Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

RUSVM SAM 2 > GI System - Upper and stomach > Flashcards

GI System - Upper and stomach Flashcards

1
Q

What is the purpose of the circular and longitudinal muscles of the pharynx?

A

Circular - constrict to push food into esophagus (bolus formation)

Longitudinal - lifts the walls of the pharynx during swallowing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the phases of swallowing and what nerves are involved?

A

Oral: pre-hend food and form bolus which moves to end of tongue (CN trigeminal V, facial VII, hypoglossal 12)

Pharyngeal: propel bolus along pharynx, closure of larynx by epiglottis and inhibition of breathing, opening of UES by cricopharyngeal m. (CN glossopharyngeal IX and accessory XI)

Esophageal: bolus moves along esophagus into stomach (CN glossopharyngeal IX and vagus X)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Your patient presents for dysphagia..

What are your top DDX?

A

Congenital - cricopharygnealachalasia or esophageal dysmotility

Neuromuscular - myasthenia gravis or brainstem lesions

Myopathy/myositis

Neoplastic or paraneoplasic

Infectious (uncommon)

  • viral distemper or rabies
  • bacterial abscess
  • spirocera lupi
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

The main presenting complaint in your patient is dysphagia… what diagnostics would you do to find the cause?

A

Physical exam - watch patient eat and drink

Neurologic assessment — assess GAG or pharyngeal reflex (CN 9 and 10)

Assess pulmonary — aspiration pneumonia

Thin muscling of head — MMM (titers)

Nutrition status

MDB +/- thyroid 
Radiographs 
Fluoroscopy 
Acetylcholineseerase receptor antibody titer — MG 
Upper GI endoscopy 
MRI for brain stem lesions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the general management for dogs with pharyngeal disease?

A

Food and water consistency —> variable amongst patients (slurry vs meatballs vs solid food)

Elevate food and water dishes

Some need feeding tubes
Monitor for pneumonia

No neck leads —> use harness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What type of muscle makes up the esophagus in dogs and cats?

A

Dog - entire length is striated

Cat - distal aspect is smooth muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the layers of the esophagus

A 
Epithelium 
Basement membrane 
Laminate propria 
Muscularis mucous 
Submucosa 
Muscularis propria 
Adventitia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What diagnostics can determine the presence of foreign body or compressive lesions?

A

Barium mixed with water or food (careful of aspiration)

Lohexol - injectable contrast agent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What diagnostic method can you use to evaluate swallowing phases and peristalsis?

A

Fluoroscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is esophagitis?

A

Inflammation of the esophageal mucosa (can affect motility)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are causes of esophagitis?

A

Secondary to meds (eg doxycycline)

Foreign bodies

Caustic toxins

Gastrointestinal reflux (GERD)

General anesthesia

Primary GI disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What could you see with rads and endoscopy that indicates esophagitis?

A

Rads : unremarkable or a mild transient dilation

Endoscopy: erythema +/- edematous mucosa +/- ulcer or erosions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the treatment for esophagitis?

A

Pain management

  • buprenorphine, codeine, fentanyl
  • magic mouthwash = lidocaine, diphenhydramine, maalox

Mucosal protection

  • sucralfate/carapace
  • antacid (omeprazole PPI)

Monitor for strictures
Look for underlying dz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are causes of esophageal stricture?

A 
Trauma 
Neoplasia
Post-foreign body 
Post-anesthesia 
Severe esophagitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Treatment fo esophageal stricture?

A

Balloon catheterization — breakdown stricture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Esophageal diverticulae are secondary to??

A

Trauma

Congenital abnormalities (PRAA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the treatment for esophageal diverticulae?

A

Clear impaction

Surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is myasthenia gravis?

A

Antibody production against acetylcholine receptions at NM junction

Congenital or acquired megaesophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

T/F: it is possible for congenital megaeosphagus to improve over time

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What breeds do we see congenital megaesophagus in?

A

SharPei, fox terrier, German shepherd, lab, Great Dane, Irish setters, mini schnauzer, Newfie, and Siamese cats

<6months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are causes of acquired megaesophagus?

A

Idiopathic
Primary CNS - brainstem lesion

Primary neuromuscular disease

Neoplastic syndrome ( thymoma)

Endocrine association

  • hypothyroidism
  • Addison’s disease
Lead toxicity (hunting or fishing dogs- evidence on blood work) 
LES stricture / dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the treatment of MG?

A

Underlying disease and symptoms

Nutritional support +/- feeding tubes
Decrease risk of aspiration pneumonia and treat PRN

Variable food consistency

  • smaller more frequent meals
  • elevated food dishes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the prognosis for megaesophagus ?

