E2: Respiratory System Evaluation Flashcards
Normal pulmonary artery pressure at rest is 25-30 mmHg. How high can it get with exercise?
Up to 125 mmHg
What is a normal respiratory rate in horses? What is the normal respiration pattern?
8-12 bpm
Biphasic respiration
What type of disease does it indicate if the head and neck are extended and the horse is making an inspiratory noise?
Upper airway obstruction
What can a plaque of edema on the pectorals indicate?
Pleural effusion
What are your DDx if upon ausculation you note diminished lung borders?
Pulmonary consolidation
Pleural effusion
Diaphragmatic hernia
What are your DDx if upon ausculation you note absent or radiating cardiac sounds?
Pleural effusion
Consolidation
What imaging modality is best for evaluating the lung parenchyma (i.e. pulmonary disease)? Which is best for thoracic disease?
Radiography
Ultrasound
What increases the rate and depth of respiration by causing CO2 rebreathing in order to elicit and/or accentuate abnormal lung sounds during an examination?
Rebreathing
Which is the correct progressive order of respiratory structures from rostral to distal?
a) Pharynx
b) Nares
c) Larynx
d) Trachea
e) Ethmoid
f) Guttural pouch
g) Nasopharynx
h) Nasal passage
b-h-e-g-f-c-d
Nares
Nasal passage
Ethmoid
Nasopharynx
Guttural pouch
Larynx
Trachea
While performing an upper airway endoscopy in a horse, in order access the esophagus, the scope needs to be passed in which direction with respect to the larynx?
Dorsally
In evaluating the guttural pouch, as seen on upper airway endoscopy in the horse, which would be the axially positioned compartment? What separates the two compartments?
Medial compartment
Stylohyoid bone
Complete this correct statement: During upper airway endoscopy as the scope travels past the end of the nasal septum, towards the caudal portion of the naso-pharynx, you will observe:
A. the opening to the oro-pharynx thus leading you to the esophagus.
B. the arytenoids which will then be followed by observation of the guttural pouch opening.
C. the dorsal pharyngeal recess which is located in the same vicinity as the openings of the guttural pouch.
D. the ethmoids which are located ventrally several centimeters caudal to the septum as you advance near the larynx.
C
During upper airway endoscopy as the scope travels past the end of the nasal septum, towards the caudal portion of the naso-pharynx, you will observe the dorsal pharyngeal recess which is located in the same vicinity as the openings of the guttural pouch.
As seen on upper airway endoscopy, in which of the following compartments of the guttural pouch do you visualize the internal carotid artery? In which one will you be able to visualize the external carotid artery?
Medial
Lateral
What length of endoscope would you use to evaluate the guttural pouch of an adult horse? Which would you use to evalute the bladder of a 4-year-old gelding?
1m
3m
T/F: The epiglottis is often temporarily seen below the soft palate after endoscopic evaluation of the esophagus in the normal horse
True
T/F: The esophageal opening is found dorsal to the arytenoids in the larynx
True
In evaluating the arytenoids, as seen on upper airway endoscopy in the horse, the one positioned on the left side of your screen is the:
Right arytenoid
On equine endoscopy, which of the following structure(s) is/are visualized on the walls of pharynx as you approach the larynx, somewhat in the middle part of the nasopharynx?
Openings to the guttural pouch
Which lymph nodes will be found under the ventral mucosal covering of the guttural pouch?
Retropharyngeal
When is it easiest to visualize the mucosa of the esophagus, as you are entering or as you are coming back out with the endoscope?
Coming back out with the endoscope
While performing an upper airway endoscopy in a horse, in order to access the left guttural pouch, where does the scope needs to be passed?
In the left nasal passage
T/F: Abnormal thoracic auscultation indicates a LRD, while normal thoracic auscultation indicates URD.
True
Which compartment in the guttural pouch is smaller?
Lateral
Which mainstem bronchus is larger in the horse?
Right
What are these structures in the dorsal potion of which nasal passage?
Ethmoids
Left
What are the structures indicated by arrows- D, R and L?
D: Dorsal pharyngeal recess
R and L: Right and Left cartilagenous flaps covering the nasopharyngeal openings of the guttural pouch
You know what to do
A: Stylohyoid
B: Internal Carotid artery
C: External Carotid artery and Maxillary artery
D: Medial compartment of the guttural pouch
E: Lateral compartment of the guttural pouch
What are some diagnostic procedures that might be used with respiratory disease?
- Transtracheal wash (TTW)
- Bronchoalveolar lavage (BAL)
- Thoracentesis
- Lung aspirate
- Lung biopsy
- Fluid cytology
- Pleuroscopy
T/F: Bilateral nasal discharge can be associated with upper or lower respiratory disease.
True
What type of respiratory disease, upper or lower, is associated with unilateral nasal discharge?
Upper
Where are respiratory sounds heard loudest in a horse? What side are lung sounds the loudest on?
Trachea
Right
What are 3 types of dagnostic imaging used for the horse respiratory evaluation?
Radiography
Ultrasound
Nuclear scintigraphy
What is nuclear scintigraphy used for in horses?
Ventilation-Perfusion evaluation
TTW is typically performed around the junction of ______________, just above the bifurcation of the __________.
Middle and distal third of the neck
Sternothyrohyoideus muscle
A 2-yr-old Standardbred gelding presents for a cough and nasal discharge. PE reveals fever, purulent nasal discharge, mild tachypnea and tachycardia, and normal thoracic auscultation. Which of the following best categorizes the disease in this horse?
A. Non-infectious URT disease
B. Infectious LRT disease
C. Infectious URT disease
D. Non-infectious LRT disease
C. Infectious URT disease
Fever, purulent discharge = infectious
Normal auscultation= Upper airway
While ____ is a sterile technique, ____ is not and is thus not indicated if a culture is necessary. ______ is for both local and focal multifocal pulmonary, _____ is indicated in diffuse pulmonary disease.
TTW
BAL
TTW
BAL
While TTW is a sterile technique, BAL is not and is thus not indicated if a culture is necessary. TTW is for both local and focal multifocal pulmonary, BAL is indicated in diffuse pulmonary disease.
