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Phase 2 TJ > TJ main pts > Flashcards

TJ main pts Flashcards

1
Q

What is the motor innervation of the lips and cheeks?

A

Facial nerve (CN VII)

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2
Q

What is the sensory innervation of the lips and cheeks?

A

Trigeminal nerve (CN V)

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3
Q

Which arteries supply blood to the lower lip and cheek?

A

Facial artery

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4
Q

Which arteries supply blood to the upper lip and cheek?

A

Infraorbital artery

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5
Q

What is the motor innervation of the tongue?

A

Hypoglossal nerve (CN XII)

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6
Q

Which cranial nerves provide sensory innervation to the tongue?

A

Trigeminal, facial, glossopharyngeal nerves

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7
Q

What is the blood supply to the tongue?

A

Lingual artery (branch of external carotid) and lingual vein

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8
Q

What muscles elevate the soft palate to protect the nasopharynx during swallowing?

A

Tensor veli palatini, levator veli palatini

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9
Q

What cranial nerves innervate the oropharynx?

A

Glossopharyngeal (CN IX) and vagus (CN X)

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10
Q

What artery supplies blood to the palatine tonsils?

A

Tonsillar artery (branch off lingual artery)

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11
Q

What is the primary control center for deglutition?

A

Swallowing center in the brainstem

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12
Q

True or False: Parotid, mandibular, and medial retropharyngeal lymph nodes receive afferent lymph from the oral cavity.

A

True

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13
Q

What is the most common congenital disorder affecting the lips?

A

Primary cleft palate

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14
Q

What is the treatment for tight lip syndrome?

A

Incise lip mucosa or excise segment of skin on chin

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15
Q

What is the most common neoplastic lesion of the lips in dogs?

A

Melanomas (oral melanoma) > SCC

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16
Q

What is the prognosis for dogs with oral melanoma (OMM) after surgery?

A

Median survival time (MST) = 34 months

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17
Q

What is the most common site of injury to the tongue?

A

Sublingual region

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18
Q

What are the types of glossectomy?

A
  • Partial glossectomy
  • Subtotal glossectomy
  • Near total glossectomy
  • Total glossectomy
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19
Q

What is the most common cause of penetrating injuries to the pharynx?

A

Sticks

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20
Q

What is the most common tonsillar neoplasm in dogs?

A

Tonsillar SCC

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21
Q

What is the MST for dogs with tonsillar SCC?

A

2 months

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22
Q

What are the complications of tonsillectomy?

A
  • Hemorrhage
  • Pharyngeal swelling
  • Postoperative aspiration
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23
Q

What is the MST for cats with tonsillar SCC?

A

2-14 weeks

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24
Q

Fill in the blank: The _______ is the most common site of ectopic mineralization in the tongue.

A

tongue

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25
Q

What are the common conditions associated with dysphagia?

A
  • Difficulty prehending food/water
  • Retention of food
  • Failure to swallow
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26
Q

What cranial nerves are involved in dysphagia affecting the oral stage?

A

CN V, VII, XII

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27
Q

What are the most common types of oral tumors in dogs?

A
  • Oral melanoma (OMM)
  • SCC
  • FSA
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28
Q

What is the treatment for oral papillomatosis?

A

Lesions regress without treatment in 4-8 weeks

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29
Q

What surgical technique can help reduce blood loss during glossectomy?

A

Preplacement of mattress sutures outside surgical margins

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30
Q

What is often the cause of feline oral pain syndrome (FOPS)?

A

Tooth eruption, oral lesions, environmental anxiety

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31
Q

What is the structure that blends with the facial nerves and the maxillary arteries near the parotid gland?

A

Thin capsule

The capsule of the parotid gland is thin and merges with surrounding anatomical structures.

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32
Q

Where does the parotid duct open in relation to the teeth?

A

At the level of the upper 4th premolar

The parotid duct travels over the lateral and ventral one-third of the masseter muscle.

