Respiratory Exam Flashcards

1
Q

What is Included in the upper respiratory tract

A
Nasal passages
Oral cavity
Sinuses
Larynx
Trachea
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2
Q

What is included in the lower respiratory tract

A

Bronchi
Bronchioles
Alveoli

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3
Q

Define eupnea

A

Normal, quiet breathing

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4
Q

Define tachypnea

A

Elevated respiratory rate

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5
Q

Define bradypnea

A

Abnormally slow respiratory rate

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6
Q

Define apnea

A

Cessation of breathing

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7
Q

Define Dyspnea

A

Difficulty breathing

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8
Q

What are the signs of Dyspnea

A

Flared nostrils
Excessive thoracic movement
Abdominal breathing

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9
Q

Define Hyperpnea

A

Elevated respiratory rate, depth or both

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10
Q

What are some things that need to be asked when taking a history for a respiratory exam

A
Lifestyle of the individual
Housing 
Coughing? (Wet or dry) (single coughs or many) (is the animal wretching after) 
Sneezing?
Difficulty breathing?
Discoloured mucus membranes 
Nasal discharge
Duration of the problem 
Vaccination status
Contact with other animals
Medications 
Eating/drinking habits
Energy levels
Productivity of the animal
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11
Q

Describe what to look for in a distant examination for a respiratory exam

A

Respiratory rate and effort

Inspiratory to expiratory ratio

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12
Q

When might a distant exam be beneficial

A

When the animal is nervous

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13
Q

True or false

There are times when a distant exam is more beneficial than a close up exam

A

True

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14
Q

What are the normal respiratory rates for

Equine, bovine, canine, and feline

A

Equine: 10-14 bpm

Bovine: 25-35 bpm

Canine: 20-35 bpm

Feline: 20-40 bpm

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15
Q

An increased respiratory effort indicates

A

The animal is having difficulty moving air

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16
Q

What is also important when paying attention to respiratory rate

A

Whether increased effort is on inspiration or expiration

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17
Q

Increased respiratory effort with inspiration indicates

A

An upper respiratory tract problems

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18
Q

Increased respiratory effort with expiration indicates

A

A lower respiratory tract problem

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19
Q

What is Inspiratory to expiratory ratio helpful in determining

A

Where the respiratory tract has pathology occurring

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20
Q

What is the normal Inspiratory:expiratory ratio

A

1:2 or less

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21
Q

What does it mean if the ratio increases to 1:4

A

Expiratory time increased, meaning there is a lower airway problem

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22
Q

What does a close up physical exam of the respiratory tract include

A

Upper respiratory sounds (stertor/stridor)

Airflow through the nostrils

Nasal discharge

Coughing/sneezing

Auscultation

Mucous membrane colors

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23
Q

What are the two upper respiratory noises?

A

Stertor and stridor

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24
Q

What is stertor

A

A low pictures noise made due to vibration of the soft tissue when breathing -occurs from the pharynx

Examples: brachycephalic dogs or an animal snoring

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25
Q

What is stridor

A

A high pitched noise that occurs generally with inspiration, caused by narrowing of the upper airways (or obstructions)

Examples: laryngeal paralysis, foreign body, tumors, laryngospasm

26
Q

Describe examination of air flow

A

Animals should have air flow through BOTH nostrils, if there is not airflow through both there may be an obstruction cranial to the mid pharynx

How to determine airflow of the nostrils: vapour trails, glass slide help under nose, back of hand

27
Q

What does it mean if there is an abnormal odour of the breath

A

A fetid or rotten smell is often indicative of a anaerobic infection seen with dental disease, abscesses, severe pneumonia, or nasal fistulas

28
Q

When is small volume of nasal discharge normal

A

When it is a small amount of serous (clear, colourless) discharge

29
Q

When is nasal discharge considered abnormal

A

Copious amounts running down the patients face or when it is not clear

30
Q

What is acceptable about large animal nasal discharge

A

When it is serous but contains food or dust particles

31
Q

Describe when nasal discharge is unilateral or bilateral

A

Unilateral: when the problem is likely located rostral the nasopharynx

Bilateral: affects both nasal cavities or the problem is located caudal to the nasopharynx

32
Q

Describe excessive clear nasal discharge

A

Seen with viral infections or nasal irritation (foreign bodies, strong smells or early infections)

33
Q

Describe a blood nasal discharge

A

Need to differentiate between epistaxis and hemoptysis

Epistaxis is seen with neoplasia of the nasal cavities/sinuses, fungal and dental infections and oronasal fistulas

