Computer test - Respiratory system Flashcards
How is the induced cough in horse ?
Intensive, sharp, high, short, dry, painless, snapping, does not recur.
Which sound do you hear in case of pulmonary edema ?
non musical ronchi (crepitation and cracking)
What can be heard in the upper region in case of hydrothorax ?
Louder sound, forced loud breathing, increased dullness
What are the lung borders in horse ?
16-14-10
Tuber coxae/Tuber ischiadicum/Point of shoulder
F/T : Narrowing the upper airways occurs mostly in held expiration
False
5 percussion sound standpoints ?
- Volume/Loudness
- Pitch/Frequency
- Tone/Resonance
- Duration
- Special sounds
4 expired air standpoints ?
- Odour
- Strenght
- T°
- Symmetry
What clinical sign(s) is/are seen in case of pericardial effusion ?
Elevation of the caudo-ventral border of the dull sound : increase of cardiac dullness (enlargement)
Why do we use Valsalva probe ?
Rubbing of pleural surface → stop breathing → if rubbing disappears = pleuropericardial/pleuropleural
Thoracic normal percussion sounds
SA : sharp, high/low, sonorous (resonant), long
LA (>40 kg): sharp, low, (non-)sonorous, (non-)resonant, short
Noises heard upon pericardial effusion
Increase of cardiac dullness, crepitation/crackling
Where and what is the Diernhofer triangle ?
Enlarged cardiac dullness and behind it the Diernhofer triangle (air containing lung lobe between the diaphragm and the caudal border of the heart). Normal percussion sound in healthy animals, can be detected even in the case of cardiac enlargement.
At the cardiac area (triangle), normally filled with air
Respiratory sounds over abdomen are (F/T, only 1 true) :
- Higher in horse than dog
- Stronger in dog than horse
- Bronchial in dogs
- Bronchial in horse
- ‘h’ sound
True : Stronger in dog than horse
In which animal(s) is the percussion of the hemithorax absolute ?
Horse + dog
What is the caudal border of lungs in cattle ?
11/-/8
Tuber coxae/Tuber ischiadicum/Point of shoulder
Splashing sound characteristics
Sounds like water in a bottle
What to check on the nasal plane ?
- Moistness
- T°
- Colour
- Surface
- Symmetry
- Smell
Moistness, colour and surface
Where does the nasal discharge come out from, when it originates from the guttural pouch ?
- Bilateral nasal discharge
- Unilateral nasal
- Oral
Bilateral nasal discharge (behind the choanae)
What can be seen on inspection of the thorax ?
- T°
- RR
- Chest size
- Deformities
- Pain
RR, chest size, deformities
What is the percussion sound of the horse thorax ?
Sharp, low, sonorous, short
What can be heard in the upper region, in case of hydrothorax ?
Splashing sound
What sound is heard during pulmonary edema ?
Non-musical ronchi : crepitation and crackling
What are the lung borders in the horse ?
16/14/10
Tuber coxae/Tuber ischiadicum/Point of shoulder
Number of ribs in horse ?
18
Number of ribs in cattle ?
13
Nb of ribs in swine ?
14
Nb of ribs in carnivore ?
13
Lung borders in swine ?
11/9/7
Tuber coxae/Tuber ischiadicum/Point of shoulder
Lung borders in carnivore ?
11/10/8
Tuber coxae/Tuber ischiadicum/Point of shoulder
Indications for tracheobronchoscopy ?
Acute cough if an inhaled body is suspected
Chronic cough
Unexplained abnormal breathing pattern, lung infiltrate
Tracheal collapse
Chronic bronchitis (sampling)
Stridor
Removal of mucoid obstruction in atelectatic lung lobes
Order of the Respiratory tract examination ?
Nose & paranasal sinuses Coughing Larynx & Pharynx Trachea Thorax
Examination of the nose and paranasal sinuses ?
External/internal inspection, palpation, percussion, smelling
Extra exams : cytological, bacteriological, parasitic, mycologic exams of the nasal fluid, probing nasal passage, X rays, endoscopy (rhino/sinuso, tracheobroncho…), diagnostic punction biopsy, diagnostic rhinotomy, CT, MRI
Describe the following stridor sounds :
- Nasal stridor
- Pharyngeal
- Laryngeal
- Collapsed trachea
- Larynx paralysis
- Narrowed trachea, bronchus
- Nasal stridor : sniffing sound
- Pharyngeal : snoring
- Laryngeal : soft, sawing
- Collapsed trachea : EXPIRATORY tooting sound
- Larynx paralysis : INSPIRATORY
- Narrowed trachea, bronchu : mixed
Examination of nasal discharge
Continuity
Side
Quantity
Quality : consistency (watery, mucous, mucopurulent, purulent, haemorrhagic, foamy, containing food, foreign material…), colour, odor
Don’t forget to lower th head (dog, horse)
How to examine paranasal and frontal sinuses ?
