Lam Test 2 Flashcards
What is in the upper air ways?
nasal passages, larynx, trachea and major bronchi
What is in the lower air ways?
small bronchi and bronchioles
*****Respiratory system order of structures:
Nares → nasal passage → ethmoid → nasopharynx → guttural pouch → Larynx—->trachea ** know this order
If you see a fever or presence of nasal discharge think?
infectious
if you hear rails, wheezing, etc on thoracic auscultation think?
LRI
-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?
Transtracheal Wash -INFECTIOUS DISEASE OF FOCAL ORIGIN -Sterile means you can culture
*if you are looking for PULMONARY DISEASE do ____
radiographs
*if you are looking for THORACIC DISEASE do ____
ultrasound
Bronchoalveolar Lavage: What are you looking for specifically? Infectious or noninfectious? DIffuse or focal? Can you see tube placement or naH?
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
Gutteral Pouch mycosis is genrally in what age bracket of horses?
younger horses
Ethmoid hematoma is usually unilateral or bilateral
uniateral
What is the number one and 2 sign for GPM? What is number 2 due to
- Epistaxis 2. Dysphagia-due to causing effects on pharyngeal branch of the vagus nerve causing dorsal displacement of soft pallate
How do we treat GPM? State a adverse side effect we can cause?
-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
Number one cause of epistaxs in exercising versus normal horse?
Exercising-EIPH Normal-Trauma (NG tube)
What condition do we see hemosideraphages up to 150 days
EIPH 150 days post race
This cause of epistaxis has both inspiratory and expiratory noises depending on the significance of the space occupying mass
Ethmoid hematoma
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?
EIPH(No fever)
Uniateral epistaxis until unpredictable major bleeding through bilateral epistaxis is seen with this cause of epistaxis
gutteral pouch mycosis
What vessels to the plaques with GPM hang around
internal carotid maxillary external carotid
If there is mild bleeding with GPM how do we treat
longterm anitfingal with indwelling catheter
What is the typical signalment for ethmoid hematoma?
Older warmblood mare
Surgical laser ablation is the preferred treatment for what cause of epistaxis and what might they need supp
ethmoid hematoma (transfusion)
Furosemide is indiated to help this cause of epistaxis and this category, this is paired with this affect
EIPH, high level bleeders (will also see poor performance with high level bleeders)
Besides laser ablation for ethmoid hematoma what is another option, Describe how it works and when we avoid this
intralesional formalin leads to necrosis of the hematoma but dont do it if its in cribiform plate area
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
30-90 min post race for racing commision
if I see direct obs of blood in tracheobronchial tree what cause of epistaxis am I thinking
EIPH
Swallowing difficulties = _______
dysphagia
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?
- DDSP; cheek puffing (expiratory)
- Epiglotic entrapment (Ex and Inspira)
- Laryngeal hemiplegia (Inspiratory)
WHich soft pallate issue do we treat with a tie back procedure versus a tie forward?
- -DDSP-tie forward
- Laryngeal hemiplegia-tie back laryngoplasty
What soft pallate disorder is the most common complaint ecercise intolerance
Laryngeal hemiplegia
What is unique about the tie back laryngoplasty with laryngeal hemiplegia?
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
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?
Epiglottic entrapment (No cheek puffing its only happening in nasopharynx)
What type of noise does EE have and is there often CS?exercise intolerance or not?
Expir+Inspiratory
Can be asymptomatic or chronic cough when EATING
(exercise intolerance)
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?
DDSP; intermittent and persistent; intermittent seen only at exercise persisten is a sign of neuro origin
What is the major dignostic signalment for DDSP
ventral placement of epiglottis relative to soft pallate for greater than 8 seconds during high speed treadmil endoscopy
What are the 2 treatment for DDSP surgically
Tie forward to position larynx more rostral and then sternomyectomy todo a strap muscle resection
What are some conservative ways to treat DDSP
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
WHat are the conservative and surgical treatments for epiglottic entrapment? Which is preferred
- Conservative
- Nsaid (yet likely to reoccur)
- Surgery: Transendoscopic laser correction preferred methos to divide entrapped membrane
The majority of laryngal hemiplegia is caused this: called ______ laryngeal hemiplegia; damage to this side only (if the other…?)??
idiopathic; LEFT
( idiopathic cause is to left side)
if its right side its not idiopathic laryngeal hemiplegia
Right or left side hemiplegia that is non idiopathic can be asociated with?
- Perivascular jugular injection
- gutteral pouch dz
- if bilateral can be by severe inflamm, gutteral pouch or neuro disease
Abnormal _____ noise that is commonly called _____ in young (2-3 yr old)race horses. Most commonly called (fancy name)
Abnormal inspiratory noise that is commonly called roars in young (2-3 yr old)race horses. Most commonly called (Laryngeal hemiplegia)
State the differences in grades of laryngeal hemiplegia??
-
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
