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Small Animal ECC > 3 selected respiratory emergencies > Flashcards

3 selected respiratory emergencies Flashcards

1
Q

upper and lower airway emergencies occur in which anatomic areas?

A
  • nose
  • esophagus
  • larynx
  • trachea
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2
Q

what respiratory issues might originate in the nose?

A
  • stenotic nares
    parat of brachycephalic obstructive airway syndromme
    contributes to heat stress
  • epistaxis can cause respiratory distress due to aspirated blood clots
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3
Q

common esophageal issue leading to respiratory issues?

A
  • esophageal mass or foreign body impinging on trachea
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4
Q

common issues of larynx?

A

paralysis
trauma
neoplasia

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5
Q

how do laryngeal issues alter breathing?

A

inspiratory dynspea

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6
Q

treatments for laryngeal issues?

A

sedation
oxygen
maybe corticosteroids

surgery

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7
Q

what surgical options for larynx problem?

A
  • temporary tracheostomy

- laryngoplasty [for paralysis]

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8
Q

common tracheal issues?

A

traumatic

obstructive lesions

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9
Q

How to Dx, Tx and repair tracheal tear:

A

Dx: sub Q emphyseam, pneumomediastinum, tracheoscopy or cervical/thoracic radiographs

tx: conservative - cage rest and rarely tube tracheostomy
sx: no advantage over conservative tx; sometimes resection and anastomosis

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10
Q

where is tracheal obstruction if patient has inspiratory distress?

A

extrathoracic

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11
Q

where is tracheal obstruction if patient has expiratory distress?

A

intrathoracis

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12
Q

Emergency Tx of tracheal obstruction?

A
  • initial:sedation, o2, corticosteroids maybe
  • sx: tube tracheostomy (cd to obstruction)
    foreign body removal
    rings/stents for tracheal collapse
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13
Q

what are anatomic regions of intrathoracic emergencies?

A

pleural space
mediastinum
lungs

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14
Q

how to dx pleural space emergencies?

what test should you be cautious with?

A
  • observe
  • auscult
  • percuss
  • thoracocentesis
  • thoracic radiography - be cautious with this b/c stretching arms up makes it harder to breathe
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15
Q

during percussion, what does hyporesonance suggest?

and hyperresonance?

A

hypo: fluid, solid organs
hyper: air, gas filled

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16
Q

pleural space emergencies:

A

pleural effusions
pneumothorax
diaphragmatic hernia

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17
Q

what are some causes of pleural effusions:

A
  • hydrothorax
  • hemothorax
  • pyothroax
  • chylothorax
  • serous pleuritis
  • neoplastic effusion
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18
Q

pleural effusion Tx:

A
  • thoracocentesis

- thoracostomy tube in intractable

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19
Q

what is the difference btwn typical and tension pneumothorax?

A

typical: some o2 escapes hole into thorax upon inhalation and some comes back in upon exhalation
tension: a flap of tissue covers hole - so air cannot escape and continues to accumulate

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20
Q

T/F: the medistinum of dog / cat is impermeable.

what are implications related to pneumothorax?

A

false

it is permeable - so both bilateral and unilateral pneumothorax are possible.

21
Q

mediastinal emergencies:

A
  • pneumomediastinum
  • septic mediastinitis
  • hemomediastinum
22
Q

what occurs during pneumomediastinum?

A

disruption of trachea, bronchi, esophagus or central portion of lungs

23
Q

what is common cause of septic mediastinitis?

prognosis?

A

esophageal perforation

high mortality rate - poor prognosis

24
Q

what is common cause of hemomediastinum?

A
  • traumatic vessel disruption
25
Q

Tx of pneumomediastinum?

A
  • address underlying cause
  • or monitor and benign neglect
  • could progress to pneumothorax
26
Q

pulmonary emergencies

A 
pulm edema
pneumonia
pneumonitis
pulm contusion
pulm thromboembolism
end airway dz
lung lobe torsion
27
Q

definition of pulmonary edema?

