Respiratory Disease Overview Flashcards
1
Q
Lung Fields in the Bovine
A
- Caudal margin: From the 5th rib at the olecranon to the 11th intercostal space through the 9th rib and the point of the shoulder
- Cranial margin is a line drawn up from the 5th rib at the olecranon
2
Q
What are 4 unique features of bovine lungs on a histologic level?
A
- Decreased Pores of Kohn
- Increased pulmonary intravascular macrophage
- Increased lobulation and interstitial tissue, which means they are more fibrous and therefore less compliant
- Reactive vessels and arteries (highly muscular, small)
3
Q
What type of pneumonia do cows get?
A
- Bronchopneumonia instead of pleuropneumonia
4
Q
How do decreased Pores of Kohn predispose cows to more respiratory issues?
A
- Pores of Kohn are openings between alveoli
- Bovine have decreased to nonexistent pores of Kohn
- Can’t equilibrate pressures across areas of lungs
- If you build pressure within an alveolus, it can either withstand the pressure or not
- If itcan’t withstand the pressure it will pop
- If one alveoli becomes too big alveoli, relative surface area to volume decreases so it’s more apt to pop again
- Extremely susceptible to emphysema because they can’t equilibrate and are more likely to rupture, which makes it even more likely to rupture again
5
Q
Why are increased pulmonary intravascular macrophages not great?
A
- If they get reactive
6
Q
Why are reactive bovine vessels bad?
A
- Highly muscular and small
- In hypoxia, there’s vasoconstriction, which will make this worse
7
Q
Signs of respiratory disease
A
- Cough
- Nasal discharge
- Stridor
- Dyspnea
- Cyanosis
- Abducted elbow
- Exercise interolance
- Ozena
- Nasal erosions
- Distortion
8
Q
Cough as a protective mechanism
A
- Involuntary
- May be suppressed if painful
9
Q
Where are sensory receptors for cough?
A
- Pharynx
- Larynx
- Bronchioles
- Parenchyma
- Pleura
- You cannot localize a disease from a cough
10
Q
Ozena
A
- Foul smell from the nose
11
Q
Where does a productive cough localize? (GENERALLY)
A
- Lower respiratory tract
12
Q
Where does a non-productive cough localize? (GENERALLY)
A
- Upper respiratory tract
13
Q
Virus impact on epithelium
A
- Can denude epithelium and set up for secondary effects
- Animal may be coughing even after antibiotics are finished because it’s not fully healed
14
Q
How long can it take for a denuded epithelium to heal?
A
- 6+ weeks for repair
15
Q
Why don’t cows generally get nasal discharge?
A
- usually keep it clean
16
Q
How can unilateral or bilateral nasal discharge help you?
A
- If it’s one sided, might be more localized (like sinusitis)
- If it’s one sided, might help you rule out lung disease more
17
Q
Where is disease if you hear stridor on PE?
A
- Extra-thoracic
- 50% due to nares
18
Q
Who can do mouth breathing?
A
- Cattle/sheep/goats
19
Q
Who is an obligate nasal breather?
A
- Camelid
20
Q
Stridor
A
Wheezing
21
Q
If it’s expiratory dyspnea, where can you localize?***
A
- Typically within the thoracic cavity
22
Q
If it’s inspiratory dyspnea, where can you localize?***
A
- Typically extra-thoracic
23
Q
Normal lung sounds
A
- Bronchial, bronchovesicular, vesicular sounds
- Can increase with fever, exercise, etc.
- Can decrease with fat, cold, etc.
24
Q
What are abnormal sounds called?
A
- Adventitial sounds
25
Examples of abnormal sounds?
- Crackles
- Wheezes
- Pleural rubs
- Absence of lung sounds
26
Epistaxis
- Blood at nares
27
Hemoptysis
- Coughing up blood
28
What can hemoptysis be pathognomonic for?
- Caudal vena caval thrombosis
29
Nasal causes of epistaxis or hemoptysis
- Foreign body, tumor, etc.
30
Pulmonary causes of epistaxis or hemoptysis
- Caudal vena cava thrombosis
| - Lung abscess, etc.
31
Reminder of CVCT?
