TJ main pts Flashcards
(152 cards)
1
Q
What is the motor innervation of the lips and cheeks?
A
Facial nerve (CN VII)
2
Q
What is the sensory innervation of the lips and cheeks?
A
Trigeminal nerve (CN V)
3
Q
Which arteries supply blood to the lower lip and cheek?
A
Facial artery
4
Q
Which arteries supply blood to the upper lip and cheek?
A
Infraorbital artery
5
Q
What is the motor innervation of the tongue?
A
Hypoglossal nerve (CN XII)
6
Q
Which cranial nerves provide sensory innervation to the tongue?
A
Trigeminal, facial, glossopharyngeal nerves
7
Q
What is the blood supply to the tongue?
A
Lingual artery (branch of external carotid) and lingual vein
8
Q
What muscles elevate the soft palate to protect the nasopharynx during swallowing?
A
Tensor veli palatini, levator veli palatini
9
Q
What cranial nerves innervate the oropharynx?
A
Glossopharyngeal (CN IX) and vagus (CN X)
10
Q
What artery supplies blood to the palatine tonsils?
A
Tonsillar artery (branch off lingual artery)
11
Q
What is the primary control center for deglutition?
A
Swallowing center in the brainstem
12
Q
True or False: Parotid, mandibular, and medial retropharyngeal lymph nodes receive afferent lymph from the oral cavity.
A
True
13
Q
What is the most common congenital disorder affecting the lips?
A
Primary cleft palate
14
Q
What is the treatment for tight lip syndrome?
A
Incise lip mucosa or excise segment of skin on chin
15
Q
What is the most common neoplastic lesion of the lips in dogs?
A
Melanomas (oral melanoma) > SCC
16
Q
What is the prognosis for dogs with oral melanoma (OMM) after surgery?
A
Median survival time (MST) = 34 months
17
Q
What is the most common site of injury to the tongue?
A
Sublingual region
18
Q
What are the types of glossectomy?
A
- Partial glossectomy
- Subtotal glossectomy
- Near total glossectomy
- Total glossectomy
19
Q
What is the most common cause of penetrating injuries to the pharynx?
A
Sticks
20
Q
What is the most common tonsillar neoplasm in dogs?
A
Tonsillar SCC
21
Q
What is the MST for dogs with tonsillar SCC?
A
2 months
22
Q
What are the complications of tonsillectomy?
A
- Hemorrhage
- Pharyngeal swelling
- Postoperative aspiration
23
Q
What is the MST for cats with tonsillar SCC?
A
2-14 weeks
24
Q
Fill in the blank: The _______ is the most common site of ectopic mineralization in the tongue.
A
tongue
25
What are the common conditions associated with dysphagia?
* Difficulty prehending food/water
* Retention of food
* Failure to swallow
26
What cranial nerves are involved in dysphagia affecting the oral stage?
CN V, VII, XII
27
What are the most common types of oral tumors in dogs?
* Oral melanoma (OMM)
* SCC
* FSA
28
What is the treatment for oral papillomatosis?
Lesions regress without treatment in 4-8 weeks
29
What surgical technique can help reduce blood loss during glossectomy?
Preplacement of mattress sutures outside surgical margins
30
What is often the cause of feline oral pain syndrome (FOPS)?
Tooth eruption, oral lesions, environmental anxiety
31
What is the structure that blends with the facial nerves and the maxillary arteries near the parotid gland?
Thin capsule
## Footnote
The capsule of the parotid gland is thin and merges with surrounding anatomical structures.
32
Where does the parotid duct open in relation to the teeth?
At the level of the upper 4th premolar
## Footnote
The parotid duct travels over the lateral and ventral one-third of the masseter muscle.
33
What is the accessory parotid gland's location relative to the parotid duct?
Dorsal to parotid duct
## Footnote
The accessory parotid gland empties into the main duct.
34
What is the blood supply to the parotid gland?
Parotid artery -- branch of external carotid
## Footnote
The blood supply includes superficial temporal vein and great auricular veins.
35
Where is the zygomatic gland located?
Ventral and rostrolateral to globe, medial to zygomatic arch
## Footnote
The major duct opens at the caudolateral aspect of the last upper molar.
36
What are the blood supplies for the zygomatic gland?
* Infraorbital artery
* Deep facial veins
* Medial retropharyngeal lymph nodes
## Footnote
These structures provide vascular and lymphatic support to the zygomatic gland.
37
What is the location of the mandibular salivary gland?
Caudomedial to angle of mandible
## Footnote
It is medial to the junction of the lingofacial and maxillary veins.