A

accumulation of fluid in pulmonary interstitum and alveoli

28
Q

what 3 things does pulmonary edema impair?

A
  • pulm compliance
  • vital capacity
  • pulm gas exchange
29
Q

why is pulm edema an emergency?

A

b/c of hypoxia

30
Q

what are 2 general causes of pulm edema?

A
  • inc pulm capillary pressure [cardiogenic]

- inc pulm capillary permeability

31
Q

what are some specific causes of pulm edema?

A
  • hypo proteinemia (along with other factors)
  • high altitude
  • thromboelbolism
  • neurogenic
  • acute respiratory distress syndrome
32
Q

pulm edema tx?

A

tx underlying cause

o2
diuretic
bronchodilators
ventilation therapy [PEEP, CPAP]

33
Q

Tx pneumonia?

A
  • supportive tx (like pulm edema)
  • abx (try to culture from transtracheal wash or bronchoalveolar lavage)
  • nebulizaiton
  • coupage
34
Q

what is pneumonia vs pneumonitis?

which has better prognosis?

A

pneumonia: inflammation of lungs due to infectious cause [bacT, fungal, viral]
pneumonitis: noninfectious inflammation of the lungs [aspiration of gastric contents]

pneumonitis has better prognosis

35
Q

pulmonary contusion definition?

A
  • traumatic injury resulting in hemorrhage and edema in lung parenchyma
  • most resolve but some cause death
36
Q

pulm contusion tx:

A
  • symptomatic
  • o2
  • resrt
  • avoid fluid overload
  • diuretic if fluid overload suspected
  • ventilatory support if not responsive to o2 therapy
  • abx NOT indicated [only if 2* pneumonia develops]
37
Q

pulm thromboembolism dx?

A

Dx by exclusion

rare to Dx antemortem

38
Q

pulm thromboembolism tx:

A
  • symptomatic
  • anticoaguulant (heparin or coumadin)
  • thrombolytics [rare b/c high risk and low benefit]
39
Q

end airway dz common in cats:

dog:

A

allergic bronchitis - more likely
feline asthma

dogs: infectious bronchitis

40
Q

signs and Tx of feline asthma (allergic bronchitis)?

A
  • paroxysmal cough, wheezing, respiratory distress, cyanosis
  • bronchodilator
  • corticosteroids
  • o2
41
Q

infectious bronchitis etiology?

Tx?

A
  • assoc w viral infection, allergic bronchitis, aspiration
  • Tx NOT emergency usually:
    bronchodilation, nebulization, abx
42
Q

lung lobe torsion: common presentation?

emergency Tx?

A

pleural effusion - may need emergency action

Tx: thoracocentesis or thoracostomy tube

43
Q

should you untwist a torsed lung lobe? why or why not?

A

NO - it will release inflammatory mediators -> may cause SIRS

44
Q

thoracic wall emergencies:

A
  • rib fractures
  • flail chest
  • thoracic wall perforation
45
Q

presentation of rib fractures:

prognosis typically?
emergency tx?

A
  • not typically life threatening
  • can cause pneumothorax, pulm contusion, myocardial injury
  • hypoventilation due to pain
  • tx: intercostal nerve block
    avoid bandage b/c restrictive
46
Q

what is flail chest?

A
  • segment of thoracic wall w multiple ribs fractured dorsally and ventrally causing paradoxical motion
  • segment moves in during inspiration and out during expiration
  • resp distress due to underlying pulm injury - not flail chest itself
47
Q

flail chest Tx:

A
  • supportive - similar to pulm contusion

- intercostal nerve blocks

48
Q

flail chest: surgical Tx

A

external splint

rarely necessary

49
Q

under what circumstances can a thoracic wall perforation be fatal?

what is emergency tx?

A

if perforates mediastinum

  • early closure of defect, thoracostomy tube

Small Animal ECC (5 decks)

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