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Year 3 respiratory > resp disease basics > Flashcards

resp disease basics Flashcards

1
Q

what does a crackle indicate?

A

small airway and alveoli lesion

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2
Q

what does a crackle indicate?

A

small airway and alveoli lesion

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3
Q

what does a wheeze indicate?

A

partial obstruction of large airway

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4
Q

what can you use an endoscopy to see in horses?

A 
nasal passages
guttural pouch
nasopharynx
soft palate
larynx
trachea
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5
Q

what is a consideration before doing SA endoscopy?

A

is the trachea over 5 mm to accomodate the tube

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6
Q

what is radiography good for?

A

pulmonary structures
fluid
gas
masses

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7
Q

what is ultrasound good for?

A

effusions
lung surface
collapsed lung

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8
Q

why would you carry out a lung biopsy?

A

identify specific pathology

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9
Q

what are some negatives of lung biopsy?

A

very invasive

may get haemorrhage or pneumothorax

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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

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11
Q

where do you do a thoracocentesis?

A

Horse - 7-8 IC space

SA - 8-9 IC space

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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

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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
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14
Q

how do you do a guttural pouch lavage?

A

endoscopically and lavage with sterile saline

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15
Q

why would you do a nasopharyngeal swab?

A

bacterial culture of non-commensals

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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
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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
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18
Q

why is bronchoconstriciton needed?

A

for a cough so more shear stress to separate mucous

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19
Q

what is a cough?

A

high velocity of air flow creates shear forces to separate mucous

  • involuntary
  • protects large airways
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20
Q

what can stimulate a cough?

A 
bronchoconstriction
excess mucous
inhaled particles
cold/hot air
intra/extralmural pressure
epithelial sloughing
enhance ep permeability
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21
Q

what does an URT cough sound like?

A

harsh
loud
non-productive

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22
Q

what does a LRT cough sound like?

A

soft
muted
productive

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23
Q

what is normal horse rr?

A

8-15

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24
Q

normal cow/sheep/pig RR?

A

10-30

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25
Q

normal goat RR

A

25-35

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26
Q

normal foal/calf RR?

A

20-40

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27
Q

normal dog RR?

A

10-30

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28
Q

normal cat RR

A

24-42

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29
Q

normal rabbit RR

A

30-60

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30
Q

what is hyperpnoea?

A

increased rate and depth of breathing

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31
Q

what pathologies can cause tachypnoea and hyperpnoea?

A 
high CO2
acidosis
low oxygen
damaged CNS
pain
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32
Q

what can cause inspiratory distress?

A

extrathoracic non-fixed airway obstruction

restrictive disease limiting lung expansion

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33
Q

what can cause expiratory distress?

A

intrathoracic airway obstruction

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34
Q

what can cause inspiratory and expiratory distress?

A

extrathoracic fixed obstruction

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35
Q

what is orthopnoea and what can cause it?

A

difficulty breathing whilst recumbent

  • pleural fluid
  • neonate
  • diaphragmatic hernia
  • CHF
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36
Q

what is haemoptysis?

A

blood in sputum

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37
Q

when is an animal classed as cyanotic?

A

PaO2 < 50 mmHg

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38
Q

what can cause cyanosis?

A

V/Q mismatch
alveolar hypoventilation
shunting
impaired diffusion

39
Q

is a trot related to breathing?

A

no

40
Q

is a gallop related to breathing?

A

yes
inspire when in flight
expire when limb extends

41
Q

what does a wheeze indicate?

A

partial obstruction of large airway

42
Q

what can you use an endoscopy to see in horses?

A 
nasal passages
guttural pouch
nasopharynx
soft palate
larynx
trachea
43
Q

what is a consideration before doing SA endoscopy?

A

is the trachea over 5 mm to accomodate the tube

44
Q

what is radiography good for?

A

pulmonary structures
fluid
gas
masses

45
Q

what is ultrasound good for?

A

effusions
lung surface
collapsed lung

46
Q

why would you carry out a lung biopsy?

A

identify specific pathology

47
Q

what are some negatives of lung biopsy?

A

very invasive

may get haemorrhage or pneumothorax

48
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

49
Q

where do you do a thoracocentesis?

A

Horse - 7-8 IC space

SA - 8-9 IC space

50
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

51
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
52
Q

how do you do a guttural pouch lavage?

