Internal Medicine: Gastroenterology: Oesophagus and Swallowing Disorders Flashcards
What are signs of oropharyngeal and oesophageal disease?
- Dysphagia
- Drooling saliva
- Halitosis
- Odynophagia- painful swallowing
Regurgitation- oesophageal disease
What are the different categories of causes of dysphagia?
Functional
* Abscence
* Spastiticty
* Incoordination
Morphological
* physical
* anatomical
How can dysphagia manifest?
- Difficulty lapping water or forming bolus
- Excessive mandibular or head motion
- Dropping food from mouth
- Persistent forceful but ineffective swallowing
- Nasal discharge
- Gagging
- Coughing
What can cause functional neuromuscular dysphagia?
- Cricopharyngeal chalasia/achalasia
- Myasthenia gravis
- Brainstem disease
- Peripheral neuropathy
- Hypothyroidism
- Botulism
What can cause morphological dysphagia?
- Oropharyngeal inflammation
- Oropharyngeal trauama
- Foreign bodies
- Neoplasia
- Congenital/developmental
What are potential sequalae of oral inflammation?
- Ulceration
- Necrosis
- Secondary infectoin
What are potential causes of morphological congenital dysphagia?
- Hare-lip
- Lip folds
- Cleft palate
- Malocclusion
- Craniomandibular osteopathy
- Temporomandibular dysphagia
What are ddxs of halitosis?
Oropharyngeal disease
* inflammation
* neoplasia
* foreign body
Oesophageal diease
Diet associated
Malabsorption
Dental disease
Nasal cavity/sinus disease
Uraemia
Liver disease
anal sac disease
What should be noted about regurgitation?
- Passive event- vomiting
- Undigested food?
- Mucus/saliva covered
- Immediate or delayed
- What is pseudoptyalism?
- What is ptyalism?
- Failure to swallow normal volume of saliva
- Increased saliva production
What are secondary signs of oesophageal or oropharyngeal disease?
- Malnutrition/dehydration
- Anorexia/polyphagia
- Aspiration pneumonia/tracheal compression
- Cough dyspnoea
How can swallowing problems be investigated?
- History- what is vomited, when, signs, concurrent signs
- physical examination- oral exam, head, palpation of neck, systemic, neurological
- Diagnosic imaging- head, neck, thorax, barium
- Endoscopy
- Lab investigations- haem, biochem
- FNA- mass, lymph nodes
- Biopsy
- Anti ACh receptor antibody
- 2-M abs
- ACTH stimulation test
What is cricopharyngeal dysphagia?
How is it treated?
Hypertension of cricopharyngeal sphincter
Cricopharyngeal myotomy
How is oropharyngeal eosinophilic granuloma treated in cats?
- Oral hygiene
- ABs
- Steroids
What are the differentials for primary salivary gland enlargment?
- Sialadenosis/hypersialosis
- Primary sialoadenosis
