Cough 1 Flashcards
Term refer to a sudden forceful noisy expulsion of air through the glottis to clear particles & other material from the tracheobronchial tree and glottis.
Cough
– important & normal respiratory defense mechanism
2 protective mechanisms that function together:
- Mucociliary escalator
2. Cough reflex
Term that refers to removing secretions from the tracheobronchial tree proximal to the level of the segmental bronchi
Cough relfex
Term that refers to the continuous wave of ciliary motion that starts at the level of the bronchioles
Mucociliary escalator
T/F: the cough neural pathway can be both involuntary & voluntarily.
True
The involuntary reflex, of the cough neural pathway, involves ______ receptor through tracheobronchial tree.
Sensory receptor
The involuntary reflex predominantly consist of what nerve?
Vagal nerve
–others: glossopharyngeal, trigeminal, and phrenic n.
What is a constant component of cough:
Bronchoconstriction is a constant component of cough.
– irritants can trigger bronchoconstriction & cough but are SEPARATE reflexes. Just bc the animal is coughing does not mean bronchoconstriction is occurring.
List the components for cough stimulation: 1. 2. 3. 4. 5. 6. 7. 8.
List the components for cough stimulation:
- bronchoconstriction
- Excessive mucous production
- deposition of inhaled particles
- release of inflammatory mediator (infectious dz)
- exposure of hot or cold air
- intramural or extramural pressure
- sloughing of airway epithelium
- enhance epithelial permeability (pulm edema)
What type of cells are found in the trachea that are involves in the mucociliary clearance mechanism:
Pseudostratified ciliated columnar epithelium
- secretion traps particulate matter
- airway epithelium takes about 7 weeks to heal.
How long does airway epithelium take to heal:
7 weeks to heal
What type of cells are located in the terminal & respiratory bronchioles that metabolize airborne toxins
Clara cells
– source of surfactant-like substance which aids in maintaining patency of airway
What are all the factors below associated with:
- decreased cell #
- mucous plug
- dehydration
- -irritant gases
- dust
- -cold water
- -anesthetic
Decreased Mucociliary clearance
What type of bacteria will produce a nasal discharge that is foul smelling:
Anaerobic bacteria – associated with foul smell.
What type of infection is present if the horse has mucopurulent discharge
Bacterial infection = mucopurulent
Rebreathing examination works by increasing ____ content where receptors will trigger the brain to tell them to breathe heavier. When the bag is taken off, they will sense the oxygen and will take a DEEP breath allowing you to listen to the areas of interest.
CO2 content
- inhalation of expired carbon dioxide, not necessarily deprive it of oxygen
- eupnea and hyperpnea
What is each lung sound describing:
- ______: increased lung sounds, crackles, and wheezes
- _______: ventral dull sound
- _______: cardiac sound larger area than normal bc improved sound conduction
What is each lung sound describing:
- _Pneumonia__: increased lung sounds, crackles, and wheezes
- _Pleuropneumonia__: ventral dull sound
- Pleural effusion: cardiac sound larger area than normal bc improved sound conduction
T/F: Fever is associated with infectious disease:
True
–Fever is associated with infectious & secondary infection to a non-infectious condition (parasitic)
NO fever:
- RAO
- -Larynx or pharyngeal abnorm
- -parasitic (can become feverish)
- EIPH
- -FB
- -Neoplasia
- -trauma
Major cause of respiratory disease in horses
Equine Influenza
How is equine influenza transmitted
aerosolized respiratory secretions >35feet
- increased exposure: crowding, transport, and stress
- cold weather may be related
Equine Influenza can destroy _____ ______
Equine influenza can destroy Ciliated epithelium
Equine Influenza effects old or young horses
Young horses – 3 yrs old = equine influenza
Equine influenza can sometimes present like laminitis because in the early stages it can cause _____
Add to dictionary in early stages – puffy joints will be seen & they are reluctant to walk
Equine influenza can sometimes present like laminitis because in the early stages it can cause POLYSYNOVITIS.
Out of EHV4 & EHV1, which one will effect respiratory and reproductive
EHV4: Respiratory & reproductive
EHV1: Respiratory & Neurologic form
Equine herpes virus incubation period:
1-3 days incubation period for EHV
EHV can have other CS that are not associated with lung tissue. What are some of the CS.