38
What lymph nodes are associated with the mandibular salivary gland?
* Mandibular lymph nodes
* Medial retropharyngeal lymph nodes
## Footnote
Their relationship is important for understanding potential spread of disease.
39
What distinguishes the monostomatic sublingual salivary gland?
Largest part within capsule shared by mandibular gland
## Footnote
It has a triangular shape and continues rostral associated with mandibular ducts.
40
What is the function of myoepithelial cells in salivary glands?
Contract to increase saliva flow
## Footnote
These cells play a crucial role in the expulsion of saliva from glands.
41
True or False: Sialadenosis is an inflammatory condition of the salivary glands.
False
## Footnote
Sialadenosis is characterized by noninflammatory, nonneoplastic bilateral swelling.
42
What are the four main presentations of sialocele?
* Exophthalmos
* Labored breathing
* Dysphagia
* Cervical swelling
## Footnote
These symptoms arise from saliva collections within subcutaneous tissues.
43
What is the most common source of sialocele?
Sublingual salivary gland/duct
## Footnote
Sialoceles are not true cysts but collections of saliva.
44
What is the treatment for zygomatic sialoceles?
Zygomatic sialadenectomy +/- sclerosing agent
## Footnote
This procedure addresses the complications arising from sialoceles.
45
What is the most common type of salivary gland neoplasia?
Adenocarcinoma or acinic carcinoma
## Footnote
These are the primary epithelial tumors affecting salivary glands.
46
Fill in the blank: The ventral approach for sublingual and mandibular sialadenectomy involves an incision at the ______.
cd ramus to mand symp
## Footnote
This incision allows access to the glandular tissue.
47
What is the primary goal of ranula marsupialization?
To create an opening for drainage
## Footnote
This procedure involves suturing the external mucosa to the lining of the sialocele.
48
What postoperative complication is not expected after bilateral removal of the mandibular/sublingual glands?
Dry mouth
## Footnote
This is due to the remaining salivary function from other glands.
49
What are the muscles of mastication associated with the mandible?
* Masseter
* Temporalis
* Pterygoideus
* Digastricus
## Footnote
These muscles play a critical role in the movement of the jaw for chewing.
50
What is the blood supply to the mandible?
* Inferior alveolar artery
* Mandibular nerve (branch of trigeminal / CN V)
* Mandibular and sublingual salivary ducts
## Footnote
The inferior alveolar artery enters the mandible at the mandibular foramen and exits at the mental foramen.
51
What bones make up the canine muzzle?
* Maxilla
* Incisive bone
* Nasal bone
## Footnote
The maxilla is the largest of these bones, housing canine, premolar, and molar teeth.
52
What is the most common type of oral tumor in canines?
* Oral Melanoma (OMM)
* Squamous Cell Carcinoma (SCC)
* Fibrosarcoma (FSA)
* Osteosarcoma (OSA)
* Canine Acanthomatous Ameloblastoma (CAA)
## Footnote
These tumors have varying metastatic rates and biological behaviors.
53
What is the metastatic rate for Oral Melanoma (OMM)?
81%
## Footnote
This indicates a high potential for spread when diagnosed.
54
What diagnostic imaging is recommended for preoperative staging of oral tumors?
* Chest X-ray (CXR)
* Dental radiographs
* CT/MRI
## Footnote
CXR helps assess the presence of metastasis, while CT/MRI are superior for detailed imaging.
55
True or False: Local nerve blocks are commonly used in preoperative patient preparation for oral surgeries.
True
## Footnote
Local nerve blocks can significantly reduce pain during and after surgery.
56
What are the surgical options for mandibulectomy?
* Rostral mandibulectomy
* Central mandibulectomy
* Caudal mandibulectomy
* Hemimandibulectomy
* Mandibular rim excision
## Footnote
These options depend on the location and extent of the tumor.
57
What complications are associated with maxillectomy?
* Dehiscences
* Chronic oronasal fistulas
* Inadvertent trauma to residual tooth roots
## Footnote
These complications can arise post-surgery and may require further intervention.
58
What is the prognosis for dogs with oral malignancies post-surgery?
* 1-year survival rates of 70% to 90%
* Local recurrence rates < 50%
## Footnote
Aggressive surgical management is associated with improved survival outcomes.
59
Which oral tumor type is associated with the best prognosis in canines?
* Canine Acanthomatous Ameloblastoma (CAA)
* Squamous Cell Carcinoma (SCC)
## Footnote
Both have high cure rates with appropriate surgical intervention.
