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A. Equine and Camelid Medicine and Surgery > Guttural Pouch Surgery > Flashcards

Guttural Pouch Surgery Flashcards

1
Q

what is in the medial compartment of the guttural pouch?

A

internal carotid artery
vagus/CN X
sympathetic trunk
cranial cervical ganglion
glossopharyngeal/CN IX
hypoglossal/CN XII
pharyngeal branch of CN X

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2
Q

what is in the lateral compartment of the guttural pouch?

A

external carotid artery
maxillary artery
facial nerve

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3
Q

is tympanic swelling painful or non-painful?

A

non-painful

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4
Q

what is the medical management treatment for guttural pouch tympany?

A

anti-inflammatories
antibiotics
decompression

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5
Q

what are the surgical treatment options?

A

partial resection of guttural pouch septum
stoma (fistula) at level of pharyngeal opening
salpingopharyngeal fistula

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6
Q

what is the prognosis of bilateral guttural pouch tympany?

A

poor

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7
Q

what is guttural pouch empyema?

A

accumulation of purulent material

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8
Q

where is the incision made for a modified whitehouse?

A

ventral and parallel to linguofacial vein

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9
Q

when is the prognosis of guttural pouch empyema poor?

A

if neurologic deficits

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10
Q

what does guttural pouch mycosis affect?

A

neurovascular structures

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11
Q

what is the most common sign of guttural pouch mycosis?

A

hemorrhage

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12
Q

how can guttural pouch mycosis be diagnosed with endoscopy?

A

diphtheritic membrane
fungal plaque
hemorrhage

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13
Q

what can you give to prevent hemorrhage?

A

aminocaproic acid

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14
Q

can you perform a salpingopharyngostomy with hemorrhage?

A

no

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15
Q

what is in the ventral part of the medial compartment?

A

pharyngeal branch of CN X

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16
Q

what is visible outwardly with guttural pouch tympany?

A

tympanic swelling: unilateral or bilateral

17
Q

how can you decompress a guttural pouch tympany?

A

pharyngeal orifice: catheter or pipette
percutaneous: needle or skin incision

18
Q

what are the surgical treatment options for guttural pouch tympany?

A

partial resection of guttural pouch septum
stoma (fistula) at level of pharyngeal opening
salpingopharyngeal fistula

19
Q

what is a complication with guttural pouch tympany?

A

iatrogenic nerve damage

20
Q

what pathogens can lead to guttural pouch empyema through a complication of a respiratory tract infection?

A

b-hemolytic streptococcus
Streptococcus equi subsp equi

21
Q

what is S. equi M protein ELISA for?

A

diagnosis of guttural pouch empyema
vaccines cause false positives

22
Q

what can you treat acute guttural pouch empyema with?

A

anti-inflammatories
antibiotics
N-Acetyl cysteine

23
Q

what are the surgical options for guttural pouch empyema (failed medical management or too many chondroids)?

A

whitehouse
modified whitehouse (best)
viborg’s triangle
hyovertebrotomy

24
Q

where is the incision with hyovertebrotomy?

A

cranial and parallel to wing of atlas

25
Q

what are the borders of viborg’s triangle?

A

ventral ramus of mandible
linguofacial vein
sternocephalicus tendon

26
Q

what are the positives of a modified whitehouse approach?

A

excellent ventral drainage
access to entire guttural pouch

27
Q

who gets guttural pouch mycosis most commonly?

A

adults
warm and humid areas

28
Q

what species are identified in guttural pouch mycosis?

A

Aspergillus sp most common
A. fumigatus
A. nidulans

29
Q

what are the clinical signs of guttural pouch mycosis?

A

hemorrhage
dysphagia
horner’s syndrome
facial paralysis
abnormal head position

30
Q

why would you give aminocaproic acid to a horse with guttural pouch mycosis?

A

stop and prevent hemorrhage

31
Q

what are some antifungals you can treat guttural pouch mycosis with?

A

itraconazole
enilconazole
amphotericin B
ketoconazole
miconazole

32
Q

when can you perform a salpingopharyngostomy with guttural pouch mycosis?

A

only if no hemorrhage

33
Q

where can you occlude arteries for guttural pouch mycosis?

A

internal carotid artery: origin, at sigmoid flexure, or dorsal to roof of pouch
external carotid artery: origin
maxillary artery: caudal to caudal alar foramen

34
Q

should you give anti-fungals post-operatively for guttural pouch mycosis?

A

no

A. Equine and Camelid Medicine and Surgery (47 decks)

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