Inspection, palpation, percussion (sharp, bony-like sound, NOT dull)
Endoscopy (horses)
Xrays
Diagnostic punction
What are the different sinuses ?
Maxillares Palatinus Frontalis Sphenoidalis Lacrimalis Ethmoidale
How to examine guttural pouches in equine ?
Localization
Inspection, palpation, percussion (resonant)
Extra exams : Xrays, endoscopy
Standpoints of coughing examination ?
Origin Frequency Strength Tone Occurence Duration Secretion content Painfulness Deepness Localization of origin Quality of sputum
Laryngeal cough description
Episodically, heavy, gagging/retching, tendecy to vomit
If laryngeal paralysis : deep, long, harsh
Tracheal cough description
Tracheitis : loud, explosive, barking-like
Trachea collapse : goose honking cough
Bronchial cough description
Acute phase : pattern similar as tracheitis = loud, explosive, barking-like
Chronic phase : mucus, pus, wet and rough cough
Lung emphysema, chronic bronchitis cough description
Short, weak dry
COPD : deep, weak, held, dull
Pneumonia cough description
Soft
Cardiac disease cough description
Hacking & wet cough
How to induce cough in horse ?
Squeeze the larynx or tracheal rings near to the larynx
How to induce cough in cattle ?
Close mouth & nose with hands/plastic bag
How is the induced cough in cattle ?
Doesn’t cough spontaneously, very difficult stimulation. Cough is medium intensive and medium deep, duller, held, dry; painles, snapping, doesn’t recur
How to induce cough in small ruminants, dogs, cats ?
Pressing the tracheal rings or the thorax quickly during expiration
How is the induced cough in small ruminants, dogs, cats ?
Goat & sheep : weak, groaning like, deep, dry, medium held, painless, does not recur
Dog & cat : medium held, snapping, doesn’t recur, medium intensive, medium deep, dry, painless, does not recur
Examination of the larynx/pharynx ?
Examination :
- external inspection (skin, deformities, swelling) and internal examination (epiglottis, nasopharynx, symmetry and synchronous movement of the arythenoids, rima glottidis, colour, capillaries, deformation of Mm, shape, size, semilunar fold, colour, surface and symmetry of the tonsillas)
- Palpation (form, outline, muscles, surface of larynx, masses, compression ability and sensitivity of the arythenoids, T°, painfulness, fremitus)
- Ausculation (normally weak stridor during insp/expiration)
Extra exams :
Xrays, endoscopy
Examination of the trachea ?
External inspection, palpation, auscultation
Extra exams
X rays, endoscopy, tracheal fluid sample and analysis)
Examination of the thorax ?
Inspection, palpation, auscultation, percussion
Extra exams : Xrays, US, endoscopy, BAL sample and analysis, thoracocentesis/tomy, biopsy, CT, MRI, scintigraphy, lung function testing, CBC, acid/base analysis
Examination of the thorax - exam of the chest ?
Skin, size, shape, bilateral symmetry, local deformities, intactness of the skin
Examination of the thorax - exam of the Respiratoy movements ?
Frequency (Tachy/Polypnoe, Oligopnoe/Bradypnoe)
Rhythm (Normal, held inspiration/expiration, shorten expi/inspiration, assymetric breathing, intermittent inspiration)
Type (Normal, abnormal)
Depth (Normal = medium deep, abnormal shallow or deep respiration)
Respiratory type of equids ?
Costo-abdominal
Respiratory type of carnivores ?
Costo-abdominal
Respiratory type of cattle ?
Mostly abdominal
Types of dyspnoea ?
Inspiratory, expiratory, mixed
Causes for inspiratory dyspnoea ( prolonged and labored inspiration) ?
- Narrowed upper airways (stridor) laryngeal oedema, laryngeal paralysis, stenotic nares, etc. -Pneumothorax
- Pleural effusions
-Diffuse pneumonia
‐Lung neoplasm
Signs of inspiratory dyspnoea ?
Prolonged and labored inspiration
Inspiratory phase is longer, extension of the head and neck, dilatation of nostrils, labial respiration, spreading of the scapules, exaggerated intercostal activity, slack or sunken flanks and sagging belly.
Causes for expiratory dyspnoea ?
