Symptoms & Management of Jaw Disorders, Parotitis, Achalasia, GERD, Hiatal Hernia, Slides of Pediatrics

Download Symptoms & Management of Jaw Disorders, Parotitis, Achalasia, GERD, Hiatal Hernia and more Slides Pediatrics in PDF only on Docsity! Disorders of the Jaw • Abnormal conditions affecting the mandible (Jaw)& the tempomandibular joint include congenital malformation, fractures , chronic dislocation , cancer , & syndrome ch.ch pain & limited motion • Tempomandibular Disorders Are a group of conditions that cause pain &\or dysfunction of the tempomandibular joint &/or the muscle of mastication, as well as contiguous tissue components Docsity.com Disorders of the Jaw • Clinical Manifestations 1. Pain (from dull to throbbing ) 2. Debilitating pain radiated to the ears, teeth, neck muscle & facial sinuses 3. Restricted jaw motion & clicking 4. Difficulty chewing & swallowing 5. Depression may accompany Docsity.com Parotitis • Medical Management 1. Preventive Measures (dental care, oral hygiene, adequate fluid& nutrition ,& D/C of medication that may diminished salivary secretion) 2. Antibiotics for infection 3. Analgesic for pain 4. Drainage of gland 5. Parotidectomy Docsity.com Impaired Esophageal Motility Achalasia • Achalasia: characterized by impaired peristalsis of smooth muscle of esophagus and impaired relaxation of lower esophageal sphincter • Manifestations: 1. Dysphagia 2. chest pain (pyrosis) 3. Sensation of food stick in lower esophagus 4. Food regurgitation Docsity.com Achalasia Treatment 1. Eat slowly &drink fluids with meals 2. Calcium channel blockers 3. Endoscopically guided injection of botulinum toxin 4. Balloon dilation of lower esophageal sphincter or pneumatic dilation 5. Esophageal myotomy (abdominal or thoracic approach Docsity.com Gastroesophageal Reflux Disease (GERD) Manifestations 1. Heartburn after meals, while bending over, or recumbent 2. Dyspepsia or indigestion 3. May have regurgitation of sour materials in mouth, pain with swallowing 4. Atypical chest pain 5. Sore throat with hoarseness Docsity.com Gastroesophageal Reflux Disease (GERD) 6. Diagnostic Tests • a. Barium swallow (evaluation of esophagus, stomach, small intestine) • b. Upper endoscopy: direct visualization; biopsies may be done • c. 24-hour ambulatory pH monitoring Docsity.com Gastroesophageal Reflux Disease (GERD) 7. Medications • a. Antacids for mild to moderate symptoms, e.g. Maalox, Mylanta, Gaviscon • b. H2-receptor blockers: decrease acid production; given BID or more often, e.g. cimetidine, ranitidine, famotidine, nizatidine • c. Proton-pump inhibitors: reduce gastric secretions, promote healing of esophageal erosion and relieve symptoms, e.g. omeprazole (prilosec); lansoprazole • d. Promotility agent: enhances esophageal clearance and gastric emptying Docsity.com Hiatal Hernia 1. Definition • Part of stomach protrudes through the esophageal hiatus of the diaphragm into thoracic cavity • Types 1. Sliding hiatal herni 2. Paraesophageal hiatal hernia: ( hernia can become strangulated; client may develop gastritis with bleeding) Docsity.com Hiatal Hernia • Manifestations: Similar to GERD • Diagnostic Tests 1. a. Barium swallow 2. b. Upper endoscopy • Treatment 1. Similar to GERD: diet and lifestyle changes, medications 2. If medical treatment is not effective or hernia becomes incarcerated, then surgery; usually 3. Fundoplication by thoracic or abdominal approach Docsity.com Diverticulum • It is an outpouching of mucosa& submucosa that protrudes through a weak portion of the musculature • Clinical Manifestations 1. Difficulty of swallowing & neck fullness 2. Belching 3. Regurgitation of undigested food 4. Gargling noise after eating 5. Halitosis & sour taste in the mouth 6. May dysphagia & chest pain Docsity.com