A

Fair to good when patients tolerated interventions or feeding tubes

Guarded to poor

  • fulminant MG crisis
  • severe aspiration pneumonia
  • intractable regurg
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the connection between the stomach and esophagus and prevents food from passing back?

A

Cardiac/esophageal sphincter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is the connection between the stomach and duodenum?
Pyloric sphincter
26
What do you call food in the area of the duodenum that is a semi-solid, soapy mixture?
Chyme
27
What gastric juices are secreted into the stomach?
``` HCl Salts Enzymes Water Mucous ```
28
What are the layers of the stomach?
Gastric mucosa made of gastric glands and muscularis mucosae Submucosa Meissners plexus Muscularis (3layers) Auerbach (myenteric) plexus Serosa
29
What are signals innervate the enteric nervous system?
Can function autonomously (sensory receptors, primary afferent, internurons, and motor neurons) Also receives PSNS and SNS innervation from the central nervous system
30
Where is gastrin produced?
Gastric antrum, duodenum, and pancrease
31
What are the main physiologic actions of gastrin?
Simulate secretion of gastric acid and intrinsic factor from parietal cells Simulate secretion of pepsinogen from chief cells Promote gastric and intestinal motility, mucosal growth
32
Where is somatostatin produced?
Stomach, intestine, and pancreas (D cells)
33
What is the main physiologic action of somatostatin?
``` Inhibit the secretion and action of many hormones, including Gastrin Cholecystokinin Secretin Vasoactive intestinal peptide Gastric inhibitory polypeptide Motilin ```
34
What are the components of the mucosa of the stomach?
Superficial epithelium Laminate propria -> loose CT, immune system cells, and nutritional support Gastric glands -> mucous neck cells, parietal cells (HCl), and chief cells (digestion) Neuroendocrine cells - enterocromafin -> serotonin, histamine - somatostatin - gastrin Muscularis mucosa - thin muscle layer
35
Most intrinsic factor in dogs comes from the ____________ and is essential for absorption of what nutrient?
Pancreas B12 (cobalmin) absorption
36
What enzymes in the stomach contribute to protein and fat digestion
Pepsin - protein Gastric lipase - fat
37
How does fatty food affect the motility of the stomach?
Slows movement
38
What clinical sign can help differentiate between esophageal disease and stomach disease?
Vomiting —> stomach disease Regurgitation —> esophageal disease
39
What is acute gastritis?
Inflammation of the stomach - sudden onset
40
What are causes of acute gastritis?
``` Drug, toxins Dietary indiscretion or intolerance Parasites Bacterial Viral Systemic illness ```
41
How can you diagnose acute gastritis?
Based on history and clinical findings —> trial response to symptomatic care if not systemically ill If clinical signs persist or systemically ill —> biopsy
42
Treatment for acute gastritis?
Fluids Antacids Anti-emetics — once foreign body rule out or vomiting is protracted/severe enough to cause dehydration or electrolyte imbalances Pain meds Water and bland diet
43
What is the diagnosis and treatment for gastric foreign body?
Based on history and clinical signs —> obstructive lesion has intermittent or persistent clinical signs RADS More common in young animals Surgery or endoscopy
44
How can you diagnose food bloat?
Acute vomiting or fetching along with abdominal distention or discomfort Rads— gas distended stomach
45
Treatment for food bloat?
Time - 24 to 36hours ``` Fluids Withhold food Walk frequently Pain managment +/- lavage +/- surgery ```
46
Gastric ulcers arise from mucosal barrier injury.. what are the types of these injuries?
Disruption of normal gastroprotection Decreased blood flow Hyper-secretion of acid Decreased mucous or bicarb
47
Mucosal barrier injury leading to gastric erosion and ulcers can be secondary to what causes?
Neoplasia: gastrinoma, MCT, other hypovolemic shock, hypotension Trauma, foreign bodies Medications: NSAID or steroid Uremic gastritis
48
Clinical signs associated with gastic erosion and ulcers?
``` +/- vomiting Hematemesis Melena Retch Inappetence Weak ```
49
What diagnostics would you do if you suspected gastric uclers and what would you expect to find?
CBC/biochem : anemia, elevated BUN Rads- defects may be seen with contrast UA- protein loss? R/O renal disease causing a gastric uremia Ultrasound +/- thickened wall or focal looks of layers/free fluid ** endoscopy - visual confirmation and biopsy
