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.systems based core clinical specialties > Intro to Respiratory > Flashcards

Intro to Respiratory Flashcards

1
Q

Localizing the problem

A

Need history from the client, and PE findings → defining the location of the lesion

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2
Q

Important questions for the owner

A

Coughing, sneezing, gagging, reverse sneezing, productive cough, nasal discharge?
Change in breathing pattern?
How long?
Housing/ environment
Timing and travel history

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3
Q

What is observed with nasal/ sinonasal disease

A

Sneezing, nasal discharge (small amount normal), stertor, facial/ nasal defects

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4
Q

Sneezing

A

Forceful expulsion of air and debris from the nasal cavity

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5
Q

Nasal discharge

A

Serous (clear watery)
Mucoid (clear thick)
Mucopurlulent (white to yellowish, thick)
Serosanguineous (blood tinged water to thick)
Epistaxis (frank blood/ hemorrhage)

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6
Q

Stertor

A

↑ noise occurring with air movement through the respiratory system
Associated with nasal and pharyngeal obstruction

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7
Q

Secondary problems to nasal/ sinonasal disease

A

Inability to retropulse eyes (mass)
Exophthalmos

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8
Q

Viral diseases of the nasal cavity

A

K9: distemper, parainfluenza, adenovirus t2, reovirus
Feline: herpes and calicivirus

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9
Q

Bacterial disease of the nasal cavity

A

K9- bordetella and non-commensal pathogens like pasterurella
Feline: Chlamydophilia, mycoplasma and bordetella

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10
Q

Fungal diseases of the nasal cavity

A

K9: aspergillosis, penicillosis, rhinosporidosis
Feline: cryptococcus, penicillosis, rhinosporidosis

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11
Q

Parasitic diseases of the nasal cavity

A

Pneumonyssoides caninum and Eucoleus boehmi in K9s

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12
Q

Inflammatory diseases of the nasal cavity

A

Nasopharyngeal polyps
Lymphoplasmacytic rhinitis (+/- overgrowth of commensal bacteria)
Allergic rhinitis (+/- overgrowth of commensal bacteria)

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13
Q

Neoplasia of the nasal cavity

A

Adenocarcinoma, carcinoma, sarcoma, lymphoma

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14
Q

Other diseases of the nasal cavity

A

FBs, trauma, dental disease, oronasal fistula, palatine defects and stenotic nares

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15
Q

Stertor is a common CS of _____________

A

Nasopharyngeal polyp in a cats

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16
Q

What is a disease of the nasopharynx?

A

Reverse sneezing: audible paroxysms of strong, inspiratory efforts made against a closed glottis
Response to irritation in the posterior nasal cavity/ nasopharynx

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17
Q

CS of laryngeal and tracheal diseases

A

Coughing
Stridor
Inspiratory dyspnea
Cyanosis if severe

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18
Q

Stridor

A

↑ noise occurring with air movement through the resp. system
Associated with cd. pharyngeal, laryngeal or tracheal obstruction

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19
Q

Laryngeal/ tracheal diseases

A

Brachycephalic airway syndrome
Infectious tracheobronchitis
Laryngeal paralysis
Collapsing trachea

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20
Q

Brachycephalic airway syndrome (congenital)

A

Stenotic nares
Elongated soft palate
Hypoplastic trachea

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21
Q

Brachycephalic airway syndrome (Acquired)

A

Everted laryngeal saccules and tonsils
Collapsed laryngeal vestibule
Dynamic bronchial collapse

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22
Q

What causes infectious tracheobronchitis

A

Bordatella bronchiseptica, parainfluenza virus and CAV2
Travel/ boarding/ grooming

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23
Q

Laryngeal paralysis

A

Unilateral or bilateral
Inspiratory stridor
Large breed dogs
if airway not protected could lead to lower resp. disease

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24
Q

Collapsing trachea

A

Collapsing process
Goose honk cough (elicited on tracheal palpation)
Middle-aged to older, toy and mini breed dogs

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25
Q

Locations of collapsing trachea

A

Cervical- inspiratory
Thoracic- expiratory
Bronchi- expiratory

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26
Q

CS of diseases of the lower respiratory tract

A

Coughing
Tachypnea (↑ rate of resp.)
Dyspnea (resp. distress)
Cyanosis

27
Q

Causes of CS of the lower resp tract

A

Ventilatory failure, resp. failure or inadequate tissue oxygenation

28
Q

Ventilatory failure

A

Inability to perform adequate ventilation
Due to airway obstruction, pleural cavity disease, chest wall disease, diaphragm disorders

29
Q

Inadequate tissue oxygenation

A

Resp. causes: ventilatory/ resp. failure
Non-resp causes: anemia, methemglobinemia

30
Q

Diseases of the lower resp. tract

A

K9 Chronic bronchitis and feline asthma/ bronchitis

31
Q

K9 chronic bronchitis and Feline asthma/ bronchitis

A

Chronic multifactorial disease associated with chronic infamm. response in the airways →bronchoconstriction, bronchial thickening, ↑ mucus secretion, fibrosis and emphysema

32
Q

Etiologies of K9 chronic bronchitis and Feline asthma/ bronchitis

A

Allergic
Infectious (K9), bacteria (feline)
Pulmonary parasites
Heartworms
Inhaled irritants

33
Q

CS of K9 chronic bronchitis

A

Chronic coughing exacerbated by exercise or excitement

34
Q

CS of feline asthma/ bronchitis

A

Mild to life threatening (open mouth breathing/ cyanosis)
Recurrent episodes of coughing and resp. disease
Primary expiratory dyspnea

