resp disease basics Flashcards
1
Q
what does a crackle indicate?
A
small airway and alveoli lesion
2
Q
what does a crackle indicate?
A
small airway and alveoli lesion
3
Q
what does a wheeze indicate?
A
partial obstruction of large airway
4
Q
what can you use an endoscopy to see in horses?
A
nasal passages guttural pouch nasopharynx soft palate larynx trachea
5
Q
what is a consideration before doing SA endoscopy?
A
is the trachea over 5 mm to accomodate the tube
6
Q
what is radiography good for?
A
pulmonary structures
fluid
gas
masses
7
Q
what is ultrasound good for?
A
effusions
lung surface
collapsed lung
8
Q
why would you carry out a lung biopsy?
A
identify specific pathology
9
Q
what are some negatives of lung biopsy?
A
very invasive
may get haemorrhage or pneumothorax
10
Q
when would you carry out a lung aspiration?
A
in very sick patients under Us guidance
when have a discrete intrapulmonary lesions which you cant get to any other way
11
Q
where do you do a thoracocentesis?
A
Horse - 7-8 IC space
SA - 8-9 IC space
12
Q
what is a tracheal aspirate?
A
get a sample of whole lung from thoracic inlet where secretions collect
via endoscope in horses
via ET tube in SA
beware of pharyngeal contamination
13
Q
what is a broncho-alveolar lavage?
A
-advance tube into bronchi until will go no further then add saline and withdraw sample
- only sample area where tube is
- horse will cough throughout
14
Q
how do you do a guttural pouch lavage?
A
endoscopically and lavage with sterile saline
15
Q
why would you do a nasopharyngeal swab?
A
bacterial culture of non-commensals
16
Q
what is a transtracheal aspirate?
A
sample secretions directly at thoracic inlet without pharyngeal contamination
- done to confirm pleuropneumonia as caused by pharyngeal commensals
- SA puncture cricotyroid ligament
- equids puncture 2/3 down trachea
17
Q
what are the normal respiratory defence mechanisms?
A
- smooth muscle tone
- mucus and mucociliary escalator
- cough
- resident macrophages, mast cells, lymphocytes, IgA, IgG
- infiltrating immune cells
- mediators from inflammatory cells
18
Q
why is bronchoconstriciton needed?
A
for a cough so more shear stress to separate mucous
19
Q
what is a cough?
A
high velocity of air flow creates shear forces to separate mucous
- involuntary
- protects large airways
20
Q
what can stimulate a cough?
A
bronchoconstriction excess mucous inhaled particles cold/hot air intra/extralmural pressure epithelial sloughing enhance ep permeability
21
Q
what does an URT cough sound like?
A
harsh
loud
non-productive
22
Q
what does a LRT cough sound like?
A
soft
muted
productive
23
Q
what is normal horse rr?
A
8-15
24
Q
normal cow/sheep/pig RR?
A
10-30
25
normal goat RR
25-35
26
normal foal/calf RR?
20-40
27
normal dog RR?
10-30
28
normal cat RR
24-42
29
normal rabbit RR
30-60
30
what is hyperpnoea?
increased rate and depth of breathing
31
what pathologies can cause tachypnoea and hyperpnoea?
```
high CO2
acidosis
low oxygen
damaged CNS
pain
```
32
what can cause inspiratory distress?
extrathoracic non-fixed airway obstruction
| restrictive disease limiting lung expansion
33
what can cause expiratory distress?
intrathoracic airway obstruction
34
what can cause inspiratory and expiratory distress?
extrathoracic fixed obstruction
35
what is orthopnoea and what can cause it?
difficulty breathing whilst recumbent
- pleural fluid
- neonate
- diaphragmatic hernia
- CHF
36
what is haemoptysis?
blood in sputum
37
when is an animal classed as cyanotic?
PaO2 < 50 mmHg
38
what can cause cyanosis?
V/Q mismatch
alveolar hypoventilation
shunting
impaired diffusion
39
is a trot related to breathing?
no
40
is a gallop related to breathing?
yes
inspire when in flight
expire when limb extends
41
what does a wheeze indicate?
partial obstruction of large airway
42
what can you use an endoscopy to see in horses?
```
nasal passages
guttural pouch
nasopharynx
soft palate
larynx
trachea
```
43
what is a consideration before doing SA endoscopy?
is the trachea over 5 mm to accomodate the tube
44
what is radiography good for?
pulmonary structures
fluid
gas
masses
45
what is ultrasound good for?
effusions
lung surface
collapsed lung
46
why would you carry out a lung biopsy?
identify specific pathology
47
what are some negatives of lung biopsy?
very invasive
| may get haemorrhage or pneumothorax
48
when would you carry out a lung aspiration?
in very sick patients under Us guidance
| when have a discrete intrapulmonary lesions which you cant get to any other way
49
where do you do a thoracocentesis?
Horse - 7-8 IC space
SA - 8-9 IC space
50
what is a tracheal aspirate?
get a sample of whole lung from thoracic inlet where secretions collect
via endoscope in horses
via ET tube in SA
beware of pharyngeal contamination
51
what is a broncho-alveolar lavage?
