Respiratory Flashcards
What is the difference between stertor and stridor?
Stertor: noise absent with mouth open and discontinous. low pitched. Nasal or nasopharyngeal obstruction - inspiratory but occasionally exp as well.
Stridor: continous, high-pitched, noise present with mouth open or closed. Laryngeal or laryngopharyngeal obstruction.
Where can a cough originate and what are the differences in each type of cough?
From alveoli or small ariwaus - preceeded by deep inspiration.
paroxysms : start sorted and increase in volume as secretions move up the tracheobronchial tree
often have post-tussive retch
From mainstem bronchi- goose honk
Laryngeal cough - stimulus is often abrupt => reflex laryngospasm so this prevents deep inspiration priot to start of the cough and => rapid fire cough that is weak or ineffective + gagging.
From airway narrowing - only noted during exercies.
Other areas - nose, nasophyrinx, paranasal sinus, ear canals, diaphrgm and pericardium.
Describe different breathing patterns?
- Normal => 1:1 or 1:2 insp to expiratory
- Obstructive:
- Extrathoracic => increased insp effort and noise => prolonged insp phase (stertor/stridor)
- intrathoracic => increased exp effort and noise => prolonged exp phase (dynamic lower airway obstruction eg asthma, TB collapse)
- fixed airway obstruction - prolonged cycle + insp and exp noise eg gade IV tracheal collapse - Restrictive:
- ixed insp and expiratory difficulty
- reduced lung compliance or airflow vols (IPF, pneumonia, pleural space disease)
=> need increased airway pressure to expand lungs thus reduce tidal volume and increase RR
=> shallow rapid respiration.
(quiet/absent lung sounds = pleural space disease)
(increased adventitious lung sounds = parenchymal disease) - Compensation for both restrictive and obstructive + pleural space disease
=> Paradoxical breathing
- fatigue of the diaphragm => abdo muscles sucked in with inspiration and then move out with expiration.
PCR testing for URTi should be obtained using what type of swab?
polyester-tipped as residue in cotton tipped or calcium alginate may inhibit PCR assays
What fungal URTi diseases can be detected by PCR?
Blasto coccidio crypto histo asper Pneumocystis
What viral URTi diseases can be detected by PCR?
Canine distemper CAV2 Canine herpes Canine parainfluenze virus 2 Canine resp coronavirus HCN2 H3N8 H1NI Canine pneumovirus
FHV1
Feline calicivirus
What bacterial URTi diseases can be detected by PCR?
Bordertella chalmydia felis mycoplasma cynos mycoplasma felis Strep equi subsp zooepidemicus
What protozoal URTi diseases can be detected by PCR?
Toxo
Neospora
Acanthamoeba
What are the different classifications of pulmonary radiographic abnormalities? (5)
- Interstitial
- unstructured/diffuse
- structured/nodular - Alveolar
- Bronchial
- Pleural effusion
- Pneumothorax
What is a radiographic interstitial pattern and possible causes?
- Diffuse/unstructured
- generalized increase in parenchymal background opacity and decreased distinction of pulmonary vasculature
Causes: pneumonia (viral, haematogenous), pulmonary oedema, neoplasia (lymphoma), pneumonitis (Eg uraemic), hypoventilation, obesity - Nodule/s:
Discrete or coalescing soft tissue nodules
>2cm = mass
- Multiple solid nodules - mets, fungal, septic emboli
- Single solid mass - primary tumour, abscess
- Multiple cavitary nodules - mets, parasitic, mullae
- Solitary cavitary mass - primary tumour, abscess, bulla
What is a radiographic alveolar pattern and possible causes?
when air within the alveoli is replaced with soft tissue or fluid =>
- increase in overall opacity.
- air bronchograms
- lobar sign
- soft tissue silhouetting
causes:
Fluid - pul oedema, hemorrhage, inflam (bronchopenumonia)
Tissue - inflam (eosinophilic bronchopneumopathy), neoplasia, PTE
Other - atelectasis
What is a radiographic bronchial pattern and possible causes?
- thickened bronchial walls or infiltation of peribronchial space with fluid or cells
=> - thickened bronchi (tram tracks or donuts)
- bronchiectasis
- cranial or middle lung lobe atelectasis
- hyperlucent lung fields (due to air trapping)
Causes:
- allergic airways disease
- parasitic
- chronic bronchitis
What can nuclear scintigraphy be used to diagnose in relation to the respiratory system?
- lung function including regional pulmonary perfusion or lung ventilation to calculate regional ventrilation to perfusion ratios to localize areas of low V/Q within diffuse lung disease (Eg pre-biopsy/lung lobectomy)
- PTE (better than angiography)
- mucocillary clearance
How much fluid should be instilled for:
- BAL
- ETW
- TTW
- BAL 1-2ml/kg in large dogs. 2-4ml/kg in smaller dogs/cats
- ETW 0.5-5ml/kg
- TTW 0.5=5ml/kg
What are the limitations and complications of:
- BAL
- ETW
- TTW
- transthoracic needle aspirate or biopsy
- BAL
- req GA
- interstitial lung disease
- hypoxemia due to ventilation perfusion mismatch
- bronchospasm - ETW
- req GA
- only large airways/productive cough
- worsening respiratory disease/cough
- bronchospasm - TTW
- only large airways/productive cough
- only large dogs >15kg
- myst tolerate restraint
- not with bleeding issues or ventral cervical pyoderma
- worsening respiratory disease/cough
- bronchospasm
- SC empyseme
- haemorrahge
- cardiac arrhythmia
- hemoptysis
- tracheal laceration => pneumomediasteinum or pneumothorax
- infection along the needle tract
- airway obstruction from haemorrhage or haematoma - transthoracic needle aspirate or biopsy
- req imaging
- not in animals with bleeding issues, cystic or bullous lesion, penumothorax, pulmonary hypertesion. resp distress ro instability
- complications inc bleeding, pnumothroax, seeding along needle tract, death
