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My 2017 RUSVM SAS 1 > Exam 2 Upper airway sx > Flashcards

Exam 2 Upper airway sx Flashcards

1
Q

What CS are associated w/ disease of the nasal passage

A

mild to severe resp distress

abn resp noises

exercise intolerance

hyperthermia

tachypnea

dyspnea

cyanosis

mucopurulent or bloody nasal discharge

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2
Q

What imaging modality is best for studying the nasal passages & skull?

Why is it important to perform biopsies or rhinoscopy following imaging?

A

CT/MRI

So you don’t create artifact

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3
Q

What are the short & long term risks associated w/ sx of th nose/nasal planum in dogs & cats

A

dehiscence

stenosis of airways

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4
Q

Describe pathophys of brachycephalic airway dz

What are the main conditions that make up BAS?

A

Refers to upper airway obstruction atribbutable to a combo of anatomic abn in brachycephalic dogs.

Elongated soft palate

Stenotic nares

shortened, flattened nasal cavity

+/- hypoplastic trachea

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5
Q

What are other anatomical conditions, dz processes & 2o changes that can contribute to airway occlusion in these animals

A

everted laryngeal saccules/Stage 1 Laryngeal collapse

Pharyngeal/laryngeal mucosal edema

tonsillar eversion

macroglossia

stage II/III laryngeal collapse

trachal collapse

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6
Q

What CS are seen w/ BAS?

What ddx should be considered in an animal presenting with these signs?

Other than the respiratory system, what other body systems can be affected by this condition?

A

Asymptomatic

Mild/moderate:

  • exercise intoleranc
  • incr. noise
  • +/- GI signs

Severe:

  • acute resp distress
    • severe upp airway swelling, hyperthermia, cyanosis
  • +/- heat stroke
  • +/- GI signs
  • +/- low airway dz
    • non cardiogenic pulm edema
    • aspiration pneumonia

Space occupying mass of the upper airway

GI & CV

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7
Q

Which components of the syndrome are dx by laryngeal exam?

What are the benefits of using an endoscope when performing a laryngeal exam?

What other conditions might warrant the use of an endoscope when examining a dog with BAS?

A

soft palate

arytenoid cartilages

laryngeal function

nares

see into nasopharnyx, more detail

assessment of 2o changes, hypoplastic trachea

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8
Q

What other diagnostics are warranted when working up a case of BAS

A

thoracic radiographs

abd radiographs

BW

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9
Q

Which abn are corrected first?

At what age should these sx be done & why?

A

stenotic nares

soft palate resection - palatectomy/palatoplasty

laryngeal collapse:

stage 1: excision of evrted laryngeal saccules

stage 2: + vocal fold excision, partial arytenoidectomy

Stage 3: permanent tracheostomy

recommended exam and corrections at time of spay/neuter sx.

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10
Q

describe procedures usedd to correct elongated soft palate.

what are perioperative & long-term complication of these procedures

A

sharp dissection

CO2 laser excision

bipolar sealing device excision

Hemorrhage, inflammation

undershortening or

overshortening:

  • nasal reflux
  • aspiration
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11
Q

list stages & events of each stage for laryngeal collapse.

Why does this condition occur with BAS?

A

Stage 1: everted laryngeal saccules

Stage 2: laryngeal collapse = collapse of cuneiform cartilage

Stage 3: laryngeal collapse = collapse of corniculate cartilage

incr airway resistance & pressures

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12
Q

Why is medical tx an important component of the mngmt of BAS?

What does medical therapy entail?

A

to decr. contributing factors to airway resistance

Weight loss

environmental changes

harness

tx underlying GI dz

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13
Q

Why is arytenoid lateralization sx not helpful in tx of laryngeal collapse?

A

because the weakened cartilages continue to collapse

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14
Q

what are the risks & complication associated w/ BAS?

Px?

What is imperative for owners to understand following sx?

A

Surgical correction of brachycephalic syndrome will alleviate signs of respiratory distress and improve quality of life in most dogs. The outcome is dependent on the age of the animal at the time of surgery and how severely the dog is affected preoperatively.

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15
Q

Define laryngeal paralysis

what is known about the etiology of ths condition

what are the 2 common age groups for laryngeal paralysis

A

complete or partial failure of the arytenoid cartilages and vocal folds to abduct during inspiration

It occurs because of dysfunction of the laryngeal muscles, recurrent laryngeal or vagus nerves, or cricoarytenoid ankylosis; acquired or congenital neurologic causes are most common.

Congenital laryngeal paralysis should be suspected in young (younger than 1 year of age) large breed dogs with upper airway obstruction

Acquired idiopathic laryngeal paralysis is most common in middle-aged or older dogs

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16
Q

what movements do the corniculate, cuneiform & arytenoid cartilages have during norm inspiration

how does this differ in dog w/ laryngeal paralysis

what about a dog w/ laryngeal collapse

A

the cricoarytenoid dorsalis contract, abducting the arytenoid cartilages

1 or both cricoarytenoid dorsalis mm fail to contract therefore the cartilages fail to abduct

first stage the laryngeal saccules evert -> cuneiform cartilages collapse -> followed by corniculate cartilages collapse

17
Q

describe the typical hx, presenting complaints & CS associate w/ layngeal paralysis

A

respiratory stridor

exercise intolerance

gagging/dysphagia

dysphonia

coughing

dyspnea that does not improve w/ open mouth breathing

18
Q

how is a definitive diagnosis made

what method is commonly used

what other diagnostic tests or evaluations should also be done in pt being worked up for a dx of laryngeal paralysis

A

laryngeal exam/laryngoscopy

under anesthetic

u/s can be done on unsedated animal (user dependent)

full neuro exam, CBC, Chem, US, TSH, T4

EMG, NCV

19
Q

what type of laryngeal paralysis is most common in SA pt

what other medical contions can be associated w/ the development of laryngeal paralysis

A

idiopathic

hypothyroidism, trauma, immune mediated (MG), infectious, toxin (lead, OP)

20
Q

why is a full neurologic exam imperative in any patient presenting w/ CS of laryngeal paralysis

A

because there can be a generlized neuropathy

as in young Rotties! (11-13 wks -> progressive)

21
Q

what is the purpose of arytenoid lateralization for tx of laryngeal paralysis

what structures are sutured together in this procedure

A

to improve air flow

the cricoid cartilage to the muscular process of the arytenoid

22
Q

what are complication of arytenoid lateralization

which complication has highest mortality associated w/ occurrence

A

over lateralization (more than under)

aspiration pneumonia

23
Q

what is long term px for pt w/ laryngeal paralysis

A

good w/ sx correction & medical mgmt.

24
Q
A

My 2017 RUSVM SAS 1 (17 decks)

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