Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Small animal surgery I > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Surgically speaking, where does the upper airway start and where does it end?

A

Nares to Larynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the neoplasias of the nasal cavity?

A

Adenocarcinoma, SCC, lymphoma, MCT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the best imaging tool for nasal disease?

A

CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

T/F: Always perform rhinoscopy and nasopharyngoscopy after imaging the nose.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the most common nasal neoplasia indicated for surgery?

A

SCC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are some complications seen with nasal surgery?

A

Hemorrhage, flap necrosis, fistula, dehiscence, stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the primary disease components of brachycephalic airway syndrome?

A

Stenotic nares, elongated soft palate, everted laryngeal saccules, hypoplastic trachea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the pathophysiology of upper airway obstructive disease?

A

Higher negative pressures that overcome obstruction, secondary soft tissue changes, decreased air flow with increased obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the most common component of BAS, and what does it lead to?

A

Elongated soft palate - leads to stertor.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How much of the airway resistance in BAS does stenotic nares make up?

A

77% of the airway obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the 3 stages of laryngeal collapse?

A

Stage 1 - everted laryngeal saccules

Stage 2 - collapse of cuniform cartilage

Stage 3 - collapse of corniculate cartilage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which dog breed most commonly has hypoplastic tracheas?

A

English Bulldogs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are some GI comorbidities that go along with BAS, and what is a potential, more important complication they can lead to?

A

Regurgitation, vomiting, hiatal hernias, ulceration

These can lead to aspiration pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How does BAS affect the cardiovascular system?

A

The chronic decrease in Pa02 from the airway obstruction leads to pulmonary vasoconstriction, V/Q mismatch, and then CV hypertenson

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What gender is more commonly affected by BAS?

A

Males

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

T/F: Aspiration pneumonia is associated with severe BAS

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are some space occupying masses that can occur in the upper airway?

A

Neoplasia, abscess, granuloma, foreign body, epiglottic retroversion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the preferred methods of examining and diagnosing BAS?

A

Examination of upper airway under light anesthesia, thoracic radiographs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What drug is a general CNS stimulant and used to improve the rate and strength of respiration?

A

Doxapram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the indications for surgery in a case of BAS?

A

Any presence of the components or clinical signs of BAS, also to prevent secondary changes of BAS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the surgical procedures used to treat BAS?

A

Wedge resection, soft palate resection, excision of everted laryngeal saccules

Spay/neuter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What anti-inflammatory would you give as a pre-op therapy for BAS?

A

Dexamethasone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What tools are used for soft palate resection?

A

CO2 laser, bipolar sealing device, sharp dissection with stay sutures on the soft palate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What surgical techniques are performed to treat stenotic nares?

A

Wedge resection, allapexy, trader’s technique

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

T/F: Tonsillectomies are not recommended because the swelling will usually resolve after the treatment of other tissues

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What must you distinguish before performing a unilateral arytenoid lateralization?

A

The presence of laryngeal paralysis (do procedure) and laryngeal collapse (do not do procedure)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are some post-op therapies for BAS?

A

Prolonged intubation, analgesia, NPO, e-collar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are some post-op complications with BAS?

A

ASPIRATION PNEUMONIA

rhinitis, swelling, bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What CxS does epiglottic retroversion cause?

A

Extreme inspiratory effort

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How do you treat epiglottic retroversion?

A

pexy of the ventral epiglottis and dorsal base of tongue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the muscle and nerve responsible for the larynx to abduct?

A

Muscle: crycoarytenoideus dorsalis

Nerve: caudal laryngeal nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are the 3 functions of the larynx?

A

Swallowing, abduction for breathing, voice production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are the two big diseases of the larynx?

A

Paralysis, trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are the CxS seen with laryngeal disease?

A

Stridor, exercise intolerance, dysphagia, coughing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is the pathophysiology of laryngeal paralysis?

A

Dysfunction to the vagus nerve that branches to the recurrent laryngeal and caudal laryngeal nerves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the most common cause of laryngeal paralysis?

A

Idiopathic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

How do you surgically treat laryngeal paralysis?

A

Unilateral arytenoid lateralization (yes, I said it already)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What are some post-op therapies for surgical treatment of laryngeal paralysis?

A

Keep ET tube in until patient is awake, NPO for 24 hours, avoid heavy sedation, check for aspiration pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What lobe of the lung is most commonly affected by aspiration pneumonia?

A

Right middle lung lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What are the chances that laryngeal paralysis may reoccur after surgical intervention?

A

33% due to suture failure, progression of disease, or contralateral issues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

When performing a ventriculocordectomy, how much of the ventral cord do you want to leave in tact and why?

A

1-2 mm to decrease the risk of webbing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Surgically speaking, what part of the trachea becomes apart of the lower respiratory tract?

