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Equine Medicine > Diseases of the Upper Respiratory Tract > Flashcards

Diseases of the Upper Respiratory Tract Flashcards

1
Q

What are the 5 major challenges in the upper respiratory tract horses need to over come for proper respiration?

A
  1. important dead space
  2. VO2 muscles
  3. narrow URT
  4. obligate nasal breathers
  5. locomotor coupling of breaths
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2
Q

What are the most common causes of unilateral mucopurulent and epistaxis nasal discharge?

A

MUCOPURULENT - sinusitis, guttural pouch

EPISTAXIS - ethmoid hematoma, guttural pouch

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3
Q

What are the most common causes of bilateral mucopurulent and epistaxis nasal discharge?

A

MUCOPURULENT - asthma, pneumonia

EPISTAXIS - EIPH

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4
Q

How do the nostrils act in a normal horse at rest and one with respiratory disease?

A

flat, comma shape

nostril flares with increased respiratory effort (normal in a horse doing exercise)

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5
Q

What should the airflow in horses be like?

A

SYMMETRICAL

  • reduction in airflow in one nostril indicates an obstructive lesion
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6
Q

What is the false nostril? When does it commonly become prominent?

A

nasal diverticulum —> dead end in the dorsal nasal cavity that can be checked with one finger for abnormal conformation or masses

when the nostrils are flared

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7
Q

What is an atheroma? What clinical sign is associated? How are they diagnosed?

A

epidermal inclusion cyst found within the false nostril

swelling

palpation and FNA to rule out neoplasia

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8
Q

How are atheromas treated?

A
  • excision, burr
  • chemical ablation
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9
Q

What meatus is targeted for nasal endoscopy? What do we try to avoid?

A

ventral meatus, shaped like a “U”

endoturbinates —> can cause profuse bleeding

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10
Q

Where is it most common to find apical infection in the maxillary teeth? What are the 5 most common clinical signs?

A

1-3rd cheek teeth (106-108 and 206-208) in the rostral portion of the maxillary bone and paranasal sinuses

  1. halitosis
  2. nasal discharge
  3. swelling
  4. pain of affected tooth
  5. decreased airflow
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11
Q

How are apical infections of rostral maxillary cheek teeth diagnosed? Treated?

A

oral examination, endoscopy, or radiographs

extraction of affected teeth followed by sealing

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12
Q

What are the most common congenital and nutritional nasal deformities?

A

wry nose —> lateral deviation

osteodystrophia fibrosa —> Ca:P mismatch

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13
Q

Where do ethmoidal hematomas originate? Where do they end up growing?

A

submucosa ethmoidal labyrinth and paranasal sinus

grow into the nasal cavity and nasopharynx

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14
Q

What are the 3 most common clinical signs associated with ethmoidal hematomas?

A
  1. chronic, intermittent, serosanguinous discharge from the nostrils (unilateral)
  2. decreased airflow and smell
  3. deformity
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15
Q

How are ethmoidal hematomas diagnosed? Treated?

A

endoscopy biopsy and radiographs

  • excision
  • ablation with 4% formaldehyde or laser for reduction
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16
Q

What sinuses are able to be percussed in horses? How should it sound?

A

frontal and maxillary sinuses

should sound hollow bilaterally while comparing left to right and over the entire area (easier to hear with mouth open)

17
Q

What is the most common cause of primary sinusitis? What is the most common clinical sign?

A

infection causing obstruction of normal nasomaxillary drainage

unilateral purulent nasal discharge

18
Q

What is the most common cause of secondary sinusitis? What 3 clinical signs are associated?

A

tooth root abscess

  1. unilateral purulent malodorous discharge
  2. epiphora, conjunctivitis
  3. deformation
19
Q

What are the 3 ways of diagnosing sinusitis?

A
  1. endoscopy
  2. radiographs —> fluid lines
  3. sinuscentesis/scopy
20
Q

How is sinusitis treated?

A
  • antimicrobials
  • trephination and flush
  • address cause —> pull tooth
21
Q

What are sinus cysts? What are the 3 most common clinical signs?