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33
Q

What is the accessory parotid gland’s location relative to the parotid duct?

A

Dorsal to parotid duct

The accessory parotid gland empties into the main duct.

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34
Q

What is the blood supply to the parotid gland?

A

Parotid artery – branch of external carotid

The blood supply includes superficial temporal vein and great auricular veins.

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35
Q

Where is the zygomatic gland located?

A

Ventral and rostrolateral to globe, medial to zygomatic arch

The major duct opens at the caudolateral aspect of the last upper molar.

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36
Q

What are the blood supplies for the zygomatic gland?

A
  • Infraorbital artery
  • Deep facial veins
  • Medial retropharyngeal lymph nodes

These structures provide vascular and lymphatic support to the zygomatic gland.

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37
Q

What is the location of the mandibular salivary gland?

A

Caudomedial to angle of mandible

It is medial to the junction of the lingofacial and maxillary veins.

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38
Q

What lymph nodes are associated with the mandibular salivary gland?

A
  • Mandibular lymph nodes
  • Medial retropharyngeal lymph nodes

Their relationship is important for understanding potential spread of disease.

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39
Q

What distinguishes the monostomatic sublingual salivary gland?

A

Largest part within capsule shared by mandibular gland

It has a triangular shape and continues rostral associated with mandibular ducts.

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40
Q

What is the function of myoepithelial cells in salivary glands?

A

Contract to increase saliva flow

These cells play a crucial role in the expulsion of saliva from glands.

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41
Q

True or False: Sialadenosis is an inflammatory condition of the salivary glands.

A

False

Sialadenosis is characterized by noninflammatory, nonneoplastic bilateral swelling.

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42
Q

What are the four main presentations of sialocele?

A
  • Exophthalmos
  • Labored breathing
  • Dysphagia
  • Cervical swelling

These symptoms arise from saliva collections within subcutaneous tissues.

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43
Q

What is the most common source of sialocele?

A

Sublingual salivary gland/duct

Sialoceles are not true cysts but collections of saliva.

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44
Q

What is the treatment for zygomatic sialoceles?

A

Zygomatic sialadenectomy +/- sclerosing agent

This procedure addresses the complications arising from sialoceles.

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45
Q

What is the most common type of salivary gland neoplasia?

A

Adenocarcinoma or acinic carcinoma

These are the primary epithelial tumors affecting salivary glands.

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46
Q

Fill in the blank: The ventral approach for sublingual and mandibular sialadenectomy involves an incision at the ______.

A

cd ramus to mand symp

This incision allows access to the glandular tissue.

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47
Q

What is the primary goal of ranula marsupialization?

A

To create an opening for drainage

This procedure involves suturing the external mucosa to the lining of the sialocele.

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48
Q

What postoperative complication is not expected after bilateral removal of the mandibular/sublingual glands?

A

Dry mouth

This is due to the remaining salivary function from other glands.

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49
Q

What are the muscles of mastication associated with the mandible?

A
  • Masseter
  • Temporalis
  • Pterygoideus
  • Digastricus

These muscles play a critical role in the movement of the jaw for chewing.

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50
Q

What is the blood supply to the mandible?

A
  • Inferior alveolar artery
  • Mandibular nerve (branch of trigeminal / CN V)
  • Mandibular and sublingual salivary ducts

The inferior alveolar artery enters the mandible at the mandibular foramen and exits at the mental foramen.

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51
Q

What bones make up the canine muzzle?

A
  • Maxilla
  • Incisive bone
  • Nasal bone

The maxilla is the largest of these bones, housing canine, premolar, and molar teeth.

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52
Q

What is the most common type of oral tumor in canines?

A
  • Oral Melanoma (OMM)
  • Squamous Cell Carcinoma (SCC)
  • Fibrosarcoma (FSA)
  • Osteosarcoma (OSA)
  • Canine Acanthomatous Ameloblastoma (CAA)

These tumors have varying metastatic rates and biological behaviors.

