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LA Sx Final > Guttural Pouch Sx > Flashcards

Guttural Pouch Sx Flashcards

1
Q

Why should you use the dorsal aspect of the guttural pouch opening to access GPs with an endoscope?

A

Salpingopharyngeal plica is ventrally

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2
Q

How do you rotate an endoscope for ease of access to the GP?

A

Abaxial rotation

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3
Q

What CNs run through the GPs?

A

CN 7-12 but not 8

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4
Q

Which CN is in the lateral compartment of the GP?

A

CN 7

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5
Q

Which carotid artery is in the lateral compartment and what artery branches from it to run along the dorsal aspect of the lateral compartment?

A

External carotid splits to maxillary artery

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6
Q

What bone divides the GP into lateral and medial compartments?

A

Styohyloid bone

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7
Q

Which GP compartment is larger?

A

Medial

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8
Q

What are predisposing factors of typmany?

A

Birth-1yo
Fillies
Arabians and Paints

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9
Q

Usually unilateral non-painful swelling in parotid area w/2* empyema

A

Tympany

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10
Q

Accumulation of pus in a normal body cavity

A

Empyema

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11
Q

Why might dyspnea, dysphagia, and aspiration pneumonia occur w/severe tympany?

A

Swelling collapses nasopharynx

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12
Q

Is there inflammation associated w/tympany?

A

No - just swelling

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13
Q

What is the most reliable way to know if a tympanic GP is uni or bilateral>

A

Deflation of affected pouch

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14
Q

What is the px for tympany resolution?

A

Good, but complications can be troublesome

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15
Q

What GP tympany treatment is only effective in unilateral cases?

A

Fenestration of medium septum

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16
Q

How do you enlarge the pharyngeal opening to the GP?

A

Removal of plica and/or small segment of cartilaginous lamina

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17
Q

What risk does GP surgery always carry?

A

Iatrogenic nerve damage

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18
Q

How can you remodel the pharyngeal opening of the GP?

A

Trans-nasal folley catheter

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19
Q

How long should you leave a trans-folley catheter in place to cause pressure necrosis?

A

4-6wk

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20
Q

GP treatment w/high success rate with no major complications

A

Trans-nasal folley catheter

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21
Q

Creating another opening to the GP

A

Salpingopharyngeal fistula

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22
Q

What is the recurrence rate of GP tympany w/all treatment options?

A

30%

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23
Q

Purulent material w/in the GP

A

GP empyema

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24
Q

What % of GP empyemas have chondroids?

A

20%

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25
What is the most common isolate from a GP empyema?
Strep spp
26
Why is strangles a concern w/GP empyema?
Strep infection very close to retropharyngeal LN
27
Does a GP empyema more commonly affect young or older animals?
Young
28
What causes a GP empyema?
LN abscess rupture, 2* to tympany, pharyngeal perforation of NG tube
29
Intermittent unilateral nasal discharge, painful swelling @ parotid area, extended head carriage, pharyngeal collapse are all clinical signs of what?
GP empyema
30
Pus @ GP opening indicates what disease?
GP empyema
31
What will you see on rads of an GP empyema?
Fluid line, chondroids
32
How do you ID carriers of S. equi equi?
PCR of GP wash
33
How do you threat a non-inspissated GP empyema?
Saline irrigation of GP
34
Why don't you want to use antiseptics to irrigate a GP?
Irritation = risk of CN neuritis
35
Emergency disease of the GP
GP mycosis
36
What fungus causes GP mycosis?
Aspergillus fumigates
37
How long from 1st bleeding episode does it take for a GPM to erode through the entire artery?
1-20d
38
What is the 2nd most common clinical sign assoc. w/GPM and why?
Dysphagia d/t damage of pharyngeal branch of CN 10 and 11
39
What other clinical signs can accompany GPM?
Recurrent laryngeal neuropathy, DDSP, Horner's
40
What artery is at the top of the GP?
Maxillary artery
41
What are non-surgical treatments of GPM?
Topical antifungals, detach plaques w/foreceps after vessel obstruction
42
What is the preferred tx for GPM?
Surgical occlusion of artery
43
2/3 of GPM cases affect which artery?
Internal carotid
44
The other 1/3 of GPM cases affect which artery?
External carotid/maxillary
45
What is the px for GPM?
50% die from hemorrhage
46
How long can neuro signs persist after GPM lesion is removed?
Up to 18mo
47
Why do you occlude a GPM vessel both proximally and distally to the lesion?
Risk of retrograde flow
48
Circle of Willis is part of which artery?
Internal carotid
49
Retrograde flow of the maxillary/Ext carotid occurs through which other artery?
Major palatine artery
50
What are methods for arterial occlusion?
Balloon catheter, trans-arterial embolization
51
Which side of the lesion do you place the balloon occlusion and what do you occlude the vessel with on the other side of the lesion?
Balloon on brain side of vessel, circumfrential ligature on heart side of lesion
52
How does a trans-arterial coil stay in place?
Radial pressure
53
What is your plug of choice for trans-arterial embolization?
Nitinol plug
54
What causes temporohyoid osteoarthropathy?
Degenerative process of the joint or otitis
55
What breed is overrepresented in THO cases?
QH
56
What is a strong predisposing factor to THO and why?
Cribbing puts lots of tension on the joint
57
Which CNs are most likley to be dysfunctional 2* to THO?
7 and 8
58
Head shaking, ear rubbing, KCS and exposure keratitis
THO
59
How can you prevent fracture of the temporal bone and severe clinical signs?
Ceratohyoidectomy
60
What is the athletic prognosis of THO?
fair
61
What are the 4 open surgical approaches to the GP?
Hyovertebrotomy, Viborg's triangle, Whitehouse and modified whitehouse
62
Which approach to GP has good access to the roof of the medial compartment and excellent ventral drainage?
Modified whitehouse
63
Which sx approach to GP has poor drainage and is usually combined w/Viborg's triangle for empyema drainage?
Hyovertebrotomy
64
Which compartment do all surgical approaches enter?
Mecial

LA Sx Final (20 decks)

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