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Equine final practical exam - Internal > 6. Examine the lower airway of the horse and summarise the findings. > Flashcards

6. Examine the lower airway of the horse and summarise the findings. Flashcards

1
Q

Strucutres/areas to examine the airways:

A
  1. Nose & paranasal sinuses
  2. Guttural pouches
  3. Cough
  4. Larynx
  5. Trachea
  6. Thorax
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2
Q

Steps to examine the thorax:

A
  1. inspection/Observation
  2. Palpation
  3. Auscultation
  4. Percussion
  5. Secondary diagnostic method
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3
Q

Name secondary diagnostic methods for examination of thorax:

A
  1. Endoscopy
  2. Radiology
  3. US
  4. CT
  5. Thoracocentesis
  6. Tracheal/Bronchoalveolar lavage
  7. Respiratory cytology
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4
Q

Inspection/Observations:

A
  1. Observe breathing pattern from both sides
  2. Contribution of rib cage
  3. Animals head position (feks: extended to promote air intake)
  4. Nasal flaring
  5. Respiratory rate
  6. Rythm
  7. Depth
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5
Q

Steps of auscultation:

A
  1. Examine both sides
  2. Start cranially, behind thorax
  3. Move 2-4 intercostal spaces caudally
  4. Start dorsally in each ICS, move ventral by 5-10 cm
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6
Q

What can increases inspiration sound indicate?

A

extrathoracic or large airway obstruction

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7
Q

What can increases exspiration sound indicate?

A

partial collapse of intrathoracic airways promoted by increased
alveolar pressure generation – characteristic of lower airway obstructive diseases (e.g.
equine heaves/recurrent airway obstruction)

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8
Q

Name abnormal sounds of thorax that is discontinuous:

A
  1. Crackles
  2. Pleural friction rubs
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9
Q

Name abnormal sounds of thorax that is continuous:

A

Wheezing

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10
Q

What can crackles indicate?

A
  1. Inflammation causing excessive secretions -> obstructing the airways
  2. Rupture of films or bubbles
  3. Opening of bronchoconstricted zones in case of airway obstruction disease
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11
Q

What can pleural friction rubs indicate?

A

sheering movements of pleural surfaces containing irregular inflamed, fibrinous or fibrous adhesions

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12
Q

What can wheezing indicate?

A
  1. Constricted airway walls
  2. Secretions which narrows the airway lumen
    3.
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13
Q

Why do we perform percussion of the thorax?

A

to isolate regions within pleural cavity or lung parenchyma where there is loss of air, due to
infiltration, effusion or space-occupying lesions

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14
Q

Which equipment do we use for percussion?

A

Hammer and pleximeter

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15
Q

Features of percussion sounds:

A
  1. Intensity: strong/sharp or weak
  2. Frequency: high or low
  3. Tone: resonant or dull
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16
Q

Normal findings of percussion of thorax:

A

Strong and sharp, low, resonant, (short)

17
Q

Normal lung borders:

A
  1. Deltoid tuberosity = 7th ICS
  2. Point of shoulder = 10th ICS
  3. Ischiadic tuber = 14th ICS
  4. Tuber coxae = 16th ICS
18
Q

What can decreased resonance indicate?

A
  1. Accumulation of fluid
  2. Consolidated lung
  3. Enlarged heart
  4. Large masses within the chest cavity (tumours)
19
Q

What can decreased resonance after a trauma indicate?

A
  • hemothorax
  • pulmonary contusion
  • diaphragmatic hernia
20
Q

What can increased resonance indicate?

A
  • pneumothorax
  • hyper-inflation
  • emphysema
21
Q

What can increased resonance after trauma indicate?

A

Most certainly pneumothorax

22
Q

What can we find and observe with endoscope?

A
  1. Direct inspection of trachea, bronchi (not parnechyma)
  2. Masses, oedema, constriction and secretion
  3. Biopsies can be taken
23
Q

When is X-ray indicated?

A
  1. abnormal auscultation
  2. dyspnea
  3. unexplained tachypnea,
  4. presence of lower airway secretions
  5. exercise intolerance
  6. external trauma
24
Q

Placement of the cassettes in case of an X-ray of the thorax:

A
  1. Leave air gap between patient and cassette
  2. 4 LL views:
    - Dorsocaudal
    - Ventrocaudal
    - Dorsocranial
    - ventrocranial
25
Q

indication of Ultrasound of thorax:

A

Abnormal radiography that doesn’t fully characterize the disease

26
Q

In which cases is ultrasound an optimal technique to investigate?

A
  1. atelectasis (collapse)
  2. diaphragmatic herniation
  3. lung consolidation (air is replaced with fluid)
  4. Pleural effusion (fluid btw pleura and the wall)
27
Q

What is thoracocentesis?

A

Sample of fluid, in case if pleural effusion, by sterile, percutaneous insertion of a cannula/needle or chest tube, since fibrin, mucopurulent exudate or clots can obstruct small needles

28
Q

Thoracentesis, what is the sample evaluated for:

A
  1. color
  2. viscosity
  3. specific gravity (high SG indicating modified transudate or exudates)
  4. protein
  5. blood
  6. total nucleated cell count
  7. pH
  8. lactate
  9. cell differential.
29
Q

High indication of sepsis in the thoracentesis sample:

A

Low pH
High lactate

30
Q

Indications for respiratory cytology:

A
  1. Inflammation
  2. Infection (bacteriology)
  3. Neoplasia
31
Q

Common problems/disease of lower respiratory tract:

A
  1. Tracheal collapse
  2. Pneumothorax
  3. Rib fracture
  4. Diaphragmatic hernia
  5. Pulmonary masses
  6. Airway obstruction

Equine final practical exam - Internal (11 decks)

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