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Equine Medicine and Surgery > Lecture 21: Equine Upper Airway conditions > Flashcards

Lecture 21: Equine Upper Airway conditions Flashcards

1
Q

What is this

A

atheroma

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2
Q

What is an atheroma

A

Epidermal inclusion cyst, contain squamous and keratin debris

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3
Q

Remove atheroma if __ or __-

A

Obstructive or cosmetic

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4
Q

How do you remove atheroma- 2 ways

A
  1. Laser- enucleate, scrap out, pack with formalin
  2. Burr technique- grab cyst, pack with formalin
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5
Q

What is this

A

nasal polyp

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6
Q

Nasal polyps attach in ___

A

Caudal nasopharynx

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7
Q

How do you remove nasal polyp

A

Amputate with cutting loop or OB wire tube

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8
Q

Nasal mucosal hemorrhage, what is causing it here

A

leaky vein

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9
Q

What are the 3 causes of nasal mucosal hemorrhage in non-race horses

A
  1. Leaky vein
  2. Ethmoid hematoma
  3. Guttural pouch mycosis
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10
Q

How do you tx nasal mucosal hemorrhage caused by leaky vein

A
  1. Cauterize
  2. Silver nitrate stick
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11
Q

What is choanal atresia

A

Failure of buconasal membrane rupture in early gestation

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12
Q

Bilateral choanal atresia is __at birth without ___

A

Fatal without tracheostomy

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13
Q

What is the main clinical sign of cleft palate

A

Nasal discharge of milk

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14
Q

What wrong

A

cleft palate

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15
Q

Horse presented with epistaxis, put scope in and found this- what is it

A

ethmoid hematoma

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16
Q

An ethmoid hematoma is an enlarging mass in the ___and/or ___

A

Ethmoturbinate, sinus

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17
Q

Ethmoid hematomas have persistent dark hemorrhage but not ___hemorrhage

A

Fatal

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18
Q

For ethmoid hematomas you ___every case for sinus involvement

A

Radiograph

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19
Q

How do you tx ethmoid hematoma

A
  1. Debulk as much as possible before laser
  2. Grab with electrosurgical loop or OB wire loop
  3. Formalin injection
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20
Q

What diagnostics should be done for all sinus diseases

A
  1. Endoscopy
  2. Oral exam
  3. Rads
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21
Q

What is circled in red

A

guttural pouch openings

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22
Q

Young foal presents with this- what is likely dx

A

Guttural pouch tympany

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23
Q

What causes guttural pouch tympany

A

Salpingopharyngeal osteum becomes one-way valve trapping air in one or more guttural pouchesw

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24
Q

What is the surgical approach for unilateral guttural pouch tympany

A

Fenestrate medium septum to allow unaffected side to empty air

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25
Q

What is the best way to tx bilaterally affected guttural pouch tympany

A

Dorsal pharyngeal recess fenestration (what divides both guttural pouches)wh

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26
Q

Image of guttural pouch- what is wrong

A

Guttural pouch empyema

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27
Q

What is a common cause of guttural pouch empyema

A

Retropharyngeal lymph node abscess

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28
Q

How do you tx guttural pouch empyema

A
  1. Guttural pouch lavage with coiled or Foley catheter
  2. Drainage
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29
Q

If you are going to drain a guttural pouch with pus what do you need to be cautious of and know

A

Know where abscess is pointing because you can damage nerves required for swallowing

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30
Q

From guttural pouch- what are these

A

chondroids

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31
Q

What wrong

A

guttural pouch mycosis

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32
Q

Guttural pouch mycosis typically has mycotic plaques on ___ or ___

A

Internal carotid or maxillary artery

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33
Q

Guttural pouch mycosis is typically due to ___dz

A

Arterial wall disease

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34
Q

Guttural pouch mycosis requires __ for tx

A

Embolization of regional arteries

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35
Q

What are some clinical signs of guttural pouch mycosis

A

Excessive arterial hemorrhage

36
Q

What is the first thing you do if you suspect guttural pouch mycosis

A

Sedate horse and do endoscopy

37
Q

What is the treatment for guttural pouch mycosis and how does it work

A

Trans arterial coil embolization- selective occlusion of affected vessels- ECA, ICA, MA, and aberrant branches

38
Q

What is temporohyoid osteopathy

A

Fusion of temporohyoid joint- reduced mobility in hyoid apparatus

39
Q

What are some early non-specific signs of temporohyoid osteopathy

A

Head shaking, ear rubbing, abnormal head position while ridden

40
Q

What are some advanced signs of temporohyoid osteopathy and what caused these signs

A

Neurological involvement following fracture of Petrous temporal bone or stylohyoid bone

Ataxia, head tilt, nystagmus, facial nerve signs

41
Q

How do you dx temporohyoid osteopathy

A

Rads, endoscopy, CT

42
Q

what is wrong

A

Temporohyoid osteopathy

43
Q

What is medical tx for temporohyoid osteopathy

A

Antibiotics, anti-inflammatories

44
Q

What is preferred surgical tx for temporohyoid osteopathy

A

Ceratohyoidectomy

45
Q

You can do a osteoectomy of stylohyoid bone to tx temporohyoid osteopathy but what are some possible negative outcomes

A

Hypoglossal nerve injury, transient dysphagia, regrowth of bone

46
Q

What wrong

A

entrapped epiglottis

47
Q

How do you tx epiglottal entrapment

A

Transecting membrane

48
Q

What these and how do you remove

A

subepiglottal cysts- remove via snare or laser

49
Q

What wrong

A

dorsal displacement of soft palate

50
Q

What is the most common cause of dorsal displacement of soft palate

A

Upper airway irritation compromising muscle tone

51
Q

All treatments for dorsal displacement of soft palate are aimed at ___

A

Maintaining epiglottis dorsal to soft palate

52
Q

What are some ways to tx dorsal displacement of soft palate

A
  1. Relieve inflammation before sx
  2. Tongue tie
  3. Sternothyroideus tenectomy
  4. Laser soft palate
  5. Tie forward
  6. Trim soft palate
53
Q

If you have a permanently dorsal displaced soft palate what is appropriate tx

A

Trim soft palate

54
Q

If you only need to tx dorsal displacement of soft palate during a race what can you do

A

Tongue tie

55
Q

During a tie forward for dorsal displaced soft palate you tie ___ to ___

A

Cricoid cartilage to basihyoid bone

56
Q

What is affected in laryngeal hemiplegia/roaring

A

Paresis of left recurrent laryngeal nerve affected cricoartyenoideus dorsalis muscle

57
Q

What are some clinical signs of laryngeal hemiplegia

A

Airway noise at exercise (not rest), exercise intolerance

58
Q

What causes the airway noise in laryngeal hemiplegia

A

Vocal folds and cords

59
Q

What causes the exercise intolerance in laryngeal hemiplegia

A

Cartilage collapse

60
Q

Horse presents to you “roaring”, endoscopy reveals this, what is wrong

A

laryngeal hemiplegia

61
Q

What is grade 1 laryngeal hemiplegia

A

Normal

62
Q

What is grade 2 laryngeal hemiplegia

A

Asynchronous movements, full abduction possible with stimulation, 20% signs at exercise

63
Q

What is grade 3 laryngeal hemiplegia

A

Asynchronous movement, full abduction can’t be induced, 80% signs at exercise

64
Q

What is a grade 4 laryngeal hemiplegia

A

No movement during any phase of respiration

65
Q

What are the 3 possible treatments of laryngeal hemiplegia

A
  1. Prosthetic laryngoplasty with ventriculocordectomy
  2. Ventriculocordectomy alone
  3. Partial artytenoidectomy
66
Q

Ventriculocordectomy alone is only appropriate for ___

A

Non-athletes

67
Q

What is a prosthetic laryngoplasty with ventriculocordectomy

A

Tie back surgery and removal of vocal folds, cords,and saccule

68
Q

A ventriculocordectomy removes source of __ and stabilizes tie back sx by ___

A

Airway noise, artyenoid thyroid cartilage adhesion

69
Q

What are some complications of prosthetic laryngoplasty

A
  1. Suture infection
  2. Dysphagia, coughing from over abduction
70
Q

Removed vocal cord for laryngeal hemiplegia and then had leaky larynx, could not fully close. What can you inject to make bigger

A

hyaluronic acid

71
Q

When you have a failure of surgery for laryngeal hemiplegia you should always do a ___exam

A

Dynamic

72
Q

If you are hearing “roaring” noise from patient who had a left laryngeal hemiplegia prosthetic laryngoplasty and ventriculodectomy what is likely the problem

A

Right side experiencing problems now because if you removed vocal cords and folds on left then you can;t have noise coming from left

73
Q

What wrong

A

arytenoid chondritis

74
Q

What typically causes artyenoid chondritis

A

Abscess in arytenoid cartilage

75
Q

What are some clinical signs of arytenoid chondritis

A

upper airway noise during exercise, exercise intolerance, airway emergency

76
Q

What are some differential diagnosis for upper airway noise

A

Left laryngeal hemiplegia, arytenoid chondritis, granuloma/ulcer on larynx

77
Q

Horses with arytenoid chondritis may also have left laryngeal hemiplegia due to ___

A

Left laryngeal hemiplegia will cause left slide to smack into right side causing ulcer and then arytenoid chondritis

78
Q

Which one is left laryngeal hemiplegia va arytenoid chondritis

A

Left: Laryngeal hemiplegia
Right: arytenoid chondritis

79
Q

How can you tx arytenoid chondritis

A
  1. Laser debridement through trochanter in cricothyroid membrane
  2. Conventional debdriment through standing laryngotomy
80
Q

What is a partial arytenoidectomy

A

Remove entire artyenoid cartilage except muscular process

81
Q

T or F: partial arytenoidecotmy can be done in athletes

A

True

82
Q

Where do you put in a trach and what muscles and ligament you cutting through

A

Ventral, mid cervical region
Cut through annular ligament and sternothyroideus muscle

83
Q

What this

A

tracheotomy tube set

84
Q

what this

A

Foal trach set

85
Q

Do not cut ___ in foals when doing a trach, will make a knot

A

Tracheal rings

86
Q

T or F: inflate cuff when during a trach on a foal to secure airway

A

FALSE- never inflate cuff because it can clog at end of tube and then they can’t breath around inflated cuff

Equine Medicine and Surgery (27 decks)

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