Resp sx Flashcards
what are the C/S for a nasal obstruction?
nasal d/c, sneezing, epistasis (uni or bilateral), stertorous inspiration
what are the C/S for an elongated soft palate?
stertorous breathing, inspiratory stridor, resp distress, cyanosis, collapse
what are the C/S for laryngeal collapse?
stertor, stridor, coughing, gagging, dyspnea, regurg, vomiting, exercise intolerance, syncope/collapse
what are the C/S of laryngeal paralysis?
change in voice/phonation, gagging/coughing, exercise intolerance, inspiratory stridor, dyspnea, cyanosis, syncope/collapse
what are the C/S for a tracheal obstruction?
cough, dyspnea, cyanosis, collapse
what surgical solutions do you have for upper airway diseases?
- create a bigger opening: open nares, turbinates , shorten soft palate, pexy the epiglottis, tie back the larynx
- bypass the upper airway completely (tracheostomy): only if the above doesn’t work
what are the C/S for tracheal rupture?
subq emphysema, anorexia,. lethargy, stridor, coughing
what are the C/S for tracheal collapse?
honking goose cough, dyspnea (waxing/waning), exercise intolerance, cyanosis, syncope/collapse
what can you do surgically to treat tracheal disease?
do something to keep the trachea open, bypass the upper airway completely with tracheostomy, otherwise resect and anastomose
what are the C/S for consolidated lung lobe and abscesses?
resp distress (varying degrees), low grade fever, exercise intolerance
what are the C/S for bronchiectasis?
cough, repeated bouts of pneumonia
what are the C/S for lung lobe torsion?
dyspnea, tachypnea, lethargy. cough, hemoptysis
what are the C/S for pulmonary neoplasia?
increased resp effort, exercise intolerance, cough
what are the solutions for lower airway diseases surgically?
cut what ever is causing disease out and remove it
what are the C/s for pleural space disease
depends on vol and rapidity of fill
restrictive breathing pattern (rapid and shallow to maintain minute vol)
rapid onset
how can you treat pleural space disease surgically?
drain the air/fluid and treat inciting cause
what does BOAS stand for?
brachycephalic obstructive airway syndrome
what are the factors involved in BOAS?
- stenotic nares
- aberrent turbinates
- elongated, thickened soft palate
- oversized tongue
- everted laryngeal saccules
- hypoplastic trachea
- laryngeal collapse, tracheal collapse
what are the C/S of BOAS?
- resp noise
- stenotic nares
- GI signs (difficulty swallowing, regurg, gastroesophageal reflux)
- obstructive sleep apnea
- heat intolerance
- cyanosis and collapse
how do you diagnose BOAS?
- PE
- laryngoscopy/endoscopy
- CT, rads
how do you manage BOAS?
- weight mgmt
- avoid overheating
- open nares (rhinoplasty)
- open turbinates (endoscope guided turbinectomy)
- shorten soft palate (staphylelctomy) or also thin it (folded flap palatoplasty)
- partial tonsillectomy
- laryngeal sacculectomy
- ongoing observation…
we do not cure BOAS!!!!!
what are the risks of BOAS treatment?
post-op airway inflammation/swelling
aspy pneu pneu
what is a hiatal hernia?
when stomach herniates through diaphragm (alongside esophagus in esophagus hiatus) into the thoracic cavity
what is the general pathophys of laryngeal paralysis? who gets it?
typically older large breed dogs, idiopathic acquired
vagus –> recurrent laryngeal nerve –> caudal laryngeal nerve
cricoarytenoideus dorsalis (CAD) fails to abduct the arytenoid cartilage
problem when bilateral
what are the C/S of lar par? (laryngeal paralysis)
- change phonation, gagging/coughing esp when E/D
- exercise intolerance
- heat intolerance
- laryngeal stridor
- acute dyspnea
- cyanosis, syncope
- regurg (megaesophagus)
progressive disorder
how do you diagnose lar par (laryngeal paralysis?)
rads
laryngoscopy under light plane anesthesia
how do you manage laryngeal paralysis? lar pars
- cooling, O2 therapy, anxiolytics
- emergency tracheostomy
- mild: weight loss, stress reduction, exercise restriction, avoid heat (progression)
- mod/severe: unilateral cricoarytenoid lateralization (unilateral “tie-back”)
we do not sure lar par :(
what are the risks for lar par intervention?
- GOLPP (geriatric onset laryngeal paralysis polyneuropathy)
- aspy pneu pneu = life long risk
tracheostomy can be used for any obstruction… where?
forward of larynx
BOAS, laryngeal collapse, lar par, granulomas
what can you do to surgically treat tracheal collapse? what should you do first?
first, try medical management!!!
stending (intraluminal > extraluminal)
dogs with severe, refractory tracheal collapse benefit from earlier stenting
malformation type collapse is more likely to require tracheal stenting
what is spontaneous pneumothorax?
leakage of air from lung without evidence of trauma
what are the C/S of pneumothorax?
mild: asymptomatic
mod/severe: restrictive breathing pattern, hypoventilation, diminished lung sounds
can be fatal
how do you diagnose pneumothorax
- PE
- rads (once stable)
- CT (?)
how do you tx pneumothorax?
- thoracocentesis
- thoracostomy tubes for animals requiring ongoing drainage
- continuous suction
- autologous blood patch? [last ditch effort, fibrin from this “helps”]
- surgery
pyothorax:
1. typical signalment?
2. what type of bac t?
- young. hunting/working breed dogs over represented
- obligate anaerobes or mix of obligate and facultative anaerobes; bac t tend to reflect oral cavity and URT
what are the C/S of pyothorax?
tachypnea, dyspnea, cough, lethargy, weight loss, anorexia, restrictive breathing pattern, muffled breath & heart sounds
may be afebrile
SIRS, sepsis… often
often fatal
how do you diagnose pyothorax?
- thoracocentesis –> cytology
- imaging
how do you medically treat pyothorax?
- drainage and Abx (fluoroquinolone & penicillin or clindamycin to start, then based on C&S)
- thoracic drainage
- thoracic lavage??
when/why do you surgically treat pyothorax?
- primary cause that requires surgical resection
- thoracostomy tube complications
- failure of medical mgmt
how do you surgically treat pyothorax?
medial sternotomy
what is the most common cause of diaphragmatic hernias? what organ is most commonly included in the hernia?
trauma
liver
what are the C/S of diaphragmatic hernias?
resp distress, exercise intolerance, potentially GI signs, muffled heart sounds, lung sounds, borborygmi
depends on what is herniated and state that organ is in
how do you diagnose diaphragmatic hernia?
rads or US
how do you correct a diaphragmatic hernia?
- surgery ASAP in stable pt (hernias trump fx)
- hernia reduction (abdominal approach)
what does PPDH stand for?
peritoneopericradial diaphragmatic hernia
PPDH’s are ____. what are they? what is the typical signalment involved?
congenital
gap in ventral diaphragm such that pericardial sac and peritoneal cavity communicate
Weimaraners and long haired cat breeds, any age
what are the clinical signs ofperitoneopericradial diaphragmatic hernias?
GI, CV, resp signs
muffled heart sounds, borborygmi
how do you diagnose PPDH?
rads or US
how do you manage PPDHs?
asymptomatic incidental: conservative mgmt
midline ceiliotomy