EHV clinical signs:
- Conjunctivitis
- lymphadenopathy
- edema
- -vasculitis
- polysynovitis *
Which 2 EHV can be respiratory but low pathogenicity? which one is associated with EMPF:
EHV 2 & 5 can be respiratory but low pathogenicity
EHV 5 - related to EMPF (equine multi nodule pulmonary fibrosis)
What are the characteristics below associated with:
- -Respiratory dz, abortions, foal pneumonia
- not age related
- close contact transmission (semen) and most infections are subclinical
- long lasting immunity= natural & vaccine exposure
Equine Viral Arteritis
T/F: equine viral arteritis can have long lasting immunity ( natural & vaccine exposure)
True
Transmission for equine viral arteritis is:
Close contact transmission (semen) and most infections are subclinical.
– not age related.
Which virus affects immunocompromised foals (SCID):
Equine Adenovirus
- immunocompromised foals (SCID)
- Pneumonia result from secondary bacteria
Which virus has pneumonia as a result from a secondary bacteria
Equine Adenovirus
What virus affects young horses in late winter-early spring & usually clinically inapparent
Equine Rhinovirus
- usually clinically inapparent (Pharyngitis, mild bronchitis, purulent nasal discharge)
- -Late winter-early spring
- -Young horses
What virus causes the following clinical signs:
- Febrile
- -Facial swelling
- -Head pressing
- -Recumbent
Hendra Virus
– human meningitis & equine respiratory illness
What type of bacteria is listed below & which is always present in the respiratory tract
- Strep zooepidemicus
- Staph aureus
- Actinobacillus Equuli
- -Pasteurella
- -E.coli
- -Klebsiella pneumonia
- -Pseudomonas
- -Rhodococcus equi
AEROBIC BACTERIA
- Strep zooepidemicus –***
- Staph aureus
- Actinobacillus Equuli
- -Pasteurella
- -E.coli
- -Klebsiella pneumonia
- -Pseudomonas
- -Rhodococcus equi
What type of bacteria is common in horses with physiologic stress including transportation, exercise, anesthesia, and viral infection.
Anaerobic Bacteria
*Bacteroides Fragilis = Penicillin resistant
What type of anaerobic bacteria is penicillin resistant
Bacteroides Fragilis – Penicillin resistant
Dictycocaulus Arnfieldi (“Lungworm”)– only occurs when the horse comes in contact with a infected donkey.
False
- 67% of farms with positive infected horses had no exposure to donkeys.
- even if the horse has not been around a donkey but find evidence on BAL= tx the horse
What parasite migrates through lung tissue especially in foals.
Roundworm: Parascaris Equorum – migrate through lung tissue
Name the primary & secondary factors where horses are prone to getting fungal pneumona
Primary = dry & dusty climate Secondary= Bacterial pneumona & Aspergillus
Most common secondary organism to cause fungal pneumonia
Aspergillus = most common secondary organism to cause fungal pneumonia
– common in foals or horses suffering from bacterial pneumonia
Major contributor for bacterial pneumonia and pleuropneumonia:
STRESS:
- transportation
- exercise
- -anesthesia
What is important in transportation of horses:
- Do NOT elevate and secure the head
- - this will compromise mucuciliary clearance mechanism. - Dehydration = decreased secretions
If the owner has a mare tied up while the foal is being introduced, what should you recommend to the owner?
Recommend letting mare drop her head down every 2 hours to be able to clear the trachea.
A high intensity exercise results in a decreased OR increased peripheral blood neutrophil function:
Decreased peripheral blood neutrophil function = high intensity exercise
– oxidative burst activity of pulmonary alveolar macrophages
4 components that cause dysphagia:
4 components that cause dysphagia:
- Neonatal encephalopathy
- Botulism
- Guttural pouch dz
- Strangles
What is carboxyhemoglobin & what is it associated to:
Carboxyhemoglobin = decrease the ability for oxygen to be released at the tissue site leading to hypoxia.
–associated with Smoke inhalation
During smoke inhalation, what is responsible for decrease O2 at the alveolar site
Severe bronchoconstriction occurs in smoke inhalation resulting in decrease O2 at the alveolar site.