A

endoscopically and lavage with sterile saline

53
Q

why would you do a nasopharyngeal swab?

A

bacterial culture of non-commensals

54
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
55
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
56
Q

why is bronchoconstriciton needed?

A

for a cough so more shear stress to separate mucous

57
Q

what is a cough?

A

high velocity of air flow creates shear forces to separate mucous

  • involuntary
  • protects large airways
58
Q

what can stimulate a cough?

A 
bronchoconstriction
excess mucous
inhaled particles
cold/hot air
intra/extralmural pressure
epithelial sloughing
enhance ep permeability
59
Q

what does an URT cough sound like?

A

harsh
loud
non-productive

60
Q

what does a LRT cough sound like?

A

soft
muted
productive

61
Q

what is normal horse rr?

A

8-15

62
Q

normal cow/sheep/pig RR?

A

10-30

63
Q

normal goat RR

A

25-35

64
Q

normal foal/calf RR?

A

20-40

65
Q

normal dog RR?

A

10-30

66
Q

normal cat RR

A

24-42

67
Q

normal rabbit RR

A

30-60

68
Q

what is hyperpnoea?

A

increased rate and depth of breathing

69
Q

what pathologies can cause tachypnoea and hyperpnoea?

A 
high CO2
acidosis
low oxygen
damaged CNS
pain
70
Q

what can cause inspiratory distress?

A

extrathoracic non-fixed airway obstruction

restrictive disease limiting lung expansion

71
Q

what can cause expiratory distress?

A

intrathoracic airway obstruction

72
Q

what can cause inspiratory and expiratory distress?

A

extrathoracic fixed obstruction

73
Q

what is orthopnoea and what can cause it?

A

difficulty breathing whilst recumbent

  • pleural fluid
  • neonate
  • diaphragmatic hernia
  • CHF
74
Q

what is haemoptysis?

A

blood in sputum

75
Q

when is an animal classed as cyanotic?

A

PaO2 < 50 mmHg

76
Q

what can cause cyanosis?

A

V/Q mismatch
alveolar hypoventilation
shunting
impaired diffusion

77
Q

is a trot related to breathing?

A

no

78
Q

is a gallop related to breathing?

A

yes
inspire when in flight
expire when limb extends

79
Q

What would you expect the blood gas changes to be with a unilateral pneumothorax?

A
  • reduced pO2
  • reduced sat%
  • reduced PaO2
  • reduced blood flow to collapsed lung
80
Q

Why would PaO2 decrease with a unilateral pneumothorax?

A

V/Q mismatch as part of lung has no gas exchange

81
Q

What are 5 explanations for reduced PaO2?

A
  • less oxygen in
  • shunting
  • obstructing
  • reduced RR
  • V/Q mismatch
82
Q

Why with a unilateral pneumothorax would SaO2 drop less than PaO2?

A

Think of oxy-hb dissociation curve which isnt a linear relationship

83
Q

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?

A
  • 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
Q

Why would blood flow be reduced to a lung on the side of a pneumothorax?

A
  • hypoxia in alveoli causing BV constriction

- any blood will be preferentially redirected to better ventilated alveoli to maintain blood O2

85
Q

Will oxygen supplementation help a patient with a pneumothorax?

A

Yes - as PaO2 will increase so improves tissue perfusion

86
Q

What physiologically processes does altitiude and reduced PaO2 stimulate?

A
  • 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
Q

What are some adaptations to altitude?

A
  • increased rr
  • polycythemia
  • increase in number of capillaries in peripheral tissues
  • hypertrophy of RH from hypoxia
  • increase HB binding ability
88
Q

Does anaemia cause hypoxia?

A

Yes

89
Q

What will the heart do to compensate for anaemia?

A

increase CO

drops to total peripheral resistance

90
Q

will short term oxygen benefit an anaemic patient?

A
  • 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
Q

what is PaO2?

A

amount of free oxygen in plasma

92
Q

what is SaO2?

A

% of haem sites carrying oxygen on Hb molecule

93
Q

what is CaO2?

A

amount of oxygen in blood = SaO2+PaO2

94
Q

What pathogens can cause diseases in birds?

A

Chlamydia (psittacosis)
mycoplasma gallisepticum
mycoplasma synoviae
mycoplasma meleagridis

Year 3 respiratory (11 decks)

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