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THRALL - Thom > 29. Larynx and trachea > Flashcards

29. Larynx and trachea Flashcards

1
Q

LABEL THE CARTILAGES!

How many layrngeal cartilages are there?

What is the mnemonic for hyoid bones?

A

8!

  • Epiglottis, arytenoid x2, thyroid, cricoid, interarytenoid, sesamoid
  • “SOME ELEPHANTS CAN BE TREATED”
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2
Q

What structures divide the different pharyngeal components?

A
  • Soft palate: seperates oro/naso
  • Palatopharyngeal arches: Band extending caudodorsal from soft palate, separates naso/layrngo
  • Epiglottis: Seperates oro/layrngo
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3
Q

Where is the piriform recess?

A

Cauddorsal aspect of layrngopharynx

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4
Q

Name the processes of the arytenoid cartilages. How many are there?

A

4!

Cuneform: Most rostral, may be visualised rx in large dogs

Corniculate

Muscular

Vocal

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5
Q

Which layrngeal cartilage is typicall most visualised when mineralisaed?

A

Cricoid

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6
Q

What are the most common tumours of the canine pharynx and layrnx?

What are the most common tumours of the feline layrngopharynx?

A

Dog:

Larynx: epithelial tumours and rhabdomyoma/sarcoma MOST COMMON -> also MCT, sarcomas, oncocytomas, plasma cell, melanoma

Pharynx: SCC (particularly tonsillar)

Cats: Lymphoma and SCC

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7
Q

DDX PHARYNGOLARYNGEAL MASS BOX

A
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8
Q

Which bone of the hyoid has a specific neoplastic syndrome associated with it?

A

Basihyoid - site of ectopic thyroid carcinoma -> strongly vascularised, heterogeneous masses with mineralised foci

=> result in severe lysis of basihyoid and infiltration of laryngeal wall

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9
Q

What % of acute oropharyngeal stick injuries develop emphysema?

A

83%

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10
Q

What is a significant consideration when hyoid fracture is observed?

A
  • Potentially open to respiratory tract -> may be contaminated
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11
Q

What radiographic features are used to characterise soft palate thickening and elongation in BOAS?

A
  • Extension of the soft palate caudal to tip of epiglottis
  • Narrowing of oropharyngeal / nasopharyngeal diameters
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12
Q

Why is layrngeal collapse infrequently documented radiographically?

A

Occure in laterolateral direction. May be seen if severe

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13
Q

Which breed has a specific upper airway obstructive syndrome described?

A

NORWICH TERRIERS

  • Supra-arytenoid swelling and laryngeal narrowing often at ventral region of thyroid cartilage
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14
Q

Features of epiglottic retroversion

A
  • RARE - excessive epiglottic mobility, with caudal retroflexion into rima glottidis
  • 80% SECONDARY TO OTHER CONDITIONS: BOAS, tracheal collapse, LarPar, epiglottic fracture, malacia, peripheral neuropathy
  • Rx: More vertically positioned epiglottis, extending dorsally to dorsal wall of layrngopharynx.
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15
Q

Features of pharyngeal collapse

A
  • Complete / partial dorsal displacement of soft palate OR ventral displacement of dorsal pharyngeal wall
  • Fluro useful as often dynamic
  • Often other resp conditions e.g. trach/bronch collapse, BOAS
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16
Q

Features of nasopharyngeal stenosis

A
  • Uncommon, typically cats
  • Commonly thought to be ACQUIRED: infection/inflam, sx
  • HOWEVER Congenital type in Dachsunds -> Palatopharyngeal dysgensis leading to thickening of muscles, seperates/obliterates nasopharynx
17
Q

Tracheal deviation BOX

A

Also, remember TO THE LEFT with Persisitent right 4th aortic arch

18
Q

List DDx for tracheal tumours - benign and malignant

A

Tracheal masses normally neoplastic!

  • Benign (dogs):

Osteochondroma (normally young dogs}

Chondroma

Leiomyoma

Malig :

  • Round cell: Lymphoma, Histiocytic, plasmacytoma
  • Sarcoma: FSA, CSA,
  • Carcinoma: ADC, SCC
19
Q

Which parasites are associated with tracheal granuloma formation?