- Sequelae to liver abscesses secondary to rumen acidosis
- Shower lungs with bacteria and get abscesses
- If it ruptures into the caudal vena cava, they shower their lungs with pus, which would kill them
- If you see an animal like this, often needs to be euthanized or salvaged
32
Dyspnea
- Clinical sign meaning shortness of breath
- Labored breathing
- May open their mouth, elbows abducted, etc.
33
Respiratory conditions that can cause dyspnea
- Pneumonia, pleuritis, pulmonary edema, etc.
34
Non-respiratory conditions that can lead to dyspnea
- Cardiovascular
- Systemic disease
- Toxicity
35
Cardiovascular disease that can lead to dyspnea
- Anemia, heart failure, shock, dehydration
36
Systemic disease that can lead to dyspnea
- Pain, hyperthermia, acidosis
37
Toxicity
Organophosphates, carbamates, nitrate, cyanide, Taxus (yew)
38
Diagnostic procedures for respiratory disease
- History
- Clinical
- Environment
- Management
- Signs
39
What causes lung sounds?
- Turbulence of air
40
At the periphery of the lung fields in a healthy animal, what should you hear?
- SHouldn't hear anything beyond the 7th branching airway
| - Air filled lungs diminish the sound
41
What will you hear in a consolidated lung field?
- More sound
| - Solid tissue propagates the sound better I guess
42
Where do you hear bronchial sounds?
- Listened to over the trachea
- Inspiratory and expiratory
- Pay attention to inspiratory and expiratory sounds
43
Where to hear bronchovesicular sounds
- Right over the hilus
| - Typically hear inspiratory and expiratory
44
Where to hear vesicular sounds?
- At the periphery
- Pretty quiet
- Should hear inspiratory sounds but likely won't hear expiratory sounds
- If you hear expiratory vesicular sounds, that's suggestive of respiratory disease or consolidation
45
Rank the order of which sounds (bronchial, bronchovesicular, vesicular) have the loudest expiratory noise?
1. Bronchial (insp and exp about equal length, but inspiration is louder)
2. Bronchovesicular
3. Vesicular (MOSTLY inspiratory)
46
Other ways to diagnose respiratory disease besides history and PE?
- Percussion
- Radiographs
- Ultrasound
- Endoscopy
47
Percussion
- Pleximeter and tap around
| - People who are adept can detect changes up to 7 cm deep in a tissue
48
Radiographs for LA
- Possible, but it has to be small enough
| - Less frequent
49
Ultrasound for LA respiratory disease
- Great for pleural disease and consolidation
| - If you have healthy lung with air, it will reflect off
50
Endoscopy for LA respiratory disease
- Typically have to be really heavily sedated
- Will chew up endoscopes
- Maybe for laryngeal problems
51
Trans-tracheal wash (TTW) - where does the sample come from?
- Pooled secretions of the caudal lung fields (mixed with upper airway material)
- Does NOT directly sample parenchyma
52
Cytology on TTW
- Poorly correlated with culture and clinical signs
53
Culture for TTW
- Most useful part
| - He still isn't a huge fan, because you can isolate pathogenic bacteria from normal animals
54
Complications of TTW
- Cut tubing
- Emphysema
- Local infection
55
Bronchoalveolar lavage - where does the sample come from?
- Airways nearest parenchyma (lower airway to alveoli)
| - Limited area sampled
56
Bronchoalveolar lavage advantages compared to TTW
- Easy to perform
| - Good for cytology
57
Bronchoalveolar lavage sterility
- Non-sterile
58
Thoracocentesis site
- Percussion
- Ultrasound
- 6th or 7th intercostal space at the costochondral junction
- Penetrate near the front of the rib
59
In the bovine, are the two pleural compartments connected?
- No, they are separate
60
Normal thoracocentesis fluid in a bovine
- WBC <10,000/µL
| - Protein <3.5 g/dL
61
Sinus trephination
- Not done as much
62
Lung biopsy
- Doable when appropriate
63
Arterial blood gas
- Hard to get in a ruminant
| - Maybe an auricular artery or carpal in a calf
64
Nuclear imaging
- hard with withdrawal times
