Quick and dirty trachea

Question 1

When performing a cervical ventral midline what aspect of the trachea are you getting access to?

Answer 1

Cranial cervical trachea

Question 2

If I want to access the caudal cervical and cranial _____ trachea what approach do I take?

Answer 2

(fill in the blank = thoracic)

Median sternotomy approach

Question 3

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)

Answer 3

Right 3rd: cranial thoracic trachea

Right 4th: tracheal birfurcation

Question 4

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!!!

Answer 4

False beetch:

surgery for tracheal collapse is only indicated when Med MNGT fails

Question 5

For tracheal collapse, what can I use that is specific for the cervical tracheal ONLY and where do I place them?

Answer 5

external prosthetic tracheal rings

must start and end placement in normal area of tracheal (not collapsed)

Question 6

Biggest potential risk with surgery for tracheal collapse?

Answer 6

laryngeal paralysis

Question 7

What might result if you are doing surgery for tracheal collapse and you accidentally penetrate the thoracic cavity near caudal cervical trachea?

Answer 7

pneumothorax

Question 8

What method result if you are doing surgery for tracheal collapse would you use to provide circumferential support without affecting vessels or nerves?

Answer 8

Intraluminal stent

Question 9

Compare and contrast areas of the trachea intraluminal stent and external prosthetic tracheal rings can work for ?

Answer 9

intraluminal stent: can be used for both cervical an thoracic trachea

external prosthetic tracheal rings: cervical tracheal ONLY

Question 10

What happens if the bronchi collapse beyond the stented region when you placed your intraluminal stent?

Answer 10

No current treatment

Question 11

Describe the perfect ideal treatment for tracheal collapse?

Answer 11

No perfect treatment!!! surgery should avoided if possible

Question 12

In terms of tracheal trauma, which is the most common cause/classification of internal or external for kitty cats?

Answer 12

Internal

rupture or necrosis secondary to ET tube or dental procedures (possible FB)!!!

Question 13

Blunt or penetrating injuries like bite wounds are classified as an ______ cause of tracheal trauma

Answer 13

external

Question 14

What is the most common CS of tracheal trauma?

Answer 14

subcutaneous emphysema

Question 15

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

Answer 15

True!

Question 16

When theres a minor tear in the trachea and it has now progressed to pneumothorax what should you do doc? ______ or ______

Answer 16

thoracocentesis or thoracostomy

Question 17

In terms of standard order, should surgical treatment be considered the first treatment and MM for tracheal trauma

Answer 17

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

Question 18

How much can we resect in adult dogs versus puppies for the trachea. What is our limiting consideration after resecting 3-4 rings?

Answer 18

25-50% in adults

20-25% in puppies

but tension is obvious after resecting 3-4 rings

Question 19

What is the biggest complication we think of with the trachea if we performed an anastomosis surgery?

Answer 19

Stricture!

• poor absorption of mucosa
• tension
• inflammation

Question 20

Why do we perform salvage procedures such as permanent tracheostomy?

Answer 20

-Untreatable airway obstruction like:

• nonresect. laryngeal neoplasia
• stage 3 laryngeal collapse
• irrev laryngeal parlaysis

Question 21

Which stage has no treatment in terms of laryngeal collapse stages

Answer 21

stage 3

Question 22

when you place a perm tracheostomy what happens for weeks post op

Answer 22

excessive secretions until squamous metaplasia of mucosa is complete

Question 23

Is the prognosis good or poor for perm tracheostomy for cats, why or why not?

Answer 23

Cats are very poor, mucus plugs are very common and the leading cause of acute death