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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
Q

What is the most common isolate from a GP empyema?

A

Strep spp

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26
Q

Why is strangles a concern w/GP empyema?

A

Strep infection very close to retropharyngeal LN

27
Q

Does a GP empyema more commonly affect young or older animals?

A

Young

28
Q

What causes a GP empyema?

A

LN abscess rupture, 2* to tympany, pharyngeal perforation of NG tube

29
Q

Intermittent unilateral nasal discharge, painful swelling @ parotid area, extended head carriage, pharyngeal collapse are all clinical signs of what?

A

GP empyema

30
Q

Pus @ GP opening indicates what disease?

A

GP empyema

31
Q

What will you see on rads of an GP empyema?

A

Fluid line, chondroids

32
Q

How do you ID carriers of S. equi equi?

A

PCR of GP wash

33
Q

How do you threat a non-inspissated GP empyema?

A

Saline irrigation of GP

34
Q

Why don’t you want to use antiseptics to irrigate a GP?

A

Irritation = risk of CN neuritis

35
Q

Emergency disease of the GP

A

GP mycosis

36
Q

What fungus causes GP mycosis?

A

Aspergillus fumigates

37
Q

How long from 1st bleeding episode does it take for a GPM to erode through the entire artery?

A

1-20d

38
Q

What is the 2nd most common clinical sign assoc. w/GPM and why?

A

Dysphagia d/t damage of pharyngeal branch of CN 10 and 11

39
Q

What other clinical signs can accompany GPM?

A

Recurrent laryngeal neuropathy, DDSP, Horner’s

40
Q

What artery is at the top of the GP?

A

Maxillary artery

41
Q

What are non-surgical treatments of GPM?

A

Topical antifungals, detach plaques w/foreceps after vessel obstruction

42
Q

What is the preferred tx for GPM?

A

Surgical occlusion of artery

43
Q

2/3 of GPM cases affect which artery?

A

Internal carotid

44
Q

The other 1/3 of GPM cases affect which artery?

A

External carotid/maxillary

45
Q

What is the px for GPM?

A

50% die from hemorrhage

46
Q

How long can neuro signs persist after GPM lesion is removed?

A

Up to 18mo

47
Q

Why do you occlude a GPM vessel both proximally and distally to the lesion?

A

Risk of retrograde flow

48
Q

Circle of Willis is part of which artery?

A

Internal carotid

49
Q

Retrograde flow of the maxillary/Ext carotid occurs through which other artery?

A

Major palatine artery

50
Q

What are methods for arterial occlusion?

A

Balloon catheter, trans-arterial embolization

51
Q

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?

A

Balloon on brain side of vessel, circumfrential ligature on heart side of lesion

52
Q

How does a trans-arterial coil stay in place?

A

Radial pressure

53
Q

What is your plug of choice for trans-arterial embolization?

A

Nitinol plug

54
Q

What causes temporohyoid osteoarthropathy?

A

Degenerative process of the joint or otitis

55
Q

What breed is overrepresented in THO cases?

A

QH

56
Q

What is a strong predisposing factor to THO and why?

A

Cribbing puts lots of tension on the joint

57
Q

Which CNs are most likley to be dysfunctional 2* to THO?

A

7 and 8

58
Q

Head shaking, ear rubbing, KCS and exposure keratitis

A

THO

59
Q

How can you prevent fracture of the temporal bone and severe clinical signs?

A

Ceratohyoidectomy

60
Q

What is the athletic prognosis of THO?

A

fair

61
Q

What are the 4 open surgical approaches to the GP?

A

Hyovertebrotomy, Viborg’s triangle, Whitehouse and modified whitehouse

62
Q

Which approach to GP has good access to the roof of the medial compartment and excellent ventral drainage?

A

Modified whitehouse

63
Q

Which sx approach to GP has poor drainage and is usually combined w/Viborg’s triangle for empyema drainage?

A

Hyovertebrotomy

64
Q

Which compartment do all surgical approaches enter?

A

Mecial

LA Sx Final (20 decks)

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