A

Oslerus osleri:

  • DOG
  • Mass near carina

Cuterebra:

  • CAT
20
Q

Rx features of tracheal rupture

A
  • Pneumomediastinum, emphysema,
  • Less commonly: intratracheal fluid, mural haematoma, stenosis

=> SITE OF RUPTURE MAY BE HARD TO DETECT

21
Q

Features of tracheal avulsion

A
  • Often blunt trauma with head extended
  • May present 1-3 weeks post, with resolution of mediastinal / ST gas

=> Rx: circumferential tracheal discontinuity 1-4cm cranial to carina, and PSEUDOAIRWAY -> dilation of lumen with thin margin

NB: Bronchial avulsion also reported

22
Q

What % of BOAS dogs have trachceal hypoplasia?

A

39%

In 10% dogs, incidental finding

23
Q

Describe the reported tracheal:thoracic inlet ratios published for different dog breeds (and also cats)

A

Non-brachys: 20%

Non-bulldog brachys +- BOAS signs: 16%

Bulldogs: 13%

=> Smalles ration in asymptomatic bulldogs was 9%

On CT:

26% reported in asympt / grade 1 english bulldogs

CATS: DSH 18%, persians 20%

24
Q

Which ratios have been desribed for evaluating tracheal diameter?

A

Trachea: thoracic inlet (see other q)

Trachea: cricoid -> smaller in brachys

25
Q

Describe how tracheal collapse tends to be vary with resp cycle

A
  • Intrathoracic collapse -> more pronounced on EXPIRATION
  • Extrathoracic collapse -> More pronounced on INSPIRATION
26
Q

What rx features may seen with chondromalacia

A
  • Collapse
  • Undulating appearance of tracheal wall
  • Mild variation in luminal diameter
27
Q

How does agreement for tracheal collapse relate between modalities? What radiographic views are described?

A
  • Better agreement between fluro and scope cf XR and scope
  • Lateral (+- inspiratory, expiratory), Craniocaudal with dorsal extension of the head and neck

FLUORO BEST

  • Detects more, and more severe grade, particularly in thoracic region
28
Q

What % of animals with tracheal collapse are challenging to make cough?

A

26%

29
Q

In what situation is bronchial collapse most likely to be visualised? Which bronchi are most common?

A

Fluoro, with induction of cough

  • Right middle and left cranial on bronchoscopy
30
Q

What % reduction in tracheal diameter is considered likely normal?

A

25%

=> On CT: 24% change in cervical tracheal CS area and 19% variation in thoracic tracheal height seen in healthy dogs under forced inspiration

31
Q

Kinking of the thoracic trachea occurs has been reported in what % of dogs with complete airway obstruction (bronchomalacia)?

A

39%

Also, remember lung herniation (70%)

32
Q

What are the most commonly reported complications of trachceal stent placement?

A
  • Fracture
  • Migration
  • Exuberant granulation tissue
  • Subsequent collapse in unstented trachea
33
Q

What considerations are important if feline tracheal collapse suspected?

A

RARE!

  • Look for extracheal mass / upper airway obstruction
34
Q

What rx features may be seen with upper airway obstruction? Loads!

A
  • Pulm hyper / underinflation
  • Upper airway dilation / collapse
  • Caudal displacement of larynx/pharynx
  • Straightening of hyoid
  • Hiatal hernia
  • Aerophagia
  • Change in thoracic shape
  • Acquired pectus excavatum
  • Asp pneumonia
  • Pulm oedema
35
Q

What landmarks are evaluated by ultrasound in cases of LarPar?

A
  • Lateral motion of CUNIFORM process of arytenoids = consistent with normal abduction.
36
Q

What is the most common site of neoplasia in the oropharnx?

A

Tonsillar fossa -> Specifically SCC (may be bilateral)

37
Q

What two tumours have been associated with hyoid bone lysis?

A

Ectopic thyroid carcinoma and tonsillar SCC

38
Q

What size difference is reported in measurements for tracheal stents fluoro vs ct?

A

1mm bigger on CT -> greater accuracy, better interobserver

THRALL - Thom (40 decks)

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