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Respiratory Pathophysiology > Clinical Evaluation of the Respiratory System > Flashcards

Clinical Evaluation of the Respiratory System Flashcards

1
Q

true/false: tachypnea is a sensitive indicator if hypercapnia or hypoxia

A

true

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2
Q

how much of a reduction of Hb/100ml does cyanosis indicate?

A

> 5g- severe hypoxia

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3
Q

what are the terms stertor and stridor used for?

A

audible abnormal breath sounds without a stethoscope
upper airway

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4
Q

what does hemoptysis usually indicate?

A

bleeding from lungs or airways

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5
Q

what is a tension pneumothorax?

A

when breathing, the patient pulls air in through a laceration and then the breathing out keeps it in

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6
Q

what does percussing the sinuses in large animals allow you to assess?

A

potential fluid or tumor tissue accumulation

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7
Q

how does consolidation of the lung parenchyma affect how you hear lung sounds?

A

more consolidation makes it louder

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8
Q

true/false: anything in the pleural space dampens lung sounds

A

true

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9
Q

what causes crackles?

A

explosive reopening of lung areas (previously collapsed)
also excess secretions in airways or rupture of fluid films

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10
Q

what causes wheezes?

A

constricted airway walls or intraluminal airway masses

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11
Q

what are pleural friction rubs?

A

sliding inflamed pleural surfaces during inspiration and expiration

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12
Q

what are the normal lung field parameters for horses?

A

tuber coxae: 17th space
tuber ischii: 16th space
mid-thorax: 13th space
shoulder: 11th space
olecranon: 6th space

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13
Q

what are the normal lung field parameters for bovine?

A

tuber coxae: 11th space
mid-thorax: 9th space
olecranon: 5th space

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14
Q

what are the normal lung field parameters for ovine?

A

tuber coxae: 11th space
mid-thorax: 8th space
olecranon: 5th space

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15
Q

what is transtracheal aspiration?

A

sterile saline is introduced via tracheal puncture and a variable amount is aspirated back

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16
Q

what is bronchoalveolar lavage?

A

a distal area is flushed with saline and sampled

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17
Q

what are the normal constituents of a transtracheal aspiration or bronchoalveolar lavage?

A

mucus, columnar epithelial cells, macrophages, and rare neutrophils

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18
Q

what can be used to evaluate how a disease impacts the respiratory system of a patient?

A

arterial blood gases
pulmonary function testing

19
Q

what would you expect in a transtracheal aspiration or bronchoalveolar lavage from a patient with an allergic reaction or parasitic infection?

A

macrophages
neutrophils

20
Q

what would you expect in a transtracheal aspiration or bronchoalveolar lavage with mucopurulent inflammation?

A

abundant neutrophils
increased mucus
bacteria

21
Q

what are some important things to distinguish when taking a history for a respiratory complaint?

A

environment and use (athlete or not)
contact with other animals- healthy or not
recent travel
previous and concurrent illness
presenting complaint

22
Q

what are some potential adverse effects of coughing?

A

removal mucous layer and less effective mucociliary transport
dissemination of infection
emphysema
pneumothorax
exhaustion

23
Q

what does rapid shallow respiration suggest?

A

restrictive disease or pain

24
Q

what does accentuated expiratory effort suggest?

A

obstructive disease

25
Q

what should you check before auscultation in a large animal with respiratory signs?

A

examine upper respiratory tract: conformation, symmetry, mucous membranes, +/- discharge
percuss sinuses
palpate trachea and larynx
intermandibular and retropharyngeal lymph nodes

26
Q

when you percuss the sinuses of a large animal, what are you checking for?

A

fluid or tumor tissue accumulation

27
Q

where are bronchial sounds generated and heard?

A

airways and when you auscultate over these airways

28
Q

true/false: fluid in the lung or pleural space will make lung sounds louder

A

false: only louder when consolidated lung
muffled with fluid OR AIR in pleural space

29
Q

when are inspiratory sounds heard more loudly and when are expiratory sounds heard more loudly?

A

inspiratory: extrathoracic airway obstruction
expiratory: constriction of intrathoracic airways

30
Q

what can be delineated by percussion?

A

lungs just beneath chest wall
large intrathoracic masses
pleural effusion

31
Q

what is the greatest advantage of ultrasound in the respiratory system?

A

evaluation of pleural space and peripheral masses in lung parenchyma
pleural fluid accumulation and pleural adhesions can be evaluated

32
Q

how are nuclear imaging or lung scans made?

A

gamma emitting isotopes to assess regional ventilation and perfusion

33
Q

what is used in rhinoscopy?

A

arthroscope in small animals

34
Q

can you do quantitative sample analysis for protein or cell numbers using fluid from bronchoalveolar lavage or transtracheal aspiration?

A

no- flush fluid in and get some back

35
Q

what are some complications of an indwelling chest tube?

A

sepsis
pneumothorax

36
Q

should a diagnostic post mortem be performed on an animal that died previously or one you euthanized?

A

one you euthanized- do not want post mortem necrosis

37
Q

how can a lung biopsy be obtained?

A

percutaneously
bronchoscope
surgical thoracotomy

38
Q

what kinds of diagnostics and procedures can be done from a post mortem?

A

bacterial culture
virus isolation
parasite identification and counts
morphologic identification

39
Q

what anticoagulants are acceptable for blood gas samples?

A

heparin

40
Q

what is the difference between bronchial sounds and vesicular sounds?

A

bronchial sounds generated in airways and heard when auscult over these
vesicular sounds are generated in the large airways but heard over periphery: attenuated during transmission through aerated parenchyma

41
Q

what does bronchoscopy allow us to assess in small animals?

A

airway lesions
foreign bodies
mucosal edema
mucous plugs
dynamic airway changes
collect samples

42
Q

what is the downside of bronchoalveolar lavage in large animals?

A

requires short term light anesthesia
may induce hypoxemia
sample analysis is not quantitative

43
Q

is a lung biopsy more useful for diffuse disease or focal/multifocal disease?

A

diffuse: could miss it with focal/multifocal

Respiratory Pathophysiology (22 decks)

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