Lam Test 2

Question 1

What is in the upper air ways?

Answer 1

nasal passages, larynx, trachea and major bronchi

Question 2

What is in the lower air ways?

Answer 2

small bronchi and bronchioles

Question 3

*****Respiratory system order of structures:

Answer 3

Nares → nasal passage → ethmoid → nasopharynx → guttural pouch → Larynx—->trachea ** know this order

Question 4

If you see a fever or presence of nasal discharge think?

Answer 4

infectious

Question 5

if you hear rails, wheezing, etc on thoracic auscultation think?

Answer 5

LRI

Question 6

-Name the STERILE technique of evaluation; sterile which means you can ________: done at the junction of middle and distal ⅓ of the neck, above bifurcation of the sternohyoideus muscle. Is this done for infectious or non infectious Diffuse or Focal?

Answer 6

Transtracheal Wash -INFECTIOUS DISEASE OF FOCAL ORIGIN -Sterile means you can culture

Question 7

*if you are looking for PULMONARY DISEASE do ____

Answer 7

radiographs

Question 8

*if you are looking for THORACIC DISEASE do ____

Answer 8

ultrasound

Question 9

Bronchoalveolar Lavage: What are you looking for specifically? Infectious or noninfectious? DIffuse or focal? Can you see tube placement or naH?

Answer 9

Bronchoalveolar Lavage -NON-INFECTIONS IN ORIGIN DISEASE, looking for inflammatory cells -Do if the horse has a diffuse disease - you do not know where the tube is going

Question 10

Gutteral Pouch mycosis is genrally in what age bracket of horses?

Answer 10

younger horses

Question 11

Ethmoid hematoma is usually unilateral or bilateral

Answer 11

uniateral

Question 12

What is the number one and 2 sign for GPM? What is number 2 due to

Answer 12

1. Epistaxis 2. Dysphagia-due to causing effects on pharyngeal branch of the vagus nerve causing dorsal displacement of soft pallate

Question 13

How do we treat GPM? State a adverse side effect we can cause?

Answer 13

-No bleeding treat medically -Bleeding treat with surgery transarterial coil placment to obstruct both sides to prvent communication from circle of willis, can cause blindness

Question 14

Number one cause of epistaxs in exercising versus normal horse?

Answer 14

Exercising-EIPH Normal-Trauma (NG tube)

Question 15

What condition do we see hemosideraphages up to 150 days

Answer 15

EIPH 150 days post race

Question 16

This cause of epistaxis has both inspiratory and expiratory noises depending on the significance of the space occupying mass

Answer 16

Ethmoid hematoma

Question 17

This cause of epistaxis has a characteristic lung location in the CAUDOdorsal lung lobe seen on rads. Is is paired with a fever or no fever?

Answer 17

EIPH(No fever)

Question 18

Uniateral epistaxis until unpredictable major bleeding through bilateral epistaxis is seen with this cause of epistaxis

Answer 18

gutteral pouch mycosis

Question 19

What vessels to the plaques with GPM hang around

Answer 19

internal carotid maxillary external carotid

Question 20

If there is mild bleeding with GPM how do we treat

Answer 20

longterm anitfingal with indwelling catheter

Question 21

What is the typical signalment for ethmoid hematoma?

Answer 21

Older warmblood mare

Question 22

Surgical laser ablation is the preferred treatment for what cause of epistaxis and what might they need supp

Answer 22

ethmoid hematoma (transfusion)

Question 23

Furosemide is indiated to help this cause of epistaxis and this category, this is paired with this affect

Answer 23

EIPH, high level bleeders (will also see poor performance with high level bleeders)

Question 24

Besides laser ablation for ethmoid hematoma what is another option, Describe how it works and when we avoid this

Answer 24

intralesional formalin leads to necrosis of the hematoma but dont do it if its in cribiform plate area

Question 25

When do you have to scope a suspected EIPH if you were the veterinarian for legal reasons and racing commision to prove this horse did indeed need performance enhancing furosemide

Answer 25

30-90 min post race for racing commision

Question 26

if I see direct obs of blood in tracheobronchial tree what cause of epistaxis am I thinking

Answer 26

EIPH

Question 27

Swallowing difficulties = _______

Answer 27

dysphagia

Question 28

Answer 28

Question 29

State the soft pallate issue that is mostly EXPIRATORY; inspiratory, and both inspriratory and expiratory component and name the common clinical sign with the expiratory compnent one?