60
Fill in the blank: Postoperative radiation therapy should be considered for tumors with high potential to _______.
[recur]
## Footnote
This is particularly true for tumors with dirty margins or those that are large.
61
What are the most common oral tumors in cats?
* Squamous Cell Carcinoma (SCC)
* Fibrosarcoma (FSA)
* Osteosarcoma (OSA)
## Footnote
SCC is particularly aggressive and often difficult to treat due to its invasive nature.
62
What is the typical surgical approach for feline mandibulectomy?
Mandibulectomy is the most frequent surgery performed for oral tumors in cats.
## Footnote
Care must be taken to avoid ligating the lingual artery to prevent ischemic necrosis of the tongue.
63
What risk factors are associated with feline oral tumors?
* Flea collars
* Canned food (especially tuna)
* Smoke exposure
## Footnote
These factors have been identified as potential contributors to the development of oral tumors in cats.
64
What is the most frequent surgical technique for treating certain conditions?
Mandibulectomy
## Footnote
Mandibulectomy is commonly performed in cases involving squamous cell carcinoma (SCC).
65
What is a common complication when sublingual SCC involves the lingual arteries?
Ischemic necrosis of tongue
## Footnote
Ligating the lingual arteries is not possible without risking ischemic necrosis.
66
What is the most common issue cats face after removal of more than 50% of the mandible?
Reluctance to eat
## Footnote
Cats often experience prolonged reluctance to eat after significant mandible removal.
67
What should be placed to assist cats that are reluctant to eat due to surgery?
E tube
## Footnote
An esophageal tube (E tube) is recommended for feeding in these cases.
68
What percentage of cats experience dirty margins leading to local recurrence?
48%
## Footnote
Among those with dirty margins, 43% had local recurrences.
69
How does the median survival time (MST) of SCC compare to fibrosarcoma (FSA) or osteosarcoma (OSA)?
Shorter
## Footnote
SCC has a shorter median survival time compared to FSA and OSA.
70
What is the MST when using radiotherapy alone?
3 months
## Footnote
90% of cases treated with RT alone had tumor recurrence.
71
What are the components involved in mandibular regeneration and immediate reconstruction?
Bone plate +/- BMP
## Footnote
Bone plates and Bone Morphogenetic Protein (BMP) can stabilize the mandible.
72
When is BMP contraindicated?
In surgical sites with tumor cells
## Footnote
BMP should not be used where tumor cells are present due to risks associated with tumor growth.
73
What is the anatomical location of the cervical esophagus?
Cricoid cartilage region → Left of trachea → thoracic inlet
74
What are the anatomical landmarks of the thoracic esophagus?
Thoracic inlet → dorsal at tracheal bifurcation → esophageal hiatus
75
Which major blood vessel crosses the left side of the mid thoracic esophagus?
Aorta
76
What structures combine to form the dorsal and ventral vagal trunks?
Combination of dorsal / ventral right and left vagal nerves
77
Where does the abdominal esophagus connect?
Connects to cardia of stomach; inconsistent
78
What is the outer layer of the esophageal wall called?
Adventitia
79
Does the esophagus have serosa?
No, it does not have serosa
80
How does the adventitia blend in the neck region?
Blends with deep cervical fascia
81
What covers the thoracic and abdominal esophagus?
Pleura/peritoneum
82
What type of muscle is found in the muscularis layer of the esophagus in dogs?
Striated muscle only
83
What type of muscle is present in the terminal esophagus of cats?
Smooth muscle
84
What constitutes the upper esophageal sphincter?
Pharyngoesophageal junction
85
Which muscles are involved in the upper esophageal sphincter?
Thyropharyngeus + cricopharyngeus muscles
86
What indicates the lower esophageal sphincter?
Increase in thickening of striated muscle at gastroesophageal junction
87
What may assist the lower esophageal sphincter?
Diaphragmatic crura & gastroesophageal mucosa
88
What is the function of the submucosa in the esophagus?
Allows mucosa to move independently / mucosal folds in undistended esophagus
89
What does the submucosa contain?
Blood vessels, nerves, mucous glands
90
What is the function of mucous glands in the esophagus?
Secrete mucus, lubricates mucosal surface
91
What type of epithelium is found in the mucosa of the esophagus?
Stratified squamous epithelium
92
What appearance do the transverse folds in the mucosa of cats create?
Herringbone appearance
93
What arteries supply the cervical esophagus?
Cranial/Caudal thyroid arteries
94
What are the main veins draining the cervical esophagus?