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53
Q

What is the metastatic rate for Oral Melanoma (OMM)?

A

81%

This indicates a high potential for spread when diagnosed.

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54
Q

What diagnostic imaging is recommended for preoperative staging of oral tumors?

A
  • Chest X-ray (CXR)
  • Dental radiographs
  • CT/MRI

CXR helps assess the presence of metastasis, while CT/MRI are superior for detailed imaging.

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55
Q

True or False: Local nerve blocks are commonly used in preoperative patient preparation for oral surgeries.

A

True

Local nerve blocks can significantly reduce pain during and after surgery.

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56
Q

What are the surgical options for mandibulectomy?

A
  • Rostral mandibulectomy
  • Central mandibulectomy
  • Caudal mandibulectomy
  • Hemimandibulectomy
  • Mandibular rim excision

These options depend on the location and extent of the tumor.

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57
Q

What complications are associated with maxillectomy?

A
  • Dehiscences
  • Chronic oronasal fistulas
  • Inadvertent trauma to residual tooth roots

These complications can arise post-surgery and may require further intervention.

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58
Q

What is the prognosis for dogs with oral malignancies post-surgery?

A
  • 1-year survival rates of 70% to 90%
  • Local recurrence rates < 50%

Aggressive surgical management is associated with improved survival outcomes.

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59
Q

Which oral tumor type is associated with the best prognosis in canines?

A
  • Canine Acanthomatous Ameloblastoma (CAA)
  • Squamous Cell Carcinoma (SCC)

Both have high cure rates with appropriate surgical intervention.

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60
Q

Fill in the blank: Postoperative radiation therapy should be considered for tumors with high potential to _______.

A

[recur]

This is particularly true for tumors with dirty margins or those that are large.

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61
Q

What are the most common oral tumors in cats?

A
  • Squamous Cell Carcinoma (SCC)
  • Fibrosarcoma (FSA)
  • Osteosarcoma (OSA)

SCC is particularly aggressive and often difficult to treat due to its invasive nature.

62
Q

What is the typical surgical approach for feline mandibulectomy?

A

Mandibulectomy is the most frequent surgery performed for oral tumors in cats.

Care must be taken to avoid ligating the lingual artery to prevent ischemic necrosis of the tongue.

63
Q

What risk factors are associated with feline oral tumors?

A
  • Flea collars
  • Canned food (especially tuna)
  • Smoke exposure

These factors have been identified as potential contributors to the development of oral tumors in cats.

64
Q

What is the most frequent surgical technique for treating certain conditions?

A

Mandibulectomy

Mandibulectomy is commonly performed in cases involving squamous cell carcinoma (SCC).

65
Q

What is a common complication when sublingual SCC involves the lingual arteries?

A

Ischemic necrosis of tongue

Ligating the lingual arteries is not possible without risking ischemic necrosis.

66
Q

What is the most common issue cats face after removal of more than 50% of the mandible?

A

Reluctance to eat

Cats often experience prolonged reluctance to eat after significant mandible removal.

67
Q

What should be placed to assist cats that are reluctant to eat due to surgery?

A

E tube

An esophageal tube (E tube) is recommended for feeding in these cases.

68
Q

What percentage of cats experience dirty margins leading to local recurrence?

A

48%

Among those with dirty margins, 43% had local recurrences.

69
Q

How does the median survival time (MST) of SCC compare to fibrosarcoma (FSA) or osteosarcoma (OSA)?

A

Shorter

SCC has a shorter median survival time compared to FSA and OSA.

70
Q

What is the MST when using radiotherapy alone?

A

3 months

90% of cases treated with RT alone had tumor recurrence.

71
Q

What are the components involved in mandibular regeneration and immediate reconstruction?

A

Bone plate +/- BMP

Bone plates and Bone Morphogenetic Protein (BMP) can stabilize the mandible.

72
Q

When is BMP contraindicated?

A

In surgical sites with tumor cells

BMP should not be used where tumor cells are present due to risks associated with tumor growth.

