Laryngeal Paralysis Flashcards
Briefly explain the laryngeal anatomy
From cranial to caudal the cartilages are the epiglottic, arytenoid, thyroid, and cricoid carriages. The arytenoid cartilages are paired, the thyroid you can’t see when looking intraorally and then the cricoid is caudal to the thyroid and innervated by the recurrent laryngeal nerve
Why is the larynx important?
The larynx prevents aspiration, controls airway resistance (glottic opening) , voice production
Laryngeal paralysis results from the __ nerve which is a branch of the vagus nerve and innervates the ___ muscle. Laryngeal paralysis is more common in __ and ___
Laryngeal paralysis results from the recurrent laryngeal nerve which is a branch of the vagus nerve and innervates the cricoarytendoideus muscle. Laryngeal paralysis is more common in dogs and males
Name some breeds associated with congenital laryngeal paralysis and when clinical signs start and what they look like
Bouvier does flandres, Dalmatians, huskies, and Rottweilers
The onset of clinical signs in <1 yr old and is progressive neurologic degeneration
Acquired laryngeal paralysis is most common in labs/golden, Saint Bernards and Irish setters with the mean age affected being __ . It is commonly __ with a generalized __ but may be caused by neoplasia such as __ or __ OR an __ or __polyneuropathy
Acquired laryngeal paralysis is most common in labs/golden, Saint Bernards and Irish setters with the mean age affected being 9 yrs. It is commonly idiopathic with a generalized polyneuropathy but may be caused by neoplasia such as thyroid tumores or mediastinal masses OR an endocrine or immune mediated polyneuropathy
Briefly scribe the clinical presentation of a patient with acquired laryngeal paralysis
The disease progressions is typically slow with exercise intolerance, inspiratory stridor and early signs of voice changes, gagging, and coughing with food and water intake. These patients may be at an increased risk of heatstroke
What diagnostics might be performed for acquired laryngeal paralysis?
- CBC, Biochem, UA
- T4, TSH
- Thoracic + cervical rads
- esophagram/swallow studies
Aspiration pneumonia occurs in __ dogs with laryngeal paralysis and up animals have up to __ risk of aspiration pneumonia post surgery. What can you pre-treat with?
Aspiration pneumonia occurs in 7.9% dogs with laryngeal paralysis and up animals have up to 21% risk of aspiration pneumonia post surgery. Pre-treat with metoclopramide
On laryngeal examination the arytenoids/vocal folds should __ during inspiration
On laryngeal examination the arytenoids/vocal folds should abduct during inspiration
What does doxopram do for a laryngeal exam?
its a CNS stimulant that causes the cartilages to move more significantly after administration
Dogs without laryngeal paralysis will open the arytenoids on inspiration, this drug helps make the motion more obvious
Explain paradoxical motion on a laryngeal exam
Paradoxical motion happens on a laryngeal exam when a dog has laryngeal paralysis or collapse. When the animal takes a breath in the cartilages will be closed but when the animal exhales the cartilages will open from the physical forces of exhalation not because of nerve innervation.
In an emergency situation, how can you medically manage laryngeal paralysis?
- Provide a cool environment or cold ice baths if the temp is >105F
- supplement O2
- IV sedation with ace or torb
- IV corticosteroids
- cautious with fluid therapy
In an emergency situation, how can you medically manage laryngeal paralysis?
- Provide a cool environment or cold ice baths if the temp is >105F
- supplement O2
- IV sedation with ace or torb
- IV corticosteroids
- cautious with fluid therapy
- intubation, surgery, or a temporary tracheostomy may also be warranted
How could you treat a patient with laryngeal paralysis without surgery?
Start by treating the concurrent problems then work on weight loss, stress reduction, exercise restriction, and avoidance of high temperatures. This is only ok to do if the case is mild.
__ is the treatment of choice for animals with moderate to severe clinical signs of laryngeal paralysis and the goal is to __ airway resistance
Surgery is the treatment of choice for animals with moderate to severe clinical signs of laryngeal paralysis and the goal is to decrease airway resistance