Quick and dirty trachea Flashcards
When performing a cervical ventral midline what aspect of the trachea are you getting access to?
Cranial cervical trachea
If I want to access the caudal cervical and cranial _____ trachea what approach do I take?
(fill in the blank = thoracic)
Median sternotomy approach
When performing a intercostal thoracotomy if I go through the right 3rd IC space I access this region, versus the right 4th IC space which is when I access this aspect of the trachea? (name the 2)
Right 3rd: cranial thoracic trachea
Right 4th: tracheal birfurcation
True or False:
When a patient comes in to your clinic and they are exhibiting signs of trachea collapse intermittently, your’re going to rush them to an OR bc the patient needs to go to surgery urgently before this gets worse!!!
False beetch:
surgery for tracheal collapse is only indicated when Med MNGT fails
For tracheal collapse, what can I use that is specific for the cervical tracheal ONLY and where do I place them?
external prosthetic tracheal rings
must start and end placement in normal area of tracheal (not collapsed)
Biggest potential risk with surgery for tracheal collapse?
laryngeal paralysis
What might result if you are doing surgery for tracheal collapse and you accidentally penetrate the thoracic cavity near caudal cervical trachea?
pneumothorax
What method result if you are doing surgery for tracheal collapse would you use to provide circumferential support without affecting vessels or nerves?
Intraluminal stent
Compare and contrast areas of the trachea intraluminal stent and external prosthetic tracheal rings can work for ?
intraluminal stent: can be used for both cervical an thoracic trachea
external prosthetic tracheal rings: cervical tracheal ONLY
What happens if the bronchi collapse beyond the stented region when you placed your intraluminal stent?
No current treatment
Describe the perfect ideal treatment for tracheal collapse?
No perfect treatment!!! surgery should avoided if possible
In terms of tracheal trauma, which is the most common cause/classification of internal or external for kitty cats?
Internal
rupture or necrosis secondary to ET tube or dental procedures (possible FB)!!!
Blunt or penetrating injuries like bite wounds are classified as an ______ cause of tracheal trauma
external
What is the most common CS of tracheal trauma?
subcutaneous emphysema
True or false:
many tracheal trauma patients respond to medical management using things like cage rest O2 suppl. and sedatives for treatment with minor tears to the trachea
True!
When theres a minor tear in the trachea and it has now progressed to pneumothorax what should you do doc? ______ or ______
thoracocentesis or thoracostomy
In terms of standard order, should surgical treatment be considered the first treatment and MM for tracheal trauma
many respond to MM first and should be attempted but if dyspnea persists or worsens surgical repair is indicated.
Also surgery is considered if pneumothorax persists > 2-3 days or theres visible tracheal damage
How much can we resect in adult dogs versus puppies for the trachea. What is our limiting consideration after resecting 3-4 rings?
25-50% in adults
20-25% in puppies
but tension is obvious after resecting 3-4 rings
What is the biggest complication we think of with the trachea if we performed an anastomosis surgery?
Stricture!
- poor absorption of mucosa
- tension
- inflammation
Why do we perform salvage procedures such as permanent tracheostomy?
-Untreatable airway obstruction like:
- nonresect. laryngeal neoplasia
- stage 3 laryngeal collapse
- irrev laryngeal parlaysis
Which stage has no treatment in terms of laryngeal collapse stages
stage 3
when you place a perm tracheostomy what happens for weeks post op
excessive secretions until squamous metaplasia of mucosa is complete
Is the prognosis good or poor for perm tracheostomy for cats, why or why not?
Cats are very poor, mucus plugs are very common and the leading cause of acute death
