Respiratory introduction Flashcards
Define the following:
Hypoxia
Hypoxemia
Hypercapnia
- Hypoxia = oxygen levels in the blood, lungs, and/or tissues is low
- Hypoxemia = insufficient oxygenation of the blood
- Resp. stimulant when PaO2 < 50mmHg (normal = 90-110mmHg)
- Hypercapnia = inc. CO2 levels, resp. stimulant
- Most powerful
Cyanosis
What is it?
What’s normal?
When will it occur?
- Bluish to red-purple color in the tissues due to increased amounts of deoxygenated or reduced hemoglobin
- Animal w/ normal hematocrit
- Needs an arterial SaO2 73 and 78% pulse ox (PaO2 39-42mmHg) before cyanosis is found
Dyspnea
Definition
What should you avoid?
What should you give to the animal?
- Difficult or labored breathing
- Avoid excessive stress or struggling, and avoid dorsal recumbency for rads
- Give animal additional oxygen immediately
Define the following:
Stridor
Stertor
Orthopnea
- Stridor = high pitched inspiratory noise, rapid flow of air passed a rigid obstruction or paralysed/collapsed larynx
- Stertor = low-pitched inspiratory noise, gurgling or snoring sound, produced as air passes soft tissue obstruction
- Normal in brachycephalic dogs
- Orthopnea–adopt a strange position
- Sternal recumbency w/ elbows abducted, the neck extended and open-mouth breathing
Respiratory disease
Diagnostic approach (steps)
4 disorders
- Diagnostic approach
- History/clinical signs
- PE/localization of disease
- Diagnostics/procedures
- Common drugs used in therapy
- Disorders
- Nasal disorders
- Airways–laryngeal, tracheal, bronchial disorders
- Pulmonary parenchymal diseases
- Pleural space diseases
Respiratory diseases
What is included in the history (diagnostic approach)?
- What is the signalment
- Ciliary dyskinesia–generally younger
- Neoplastic–generally older
- Breed
- Brachycephalic–stertor
- Mesocephalic
- Dolichocephalic–obstructions, fungal inf.
- How long has it been going on for?
- Acute signs
- Progressive
- Chronic
- Acute signs
- Where is the location
Differentiate between clinical signs of upper and lower respiratory diseases
- Upper = nares to larynx
- Lower = larynx to lungs
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What should you look for during the physical exam?
- What can you see
- Look for nasal discharge/disease
- Is there respiratory distress
- What can you hear
- Sneezing
- Breathing louder than normal
- Evidence of a cough
- What can be heard on auscultation
- What can you feel/touch
- What can you palpate
Nasal disease
Signalment
Age, breed
Nasal disease: physical exam
Airflow
Facial palpation
- Bilateral airflow?
- Glass slide technique, wisp of cotton wool
- Facial palpation
- Pain?
- Symmetry vs. asymmetry?
- Normal ocular retropulsion?
- Place thumbs over eyelids and gently press backwards, upwards, medially, laterally (checks for masses)
Nasal disease: physical exam
Oral exam
Nasal discharge
- Oral exam
- Check dentition and dental arcade
- Check hard palate for abnormalities
- Check soft palate to see that it can be easily pressed upwards (anesthetized)
- Nasal discharge
- Characterize discharge:
- Serous (clear), mucoid (not clear), mucopurulent (cloudy), purulent (white/yellow), hemorrhagic (bloody)
- Unilateral vs. bilateral (doesn’t really matter when hemorrhagic)
- Persistent vs. intemittent
- Duration, has it changed over time
- Acute nasal disease often accompanied w/ sneezing
- Chronic nasal disease often has purulent to hemorrhagic discharge
- Characterize discharge:
Nasal disease: physical exam
Sneezing
- Localizes disease to nasal cavity
- Protective mech. of upper airways
- May have concurrent nasal discharge
- Normal sneezing: expiratory, forceful
- Occasional, intermittent, persistent, paroxysmal
- Reverse sneezing
- Inspiratory
- Duration?
Physical exam
Breathing sounds
- Stertor (low pitch, snoring)
- Brachycephalic airway syndrome
- Stridor
- Laryngeal paralysis
- Tracheal collapse
- Nasopharyngeal stenosis
Physical exam
Cough–hallmark of?
- Hallmark of a tracheal or pulmonary disease (lower airways) or cardiac failure
- Use the signalment, history, clinical finding and rads to be able to distinguish between these causes
- Forceful expiratory effort/protective reflex
Physical exam
Cough–triggers? Classification?
- Triggers include:
- Irritant receptors that lie between epithelial cells lining the airways (cough receptors)
- Inflammatory products of neutrophils or eosinophils
- Excessive secretions
- Airway compression or collapse
- Classified as
- Dry/non-productive
- Moist/productive
- Harsh/intermittent or paroxysmal (once it starts, gets progressively worse)
Beautiful massive chart of cardiogenic vs. non-cardiogenic coughing?
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