Exam 2 - Respiratory Surgery Flashcards
what are the components of brachycephalic obstructive airway syndrome (BOAS)?
- hypoplastic trachea
- stenotic nares
- everted laryngeal saccules
- elongated soft palate
in an animal with an elongated soft palate, what surgery can be performed to correct it?
staphylectomy - resection of the posterior soft palate
label the numbered structures
- trachea
- laryngeal ventricle
- epiglottis
- vocal fold
- corniculate process
- cuniform processes
what are some different factors of laryngeal paralysis?
breed specific
acquired - metabolic or idiopathic
what age animals are typically affected by acquired laryngeal paralysis?
over 6 years old
what age animals are typically affected by congenital laryngeal paralysis?
breed specific - less than 6 months
what are some different causes of acquired laryngeal paralysis?
neoplasia, trauma, infection, iatrogenic, idiopathic, & metabolic
T/F: hypothyroidism is a metabolic cause of laryngeal paralysis
false - not proven but may worsen animal’s clinical signs
what animals are typically affected by the idiopathic acquired form of laryngeal paralysis?
9-12 year old large breed dogs (labs, st. bernard, irish setter, afghan hounds, rotties)
what are some clinical signs associated with idiopathic laryngeal collapse?
stridor, dyspnea, difficulty rising, paresis, dysphagia, muscle atrophy, & exercise intolerance
what is the treatment for idiopathic laryngeal paralysis?
tie back surgery - open the larynx permanently
what are the pros & cons for a tie back surgery for laryngeal paralysis?
larynx is permanently opened
risk of aspiration pneumonia & dogs can’t swim
what is the approach for a temporary tracheotomy?
between the 3rd & 4th tracheal rings, ventral approach
if placing a temporary tracheotomy, what should you be careful in avoiding?
recurrent laryngeal nerve on the lateral aspect & vagosympathetic trunk, & carotid artery
as far as managing a patient with a endotracheal tube, what should be considered?
use as big of a tube as possible
don’t inflate the cuff unless the animal is on a ventilator/anesthetic gas
humidify - add sterile saline/nebulize
replace tube as needed
suction mucous as needed
provide 24 hour care
why should you use as big of a tube as possible when doing a tracheotomy?
less clogging
why is a tracheotomy used?
bypass everything cranial to the tracheotomy
what are the potential complications of tracheotomy?
occur in about 1/2 of the animals - sudden death
cats have a higher rate of tube occlusion
what is the medical management for collapsing trachea?
anti-tussives, sedatives, better environment
what should be included in the work-up of a patient with a collapsing trachea?
radiographs, fluoroscopy, & tracheobronchoscopy
what surgical treatment can be done for animals with a collapsing trachea?
intraluminal stent & extraluminal rings
what are some post-op complications associated with corrective surgery for collapsing trachea?
laryngeal paralysis - extraluminal rings
tracheal necrosis - extraluminal rings
stent fracture/migration/granuloma - stent
still will need cough suppressant - stent
continued/progressive collapse
T/F: surgical correction of tracheal collapse is considered curable
false - neither stents/rings directly address mainstem bronchus collapse
how long should the soft palate be?
end at the tip of the epiglottis & tonsillar crypts
what are examples of lower respiratory tract abnormalities that may require a chest tube?
masses, bullae/bleb
if surgically correcting stenotic nares in a BOAS dog, what should you do?
resect all the way back to the alar wing
what is the vertical wedge approach for surgically correcting stenotic nares?
broad base is taken at the bottom & then triangular up to the top & suture laterally to open the airway
what is the horizontal wedge approach for surgically correcting stenotic nares?
take the broad base laterally & then suture upwards to open the airway
how are everted laryngeal saccules surgically corrected?
pull them out with allis tissue forceps & snip it off being sure not to cut the vocal folds
how should an elongated soft palate be corrected surgically?
place 1 stay suture on either side at the distance you want to resect
cut & suture while you cut