35
Q

Wheezing loudest @ the cervical trachea/ larynx

A

Inspiration: upper airway obstruction, laryngeal paralysis
Expiration: Attempt to keep small airways from closing early (rare)

36
Q

Wheezing loudest @ the chest wall

A

Inspiration: Large airway obstruction
End of expiration/ cough: Intrathroacic, small airway obstruction

37
Q

Bacterial pneumonia (parenchymal disease)

A

Common in dogs
Primary: lung → bordetella, strep zoo.
Secondary: pneumonia→ E. coli, pasteurella, strep, staph, pseudomonas, klebs

38
Q

CS of Bacterial pneumonia

A

Nonspecific: depression, anorexia, WL and fever
Cough, nasal discharge, dyspnea and crackles

39
Q

How do you diagnose bacterial pneumonia

A

Thoracic rads:
FB: focal
Dependent: secondary to airway disease of aspiration
Caudodorsal: hematogenous spread

40
Q

What causes fungal pneumonia (parenchyma disease)

A

Blastomycosis, histoplasmosis, coccidiomycosis, cryptococcus, aspergillosis

41
Q

Hypersensitivity/ immune mediated parenchymal diseases

A

Eosinophilic pneumonitis
Eosinophilic pulmonary granulomatosis

42
Q

Pulmonary edema (parenchyma)

A

Syndrome not disease:
↓ plasma colloid osmotic pressure → hypoalbuminemia
↑ hydrostatic pressure/ vascular overload → cardiac disease/ CHF, fluid overload, obstruction of pulmonary veins
↑ vascular permeability (stroke, trauma, near drowning, pulmonary contusions)
Systemic (DIC, sepsis, uremia, electrocution, etc)
Lymphatic obstruction

43
Q

Unknown mechanisms that cause pulmonary edema

A

Thromboembolism
Severe upper airway obstruction
Neurogenic
Hepatic failure
Pulmonary hypertension

44
Q

CS of diseases of the thoracic wall, pleural space and mediastinum

A

Dyspnea, cough, pleural effusion, mediastinal mass

45
Q

Diseases of the thoracic wall, pleural space and mediastinum

A

Pneumothorax
Pleural effusion
Diaphragmatic hernia
PPDH, diaphragmatic paralysis, blunt chest trauma, thoracic wall deformities

46
Q

Pneumothorax

A

Movement of air into the pleural space
Loss of chest wall integrity, puncture of the pulmonary pleura, rupture of the airway and mediastinum and rupture of the diaphragm with free abdominal air

47
Q

Tension pneumothorax

A

Respiratory movements pulls air into pleural space but prevent escape
Difficult to hear lung sounds, resonates percussion

48
Q

Etiologies of pneumothorax

A

Traumatic
Pulmonary disease (rupture of cysts, cavitations, emphysema)
Iatrogenic (thoracocentesis, needle aspirate, catheters, surgery, etc.)
Parasitic

49
Q

Pleural effusion

A

Pathologic accumulation of fluid
Inspiratory dyspnea with expanded chest wall
Dullness on thoracic percussion
↓ bronchovesicular and heart sounds

50
Q

Classifications of pleural effusions

A

Transudate protein
Modified transudate (obstructive)
Exudate protein
Chylous/ pseudochylous

51
Q

Diaphragmatic hernia

A

Congenital and acquired (blunt abdominal trauma against a close glottis)

52
Q

CS of a diaphragmatic hernia

A

Acute v chronic
Maybe no CS
Resp. signs (space occupying organs, pleural adhesions atelectasis)
Organ entrapment (bowel, liver, gastric, etc)

53
Q

CS of mediastinal diseases

A

Resp: airway/ parenchymal compression
Dysphagia: esophageal obstruction
Horner’s syndrome
Cr. vena cava syndrome

54
Q

Mediastinal diseases

A

Mediastinitis
Medastinal hemorrhage
Pneumomediastinum
Lymphadenopathy
Neoplasia (thymoma, lymphosarcoma)

55
Q

Dx tools for resp. cases

A

CBC with side evaluation and full WBC differential
Chemistry panel (for systemic disease)
Urinalysis (proteinuria, urine conc.)
Fecal
Basic infectious tests

56
Q

Dx rads aren’t useful for ________________

A

Sinonasal disease

57
Q

Dx rads

A

3 views: R, L and VD
Include lateral of the cervical trachea and larynx/ pharynx
Prefer inspiratory views

58
Q

Dx for nasal/ sinonasal diseases

A

Cytology- exudates/ discharge
Culture- tissue samples for fungal/ bacteria
Virus isolation/ resp. PCR
CT scan (nasal passages, sinuses, turbinate, masses, bone destruction)
Rhinoscopy/ pharyngoscopy

59
Q

Dx tools for pharynx, larynx and trachea

A

CT scan, fluoroscopy, bronchoscopy/ pharyngoscopy, sedated laryngeal exam

60
Q

Dx tools for lower resp tract/ parenchymal

A

Ct scan, blood gases, pulse oximetry, ultrasound, borchoscopy, fine needle aspiration, histopathology, ECG

61
Q

Dx tools for pleural space

A

CT scan, ultrasound, thoracocentesis (fluid analysis, cytology, culture)

62
Q

Dx tools for thoracic wall/ cage

A

CT scan, ultrasound, contrast studies (barium)

63
Q

Dx tools for mediastinum

A

Fine needle aspirate, histopathology, bronchoscopy

.systems based core clinical specialties (27 decks)

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