Term
| What are some common examples of esophageal abnormalities? |
|
Definition
-obstruction
-stricture
-diverticulum
-rupture |
|
|
Term
| What is the purpose of the UES? What composes it? |
|
Definition
-prevents air aspiration & esophagopharyngeal reflux
-composed of esopahgeal striated mm & cricopharyngeus m |
|
|
Term
| What is the purpose of the LES? What composes it? |
|
Definition
-prevents reflux
-composed of thickening of smooth m at gastroesophageal junction |
|
|
Term
| At what 4 locations is the esophagus narrowed? |
|
Definition
-post-pharyngeal region
-thoracic inlet
-base of heart
-cardia |
|
|
Term
| How does atropine affect esophageal peristalsis? |
|
Definition
| -reduced amplitude in distal third |
|
|
Term
|
Definition
| -treats colic by relaxing small colon |
|
|
Term
| What do Xylazine & Detomidine do to esophageal peristalsis? |
|
Definition
-relax striated m of the esophagus
-induce lowering of the head |
|
|
Term
| What does Oxytocin do to esophageal peristalsis? |
|
Definition
| -provides short-term relaxation of esophageal musculature |
|
|
Term
| What are the CS of esophageal obstruction? |
|
Definition
-NASAL FEED REGURGITATION
-dysphagia
-coughing
-retching
-extension of head/neck
-agitatio or colic when first obstruct
-ptyalism |
|
|
Term
| What are some other differentials for ptyalism in addition to choke? |
|
Definition
-slobber factor
-gasric reflex due to acute SI obstruction
-oral FB
-tongue abscess
-oral ulcerations: VS, foxtail, NSAIDs |
|
|
Term
| Which of the four locations of esophageal narrowing is predisposed to aspiration pneumonia? |
|
Definition
|
|
Term
| What physiologically causes stricture w/ choke? |
|
Definition
|
|
Term
| What physiologically causes diverticula w/ choke? |
|
Definition
-pulsion diverticulum: inc luminal P
-traction diverticulum: adhesions to surrounding structures |
|
|
Term
| How do we diagnose choke? |
|
Definition
-palpation
-nasogastric tube
-endoscopy
-U/S
-rads |
|
|
Term
| What kind of contrast medium do we use w/ choke suspects? |
|
Definition
-barium
-if suspect rupture, use iodine |
|
|
Term
| What are the CS of esophageal rupture? |
|
Definition
-inflammation of cervical area
-crepitation
-air contrast in surrounding tissue on rads
-U/S
-fever, inflamm leukogram |
|
|
Term
|
Definition
-sedation: lower head & relax striated esophageal mm
-nasogastric intubation: DO NOT FORCE
-local aneshtetic
-gentle warm water or isotonic saline lavage
-oxytocin: proximal
-Buscopan |
|
|
Term
| Which agents are CI w/ choke? |
|
Definition
|
|
Term
| What do we do if initial choke tx is unsuccessful? |
|
Definition
=NPO
-start IV fluids
-abx
-wait 8h & repeat initial course |
|
|
Term
| How do we treat chronic esophageal obstructions? |
|
Definition
-fluids: replace electrolytes (frequently met alkalosis)
-abx
-anti-inflamm
-sedation/lavage |
|
|
Term
| What tx is our last resort for esophageal choke? |
|
Definition
|
|
Term
|
Definition
-anti-inflamm: Flunixin
-water & electrolytes for 24-48h
-solf feed initially |
|
|
Term
| What are some complications seen with choke? |
|
Definition
-reobstruction early post feeding
-aspiration pneumonia
-pleuropneumonia
-pulmonary abscess: less common but guarded prognosis
-perforation/rupture
-granulation tissue
-stricture
-divertiuclum |
|
|
Term
| How do we treat aspiration pneumonia? |
|
Definition
-abx: BS IV
-anti-inflamm: Flunixin |
|
|
Term
| Are circumferential or longitudinal strictures secondary to choke more manageable? HOw is it treated? |
|
Definition
-longitudinal
-tx = sx, soft feed, bouginage if used early |
|
|
Term
| How do we diagnose esophageal strictures & diverticula as complications of choke? |
|
Definition
|
|
Term
| How do we treat esophageal diverticula secondary to choke? |
|
Definition
-dietary management
-sx correction |
|
|
Term
| What is a pulsion diverticulum? |
|
Definition
-forms proximal to a stricture
-injruy or defect in muscular layer of esophagus |
|
|
Term
| What is a traction diverticulum? |
|
Definition
-follows esophageal injury due to scarring
-distortion of all layers of esophageal wall |
|
|
Term
| What is aftercare of choke? |
|
Definition
-w/ mucosal erosion: soft diet for 2-4w
try grass/wet hay first
-returning to solid dry feed too quickly will cause reoccurrences |
|
|
Term
|
Definition
-feed separately or place bricks in feeding bucket
-routing dental care
-do not feed dehydrated horses
-do not feed sedated horses |
|
|
Term
| What are the three main congenital disorders of the equine esophagus? |
|
Definition
-Ectasia: loss of myenteric plexus ganglion = muscle degen
-PRRA
-esophageal cysts |
|
|
Term
|
Definition
| -complication of gastroduodenal ulceration & subsequent refux |
|
|
Term
| How do we treat esophagitis? |
|
Definition
-frequent small meals
-omeprazole
-Bethanechol
-Metoclopramide |
|
|