Cranial/Caudal thyroid veins, external jugular
95
What artery supplies the thoracic esophagus?
Bronchoesophageal artery (cranial 2/3); esophageal branch of aorta or dorsal intercostal artery (caudal 1/3)
96
What veins drain the thoracic esophagus?
Bronchoesophageal vein, dorsal intercostal vein, azygous vein
97
What artery supplies the abdominal esophagus?
Left gastric artery
98
What is the venous drainage of the abdominal esophagus?
Left gastric vein → portal vein
99
What is found in the rich intramural plexus of the esophagus?
Arteries and veins in submucosa
100
What are the lymphatic drainage points for the esophagus?
Medial retropharyngeal, deep cervical, cranial mediastinal, portal/splenic/gastric
101
What nerves innervate the esophagus?
Branches of vagus nerve, pharyngoesophageal nerves, recurrent laryngeal nerves, pararecurrent laryngeal nerves, dorsal/ventral vagal trunks
102
What is the role of the mylohyoid and digastricus muscles during the oral stage of swallowing?
Prehension and formation of bolus at the base of the tongue
## Footnote
These muscles are responsible for moving the tongue and manipulating food in preparation for swallowing.
103
Is the oral stage of swallowing voluntary or involuntary?
Voluntary
104
Which cranial nerves are involved in the oral stage of swallowing?
CN V, VII, XII
## Footnote
These correspond to the trigeminal, facial, and hypoglossal nerves.
105
What happens during the pharyngeal stage of swallowing?
Pharyngeal contraction pushes bolus to laryngopharynx
## Footnote
This stage is critical for guiding the bolus safely towards the esophagus.
106
Is the pharyngeal stage of swallowing voluntary or involuntary?
Involuntary
107
Which cranial nerves are involved in the pharyngeal stage of swallowing?
CN IX, X
## Footnote
These correspond to the glossopharyngeal and vagus nerves.
108
What is the function of the cricopharyngeus and thyropharyngeus muscles during the pharyngoesophageal stage of swallowing?
Relaxation to allow the bolus to enter the esophagus
## Footnote
This relaxation is essential for the passage of food from the pharynx to the esophagus.
109
Is the pharyngoesophageal stage of swallowing voluntary or involuntary?
Involuntary
110
Which cranial nerves are involved in the pharyngoesophageal stage of swallowing?
CN IX, X
## Footnote
These are the glossopharyngeal and vagus nerves, continuing their role from the previous stage.
111
What are the types of esophageal pathophysiology?
Mechanical/anatomic dysfunction, functional/neuromuscular dysfunction, inflammatory/esophagitis
## Footnote
Mechanical dysfxn includes lesions and compressions, while functional dysfxn often presents as megaesophagus.
112
What can cause mechanical/anatomic dysfunction in the esophagus?
FB, stricture, tumor, VRA, HH, GE intussus
## Footnote
FB: foreign body; VRA: vascular ring anomaly; HH: hiatal hernia; GE: gastroesophageal.
113
What is megaesophagus?
Diffuse esophageal dilatation with hypo or aperistalsis
114
What are the characteristics of esophagitis?
Acute/chronic mucosal inflammation, severe lesions may extend into submucosa/muscularis
115
What factors are associated with increased dehiscence rates in esophageal surgery?
Lack of serosa, segmental nature of blood supply
116
What is the most common cause of ischemic necrosis at the incision site in esophageal surgery?
Damage to intramural vascular supply
117
What is the purpose of esophageal patching?
To improve vascularity and reinforce existing esophagus
## Footnote
Patch types include on-lay and in-lay patches.
118
What are the two types of esophageal patches?
On-lay patches, in-lay patches
119
What is the most common suture pattern used in esophageal surgery?
Interrupted pattern
120
What is the significance of submucosa in esophageal surgery?
It is the holding layer providing tensile strength
121
What are the indications for an esophagotomy?
Foreign body removal, closure of esophageal perforations, diverticula
122
What should be done post-esophagotomy regarding feeding?
NPO for 24 to 48 hours after surgery
123
What conditions may require esophageal resection and anastomosis?
Congenital obstructions, acquired strictures, severe localized injury, diverticula, neoplasia
124
What is the maximum length of esophagus that can be resected to minimize risk of dehiscence?
Up to 20% of cervical esophagus, 50% of thoracic esophagus
125
What surgical technique may reduce anastomotic tension?
Circumferential partial myotomy
126
What is the main complication of esophageal substitution techniques?