Answer 29

• DDSP; cheek puffing (expiratory)
• Epiglotic entrapment (Ex and Inspira)
• Laryngeal hemiplegia (Inspiratory)

Question 30

WHich soft pallate issue do we treat with a tie back procedure versus a tie forward?

Answer 30

• -DDSP-tie forward
• Laryngeal hemiplegia-tie back laryngoplasty

Question 31

What soft pallate disorder is the most common complaint ecercise intolerance

Answer 31

Laryngeal hemiplegia

Question 32

What is unique about the tie back laryngoplasty with laryngeal hemiplegia?

Answer 32

It wont stop the noise you will need todo a ventriculochrodectomy which doesnt imporve airway mechanics; to reduce noise indicated in grade 2 B, C and 4 affected horses

Question 33

Name the soft pallate issue?

ENtrapment occurs when ventral tissues roll up around the apex and lateral margins of the epiglottis over the dorsal surface of the epoglottis.

Is cheek puffing seen why or why not?

Answer 33

Epiglottic entrapment (No cheek puffing its only happening in nasopharynx)

Question 34

What type of noise does EE have and is there often CS?exercise intolerance or not?

Answer 34

Expir+Inspiratory

Can be asymptomatic or chronic cough when EATING

(exercise intolerance)

Question 35

With which SPissue is there frequent neck stretching and quitting making choking noises, this issue has an option to flex the poll when exercising, what are the types as well?

Answer 35

DDSP; intermittent and persistent; intermittent seen only at exercise persisten is a sign of neuro origin

Question 36

What is the major dignostic signalment for DDSP

Answer 36

ventral placement of epiglottis relative to soft pallate for greater than 8 seconds during high speed treadmil endoscopy

Question 37

What are the 2 treatment for DDSP surgically

Answer 37

Tie forward to position larynx more rostral and then sternomyectomy todo a strap muscle resection

Question 38

What are some conservative ways to treat DDSP

Answer 38

Change poll flexion (flex their head with the bridle meaning bring their head to their chest to be collected)

TOngue tie prevent retraction of larynx

TSD which is throat supporting device to hold laynx in place

Question 39

WHat are the conservative and surgical treatments for epiglottic entrapment? Which is preferred

Answer 39

• Conservative
  
  • Nsaid (yet likely to reoccur)
• Surgery: Transendoscopic laser correction preferred methos to divide entrapped membrane

Question 40

The majority of laryngal hemiplegia is caused this: called ______ laryngeal hemiplegia; damage to this side only (if the other…?)??

Answer 40

idiopathic; LEFT

( idiopathic cause is to left side)

if its right side its not idiopathic laryngeal hemiplegia

Question 41

Right or left side hemiplegia that is non idiopathic can be asociated with?

Answer 41

• Perivascular jugular injection
• gutteral pouch dz
• if bilateral can be by severe inflamm, gutteral pouch or neuro disease

Question 42

Abnormal _____ noise that is commonly called _____ in young (2-3 yr old)race horses. Most commonly called (fancy name)

Answer 42

Abnormal inspiratory noise that is commonly called roars in young (2-3 yr old)race horses. Most commonly called (Laryngeal hemiplegia)

Question 43

State the differences in grades of laryngeal hemiplegia??

Answer 43

• Grade 1 and 2
  
  • full abduction at rest and usually fully during exercise. it is just moving slowly
• Grade 2: 77% have significant dysfunction at exercise
  
  • ​A- abduction in exercise
  • B- incomplete abduction
  • C- severe collapse at exercsise
• Grade 4:
  
  • ​paralysis evident at resting endoscopy