A

Cricoid cartilage to the carina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Where does the trachealis muscle connect to on the trachea?

A

Dorsally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What are the layers of the trachea?

A

Mucosa, submucosa, mucociliary elevator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What are some surgical approaches to reach the trachea?

A

Cervical ventral midline, median sternotomy, intercostal thoracotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Name some big surgical tracheal diseases

A

Tracheal collapse, foreign bodies, tracheal rupture (from ET tube), trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

T/F: Tracheal collapses are reversible degenerations of the upper airway.

A

False. Progressive, irreversible degeneration of the LOWER airway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What is the cause behind tracheal collapse?

A

Weakness of the tracheal cartilage from decreased water retention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What are some factors that lead to tracheal collapse?

A

Obesity, environmental allergens, respiratory irritants, kennel cough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What is the typical signalment for tracheal collapse?

A

Small/toy breed dogs, middle aged.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What does a tracheal collapse sound like?

A

Goose honk. waxing and waning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What is the gold standard diagnostic technique for tracheal collapse?

A

Tracheoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What % of the trachea is affected with Grade I-IV tracheal collapse?

A

Grade I - 25%
Grade II - 50%
Grade III - 75%
Grade IV - almost 100%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

When is surgery indication for tracheal collapse?

A

When medical management fails

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What portion of the trachea are external prosthetic tracheal rings placed on?

A

Cervical portion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What are some surgical complications that can occur with surgery on the trachea?

A

Laryngeal paralysis, tracheal necrosis, pneumothorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What is the surgical method of treating tracheal collapse?

A

Intraluminal stent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

How do you determine the size of the surgical stent for tracheal collapse?

A

Imaging using an esophageal measurement probe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What are the pros and cons of an intraluminal stent to treat tracheal collapse?

A

Pro: not invasive, fast procedure, used on all portions of trachea, immediate improvement

Cons: expensive, uses scope, short-lifespan of stent, complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What are some complications with an intraluminal stent placement?

A

Stent fracture, stent migration, tracheitis, extended collapse, granulation formation leading to obstruction, tracheal rupture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

How can the trachea have internal trauma?

A

Foreign body, ETT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What is the primary method of treating tracheal trauma?

A

Medically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

When is surgical treatment of tracheal trauma indicated?

A

When dyspnea persists, pneumothorax, or trauma is severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What are the ways to surgically treat tracheal trauma?

A

Primary tear closure, resection & anastomosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What are some complications of surgical treatment of tracheal trauma?

A

Stricture, pneuothorax/mediastinum, infection

66
Q

When would you perform a permanent tracheostomy?

A

as a salvage procedure when you cannot treat an upper airway obstruction

67
Q

What are some complications associated with permanent tracheostomies?

A

Infection, bleeding, stenosis, foreign bodies, pneumonia,

68
Q

What kinds of dogs are best suited for permanent tracheostomies?

A

Indoor dogs with diligent owners

69
Q

T/F: Permanent tracheostomies are also indicated for cats!

A

False. poor prognosis

70
Q

What are some key things to do when performing a median sternotomy and opening the thoracic cavity? How do you close it?

A

Leave the manubrium and xiphoid intact

Close the cavity with a figure of 8 polypropylene suture or orthopedic wire

71
Q

Besides the median sternotomy, what is another approach to access the thoracic cavity? When is this indicated? How do you perform this approach?

A

Lateral/intercostal thoracotomy

Used to approach a specific structure in the cavity

Incise layer by layer

Close with circumcostal suture

72
Q

T/F: Median sternotomy is less painful than lateral thoracotomy

A

False.

73
Q

Which is the most minimally invasive technique to access the thoracic cavity?

A

Thoracoscopy

74
Q

What approach to the thoracic cavity is used to access the thorax during a celiotomy, and is used to ligate the thoracic duct, caudal esophagus, or intra-operative CPR?

A

Transdiaphragmatic approach

75
Q

T/F: Positive pressure ventilation is mandatory when performing thoracic surgery

A

True

76
Q

How would you access the thoacic cavity when performing a total or partial lung lobectomy? (2 answers)

A

Lateral thoracotomy, thoracoscopy

77
Q

What is the name of the procedure where you remove all lobes of one lung?

A

Pneumonectomy

78
Q

What is the maximum lung mass that can be acutely removed without being fatal?

A

65%

79
Q

When is a pneumonectomy indicated?

A

When disease is diffuse through multiple lung lobes

80
Q

What surgical instrument is used with complete or partial lung lobetomies?

A

Thoracoabdominal stapler (TA)

81
Q

T/F: The thoracoabdominal stapler is too large for small patients

A

True

82
Q

What can the thoracoabdominal stapler be used to do?