Leakage, stricture, chronic vomiting, reflux esophagitis
127
What embryological structures are involved in vascular ring anomalies?
Paired dorsal/ventral aortas and six pairs of aortic arches
128
What is the most common vascular ring anomaly in dogs?
Persistent right aortic arch with a left ligamentum arteriosum
129
What is the typical clinical sign of vascular ring anomalies?
Postprandial regurgitation due to esophageal obstruction
130
What diagnostic imaging can be used to identify vascular ring anomalies?
Radiographs, fluoroscopy, angiography, CT scan, esophagoscopy
131
What is the surgical approach for correcting most vascular ring anomalies?
Left lateral thoracotomy
132
What should be preserved during surgery for vascular ring anomalies?
Vagus nerve and left recurrent laryngeal nerve
133
What is the prognosis for dogs undergoing surgical correction of PRAA?
92% survival to discharge reported
134
What are common complications after esophageal surgery?
Aspiration pneumonia, leakage, stricture, chronic vomiting
135
What is congenital generalized megaesophagus?
Alteration in motor function of the esophagus possibly due to vagal nerve defects
136
What is the survival rate at 2 weeks for animals undergoing esophageal surgery as reported by Muldoon et al?
94%
## Footnote
The outcome was considered excellent in 92% and good in 8%.
137
What is congenital generalized megaesophagus?
Alteration in motor function of the esophagus due to possible defect in vagal afferent innervation
## Footnote
Results in lack of aboral propulsion of food.
138
What is the mortality rate associated with congenital generalized megaesophagus?
75%
## Footnote
This high mortality rate highlights the severity of the condition.
139
What surgical technique is used to improve esophageal emptying in congenital generalized megaesophagus?
Esophagodiaphragmatic cardioplasty using Torres technique
## Footnote
Involves resecting a segment of diaphragm and suturing it to the esophagus.
140
What are common esophageal foreign bodies in dogs and cats?
Dogs: ingested bones; Cats: fishhooks, needles, and string foreign bodies
## Footnote
These foreign bodies often lodge at the thoracic inlet, heart base, and caudal esophagus.
141
What are classic clinical signs of esophageal foreign bodies in small-breed dogs?
Regurgitation of food within a few minutes of eating
## Footnote
Water intake is generally unaffected.
142
What complications can arise from sharp or chronic foreign bodies in the esophagus?
Esophageal perforation, pneumomediastinum, pneumothorax, mediastinitis, pleuritis, pyothorax, mediastinal abscessation, bronchoesophageal, tracheoesophageal, or aortic esophageal fistulas
## Footnote
Respiratory distress or aspiration pneumonia may also occur.
143
What diagnostic method is most commonly used to identify esophageal foreign bodies?
CXR (chest radiographs)
## Footnote
99% of bone foreign bodies are seen on radiographs.
144
What treatment options are available for esophageal foreign bodies?
Endoscopic retrieval, push into stomach, esophagotomy or R&A
## Footnote
Balloon catheter techniques can also be used.
145
What is the prognosis for patients with esophageal perforations?
Excellent except if thoracic esophageal perforation
## Footnote
Mortality rates vary: 7% for endoscopic retrieval and 14-40% for surgery.
146
What are the common causes of acquired esophageal strictures?
Esophageal reflux, chronic vomiting, ingestion of corrosive substances, thermal burns, radiation injury, and foreign bodies
## Footnote
In cats, doxycycline and clindamycin are associated with focal esophagitis and stricture formation.
147
What is the preferred treatment for esophageal strictures?
Bougienage or balloon dilatation
## Footnote
Usually requires ~4 treatments.
148
What are esophageal diverticula?
Rare; single or multiple dilatations of the esophagus that may be associated with bronchoesophageal fistula
## Footnote
Diagnosis can be made via CXR or esophagoscopy.
149
What is a common clinical sign associated with esophageal neoplasia in dogs?
Regurgitation or vomiting
## Footnote
Hypertrophic osteopathy is also common with spirocerca-induced sarcomas.
150
What is the most common type of esophageal cancer in cats?
Squamous cell carcinoma (SCC)
## Footnote
It typically occurs in the cranial thoracic esophagus.
151
What is cricopharyngeal dysphagia?
Failure of the upper esophageal sphincter (UES) to open during swallowing
## Footnote
Results in food boluses not passing from the oropharynx to the cervical esophagus.
152
What is the prognosis for dogs after cricopharyngeal myotomy?
Resolution in 49% of dogs
## Footnote
Continued clinical signs may occur due to incomplete transection or concurrent esophageal dysfunction.