- Compression or obstruction of lower air passages
- Microbronchitis
- Pulmonary emphysema
Fibrous pleuritis - Rarely neoplasms in larynx and pharynx
Signs of expiratory dyspnoea ?
Expiration phase is extended; the work of abdominal muscles is more severe, extensions of the head and neck, thorax very fasten collapsed during expiration. Expiratory dyspnoea is abdominal, duplicate or strongly held “heave line”.
Causes for mixed dyspnoea ?
- Decreased compliance
-Pulmonary oedema
-Pulmonary emphysema
‐Compressed diaphragm
Signs of paradoxical respiration ?
Chest movement is restricted, not able to expand properly.
Intercostal muscles may collapse inwards with inspiration as they fatigue, and as greater negative pressures are crated within the thoracic cavity
Abdominal wall move in the opposite direction to that expected
Causes for paradoxical respiration ?
Pleural fluid, pneumothorax, diaphragma paralysis, broken ribs..
Standpoints of a thoracic palpation ?
T°
Fremitus pectoralis (pleuritis, bronchitis, fibrinous pericarditis, stenotic valves or valve insufficiencies)
Painfulness
Deformities
How can the respiratory sounds reach our ears ?
Resonance sound → lung → chest wall → diminish → some of it reflected from bordering places depending on acoustic impedance.
Acoustic impedance formula ?
Density of the material x speed of sound
Normal respiratory sound description ?
Blow like sound, developed in the upper airways.
Stronger during inspiration, weaker/slighter during expiration (developed in the upper airways)
Contains of normal respiratory sounds ?
- Weak stenotic noise (nose, pharynx)
2. Weak blow noise (Turbulence before bifurcatio tracheae or branch of larger bronchi, after bronchi laminar spread)
Directly audible sounds for auscultation ?
Nose, larynx, trachea
Indirectly audible sounds for auscultation ?
Larynx, trachea, thorax
Basic respiratory sounds in horses ?
Inspiratory : soft
Expiratory : very weak
Basic respiratory sounds in cow ?
Inspiratory : strong, rugged, blow-like
Expiratory : weak, blow
Basic respiratory sounds in sheep, goat ?
Inspiratory : strong, rugged
Expiratory : : weaker, can be heard during expiration
Basic respiratory sounds in swine ?
Inspiratory : strong, rugged
Expiratory : strong, bronchial
Basic respiratory sounds in dog, cat ?
Inspiratory : strong, rarely bronchial
Expiratory : strong, can be heard over the thorax
Basic respiratory sounds in rabbit ?
Inspiratory : like in dogs & cats but not as strong
Basic respiratory sounds in birds ?
Inspiratory : strong, blow-like
Normal physiological sound description
Soft, blowing sound, stronger in carnivores, sometimes bronchial like bovine: strong, rugged
‘f’ like
Bronchial sound description
Strong, audible blowing sound
‘(c)h’ like sound, during INHALATION or abnormal
Normal above and larynx trachea ONLY
Normal in small animal/thin animals, less heard in large ones.
Bronchial like sound description
Deeper, softer, harsher than the bronchial sound
Only during INHALATION or abnormal
‘f-h’ like sound
Physiologic in carnivores, swine, cow
Adventitious respiratory sounds classification ?
Non musical rhonchi vs musical rhonchi
Non musical rhonchi classification ?
Crepitation (hair-rubbing like) Crackling sound (burning wood like) Rattling sound (sucking coke with a straw)
Musical rhonchi classification ?
Whistling (monophonic/polyphonic high "HUIH" sound) Wheezing sound (mono/polyphonic sound), low "BBuuuu" sound)
Meaning of COPD ?
Meaning of RAO ?
Chronic Obstructive Pulmonary Disease ( Early inspiratory or expiratory crepitation and crackling, wheezing)
Reccurent Airway Obstruction
Other abnormal sounds heard over the thorax by auscultation ? (not the rhonchi)
Rubbing
Splashing (Gas and fluid movement)
Stridor (Strong stenotic sound)
Metallic sound (“PLOM-PLOM” sound)
Main percussion sounds ?
Sonorous/resonant : fairly low, strongly resonant (normal lungs)
Damped/dull : short sound of low intensity (liver, heart, muscle)
Tympanic : stronger, longer, higher sound than sonorus, higher in pitch (gastric volvulus)
Other special percussion sounds ?
Metallic (steel-like) : high-pitched, sharp musical sound
Cracked-pot sound : rasping, wheezing sound +/- noises
Hollow sound : strong, high, long sound, tympanic or not