73
Q

What is the anatomical location of the cervical esophagus?

A

Cricoid cartilage region → Left of trachea → thoracic inlet

74
Q

What are the anatomical landmarks of the thoracic esophagus?

A

Thoracic inlet → dorsal at tracheal bifurcation → esophageal hiatus

75
Q

Which major blood vessel crosses the left side of the mid thoracic esophagus?

A

Aorta

76
Q

What structures combine to form the dorsal and ventral vagal trunks?

A

Combination of dorsal / ventral right and left vagal nerves

77
Q

Where does the abdominal esophagus connect?

A

Connects to cardia of stomach; inconsistent

78
Q

What is the outer layer of the esophageal wall called?

A

Adventitia

79
Q

Does the esophagus have serosa?

A

No, it does not have serosa

80
Q

How does the adventitia blend in the neck region?

A

Blends with deep cervical fascia

81
Q

What covers the thoracic and abdominal esophagus?

A

Pleura/peritoneum

82
Q

What type of muscle is found in the muscularis layer of the esophagus in dogs?

A

Striated muscle only

83
Q

What type of muscle is present in the terminal esophagus of cats?

A

Smooth muscle

84
Q

What constitutes the upper esophageal sphincter?

A

Pharyngoesophageal junction

85
Q

Which muscles are involved in the upper esophageal sphincter?

A

Thyropharyngeus + cricopharyngeus muscles

86
Q

What indicates the lower esophageal sphincter?

A

Increase in thickening of striated muscle at gastroesophageal junction

87
Q

What may assist the lower esophageal sphincter?

A

Diaphragmatic crura & gastroesophageal mucosa

88
Q

What is the function of the submucosa in the esophagus?

A

Allows mucosa to move independently / mucosal folds in undistended esophagus

89
Q

What does the submucosa contain?

A

Blood vessels, nerves, mucous glands

90
Q

What is the function of mucous glands in the esophagus?

A

Secrete mucus, lubricates mucosal surface

91
Q

What type of epithelium is found in the mucosa of the esophagus?

A

Stratified squamous epithelium

92
Q

What appearance do the transverse folds in the mucosa of cats create?

A

Herringbone appearance

93
Q

What arteries supply the cervical esophagus?

A

Cranial/Caudal thyroid arteries

94
Q

What are the main veins draining the cervical esophagus?

A

Cranial/Caudal thyroid veins, external jugular

95
Q

What artery supplies the thoracic esophagus?

A

Bronchoesophageal artery (cranial 2/3); esophageal branch of aorta or dorsal intercostal artery (caudal 1/3)

96
Q

What veins drain the thoracic esophagus?

A

Bronchoesophageal vein, dorsal intercostal vein, azygous vein

97
Q

What artery supplies the abdominal esophagus?

A

Left gastric artery

98
Q

What is the venous drainage of the abdominal esophagus?

A

Left gastric vein → portal vein

99
Q

What is found in the rich intramural plexus of the esophagus?

A

Arteries and veins in submucosa

100
Q

What are the lymphatic drainage points for the esophagus?

A

Medial retropharyngeal, deep cervical, cranial mediastinal, portal/splenic/gastric

101
Q

What nerves innervate the esophagus?

A

Branches of vagus nerve, pharyngoesophageal nerves, recurrent laryngeal nerves, pararecurrent laryngeal nerves, dorsal/ventral vagal trunks

102
Q

What is the role of the mylohyoid and digastricus muscles during the oral stage of swallowing?

A

Prehension and formation of bolus at the base of the tongue

These muscles are responsible for moving the tongue and manipulating food in preparation for swallowing.

103
Q

Is the oral stage of swallowing voluntary or involuntary?

A

Voluntary

104
Q

Which cranial nerves are involved in the oral stage of swallowing?

A

CN V, VII, XII

These correspond to the trigeminal, facial, and hypoglossal nerves.