34
Q

What is hemoptysis

A

Spitting of blood that originated in the lungs or bronchioles

35
Q

Describe mucopurulent nasal discharge

A

A mixture of clear and yellow nasal discharge

Seen with viral infections and nasal irritation

36
Q

Describe purulent nasal discharge

A

Yellow/green discharge seen with bacterial infections

37
Q

Describe a green/brown nasal discharge

A

Due to reflux of food and may see food particles

38
Q

Describe sneezing

A

Forceful expulsion of air through the nasal passages

Indicates nasal irritation

Could be from:
Nasal discharge or infections, allergies, sting scents/chemicals, foreign bodies,

May see animal pawing at face/muzzle intermittently

39
Q

If an animal is not coughing in the exam room, how can we elicit a cough

What is considered normal

A

Small animals: palpation of the trachea at the 2nd tracheal ring (if there is inflammation/irritation of the trachea they will cough)

Large animals: squeeze the 2nd tracheal ring temporarily, cover the nostrils or use a rebreathing bag

In large animals It is considered a normal finding to produce 1-2 coughs, any more is abnormal

Small animals will not cough unless there is irritation

40
Q

Describe the 3 types of coughs

A

Dry cough: seen with viral infections, allergies, tracheal disease or collapse, heart enlargement

Moist cough: seen with bacterial infections and congestive heart failure

Paroxysmal cough: an aggressive episode of coughing, often several in row, may bring up mucus (common in kennel cough)

41
Q

Where should you listen when auscultation get the lungs

A

Mid trachea and at least 4 sites on each lung side (cranioventral, mid cranial thorax, craniodorsal, caudodorsal)

42
Q

When should breath sounds be the loudest

A

Over the trachea

43
Q

When are lungs sounds the most audible

A

In lean or young animals

44
Q

True or false

Inspiratory sounds should be louder than expiratory sounds

A

True

45
Q

Breath sounds increased when the animal is breathing more deeply, this occurs with

A

Exertion or lung disease

46
Q

Describe this abnormal lung sound: bronchial tones

A

Produced by consolidated lungs (fluid in the lungs-blood, pus, cells)

Inspiratory and expiratory sounds are similar (normally Inspiratory should be louder)

Closely resembles tracheal sounds

47
Q

Describe this abnormal lung sound: crackles

A

Short duration, low pitched and discontinuous

Intensity will fluctuate

48
Q

Describe this abnormal lung sound: wheezing

A

High pitched sounds and have a long duration and pitch and intensity are constant (whistle sound)

Only heard when listening to the lungs

49
Q

Describe this abnormal lung sound: squeaks

A

High pitched and short duration

50
Q

Describe this abnormal lung sound: pleural friction

A

Rubbing sound that occurs with inspiration and expiration.

Sounds like watching crunchy snow

51
Q

What are some things we can do to exaggerate lungs sounds when having difficulty finding abnormal sounds

A

Make them exercise

Cover nostrils for up to 20 sec

“Bag off” using a rebreathing bag for 1-3 minutes

52
Q

How do the previous methods of exacerbating lung sounds cause lung sounds to be more prominent

A

The animal will start breathing deeper before stoping the technique and for a few breaths after stopping, this will make lung sounds more audible

53
Q

What are some exam findings that indicate a upper respiratory tract disease

A
Sneezing
Stertor and stridor 
Increased Inspiratory effort
Coughing
Unilateral nasal discharge
54
Q

What are some exam findings that indicate a lower respiratory tract disease

A

Abnormal lung sounds
Abnormal Inspiratory to expiratory ratio
Increased expiratory rate

55
Q

What are some exam findings that can indicate a upper or lower respiratory tract disease

A

Bilateral nasal discharge
Coughing
Tachypnea
Dyspnea

56
Q

What are some diagnostics for lung disease

A

Radiography
Ultrasonography
Bronchoscopy
Cultures

57
Q

Why is ultrasonography limited when examining the lungs

A

Air shows up as black on ultrasound, so unless there is fluid in the lungs it is not diagnostic

58
Q

What is a bronchoscopy useful for

A

Examination of the upper respiratory tract (nasal cavities, trachea, guttural pouches)

59
Q

What are some ways culture samples of the respiratory tract are taken (for bacterial/fungal or cytology cultures)

A

Nasal flush
Transtracheal wash
Endotracheal wash
Bronchoalveolar lavage

60
Q

What is a nasal flush

A

Animal is intubated and sterile saline is flushed through the nostrils and collected or sampling

61
Q

What is a transyracheal wash

A

Long catheter into the trachea and saline is flushed into the airway and retrieved for sampling

62
Q

What is a bronchoalveolar lavage

A

Similar to transtracheal wash, but a bronchoscope is used to identify diseased lung and fluid is collected from that area