us? Prolonged CRT
A
hypoperfusion (shock)
8
Q
The oral mucosa can be an indicator of systemic Dz, what does this tell us? Ulceration
A
- phenylbutazone in horses some
- viral diseases (e.g. Bovine Viral Diarrhea, Calicivirus in cats)
- renal failure / uremic stomatitis
9
Q
The oral mucosa can be an indicator of systemic Dz, what does this tell us? Petechiae
A
Thrombocytopenia and/or vasculitis
10
Q
The oral mucosa can be an indicator of systemic Dz, what does this tell us? Moisture or lack there of
A
Hydration status (dehydration)
11
Q
What makes up the oral stage of deglutition? and what CN are utilized
A
Food is prehended, masticatd and formed into a bolus
- CN V (trigeminal)
- VII (Facial), XII (hypoglossal)
12
Q
What is involved in the pharyngeal stage of deglutition, and what CN are utilized
A
Involuntary, initiated when bolus is propelled into pharynx by the base of tongue (larynx and internal nares sealed)
- CN IX (glossopharyngeal)
- X (Vagus)
13
Q
what is palatoschisis?
A
Cleft palate
14
Q
what is cheiloschisis
A
Cleft lip
15
Q
what is heterotopic polyodontia? and give an example
A
extra tooth outside the dental arcades
- “ear teeth” in horses, the tooth cyst usually found in parotid area which my fistulate to the exterior
16
Q
what is brachygnathism
A
mandible is shorter then the maxilla (collies and dachshunds)
17
Q
what is prognathism
A
mandible is longer then maxilla (pekingese and other brachycephalic breeds)
18
Q
what are some of the consequences of malocclusions?
A
{a} traumatize soft tissues of the oral cavity
{b} cause abnormal wear and accelerated tooth attrition
{c} contribute to and accelerate periodontal disease
19
Q
Anomalies of tooth wear = …….
A
Degenerative Conditions
20
Q
define stomatitis
A
Inflammation of the mouth (i.e. of oral mucous membranes)
21
Q
define glossitis
A
inflammation of the tongue
22
Q
define gingivitis
A
inflammation of the gums (gingiva)
23
Q
define cheilitis
A
inflammation of the lips
24
Q
define vesicle
A
blister - fluid filled raised area
25
define bulla
fluid filled raised area \>5 mm (large blister)
26
define erosion
discontinuity of the mucosa, exhibiting incomplete loss of the epithelium
27
define ulcer
discontinuity of the mucosa with complete loss of epithelium, often excavative extending deep into the submucosa and possibly muscularis
28
what is dental plaque
= accumulated bacterial mass that becomes adherent to tooth surfaces
also includes
* food particles
* exfoliated cells
* saliva & mucus
29
what is dental calculus?
can be called "tartar" = mineralization of plaque an indicator of serious plaque build-up
30
what is periodontal Dz
peridontitis = bacterial plaque and calculus leading to
* progressive destruction of gingiva and supporting adjacent tissue
31
what is a common outcome of chronic inflammation of the gingiva
Gingival hyperplasia
32
what are dental caries?
Decay...
bacterial induced decalcification of the inorganic portions of the tooth, accompanied or followed by dissolution of the organic components this may account for 20% of the tooth loss among cats and 10% among dogs
33
Actinobacillus Lingnieresii the causative agent in "wooden tongue", is an example of.......
Bacterial stomatitis
34
what is the pathogenesis of Bacterial stomatitis
Pathogenesis
- deep glossitis / stomatitis → normal oral flora →begins with traumatic lesions in mouth (feed?) →organisms access submucosa and deep soft tissue →pyogranulomatous host inflammatory response →“sulfur granules” and fibrosis
35
T or F Bacterial stomatitis is a great example of a primary pathogen causing pathology
False
Bacterial stomatitis is generally secondary
* typically follows mucosal injury or systemic Dz
36
Vesicular stomatitis is caused by a group of viruses that produce vesicles in the oral cavity, how are they differentiated?
(1) lesions
- (nature & location)
(2) host species affected
(3) PCR, virus isolation\*\*, serology
37
what are some examples of virus associated vesicular stomatitides?