105
Q

What happens during the pharyngeal stage of swallowing?

A

Pharyngeal contraction pushes bolus to laryngopharynx

This stage is critical for guiding the bolus safely towards the esophagus.

106
Q

Is the pharyngeal stage of swallowing voluntary or involuntary?

A

Involuntary

107
Q

Which cranial nerves are involved in the pharyngeal stage of swallowing?

A

CN IX, X

These correspond to the glossopharyngeal and vagus nerves.

108
Q

What is the function of the cricopharyngeus and thyropharyngeus muscles during the pharyngoesophageal stage of swallowing?

A

Relaxation to allow the bolus to enter the esophagus

This relaxation is essential for the passage of food from the pharynx to the esophagus.

109
Q

Is the pharyngoesophageal stage of swallowing voluntary or involuntary?

A

Involuntary

110
Q

Which cranial nerves are involved in the pharyngoesophageal stage of swallowing?

A

CN IX, X

These are the glossopharyngeal and vagus nerves, continuing their role from the previous stage.

111
Q

What are the types of esophageal pathophysiology?

A

Mechanical/anatomic dysfunction, functional/neuromuscular dysfunction, inflammatory/esophagitis

Mechanical dysfxn includes lesions and compressions, while functional dysfxn often presents as megaesophagus.

112
Q

What can cause mechanical/anatomic dysfunction in the esophagus?

A

FB, stricture, tumor, VRA, HH, GE intussus

FB: foreign body; VRA: vascular ring anomaly; HH: hiatal hernia; GE: gastroesophageal.

113
Q

What is megaesophagus?

A

Diffuse esophageal dilatation with hypo or aperistalsis

114
Q

What are the characteristics of esophagitis?

A

Acute/chronic mucosal inflammation, severe lesions may extend into submucosa/muscularis

115
Q

What factors are associated with increased dehiscence rates in esophageal surgery?

A

Lack of serosa, segmental nature of blood supply

116
Q

What is the most common cause of ischemic necrosis at the incision site in esophageal surgery?

A

Damage to intramural vascular supply

117
Q

What is the purpose of esophageal patching?

A

To improve vascularity and reinforce existing esophagus

Patch types include on-lay and in-lay patches.

118
Q

What are the two types of esophageal patches?

A

On-lay patches, in-lay patches

119
Q

What is the most common suture pattern used in esophageal surgery?

A

Interrupted pattern

120
Q

What is the significance of submucosa in esophageal surgery?

A

It is the holding layer providing tensile strength

121
Q

What are the indications for an esophagotomy?

A

Foreign body removal, closure of esophageal perforations, diverticula

122
Q

What should be done post-esophagotomy regarding feeding?

A

NPO for 24 to 48 hours after surgery

123
Q

What conditions may require esophageal resection and anastomosis?

A

Congenital obstructions, acquired strictures, severe localized injury, diverticula, neoplasia

124
Q

What is the maximum length of esophagus that can be resected to minimize risk of dehiscence?

A

Up to 20% of cervical esophagus, 50% of thoracic esophagus

125
Q

What surgical technique may reduce anastomotic tension?

A

Circumferential partial myotomy

126
Q

What is the main complication of esophageal substitution techniques?

A

Leakage, stricture, chronic vomiting, reflux esophagitis

127
Q

What embryological structures are involved in vascular ring anomalies?

A

Paired dorsal/ventral aortas and six pairs of aortic arches

128
Q

What is the most common vascular ring anomaly in dogs?

A

Persistent right aortic arch with a left ligamentum arteriosum

129
Q

What is the typical clinical sign of vascular ring anomalies?

A

Postprandial regurgitation due to esophageal obstruction

130
Q

What diagnostic imaging can be used to identify vascular ring anomalies?

A

Radiographs, fluoroscopy, angiography, CT scan, esophagoscopy

131
Q

What is the surgical approach for correcting most vascular ring anomalies?

A

Left lateral thoracotomy

132
Q

What should be preserved during surgery for vascular ring anomalies?

A

Vagus nerve and left recurrent laryngeal nerve

133
Q

What is the prognosis for dogs undergoing surgical correction of PRAA?

A

92% survival to discharge reported

134
Q

What are common complications after esophageal surgery?

A

Aspiration pneumonia, leakage, stricture, chronic vomiting

135
Q

What is congenital generalized megaesophagus?

A

Alteration in motor function of the esophagus possibly due to vagal nerve defects

136
Q

What is the survival rate at 2 weeks for animals undergoing esophageal surgery as reported by Muldoon et al?

A

94%

The outcome was considered excellent in 92% and good in 8%.

137
Q

What is congenital generalized megaesophagus?

A

Alteration in motor function of the esophagus due to possible defect in vagal afferent innervation

Results in lack of aboral propulsion of food.

138
Q

What is the mortality rate associated with congenital generalized megaesophagus?

A

75%

This high mortality rate highlights the severity of the condition.

139
Q

What surgical technique is used to improve esophageal emptying in congenital generalized megaesophagus?

A

Esophagodiaphragmatic cardioplasty using Torres technique

Involves resecting a segment of diaphragm and suturing it to the esophagus.

140
Q

What are common esophageal foreign bodies in dogs and cats?

A

Dogs: ingested bones; Cats: fishhooks, needles, and string foreign bodies

These foreign bodies often lodge at the thoracic inlet, heart base, and caudal esophagus.

141
Q

What are classic clinical signs of esophageal foreign bodies in small-breed dogs?

A

Regurgitation of food within a few minutes of eating

Water intake is generally unaffected.

142
Q

What complications can arise from sharp or chronic foreign bodies in the esophagus?

A

Esophageal perforation, pneumomediastinum, pneumothorax, mediastinitis, pleuritis, pyothorax, mediastinal abscessation, bronchoesophageal, tracheoesophageal, or aortic esophageal fistulas

Respiratory distress or aspiration pneumonia may also occur.

143
Q

What diagnostic method is most commonly used to identify esophageal foreign bodies?

A

CXR (chest radiographs)

99% of bone foreign bodies are seen on radiographs.

144
Q

What treatment options are available for esophageal foreign bodies?

A

Endoscopic retrieval, push into stomach, esophagotomy or R&A

Balloon catheter techniques can also be used.

145
Q

What is the prognosis for patients with esophageal perforations?

A

Excellent except if thoracic esophageal perforation

Mortality rates vary: 7% for endoscopic retrieval and 14-40% for surgery.

146
Q

What are the common causes of acquired esophageal strictures?

A

Esophageal reflux, chronic vomiting, ingestion of corrosive substances, thermal burns, radiation injury, and foreign bodies

In cats, doxycycline and clindamycin are associated with focal esophagitis and stricture formation.

147
Q

What is the preferred treatment for esophageal strictures?

A

Bougienage or balloon dilatation

Usually requires ~4 treatments.

148
Q

What are esophageal diverticula?

A

Rare; single or multiple dilatations of the esophagus that may be associated with bronchoesophageal fistula

Diagnosis can be made via CXR or esophagoscopy.

149
Q

What is a common clinical sign associated with esophageal neoplasia in dogs?

A

Regurgitation or vomiting

Hypertrophic osteopathy is also common with spirocerca-induced sarcomas.

150
Q

What is the most common type of esophageal cancer in cats?

A

Squamous cell carcinoma (SCC)

It typically occurs in the cranial thoracic esophagus.

151
Q

What is cricopharyngeal dysphagia?

A

Failure of the upper esophageal sphincter (UES) to open during swallowing

Results in food boluses not passing from the oropharynx to the cervical esophagus.

152
Q

What is the prognosis for dogs after cricopharyngeal myotomy?

A

Resolution in 49% of dogs

Continued clinical signs may occur due to incomplete transection or concurrent esophageal dysfunction.

Phase 2 TJ (9 decks)

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