A

Isolate hilus of lobe or portion of it so it can be excised

83
Q

T/F: When suturing a partial lobectomy, you want to suture distal to the clamps.

A

False. Proximal

84
Q

What type of suture pattern is used for small peripheral masses?

A

Guillotine.

85
Q

How do you suture for a complete lobectomy?

A

Triple ligate the vessels, pre-place horizontal sutures and tie before cutting, close bronchus with sutures

86
Q

Why should you isolate affected lung tissue with moistened laparotomy sponges when performing pulmonary surgery?

A

Decreases the risk of contamination

87
Q

What are some things to check before closing up the surgery?

A

Hemorrhage, air leaking, chest tube placement

88
Q

What are some surgical diseases of the lungs?

A

Cysts, fistulas, abscesses, lacerations, torsions, neoplasia

89
Q

What is a bleb?

A

localized collection of air between internal and external layers of the visceral pleura

90
Q

What is a bullae?

A

Cavity in the lung not separated by epithelium or viscera

91
Q

What are some complications that can occur with cysts, bullae, and blebs?

A

Abscessation, rupture, spontaneous pneumothorax

92
Q

What is the problem with treating cysts, bullae, and blebs conservatively?

A

high recurrence rate

93
Q

What are the surgical methods of treating cysts, bullae, and blebs?

A

Partial or complete lung lobectomy

94
Q

What types of dogs are most commonly affected by lung lobe torsion?

A

Large, deep chested dogs and pugs

95
Q

What CxS will you find with lung lobe torsion?

A

Dyspnea, tachycardia, cough, exercise intolerance, hemoptysis

96
Q

What PE findings are reported with lung lobe torsion?

A

Pyrexia, pale mucous membranes, decreased ventral lung sounds

97
Q

How can you diagnose lung lobe torsion?

A

Thoracocentesis - serosanguinous/chylous effusion

Imaging - rads/CT

98
Q

What will happen if you untorse a lung lobe torsion?

A

It will release cytokines and endotoxins - reperfusion injury

99
Q

What surgical treatment do you use for lung lobe torsion?

A

Lung lobectomy

100
Q

What do you want to do to treat lung lobe torsion before performing the lung lobectomy?

A

patient stabilization - thoracocentesis, O2, fluids

101
Q

Which dog, large or pug, has a better prognosis with lung lobe torsion?

A

Pug

102
Q

What are the two most common types of primary pulmonary neoplasias?

A

Bronchiolar and alveolar carcinomas

103
Q

How do you treat primary lung neoplasias?

A

Lung lobectomy for peripheral tumors not involving the hilus

104
Q

What is the most common cause of thoracic wall trauma?

A

Hit by car

105
Q

T/F: Most thoracic wall traumas do not require surgery

A

True

106
Q

How do you treat a patient with a penetrated chest wound?

A

Stabilize, cover wound with dressing until patient is stable enough for surgery (may not need it if mild wounds)

107
Q

What should you NOT do with an object that is penetrating the chest wall?

A

Remove it before fully accessing and preparing the area for removal

108
Q

What is the most common cause for chylothorax?

A

Idiopathic

109
Q

How do you diagnose chylothorax? What will you see?

A

Cytology of pleural effusion.

Modified transudate, lymphocytic effusion, triglycerides more in fluid, cholesterol less in fluid

110
Q

How do you surgically treat chylothorax?

A

Thoracic duct ligation, cysterna chyli ablation, subtotal pericardiectomy

111
Q

How can you better visualize the lymphatic structures when performing surgery on the chylothorax?

A

Injection of methlyene blue

Lymphangiography

112
Q

Where on the dog do you approach the chylothorax surgery? Cat?

A

Dog: Right 10th IC space
Cat: Left 10th IC space

113
Q

Where do you ligate and clip the thoracic duct when performing the thoracic duct ligation?

A

Close to the diaphragm as possible

114
Q

How can you approach a subtotal pericardectomy?

A

Intercostal, median sternotomy or transdiaphragmatic approach

115
Q

Where do you excise the pericardium for a subtotal pericardiectomy with a chylothorax?

A

Ventral to the phrenic nerve

116
Q

What does a cisterna chyli ablation do

A

Re-routes the abdominal lymphatic drainage to major abdominal vessels

117
Q

Which pet, dog or cat, has a better outcome with thoracic duct surgery?

A

Dog

118
Q

What are some complications with thoracic duct ligation surgery?

A

Persistent chylous/non-chylous effusion, lung lobe torsion, pneumothorax

119
Q

What is the most common cause of diaphragmatic hernias?

A

traumatic

120
Q

What part of the thorax is most susceptible to tears from blunt force?

A

Muscle

121
Q

What diagnostic imaging technique is the most accurate for diaphragmatic hernias?

A

Ultrasound

122
Q

What CxS are seen with DH?