- Foot and mouth disease
- Vesicular stomatitis
- Vesicular exanthema of swine
- Swine vesicular disease
38
what is the etiology of foot and mouth Dz, and what species is it found in
Picornavirus
* Ruminant
* pigs
39
what is the etiology of Vesicular stomatitis, and what species is it found in
Rhabdovirus
* Ruminant \> pig = horses
40
what is the etiology of vesicular exanthema, and what species is it found in
Calicivirus
* Pigs
41
What is the etiology of swine vesicular Dz
Enterovirus
42
BVD is an example of what type of oral Dz?
this Dz has varied affects on an individual animal, what are some of those factors that contribute to that?
erosive / ulcerative stomatitides (viral)
Outcome of infection with BVD depends on
* Strain/virulence of virus
* Immune status
* Age that animal is affected
* Pregnancy and state of pregnancy
43
Oral inflammation and ulcers is characteristic of Felid Dz. what is it?
oral inflammation is THE most comon clinical abnormality recognized. also some association with the feline gingivitis stomatitis complex
44
what are the 4 causes of ulcerative stomatitis and cheilitis in bovine
1. Bovine viral diarrhea
2. Vesicular stomatitis
3. Malignant catarrhal fever
4. Foot and Mouth Dz
45
how would you characterize BVD mucosal Dz
Acute: Pyrexia, depression, weakness, anorexia with dehydration, hypersalivation, mucopurulent nasal discharge, corneal edema, profuse watery diarrhea with tenesmus
46
what is the pathogenesis of BVD mucosal Dz?
Pathogenesis: calf infected by noncytopathic strain in utero (before 125 days) becomes immunotolerant, then infection by cytopathic strain after birth =\> mucosal disease
47
what lesions are found in BVD
Lesions: erosions and ulcers in oral cavity, esophagus, intestine…any mucosa Peyer’s patch necrosis
48
what are the 4 main causes of Stomatitis (non infectious)
1. Physical
2. Chemical
3. Autoimmune
4. Metabolic & Systemic Disorders
49
what is uremic stomatitis
Uremic stomatitis is caused by Renal failure results in uremia, which can cause stomatitis, oral ulcers & halitosis
50
what is the pathogenesis of Uremic stomatitis
Renal failure → urea secretion by salivary glands → conversion of salivary urea to ammonia by oral bacteria + vascular necrosis → oral/lingual ulcers → halitosis
51
what is feline gingivitis - stomatitis - pharyngitis complex, and how is it caused?
* chronic progressive inflammation – may be ulcerative and/or proliferative
* very common & important → inappetance, weight loss
Many think this condition is an example of a host response, which is normally protective, resulting instead in tissue destruction and chronic inflammation. An aberrant immune response to normal flora/plaque
52
seeing as how Feline Gingivitis - Stomatitis - Pharyngitis Complex is very difficult to to pin point how it is caused, how might it be classified?
* clinical appearance
* microscopic appearance (cell types)
* response to treatment
53
what is meant by Gingivitis - Stomatitis - Pharyngitis Complex is multifactorial?
it is poorly understood.
* most common form is associated with plaque & calculus
* plasmacytic-lymphocytic gingivitis/stomatitis
* can be associated with FIV and calicivirus infection (about 23% are FIV+ and 70 to 90% calicivirus +)
* opportunistic oral bacteria can also be involved (response of oral tissue to normal flora ???)
54
A serology survey of the herd indicates that approximately 40% of the animals are seropositive for BLV What is the most likely meaning of the seropositive state in these animals?
A. These animals have been exposed to BLV.
B. These animals have been exposed to BLV and may have successfully cleared the virus.
C. These animals are currently INFECTED with BLV virus.
C. These animals are currently INFECTED with BLV virus.
55
A serology survey of the herd indicates that approximately 40% of the animals are seropositive for BLV.
Based on the biology of this Virus/disease, approximately how many cases of bovine lymphoma might you expect in this herd of 1000 animals?
A. 400 (40%)
B. 70 (30%)
C. 50 (5%)
D. 20 (2%)
E. Impossible to predict
D. 20 (2%) • 40% of 1000 are infected = 400 • 30% of 400 will have asymptomatic PL = 120 • Approx. 5% of 400 will develop lymphoma = 20
56
what are the most common effects seen resulting from oral tumors?
* dysphagia
* salivation
* oral hemorrhage
* weight loss
* halitosis
* facial deformity
57
what is the most common benign oral tumor in a dog?
Epulis
58
what is an Epulis?
this is tumor of peridontal ligament origin or dental lamina epithelium, it is very common in dogs (most common benign oral neoplasm)
59
what are the subclassification of an epulis.
* Fibromatous epulis (peripheral odontogenic fibroma)
* Benign behavior
* Ossifying epulis (peripheral odontogenic fibroma)
* Benign behavior
* Acanthomatous epulis (peripheral ameloblastoma or acanthomatous ameloblastoma)
* Locally invasive
60
what are the 7 most common types of neoplastic disorders of the oral cavity?
1. Malignant melanoma
2. Squamous cell carcinoma
3. Fibrosarcoma
4. Epulis
5. Osteosarcoma
6. Dental (odontogenic tumors)
7. Oral papilloma (viral and self limiting)
61
T or F
an Acanthomatous Ameloblastoma is not invasive but will commonly metastize
False
* very commonly invasive → bone
* NOT metastatic
62
what is the most common oral neoplasm in cats?
1. SCC
2. Fibrosarcoma
63
What oral neoplasm in dogs is characterized by.....
* rapid growth
* local invasion
* early metastasis
* usually to the lungs
Oral Melanoma
64
Characterized the behavior of an oral melanoma in a dog.
characterized by.....
* rapid growth
* local invasion
* early metastasis
* usually to the lungs
65
What oral neoplasm in dogs is characterized by.....
* rapid growth
* local invasion
* including bone
* common recurrence
* late to metastasis
* usually to Lymph Nodes
SCC
66
This form of SCC is VERY aggressive and has generally metastasized by the time of diagnosis
Tonsillar SCC
67
Characterized the behavior of an oral SCC in a dog.
Squamous Cell Ca
* rapid growth
* local invasion
* including bone
* common recurrence
* late to metastasis
* usually to Lymph Nodes
68
what oral neoplasm is dogs is characterized by...
* locally invasive
* common recurrence
* intermediate metastatic potential
Fibrosarcoma
69
Characterize the behavior of an oral Fibrocarcoma in a dog
characterized by...
* locally invasive
* common recurrence
* intermediate metastatic potential
70
although rare, what are the most common disorders of the salivary glands?
* Sialoadenitis
* Sialocele/ranula
* Salivary gland infarction
* Neoplasia
71
What is a Salivary Mucocele or sialocele
extraductal accumulation of salivary secretion in adjacent soft tissue -most often at angle of mandible Results from trauma to a salivary gland or rupture of ranula
72
what is a ranula? and how is it caused
Definition = cystically distended salivary duct in floor of mouth
* due to salivary duct obstruction
73
what are come potential pathological consequences of a Cleft palate
* nasal regurgitation
* aspiration pneumonia
74
compare and contrast regurgitation and vomiting
* Vomiting = forceful ejection of food or fluid through the mouth from the stomach and, sometimes, the duodenum
* Regurgitation = more passive • results in expulsion of food or fluid from the oral or pharyngeal cavity or the esophagus
75
what are the 4 steps in "filling in" a deep esophageal ulcer? and what is the primary goal
1) inflammatory cells enter first (scavengers)
2) granulation tissue will fill the defect
3) epithelial covering
4) contraction of scar (myofibroblasts) GOAL = ↓ damaged surface area
76
what are two potential pathological consequences of esophageal ulcer healing?
WOUND CONTRACTURE may:
a) decrease lumen diameter (stricture) and/or
b) decrease distensibility
77
what are some consquences or clinical signs of Choke
* anorexia
* dysphagia
* regurgitation
* palpable lesion in esophagus (mass/food bolus)
* secondary aspiration pneumonia
78
what potential neoplasm's can occur in the esophogus, and which cell line to they belong to?
* smooth muscle → leiomyoma
* skeletal muscle → rhabdomyoma
* epithelium (stratified squamous) → SCCa, papilloma
* fibroblasts → fibroma, fibrosarcoma
79
what are your 3 DfDx for peri-esophageal obstruction (extramural)
{a} Congenital - persistent right aortic arch AKA: vascular ring anomaly → constriction of esophagus
{b} Neoplastic - intrathoracic tumors
{c} Inflammation - e.g. fungal granuloma
80
what is the defination of megaesophagus, and what are some of the consequences and signs?
* Definition = flaccid, dilated esophagus
* Can be diffuse or segmental (focal)
* Consequences / Signs:
* regurgitate - after eating (minutes to hours)
* client complaint is commonly “vomiting”
* +/- aspiration pneumonia
* failure to thrive / weight loss
81
There are 6 primary etiologies of megaesophagus...... what are they?
1. Congenital
2. Primary degeneration of muscle
3. Obstruction e.g. PRAA, tumor, etc.
4. Denervation
5. Secondary to certain systemic diseases
* e.g. hypoadrenocorticism
* lead poisoning
6. Idiopathic
82
what are the 3 primary causes of esophagitis
1. Trauma / foreign body
2. Chemical
* exogenous vs endogenous
3. Infectious (uncommon)
* Viral
* BVD
* Candida
* avain crop infections
* Parasitic
* Spirocerca lupi
83
84
What is the lesion this is showing?
Persistent right aortic arch (PRAR)
85
Write a Morphological Dx:
Possible etiologic agent?
Chronic, Multifocal, severe, ulcerative glossitis
Actinobacillus Lignieressii (Wooden Tongue)
86
What appears to be wrong? Diagnosis this photo
Megaesophagus