A

fluid-filled, space-occupying lesions found int he sinus cavities that push against the bone and make them softer

  1. deformation
  2. nasal discharge
  3. reduced airflow
22
Q

How are sinus cysts diagnosed? Treated?

A

radiographs, CT, MRI

removal

23
Q

How does the pharynx look in cases of pharyngitis? In what horses is this most common? Does it usually need treatment?

A

follicular pharyngeal hyperplasia of the lymphoid tissue

young racehorses

it is usually self-limiting and a normal response to inhaled antigens/allergens, but it can have an effect of dynamic URT obstruction

24
Q

How is pharyngitis diagnosed? What are the 2 kinds of treatment?

A

endoscopy

  1. general = NSAIDs
  2. local = spray containing glycerin, DMSO, nitrofurazone, and prednisolone
25
Q

What is a cleft palate? What is the most common clinical sign?

A

congenital communications between the oral and nasal passages

dysphagia —> after foals nurse, there is commonly bilateral nasal discharge containing the milk

26
Q

How do horses breath? How does locomotion play into their breathing?

A

obligate nasal breathers

horses exhale on touchdown

27
Q

Endoscopy at rest:

A

DPR = retropharyngeal recess
GPO = guttural pouch opening
E = epiglottis
SP = soft palate

28
Q

Dynamic collapse of URT:

A
29
Q

What is dorsal displacement of the soft palate? When does it most commonly occur?

A

the soft palate is displaced over the epiglottis, most commonly during exercise

30
Q

What are the 3 most common clinical signs associated with dorsal displacement of the soft palate?

A
  1. horse “chokes down” towards the end of a race
  2. EXPIRATORY noise during exercise caused by air expelled from the trachea pushing against the soft palate
  3. decreased performance
31
Q

What 3 conservative treatments are used for dorsal displacement of the soft palate?

A
  1. nose bands or tongue ties to stop horses from swallowing
  2. bit
  3. Cornell collar obstructs specific head positions that are thought to induce DDSP
32
Q

What is the most common surgical treatment of dorsal displacement of the soft palate? What are some other options?

A

tie forward to get the larynx closer to the soft palate

  • palatoplasty
  • staphylectomy
  • strap muscle myectomy
  • tracheostomy
33
Q

What happens to the larynx in left laryngeal hemiplegia? What are the 2 causes?

A

left recurrent laryngeal neuropathy causes the left arytenoid cartilage to no longer abduct on inspiration, causing it to obstruct the trachea

  1. RECURRENT - congenital in large breeds, like Warmbloods and Thoroughbreds
  2. ACQUIRED - chondritis, damage to nerve, toxicity
34
Q

What are the 2 most common clinical signs of left laryngeal hemiplegia?

A
  1. INSPIRATORY noises during exercise - roaring
  2. decreased performance
35
Q

What test is commonly done on the larynx to confirm left laryngeal hemiplegia?

A

slap test - palpate over the area of the arytenoids and slap the withers on the contralateral side, resulting in slight movement/abduction

  • horses with LLH may have a reduced slap test due to degeneration of the nerve and a more pronounced muscular process of the arytenoid cartilage due to muscular atrophy
36
Q

What is the best definitive diagnosis of left laryngeal hemiplegia?

A

dynamic endoscopy

37
Q

What is the most common treatment for left laryngeal hemiplegia? What are some other options?

A

prosthetic laryngoplasty (tie back) —> if overzealous, horse can experience dysphagia

  • ventricul/chord/ventriculocordectomies
  • pedicle nerve graft
  • arytenoidectomy
38
Q

How do the respiratory noises associated with DDSP and LLH compare?

A

DDSP = expiratory noise due to air hitting and flapping the soft palate

LLH = inspiratory noise (roaring)

39
Q

What are the 2 most common clinical signs associated with ethmoidal hematomas?

A
  1. unilateral discharge with possible epistaxis
  2. decreased airflow

Equine Medicine (33 decks)

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