50
What is the treatment for gastric erosion/ulceration?
Treat primary dz Mucosal protection —> sucralfate, proton pump inhibitor (omeprazole) Pain management Blood transfusion Nutrition
51
What treatment options can you use for helicobacer gastritis?
Antibiotics — amoxicillin / tetracycline / erythromycin / flagyl Antacids — omeprazole / Pepcid AC Pepto-bismol - accumulates in cell wall and destroys helicobacter
52
Common roundworms found in dog stomach?
Toxocara canis
53
What is the treatment for toxocara ?
Fenbendazole or paraneoplasic palmate
54
Stomach worm of canines and felines? How can each be diagnosed?
Round worms (toxocara canis/cati) - visualize or fecal Physalloptera - difficult to float but 2-6cm worms can be seen on endoscopy Feline — ollulanus tricuspsi - biopsy, gastric juice evaluation, vomitus evaluation
55
How can physalloptera be treated?
Pyrantel pamoate
56
How do you treate ollulanus tricuspsi?
Fenbendazole
57
You have chronic vomiting in your dog.. you do endoscopy and see a thickened gastric outflow tract and masses which biopsy shows to be pyogranulomatous inflammation What would be on your Dx?
Pythiosis | Oomycete - P. Insidiosum
58
What is the treatment and prognosis for pythiosis?
Pythiosis vaccine (preventative) Terbinafine and itraconazole antifungals surgery — wide margins required High fatality ate
59
Clinical signs associated with gastroesophageal reflux?
Chronic vomiting or regurgitation Lip licking, hard swallow, ptyalism, esophagitis
60
How do you treat gastroesophageal reflux?
Sucralfate and proton pump inhibitor Treat primary disease
61
How can you diagnose inflammatory gastritis?
Endoscopy / surgical biopsy — infiltrate of inflammatory cells (lymphoplasmacytic, also eosinophilic and mast cells) in mucosa and lamina propria
62
You suspect an inflammatory gastritis but are waiting for your biopsy to confirm... how do you treat in the meantime?
Symptomatic therapy Antacid/gastorprotectant Antiemetics Empirical deworming — fenbendazole and pyrantel pamoate Diet trial with hypoallergenic or novel protein diet
63
Biopsy confirms inflammatory gastritis... how do you treat?
Immune modulation Prednisone (dog)/ Prednisolone (cat) Cyclosporine or atopica Mycophenolate Azathioprine Chlorambucil
64
Your patient has atrophic gastritis... what happens if the inflammation is not treated?
Chronic vomiting Marked mononuclear (lymphocytes, macrophages) Thinning of gastric mucosa Atrophy of gastric glands
65
How is atrophic gastritis treated??
Same also other inflammatory dz.. Immune modulation Prednisone (dog)/ Prednisolone (cat) Cyclosporine or atopica Mycophenolate Azathioprine Chlorambucil
66
Clinical signs associated with hypertrophic gastropathy?
Chronic vomiting — hours after earring
67
What are causes of of hypertrophic gastropathy?
Inflammatory infiltrates Hypergastrinemic conditions - decreased clearance from renal or liver dz - gastrin secreting tumor
68
Breeds associated with hypertrophic gastropathy?
Older, small breeds
69
Therapy for hypertrophic gastropathy?
Treat underlying dz | Surgical resection of thickened tissue
70
Congenital pyloric stenosis/hypertrophy is see in what breeds?
Boxer, Boston terrier, English bulldog, and Siamese cats
71
Clinical signs of pyloric stenosis/hypertrophy?
``` Vomiting several hours after meal — delayed gastric emptying (rads) Weight gain Aspiration pneumonia Depression Dehydration ```
72
Acquired causes of pyloric stenosis?
Inflammation | Neoplasia (gastrinoma)
73
What is Zollinger-Ellison syndrome?
Gastrinoma— gastrin secreting tumor Chronic vomiting Thickened gastric wall, hypertrophy of pyloris, gastric ulceration Reflux esophagitis +/- diarrhea
74
Where are gastrinoma tumors usually located?
Pancreas
75
How can you diagnose a gastrinoma?
Gastrin level assessment Low pH of gastric juice + high level of gastrin US/CT scan Scintigraphy Biopsy
76
Treatment of a gastrinoma?
Surgical removal of tumor (often has mets) PPI- high dose Octreotide — inhibits gastrin
77
DDX for stomach neoplasia?
Leiomyoma/leiomyosarcoma Adenomatous polyps * *Adenocarcinoma (DOG) * *LSA (CAT)
78
How do you diagnose bilious vomiting syndrome ?
Early morning bile vomiting Usually young dogs Caused by reflux of duodenal fluid into stomach and irritation of GI mucosa
79
Treatment of Bilioius vomiting syndrome?
Frequent small feedings Prokinetic Gastroprotectants Novel protein diet

RUSVM SAM 2 (44 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions