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!Equine Medicine And Surgery > Mouth&Esophagus > Flashcards

Mouth&Esophagus Flashcards

1
Q

Main types of Mandibular and maxilla fractures

A

Incisive/ rostral region
Interdental space
Caudal horizontal ramus
Vertical ramus

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2
Q

What causes fractures in the incisive and interdental space?

A

Thin bones and minimal soft tissue coverage
Direct trauma from other horses or objects

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3
Q

Why are fractures of the caudal horizontal ramus (molars/ temporomandibular joint) less common?

A

Greater bone and muscle mass (masseter muscle)
Higher morbidity

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4
Q

Acute clinical signs of mandibular and maxilla fractures

A

Displacements
Pytalism
Swelling
Prehensile difficulties
Dysphasia
Oral/ cutaneous wounds

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5
Q

Chronic clinical signs of mandibular and maxilla fractures

A

Debilitation
Difficult prehension
Malodorous breath
Loss of normal occlusal alignment of dental structures

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6
Q

Diagnosing mandibular and maxilla fractures

A

Clinical signs
Radiographs
Cross bite (cd. mandible, vertical ramus, temporomandibular joint fractures/ luxations)

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7
Q

Treatment for incisive fractures

A

Orthopedic wires
Interdigitate on reduction
Eat normal diet
Heal within 4-8 weeks

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8
Q

Treatments for interdental space fractures

A

Interdigated: orthopedic wires
Long oblique fractures: cortical screws

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9
Q

Treatments for unstable fractures of the interdental space

A

Acrylic splints
Dynamic compression plates
Kirschner- Ehmer appliances

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10
Q

Treatment for unilateral non-displaced ramification fractures

A

Non surgical
Soft diets
Analgesics (non steroidal anti inflammatory drugs)
4-6 weeks (good prog)

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11
Q

Where are caudal angle mandibles fractured?

A

From the junction of the vertical and horizontal ramus as a free fragment (uncommon)

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12
Q

Treatment of caudal angle mandible

A

Excision of fragments
With molar involvement: internal fixation with plates/ screws

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13
Q

Treatment for the temporomandibular area fracture

A

Rare and difficult to repair
Mandibular condylectomy

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14
Q

Treatment for the coronoid process

A

Excision (preferred if dental abnormalities result) or conservative management

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15
Q

Prognosis for mandibular and maxilla fractures

A

Incisive region/ interdental area: good
Horizontal and vertical rami: guarded to fair
Temporomandibular and coronoid: guarded

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16
Q

What are the predisposing causes of esophageal impaction (choke)

A

Communal feeding
Post exercise (after feeding)
Esophageal lesions
Dental problems

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17
Q

What is the most common site of esophageal obstruction?

A

Second cervical vertebra

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18
Q

Causes of esophageal impaction

A

Feeds, pellets, sugar beet pulp, wood shavings, rough hay

19
Q

Clinical signs of esophageal impaction

A

Food, mucous, saliva from nostrils
Retching
Nasal cough
Aspiration pneumonia

20
Q

How do you dx esophageal impaction?

A

CS
Radiographs (radiodense or solid fluid and gas proximal to site of impaction)
Endoscopy (obstruction and esophageal mucosa)

21
Q

When are contrast esophagrams necessary?

A

Chronic recurrent choke

22
Q

Treatment of esophageal impaction

A

Nasogastric tube
Tranquilization
Anesthesia and endotracheal intubation (lateral recumbency)

23
Q

How does nasogatric tube for impaction work?

A

Blow air into esophagus to induce secondary peristalsis then advance obstruction
If fails then sedate with xylazine

24
Q

What is considered a risky tx for impaction?

A

Esophagostomy
Longitudinal incision —> feed through incision —> 4-6w recovery

25
Q

Aftercare of impaction

A

Confirm if entire esophageal lumen is patent with nasogastric tube
Endoscopic evaluation
Scurried diet for a few days (pelleted feeds, bran mashes)

26
Q

Prognosis for esophageal impaction

A

Acute: good
Chronic: guarded to good

27
Q

Eophageal ulceration?

A

Any trauma , chemical or infectious origin
Longitudinal scars expand well, circular scars don’t

28
Q

What causes esophageal ulceration

A

Protraction esophageal impaction (acute, most common)
External trauma to neck (chronic)

29
Q

__________ and __________ are the most common causes of recurrent choke

A

Ulceration and stricture

30
Q

Conservative tx for mild cases of esophageal ulceration

A

Slurries diet for a few days then pelleted feed and bran mashes
Constriction worse at 30 days then normal function at 60

31
Q

Surgical tx for esophageal ulceration

A

Esophagostomy/ Esophagplasty
Esophagomyotomy
Patch grafting
Resection and anastomosis

32
Q

Why isn’t resection and anastomosis the best option for tx of esophageal ulceration?

A

Stricture
Doesn’t hold together (lacks serosa)
Long

33
Q

Esophageal wounds

A

Longitudinal slits along the ventral and dorsal esophageal walls
Closed and open wounds

34
Q

Why are closed esophageal wounds more dangerous?

A

Secretions and food material trapped in deep fascial planes

35
Q

What causes esophageal wounds?

A

Closed: ingested wire, impacted foreign bodies, pre-existing defects
Open: blunt trauma (cervical vertebrae)

36
Q

CS of open esophageal wounds

A

Swollen wound
Salivary discharge
Food drainage

37
Q

CS of closed esophageal wounds

A

Cellulitis causing ventral neck swelling
Anorexia
Febrile and depression
Shock from toxic products that accumulate in tissues

38
Q

What causes mediastinitis and pleuritis in closed esophageal wounds?

A

Cellulitis and necrosis in the neck —> causing infection and gas dissect along fascial planes to mediastinum

39
Q

Dx of esophageal wounds

A

Acute swelling ventral neck
SQ emphysema over neck and shoulders
Endoscopy
Rads (gas through facial planes and extra luminal food)

40
Q

Conservative tx for esophageal wounds

A

Good ventral drainage: esophagostomy and excise necrotic tissue
Second intention healing
Abx and anti- inflammatories
Tetanus prophylaxis
3-4 weeks healing

41
Q

What does saliva lost via wounds and fistulas causes?

A

Hyponatremia, hypochloremia
Metabolic acidosis then metabolic alkalosis

42
Q

Sx tx for esophageal wounds

A

Resection and anastomosis
Esophagostomy

43
Q

Sx complications from esophageal wounds

A

Esophagus has no serosa surface
Constant movement
Neurological complications

44
Q

What results from esophageal wounds?

A

Cellulitis
Laryngeal hemiplegia (left recurrent laryngeal nerve)
Horners syndrome (ptosis, miosis, enophyhalmos)
Chronic esophagocutaneous fistula
Strictures are rare

!Equine Medicine And Surgery (20 decks)

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