–pseudomembranous cast
To diagnose smoke inhalation in a horse the carboxyhemoglobin must be over what %
> 10%
–Diagnosed: Carboxyhemoglobin >10%
Transtracheal intubation can cause tracheal necrosis if
Excessive cuff pressure = tracheal necrosis
Anesthetics cause ____ of the respiratory defense mechanism:
Depression
– anesthetics cause depression of the respiratory defense mechanism
Penetrating thoracic injuries can result in:
Penetrating thoracic injuries can result in:
- Fracture rib
- Hemothorax
- Pneumothorax
Where do you do an abdominal tap if suspect trauma in a horse:
Caudal to 6th rib = abdominal tap
others:
- US and rads
- Chest tubes and lavage
Thoracic Neoplasia in horses has a very low incidence. However, the lungs are susceptible to ______ ______
Neoplastic emboli
– lungs are susceptible to neoplastic emoboli
In dealing with thoracic neoplasia, what are the primary pulmonary tumors:
1.
2.
Primary Pulmonary Tumors:
- Granular cell tumor
- Pulmonary chondrosarcoma
Equine Multinodular pulmonary fibrosis is associated with which EHV
EHV-5
How can EMPF present:
EMPF can present as:
- Exercise intolerance
- Acute resp distress
EMPF creates what type of lung pattern:
–Diffuse Bronchointerstitial pattern w/ multiple coalescing circular nodules throughout the lung field.
What is the characteristics below associated to:
- -Thin dull attitude, poor hair coat
- tachypneic
- increased RE, RR
- -Abnormal lung sounds
- occasional dry cough
- -increased WBC count
- increased fibrinogen
- -anemia, lymphopenia also reported.
EMPF
What will the ultrasound look like on a EMPF patients:
Multiple circular hypoechoic masses ==> Pleural effusion is generally NOT present
Gross Pathology of the lungs of a EMPF horse will look like:
Severe multifocally distributed nodules with diffuse interstitial fibrosis.
T/F: EMPH horses have an excellent prognosis with correct treatment
FALSE
3 viruses associated with Foal pneumonia in foals <1 month.
EVA
EHV1
EHV4
In foals around 1-6 months of age, the foal pneumonia is usually from what type of pathogens:
1-6 months
- S. Zooepidemicus
- -R.equi
- Respiratory viruses are often the primary offending agents.
T/F: an abnormal CBC is specific for pneumonia
FALSE
– abnormal CBC is not specific – reflect chronicity & severity of the inflammatory process.
The clinical pathology in a ACUTE pneumonia case will have:
Acute = Hyperfibrinogenemia & neutropenia
Chronic= Neutophilia & anemia of chronic dz
In pneumonia diagnostics, what is the hyperbilirubinemia associated with:
Anorexia = Hyperbilirubinemia
In pneumonia diagnostics, the ultrasound examination can be described as:
Pleura irregularities
– US - not good for evaluation of deep parenchyma
In pneumonia diagnostics, which is the preferred method in evaluation of the deep parenchyma of the lung:
Radiography = deeper parenchyma evaluation
US = cannot evaluate deeper parenchyma
Does US or Rads allow you to evaluate long term progression in pneumonia cases
Radiography = evaluation of long term progression.
What complications are associated to TTW in pneumonia cases
Cellulitis & chronditis
What can identify inflammatory process & used to determine appropriate tx in pneumonia cases
Cytology of TTW
What is used to obtain fluid form the lung for cytology and possible culture
BAL
In pneumonia diagnostics, what can give you results IMMEDIATELY
Arterial blood gase – hypoxemia, hypercapnia, and resp acidosis
How is pneumonia treated:
- Control hydration status
- Antimicrobials
- Anti-inflammatories
- Bronchodilators
- palatable feed (green grass)
- stall rest
Antimicrobial therapy for foal pneumonia is based on culture& sensitivity. Name the drugs specific for each of the following:
- S. Zooepidemicus=
- Rhodococcus equi =
- Bacteriodes fragilis =
- S. Zooepidemicus = Penicillin
- Rhodococcus equi = Clarithromycin & Rifampin
- Bacteriodes fragilis = Metronidazole
What method of administering antimicrobials can reach 12 x higher concentration than IV administration with a lower toxicity
Aerosolized Antimicrobial
– optimal combos of particle size & aerosol density
Commonly used for aerosolized antimicrobial therapy
Gentamicin or Ceftiofur
2 bronchodilators used in treating pneumonia
Bronchodilators;
- Albuterol
- Clenbuterol
