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MOD > Disease of Equine head + neck 3 > Flashcards

Disease of Equine head + neck 3 Flashcards

1
Q

What separates the nasopharynx + oropharynx?

A

*Soft palate

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2
Q

The pharynx lacks rigid support by bone, What does this mean it’s prone to?

A

*Collapse

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3
Q

What is the function of the pharynx?

A

*Passage of air
*Passage of ingesta

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4
Q

What innervates the pharynx?

A

*CN 5, 10 + 11
*Cervical nerves

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5
Q

What is the function of the larynx?

A

*Breathing
*Protect lower airway
*Vocalisation

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6
Q

What are the 4 parts of the larynx?

A

*Cricoid cartilage
*Thyroid cartilage
*Epiglottis
*Paired arytenoid cartilages

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7
Q

What are the 3 processes of the arytenoid cartilages?

A

*Muscular process - cAD muscles attachment (cricoarytenoideus dorsalis)
*Corniculate process - in the airway
*Vocal process - vocal cord attachment

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8
Q

What causes opening of the glottis? (abduction)

A

*Cricoarytenoideus dorsalis muscle
-innervation = recurrent laryngeal nerve

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9
Q

What causes closure of the glottis? (Adduction)

A

*Cricoarytenoideus lateralis muscle
-innervation = recurrent laryngeal nerve

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10
Q

What are key presenting signs of disease of the larynx + pharynx?

A

*Respiratory noise - inspiratory
*Exercise intolerance
*Poor performance

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11
Q

What can be used to diagnose larynx + pharynx problems?

A

*Endoscopy
-at rest = look at structures
-at exercise = dynamic problems
*Ultrasound
*Radiography
*CT
*MRI

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12
Q

What are clinical signs of pharynx problems?

A

*Poor performance
*Resp noise
*Dysphagia
*Resp distress
*Nasal discharge
*Coughing

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13
Q

What are key disorders of the pharynx?

A

Dorsal displacement of the soft palate (DDSP)
-intermittent / persistent
*Naso-pharyngeal collapse
*Pharyngeal lymphoid hyperplasia
*Cleft palate
*Foreign body
*Pharyngeal mass

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14
Q

What is intermittent DDSP?

A

*Dynamic condition - only during intense exercise (dynamic endoscopy for Dx)
*Soft palate displaces = expiratory obstruction, horse slows down

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15
Q

What is persistent DDSP?

A

*Soft palate permanently displaced over epiglottis - can’t replace on swallowing
-may have nasal discharge with food material

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16
Q

What are pathogenesis of intermittent DDSP?

A

Neuromuscular dysfunction - pharyngeal branch of Vagus (CN x)
*Lower airway disease
*Structural abnormalities

17
Q

How is DDSP diagnosed?

A

Endoscopy - exercising

18
Q

What is intermittent DDSP conervative treatment?

A

*Maturity - happens more in youngsters
*get horse fit - train resp muscles
*Change tack - keep mouth closed
*Tongue tie

19
Q

What are surgical treatment of intermittent DDSP?

A

*Tie larynx forward - best efficacy
*Palatoplasty - burn so that scarring + thicker soft palate + more stable

20
Q

What happens with nasopharyngeal collapse in neonates?

A

*Dysphagia
*Self resolves

21
Q

What can cause dynamic pharyngeal collapse?

A

*Neck flexion - dressage / show ponies

22
Q

What is seen wtih cleft palate?

A

*Congenital - can cause inhalational pneumonia
*Milk seen coming from nostrils

23
Q

What is diagnosis + treatment of cleft palate?

A

*Dx = oral exam - endoscopy

*Surgical repair - but not often attempted as difficult + expensive
*Get off milk so inhalation less likely + feed solid material

24
Q

What are laryngeal disorders?

A

Recurrent laryngeal neuropathy (RLN)
* Fourth branchial arch defect (4-BAD)
* Dynamic laryngeal disorders
* Arytenoid chondritis
* Epiglottic abnormalities

25
Q

What are key clinical signs of laryngeal disorders?

A
  • Respiratory noise
  • Poor performance
  • Dysphagia
  • Coughing
  • Respiratory distress
26
Q

What side is RLN (recurrent laryngeal neuropathy) more common?

A

Left - longer as it goes to aortic arch = more prone to injury

27
Q

How is a RLN diagnosed?

A

*Large breeds
*History - poor performance
*Endoscopy - asymmetry of arytenoid cartilage

28
Q

What are the different grades of laryngeal function

A

*Grade 1 = normal
*Grade 2 = can fully abduct but doesn’t stay there
*Grade 3 = can’t fully abduct
*Grade 4 = complete paralysis

29
Q

How do you treat RLN?

A

*Tie back -out of the way (prosthetic laryngoplasty)
*Arytenoidectomy
*Laryngeal re-innervation - nerve graft

30
Q

What are complications of prosthetic laryngoplasty? (tie back)

A

*Coughing
*Seroma
*Infection
*Dysphagia
*Prosthetic failure
*Chondritis

31
Q

What are DDx for laryngeal paralysis?

A

*Unilateral
=guttural pouch mycosis, previous surgery, perivascular injection
*Bilateral
= Hepatic disease, toxicity, post anaesthetic complication

32
Q

What is laryngeal dysplasia?

A

*Congenital - 4/6th branchial arch deformity
*LAryngeal dysfunction - limited abduction of right arytenoid

33
Q

What can be done about vocal cord collapse?

A

*V loud noise
*Tx = vocalcordectomy

34
Q

What is epiglottic entrapment? Tx?

A

*Epiglottic cartilage trapped by subepiglottic tissue
*CS = resp noise, coughing
*Dx = endoscopy
*Tx = laser resection

35
Q

What is sub epiglottic cyst? What can be done?

A

*Congenital
*Dx = endoscopy
*Tx = laser excision / snare excision

36
Q

What is arytenoid chondritis? What can be done?

A

*Infection of arytenoid cartilage = resp noise, obstruction
*Dx = endoscopy
*Tx = antibiotics, arytenoidectomy

MOD (103 decks)

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