5.Examination of the Alimentary System of the Horse Flashcards Preview

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1
Q

What is important to check when doing the history?

A
  • Appetite
  • Water intake
  • Prehension
  • Mastication
  • Swallowing
  • Defecation
  • Pain (colic)
2
Q

How is the body scoring system?

A
  • Scale 1-9 most widely accepted
  • Based on visual inspection and palpation of certain regions
  • Positively related to body fat percentage
  • No correlation to body weight
  • Modified scale for foals (1-5)
3
Q

What do you examine in the oral cavity?

A
  • Odour
  • Mucous membranes
  • Saliva
  • Teeth
  • Tongue
4
Q

Which salivary glands do you examine?

A
  • Parotid gland
  • Mandibular gland
  • Sublingual gland
  • Buccal gland
5
Q

How do you examine the Pharynx:

A

External examination:
• Inspection
• Palpation

Internal examination:
• Palpation
• Endoscopy
• Nasogastric tubing
• Watering and feeding test
6
Q

How do you examine the Esophagus?

A
  • Inspection
  • Palpation
  • Nasogastric Tubing
  • Watering and Feeding test
  • Endoscopy
  • X-ray (contrast)
  • Ultrasound
7
Q

What are the regions of the abdomen?

A
  • Epigastric region
  • Mesogastric region
  • Hypogastric region
8
Q

What are the specific examination methods of the abdomen?

A
  • Rectal palpation
  • Nasogastric intubation
  • Abdominocentesis
  • Endoscopy
  • Radiography
  • Ultrasonography
  • Laparoscopy
  • Laparotomy
  • CT (foals)
9
Q

Explain the inspection and palpation of the abdomen:

A

Inspection:
• From behind, the side, the front, below
• Shape, contour, volume, movements

Palpation:
• Temperature, thickness, tenseness, sensitivity, pain, swellings

10
Q

Explain the auscultation of the abdomen:

A

Aim: detecting normal and abnormal sounds
• Gurgling, murmuring, rumbling sounds
• Tinkling, splashing sounds
• Increased borborygmi: early stages of enteritis
• Reduced or absent sounds: atony, impaction, obstruction, shock, poor perfusion, high sympathetic tone
• At least 3 areas on each side
• 1 minute at 1 area

11
Q

Explain the percussion of the abdomen:

A

Historically important part of colic work-up
• Provides information regarding gas distention of caecum and large colon
• Usefullness is limited due to size of the abdomen
• More sensitive and specific diagnostic methods are available

12
Q

What are the normal finding on the left side of the abdomen?

A

Leftside:
• Dorsal third: dulled tympanic
• Medium third: dulled tympanic
• Ventral third: dulled

13
Q

What are the normal finding on the right side of the abdomen?

A

Right side:
• Dorsal third: tympanic
• Medium third: dulled tympanic
• Ventral third: dulled

14
Q

What are the parameteres you check for the gastric content?

A

Gastriccontent: quantity, quality, colour, smell, pH, components, foreign materials

15
Q

Examination of the Liver:

A

Location: deep in the diaphragmatic dome, asymmetrically.

• Physical examination is impossible

16
Q

Ancillary diagnostic methods of the liver examination:

A
  • Ultrasonography
  • Biopsy
  • Clinicopathological examination
17
Q

What are the Clinicopathological examination methods of the liver?

A
o Serum levels of hepatic enzymes
o Bile salts
o Ammonia
o Glucose
o Bilirubin
o Clotting factors 
o Plasma proteins
18
Q

Examination of the Pancreas

A
  • Location: behind the stomach and the liver, in the dorsal part of the r. epigastrica, above the duodenum
  • Physical examination is impossible
  • Not imageable with ultrasound
  • Difficult to see during laparotomy

Laboratory diagnostic methods:

  • Serum amylase and lipase activity,
  • Peritoneal fluid amylase activity (notspecific)
19
Q

Rectal Palpation

A

-Only 40% of the abdomen is palpable

Preparation: restraint, spasmolytics, sedation
Inspection: perianal area, anus

Introducing the hand: long sleeved plastic glove, lubricant, cone-shaped hand, gentle gliding, drilling movement

20
Q

What can you palpate with rectal palpation?

A
  • Mucous membrane
  • Rectum
  • Bony pelvis
  • Internal inguinal rings
  • Prostate
  • Vagina, uterus, ovaries
  • Urinary bladder
  • Small colon
  • Abdominal aorta
  • Cranial root of mesentery
  • Left kidney
  • Spleen
  • Nephrosplenic ligament
  • Nephrosplenic space
  • Peritoneum
  • Left ventral and dorsal colon
  • Pelvic flexure
  • Ampulla of the colon
  • Head of the caecum
  • Ventral/medial taenia of the caecum
  • (Small intestines)
21
Q

Abdominocentesis: What can you evaluate and how could the sample look?

A
Evaluation of numerous pathological conditions
– Peritonitis
– Abdominal neoplasia
– Abscesses
– Strangulating obstructions
– Uroperitoneum
– GI rupture
Sample:
• Transsudate
• Modified transsudate 
• Exsudate
• Blood
• Urine
22
Q

what are the indications of abdominal ultrasound?

A
Indications
• Colic
• Weight loss, anorexia
• Pyrexia
• Leucocytosis, leucopenia
• Elevated plasma fibrinogen
• Abnormal X-ray findings
• Elevated liver enzymes
• Elevated kidney values
• Abnormal peritoneal fluid
23
Q

What do you see on the ultrasound of the stomach?

A
  • Left side 10th-15th ICS
  • Medial to the hylus of the spleen
  • Content
  • Wall thickness
  • Size
24
Q

What do you see on the ultrasound of the small intestine?

A
  • Duodenum

* Jejunum, ileum

25
Q

What do you see on the ultrasound of the caecum?

A
  • Right paralumbar fossa adjacent to the right kidney and descending duodenum
  • Wall thickness
  • Content
26
Q

What do you see on the ultrasound of the large intestine?

A
  • Wall thickness
  • Content ( gas vs. fluid)
  • Displacements
27
Q

What are some of the conditions that we could look for on an ultrasound of the peritoneum?

A
  • Septic peritonitis
  • Abdominal neoplasia
  • Hemoperitoneum
  • Uroperitoneum
28
Q

Why do we do radiography of abdomen?

A
  • Check NG tube placement in neonatal foals
  • Diagnose certain diseases in neonates
  • Detect sand in the ventral colon
  • Detect enteroliths