cardioresp exam Flashcards
what are you looking at from a distance fro a cardioresp exam on the horse?
From a distance - Observation of respiratory effort
* stance (pleural disease)
* coughing
what are yuo assessing regarding the nostrils, LN and paranasal sinuses durign a cardioresp exam of the horse?
Nostrils:
* Discharge
◦ Unilateral or bilateral
◦ Character
◦ Odor
* Excessive dilation
◦ Poor lung function
◦ Respiratory distress
◦ Pain
* Check for normal airflow
◦ Unilateral
‣ Obstruction
Lymph nodes:
palpate:
* size
* heat
* pain
* discharge
Only submandibular lymph nodes are palpable
Many other lymph nodes of the head that are difficult to differentiate from salivary glands
May discharge when infected
Paranasal sinuses:
* percussion of the sinuses
what are you thinking about during asucultation of the cardioresp system in horses?
Is there air moving throughout the entire lung field?
* Areas of dullness suggesting pleural effusion or pulmonary consolidation/abscessation/masses
Are there any abnormal sounds?
* Large airway sounds suggesting consolidation
* Wheezes and crackles suggesting airway narrowing, or discharges in airways
Does the horse tolerate and recover from re-breathing rapidly?
* Coughing, distress suggesting pleural pain
Is there a tracheal rattle?
* Suggesting discharge pooling at the thoracic inlet
how does an equine rebreathing bag exam work?
Rebreathing bag:
* Large garbage bag
* Rebreath air: build up CO2
* Drive respiratory centers
* Deeper, more rapid breaths
* Rebreath until animal starts to become distressed
* CONTINUE to LISTEN!
listening for adventitious lung sounds
what does a murmur vs an an arrhythmia mean in a horse?
◦ Murmur - endocardial
◦ Arrhythmia – myocardial
what does jugular distenion in the horse indicate?
- right sided cardiac faiulre
- throacic disease
- pericardial disease
what does peripheral odaema in the horse suggest?
◦ Right sided heart failure (chronic endocardial disease
◦ Hypoproteineamia
◦ Vascular disease
what are the causes of left sided heart failure and pulmonary oedema in the horse?
◦ Ruptured chordae tendonae
◦ Bacterial endocarditis
◦ Congenital cardiac disease
how do you auscltate a horse? what are you listening to at each area?
START ON LEFT
* Listen just behind triceps
◦ Halfway between elbow and shoulder
‣ LIC 5 – MITRAL VALVE
◦ Under triceps
‣ LIC 4 – AORTIC (and pulmonic valve)
◦ LISTEN ON RIGHT – UNDER TRICEPS – MOVE LEG FORWARD
what causes each of the heart sounds?
S4 (shh)
* Onset of atrial systole - Audible in 60% of TB
S1 (Lub)
* Onset of ventricular systole
* Closure of AV valves opening of Semilunar valves
* Loudest over LIC 5
S2 (Dub)
* Onset of diastole
* Closure of semilunar valves, open AV
* Loudest over LIC 4
S3 (de)
* Rapid ventricular filling
* Loudest over cardiac apex (low LIC5) - 40% OF TBS
what are the two types of encocardial disease inthe horse?
- Endocardiosis
◦ Valvular degeneration – progressive
‣ Mitral, aortic, tricuspid valves - Endocarditis
◦ Bacterial in origin secondary to bacteraemia
what are the causes of bacterial endocarditis inthe horse? what are the clinical signs? how is it diagnosed?
Dental, respiratory, thrombophlebitis
‣ Other causes
* Valve dysplasia
* Valvulitis
* Valve prolapse
* Ruptured chordae tendinae
Clinical signs:
* Acute onset Congestive heart failure
* Fever, cardiac murmur, tachycardia, tachypnoea
Laboratory data
* Hyperfibrinogenaemia, anaemia and leucocytosis
* Blood culture
◦ Repeat x3 (false negatives) ideally when pyrexic
◦ Sterile procedure (do not use indwelling catheter)
Echocardiography - valves and chamber enlargment
what is the treatment and prognosis of bacterial endocarditis inthe horse?
Treatment - Broad spectrum antibiotics based on sensitivity
Prognosis
* Guarded even after bacteriological cure
◦ Permanent structural damage to valve
◦ Right-sided lesions may have return of performance
* Septic emboli may shed to distant sites
◦ Lungs (right heart)
◦ Kidneys / Joints etc (left heart)
