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LA Sx scs RUSVM > E2: Respiratory surgery, Guttural pouch > Flashcards

E2: Respiratory surgery, Guttural pouch Flashcards

1
Q

Diagnosis?

A

Epidermal inclusion cyst

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2
Q

What type of noise do you expect from a horse with redundant alar folds? How is the fold stabilized?

A

Expiratory

Large temporary mattress suture (for diagnosis)

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3
Q

A foal presents with stridor, nasal discharge, and facial distortion. What is the likely diagnosis?

A

Wry nose

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4
Q

What should you do preoperatively before nasal septum surgery?

A

Collect 4-8L of blood

Tracheotomy

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5
Q

What is the incsion called that you make to access the nasal septum?

A

Trephine hole

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6
Q

Where is the lesion if there is unilateral epistaxis?

A

Cranial to the caudal edge of the nasal septum

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7
Q

What noise do you expect from a horse with a progressive ethmoid hematoma?

A

Stridor

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8
Q

T/F: The nasal sinuses can be evaluated using an endoscope.

A

False

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9
Q

What is used for transendoscopic chemical ablation? When must it be repeated?

A

4% formalin

In 2-3 weeks

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10
Q

Which surgical approach to the guttural pouches does not provide ventral drainage?

a. Hypovertebrotomy
b. Viborg’s triangle
c. Whitehouse
d. Modified Whitehouse

A

a. Hypovertebrotomy

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11
Q

Which surgical approach is best suited for treating guttural pouch mycosis?

a. Low hyovertebrotomy
b. Viborg’s triangle
c. Whitehouse
d. Modified Whitehouse

A

a. Low hyovertebrotomy

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12
Q

What is the most common complication of guttural pouch surgery?

a. blindness
b. dysphagia
c. facial nerve paralysis
d. abmormal respiratory noises

A

b. dysphagia

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13
Q

Mycotic lesions of the guttural pouch have a propensity for developing in the _____ artery.

a. maxillary
b. external carotid
c. internal carotid
d. palatine

A

c. internal carotid

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14
Q

Which organisms are most commonly grown from diphtheritic plaques in cases of guttural pouch mycosis?

a. A. fumigatus and S. equi
b. E. nidulans and H. capsulatum
c. E. nidulans and A. fumigatus
d. C. albicans and B. dermatitis

A

c. E. nidulans and A. fumigatus

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15
Q

What is the most common presenting sign of guttural pouch mycosis?

a. dysphagia
b. bilateral epistaxis, especially after work
c. Facial nerve paralysis
d. Unilateral epistaxis at rest

A

d. Unilateral epistaxis at rest

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16
Q

Which ancillary procedure is most effective in diagnosing guttural pouch mycosis?

a. endoscopy
b. radiography
c. US
d. Fluroscopy

A

a. endoscopy

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17
Q

What is the recommended therapy for guttural pouch mycosis?

a. scraping the fungal plaque off the guttural pouch membrane
b. irrigiation with antifungal medication
c. surgery
d. systemic antifungal medication

A

c. surgery

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18
Q

Which artery is most likely to cause retrograde blood flow to myocotic lesions in the external carotid and maxillary arteries?

a. linguofacial
b. major palatine
c. infraorbital
d. external ophthalmic

A

b. major palatine

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19
Q

Current surgical techniques for arterial occlusion in treating guttural pouch mycosis include

a. ligation
b. baloon catheterization
c. transarterial coil embolization
d. all of the above

A

d. all of the above

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20
Q

Definitive diagnosis of ethmoid hematoma in horses is made by

a. endoscopic examination
b. history and clinical examination
c. CT
d. histopathologic examination

A

d. histopathologic examination

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21
Q

What is the prognosis for long-term resoluition of progressive ethmoid hematoma?

a. grave no matter what treatment is performed
b. good if treated with intralesional formalin
c. guarded to poor no matter what treatment is performed
d. good if treated with surgical excision and cryotherapy

A

c. guarded to poor no matter what treatment is performed

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22
Q

In what breed have there been no reports of progressive ethmoid hematoma?

A

Standardbred

23
Q

What causes the color variations of progressive ethmoid hematoma when viewed through a video endoscope?

a. age of the leison
b. fibrosis of the mass
c. type and distribution of hemoglobin pigments
d. none of the above

A

c. type and distribution of hemoglobin pigments

24
Q

What is the most common clinical sign observed in horses with progressive ethmoid hematoma?

a. coughing
b. epistaxis
c. head pressing
d. respiratory distress

A

b. epistaxis

Mild, intermittent, unilateral

25
Q

Which survey radiographic view most consistently demonstrates the lesion associated with progressive ethmoid hematoma?