-advance tube into bronchi until will go no further then add saline and withdraw sample
- only sample area where tube is
- horse will cough throughout
52
how do you do a guttural pouch lavage?
endoscopically and lavage with sterile saline
53
why would you do a nasopharyngeal swab?
bacterial culture of non-commensals
54
what is a transtracheal aspirate?
sample secretions directly at thoracic inlet without pharyngeal contamination
- done to confirm pleuropneumonia as caused by pharyngeal commensals
- SA puncture cricotyroid ligament
- equids puncture 2/3 down trachea
55
what are the normal respiratory defence mechanisms?
- smooth muscle tone
- mucus and mucociliary escalator
- cough
- resident macrophages, mast cells, lymphocytes, IgA, IgG
- infiltrating immune cells
- mediators from inflammatory cells
56
why is bronchoconstriciton needed?
for a cough so more shear stress to separate mucous
57
what is a cough?
high velocity of air flow creates shear forces to separate mucous
- involuntary
- protects large airways
58
what can stimulate a cough?
```
bronchoconstriction
excess mucous
inhaled particles
cold/hot air
intra/extralmural pressure
epithelial sloughing
enhance ep permeability
```
59
what does an URT cough sound like?
harsh
loud
non-productive
60
what does a LRT cough sound like?
soft
muted
productive
61
what is normal horse rr?
8-15
62
normal cow/sheep/pig RR?
10-30
63
normal goat RR
25-35
64
normal foal/calf RR?
20-40
65
normal dog RR?
10-30
66
normal cat RR
24-42
67
normal rabbit RR
30-60
68
what is hyperpnoea?
increased rate and depth of breathing
69
what pathologies can cause tachypnoea and hyperpnoea?
```
high CO2
acidosis
low oxygen
damaged CNS
pain
```
70
what can cause inspiratory distress?
extrathoracic non-fixed airway obstruction
| restrictive disease limiting lung expansion
71
what can cause expiratory distress?
intrathoracic airway obstruction
72
what can cause inspiratory and expiratory distress?
extrathoracic fixed obstruction
73
what is orthopnoea and what can cause it?
difficulty breathing whilst recumbent
- pleural fluid
- neonate
- diaphragmatic hernia
- CHF
74
what is haemoptysis?
blood in sputum
75
when is an animal classed as cyanotic?
PaO2 < 50 mmHg
76
what can cause cyanosis?
V/Q mismatch
alveolar hypoventilation
shunting
impaired diffusion
77
is a trot related to breathing?
no
78
is a gallop related to breathing?
yes
inspire when in flight
expire when limb extends
79
What would you expect the blood gas changes to be with a unilateral pneumothorax?
- reduced pO2
- reduced sat%
- reduced PaO2
- reduced blood flow to collapsed lung
80
Why would PaO2 decrease with a unilateral pneumothorax?
V/Q mismatch as part of lung has no gas exchange
81
What are 5 explanations for reduced PaO2?
- less oxygen in
- shunting
- obstructing
- reduced RR
- V/Q mismatch
82
Why with a unilateral pneumothorax would SaO2 drop less than PaO2?
Think of oxy-hb dissociation curve which isnt a linear relationship
83
Why is there a difference with a unilateral pneumothorax between the fall in arterial(29 mmHg drop) and venous (5mmHg drop) pp of o2 and a similar drop in Hb sat in arterial and venous(both 7%) blood?
- the Hb drop is same for both as tissues will be taking the same (7%) amount of oxygen from the Hb despite the hypoxia
- there will be less overall O2 so a bigger drop in Pa/v O2
84
Why would blood flow be reduced to a lung on the side of a pneumothorax?
- hypoxia in alveoli causing BV constriction
| - any blood will be preferentially redirected to better ventilated alveoli to maintain blood O2
85
Will oxygen supplementation help a patient with a pneumothorax?
Yes - as PaO2 will increase so improves tissue perfusion
86
What physiologically processes does altitiude and reduced PaO2 stimulate?
- increase Hb conc so blood has a higher oxygen carrying capacity
- a left shift caused by blood alkalosis of the oxy-hb dissociation curve so more efficient loading of O2 in the pulmonary capillaries - so less inspired O2 needed for same Hb sat
- increased RR so more O2 getting into system and being pushing into Hb
87
What are some adaptations to altitude?
- increased rr
- polycythemia
- increase in number of capillaries in peripheral tissues
- hypertrophy of RH from hypoxia
- increase HB binding ability
88
Does anaemia cause hypoxia?
Yes
89
What will the heart do to compensate for anaemia?
increase CO
| drops to total peripheral resistance
90
will short term oxygen benefit an anaemic patient?
- all Hb already saturated so wont increase CaO2 significantly
- gives body false sense of security so wont make new RBC
- its a lack of Hb that is the issue not a lack of O2
- yes as will decrease CO and put less strain on heart
91
what is PaO2?
amount of free oxygen in plasma
92
what is SaO2?
% of haem sites carrying oxygen on Hb molecule
93
what is CaO2?
amount of oxygen in blood = SaO2+PaO2
94
What pathogens can cause diseases in birds?
Chlamydia (psittacosis)
mycoplasma gallisepticum
mycoplasma synoviae
mycoplasma meleagridis