A

muffled heart sounds, borborygmi heard in thoracic cavity, tachycardia, tachypnea

123
Q

What should you do to treat a patient with a diaphragmatic hernia before surgery?

A

Stabilize, look for other conditions, O2 therapy, prop patient at angle to drop organs down

124
Q

How do you approach a diaphragmatic herniorrhaphy?

A

Ventral midline abdominal

125
Q

What organ is most commonly herniated?

A

Liver

126
Q

What suture pattern do you use to repair the hernia? Material?

A

Simple continuous suture pattern with PDS or Prolene

127
Q

T/F: Re-expansion pulmonary edemas associated with rapid expansion of previously atelectic lungs are most commonly caused from acute hernias

A

False. Chronic hernias

128
Q

What pressure ventilation must you keep at all times during a diaphragmatic herniorrhaphy?

A

< 15 cm H2O

129
Q

How do you treat re-expansion pulmonary edema?

A

You can’t. It’s fatal

130
Q

What is the prognosis for diaphragmatic hernias?

A

Good if patient survives 24 hours after surgery. 90%

131
Q

What are some factors that decrease prognosis with DH?

A

Chronicity, age, concurrent injuries

132
Q

T/F: Peritoneopericardial diaphragmatic hernias are congenital

A

True

133
Q

What occurs with PPDH?

A

There is a communication with the pericardium and peritoneal cavity

134
Q

What other congenital defects are seen with PPDH?

A

Polycystic kidneys, ventricular septal defects, sternal deformation

135
Q

What PE findings are noticed with PPDH?

A

Muffled heart sounds, ascites, murmur

136
Q

How do you diagnose PPDH?

A

Rads, U/S

137
Q

What will you see on rads with PPDH?

A

Enlarged cardiac silhouette, dorsal elevation of trachea, overlap of heart and diaphragm borders, gas in pericardial sac

138
Q

How do you treat PPDH?

A

Surgery with ventral midline abdominal approach asap, antibiotics

139
Q

How do you suture close the surgery of PPDH?

A

Simple continuous pattern

140
Q

What is the most common congenital cardiac defect in dogs?

A

Patent Ductus Arteriosis

141
Q

What happens with PDA?

A

Blood is shunted from left to the right side of the heart causing severe volume overload progressing to heart failure of the left side

142
Q

What do you see with reverse PDA?

A

Right to left shunt - severe pulmonary hyppertension

143
Q

How can you treat PDA?

A

Coil embolization, ductal occluder

Surgical ligation - indicated with top two don’t work

144
Q

What are some complications of surgical ligation with PDA?

A

Severe hemorrhage due to PDA rupture, bradycardia (reflex), recanalization

145
Q

What is the prognosis for PDA? Reverse PDA?

A

PDA - excellent if younger.

Reverse PDA - grave

146
Q

T/F: Mitral regurgitation and myocardial insufficiency from PDA is likely to resolve after surgery.

A

True

147
Q

What is the most common cardiac neoplasia in the dog?

A

Hemangiosarcoma of the right auricle

148
Q

How do you treat hemangiosarcoma of the right auricle?

A

Emergency pericardiocentesis due to acute cardiac tamponade.

Chemotherapy

149
Q

What are the functions of the pericardium?

A

Prevents over-distension of the heart, a gliding surface, and protection from spread of infection from thoracic cavity

150
Q

What cardiac signs will you see with cardiac tamponade?

A

Increase intra-cardiac diastolic pressure, decreased stroke volume, decreased cardiac output, increased systemic venous pressure

151
Q

List some pericardial diseases.

A

Rupture, effusion, inflammation, herniation

152
Q

What CxS will you see in animals with pericardial disease?

A

Muffled heart sounds, weak femoral pulses, weakness, lethargy, dyspnea, exercise intolerance

153
Q

What is both therapeutic and diagnostic for pericardial diseases?

A

Pericardiocentesis

154
Q

What imaging tool will give you instantaneous information on fluid present in the pericardium?

A

Ultrasound

155
Q

What types of surgeries are used to treat pericardial disease? What is the difference?

A

Total pericardiectomy - phrenic nerves dissected from pericardium

Subtotal pericardiectomy - all pericardium ventral to phrenic nerves are removed

156
Q

What is the most common cause of vascular ring anomaly?

A

Persistent right aortic arch

157
Q

What breed of dog is most commonly reported to have PRAA?

A

German shepards

158
Q

What signs are seen with PRAA?

A

Regurgitation, unthrifty, respiratory signs

159
Q

How do you treat PRAA?

A

Surgically via left intercostal thoracotomy (5-7 IC space), isolation of the ligament, double ligate and transect

160
Q

What is the prognosis for PRAA with surgery?

A

Good to excellent

Small animal surgery I (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions