Lower respiratory tract diagnostics (3)

Question 1

how does inflammation effect cough receptors?

Answer 1

causes them to become more sensitive

Question 2

how does discharge compare in lower respiratory tract infection compare to upper?

Answer 2

lower you get a bilateral discharge

Question 3

how does lower respiratory tract infection cause tachypnoea/dyspnoea?

Answer 3

pathology in the lungs causes reduced gas exchange leading to hypercapnia, acidaemia and hypoxaemia which is recognised by chemoreceptors in the aortic and carotid bodies
impulses send to the respiratory centre in the medulla to increase respiratory rate and effort

Question 4

what effect does the horses having a huge respiratory capacity have on the clinical signs on respiratory disease?

Answer 4

they may not be apparent at rest (may need to exercise in cases of mild disease)

Question 5

what posture suggests severe respiratory distress?

Answer 5

extended head and neck

Question 6

what muscle hypertrophies to cause heave lines?

Answer 6

external abdominal oblique

Question 7

what sound is normally associated with collapse?

Answer 7

wheeze

Question 8

what is likely to cause an inspiratory wheeze?

Answer 8

upper respiratory collapse

Question 9

where is an inspiratory noise most likely to be localised to?

Answer 9

upper respiratory tract

Question 10

is lower respiratory collapse more likely to cause an inspiratory or expiratory noise?

Answer 10

expiratory

Question 11

where is the loaded respiratory noise heard in a normal horse?

Answer 11

tracheal bifurcation

Question 12

what are normal breath sounds?

Answer 12

turbulent air in large airways causing a soft blowing sound that are louder on inspiration

Question 13

are normal breath sounds heard more on inspiration or expiration?

Answer 13

inspiration

Question 14

what are the adventitious sounds of the respiratory tract?

Answer 14

wheezes
crackles
pleural rubs

Question 15

what causes a wheeze?

Answer 15

narrowing of airway causing vibrations

Question 16

what are some possible causes of respiratory wheezes?

Answer 16

thickened walls (oedema/inflammation)
intraluminal obstructions
bronchospasm
extraluminal compression

Question 17

what usually causes monophonic wheezes?

Answer 17

single areas of airway obstruction/narrowing

Question 18

what are the two types of crackles?

Answer 18

coarse
fine

Question 19

what causes coarse crackles?

Answer 19

bubbling mucous in airway

Question 20

what causes fine crackles?

Answer 20

opening of collapsed small airways

Question 21

when are fine crackles usually auscultated?

Answer 21

early inspiration

Question 22

what causes pleural friction rubs?

Answer 22

inflamed parietal and visceral pleural membranes rubbing together

Question 23

how can respiratory sounds be exaggerated?

Answer 23

making horse work
making horse rebreathe (put bag over head)

Question 24

what can thoracic percussion be used for?

Answer 24

assess for fluid (more resonance means more fluid) - looking for changes in resonance

Question 25

what is seen on an inflammatory profile in blood samples?

Answer 25

increase white blood cells
increased proteins
increased fibrinogen and serum amyloid A

Question 26

what are the main acute phase proteins?

Answer 26

fibrinogen
serum amyloid A

Question 27

what are the three main samples that can be obtained from the lower respiratory tract?

Answer 27

tracheal aspirate
bronchoalveolar lavage
thoracocentesis

Question 28

what are the disadvantages of a endoscopically guided tracheal aspirate?

Answer 28

samples contaminated with nasopharyngeal
needs specialist equipment

Question 29

what are the two ways to tale a tracheal aspirate?

Answer 29

endoscopically guided
transtracheal aspiration

Question 30

what percentage neutrophils is seen in a normal tracheal aspirate?

Answer 30

<20%

Question 31

why is bronchoalveolar lavage unsuitable for bacteriology?

Answer 31

contaminated by upper respiratory tract

Question 32

what should you see on the appearance of BAL fluid if the sample was successful?

Answer 32

foam on top - surfactant