A

Lateral

26
Q

Diagnostic differentials after visualization of the mass lesion (which looks to be progressive ethmoid hematoma) with the video endoscop should include all of the following except:

a. pulmonary neoplasia
b. nasal trauma
c. nasal neoplasia
d. mycotic rhinitis

A

a. pulmonary neoplasia

27
Q

What is the most substantial complication after surgical excision of a progressive ethmoid hematoma?

a. facial deformity
b. respiratory distress
c. wound dehiscence
d. hemorrhage

A

b. respiratory distress

Most common intra-op complication = hemorrhage

28
Q

What is the most common cause of noise in a horse?

A

ILH

29
Q

Formalin (10%) treatment for progressive ethmoid hematoma in the horse is administered via which route?

a. intralesional injection
b. intravenous injection
c. intramuscular injection
d. Via NG tube

A

a. intralesional injection

30
Q

To monitor for recurrence after treatment of a progressive ethmoid hematoma, repeat endoscopic examinations should be performed at ____ intervals for ____.

a. 2- week; 2 years
b. 1-month; 1 year
c. 3- to 6-months; 5 years
d. 1-year; 10 years

A

c. 3- to 6-months; 5 years

31
Q

What are the landmarks for the maxillary sinus? Where do you make your incision?

A

Medial canthus of the eye = rostral compartment

Cranial edge of the facial crest = caudal compatment

1 cm above the line between the 2 landmarks

Alternative 2nd landmark = intraorbital foramen ; then incsion half way between the landmarks

32
Q

T/F: Trephination sites are usually left open and should be flushed daily (for 1 day past finding flakes in the flush).

A

True

Also antibiotics and NSAIDs

33
Q

T/F: Getting your horse a goat buddy may prevent the horse from cribbing.

A

True

34
Q

The removal of which muscles can be used to treat/prevent cribbing? Which nerve can be removed?

A

Sternomandibularis

Sternothryohyodeus

Omohyoideus

Ventral neck muscles

Ventral branch of CN XI (spinal accessory nerve)

35
Q

The modified Forssel’s procedure is done to prevent the distortion caused by the surgical treatment of cribbing. In addition to a neurectomy of the ventral branch of CN XI, which muslces are myoectomized for this procedure?

A

Sternothyrohyoideus

Omohyoideus

36
Q

How many tracheal rings worth of muscle is removed in the modified Forssel’s procedure?

A

10

37
Q

Nicking which 2 structures during a modified Forssel’s can cause profuse bleeding?

A

Jugular vein

Thyroid gland

38
Q

Which nerve innervates the cricoarytenoideus dorsalis muscle? What is it’s parent?

A

Recurrent laryngeal

Vagus

39
Q

Which side is usually aftected in a roarer?

A

Left

40
Q

What type of noise is roaring?

A

Inspiratory

41
Q

During a slap test, the withers are slapped during endoscopy and the _____of the _________ arytenoid cartilage is observed.

a. abduction, contralateral
b. abduction, ipsilateral
c. adduction, contralateral
d. adduction, ipsilateral

A

c. adduction, contralateral

42
Q

How many grades of ILH are there?

A

4

(I - IV)

43
Q

What is the common name for a laryngoplasty?

A

Tieback surgery according to Marks

44
Q

The skin incision for a tieback surgery is ventral to which vein?

A

Linguofacial

45
Q

Which muscle will be atrophied in a horse with chronic ILH?

A

Crycoarytenoideus dorsalis

46
Q

Which of these is NOT a complication associated with tieback?

a. seroma
b. cough
c. epistaxis
d. dysphagia

A

c. epistaxis

47
Q

In which position is a venticulectomy performed?

A

Dorsal recumbency

48
Q

What’s this?

A

Roaring burr

49
Q

How do you know whether you have excised enough of the ventricle during a ventriculectomy? Which ventricle should be removed if the left side is affected?

A

Place on finger, should cover distal 1/3

Both

50
Q

What can be done to reinnervate the cricoarytenoid muscle?

A

Neuromusclar pedicle graft

51
Q

What is removed in a total arytenoidectomy? Partial?

A

Total: Arytenoid body, corniculate, muscular process

Partial: Arytenoid body, corniculate Preferred treatment

52
Q

What is the vet term for “choking up”

A

DDSP

53
Q

What is the preferred surgery for DDSP?

A

Laryngeal tie-forward

Used to be myoectomy of sternothyrohyoideus muscle

54
Q

What’s this and what is it used for? What is the alternative?

A

Bistoury

To transaxially divide the membrane entrapping the epiglottis in case of EE

Laser

LA Sx scs RUSVM (20 decks)

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