Respiratory Medicine (Basics) Flashcards

1
Q

What is the medical term for increased respiratory effort?

A

Dyspnoea

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2
Q

what is the normal RR of a dog/cat?

A

20-30bpm

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3
Q

In which direction do the EXTERNAL intercostal muscles run?

A

caudoventrally

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4
Q

In which direction do the INTERNAL intercostal muscles run?

A

cranioventrally

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5
Q

Which muscles contract on inspiration?

A

Diaphragm

External intercostals

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6
Q

What are the two things which lung compliance depends on?

A

Surface Tension in alveoli

Elasticity of lungs/thoracic cage

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7
Q

When is resistance in the LOWER airways greater?

A

Expiration

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8
Q

When is resistance in the UPPER airways greater?

A

Inspiration

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9
Q

Which receptors are responsible for sympathetic innervation of the Respiratory tract?

A

B2 adrenoreceptors

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10
Q

What is the formula for minute volume?

A

Tidal vol x RR

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11
Q

What gaseous abnormality will HYPOventilation lead to?

A

Hypercapnia & hypoxia

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12
Q

What is the net parasympathetic effect on the resp blood supply?

A

Vasodilation

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13
Q

What are the 3 mechanisms to reduce acidosis?

A

Buffering
Lungs
Kidneys

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14
Q

What are the 3 broad classes of sensory receptor found in the airway?

A

Rapidly Adapting
Slowly Adapting
C-fibres

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15
Q

Where are Rapidly Adapting Receptors found and what do they respond to?

A

Intrapulmonary airways
URT = mechanical
Bronchi = chemical

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16
Q

What actions can Rapidly Adapting Receptors initiate?

A

PARASYMP: bronchoconstriction and mucus secretion
Reflexes: cough, expiration, tachypnoea etc

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17
Q

Where are Slowly Adapting Receptors found and what do they respond to?

A

In bronchioles and alveoli.

Mechanical Forces.

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18
Q

What actions can Slowly Adapting Receptors initiate?

A

Hering-Breuer Reflex

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19
Q

What do C fibres respond to?

A

noxious chemical/mehcanical stimuli

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20
Q

What actions can C Fibres initiate?

A

bronchoconstriction
mucus secretion
apnoea/shallow breaths
cough

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21
Q

Where in the brain is the cough centre located?

A

Medulla oblongata and pons

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22
Q

Which nerve sends impulses to the diaphragm?

A

Phrenic

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23
Q

Which two nerves send impulses to the larynx as part of the cough reflex?

A

Vagus

Recurrent Laryngeal

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24
Q

Which nerve is afferent for the sneeze reflex?

A

Trigeminal

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25
What is Type 1 respiratory failure?
Hypoxia with Normo/hypocapnia
26
What is Type 2 Respiratory Failure?
Hypoxia with HYPERcapnia
27
What is Type 1 respiratory failure caused by?
Parenchymal Disease
28
What is Type 2 Respiratory Failure caused by?
Airway obstruction
29
Which type of respiratory failure responds to oxygen supplementation?
Type 1. Hypercapnia in Type 2 may be worsened by O2 supp.
30
What are the 7 different groups of drugs which work on the respiratory system?
1. Surfactants 2. Anti-Tussives 3. Drugs affecting Bronchial Diameter 4. Mucolytics 5. Expectorants 6. Decongestants 7. Drugs affecting Respiratory Centre
31
Which receptors mediate bronchodilation?
B2 adrenoreceptor
32
Which receptors mediate bronchoconstriction?
Muscarinic
33
Give 4 examples of non-selective adrenoreceptor antagonist.
Adrenaline Noradrenaline Ephedrine Isoprotenerol
34
Which B2 agonist agent is the most selective?
Terbutaline (loses this at high doses)
35
Which selective B2 agonist agent is metabolised in the liver?
Albuterol
36
Which selective B2 agonist is only given orally?
Clenbuterol
37
Which 4 conditions are CIed with adrenoreceptor agonist use?
BP abnormalities Tachycardia Hypokalaemia Seizures
38
Which drugs are CIed in patients with asthma & why?
Beta Blockers - cause bronchoconstriction
39
What are the 4 effects of anticholinergics on the lungs?
Bronchodilation Reduced inflammation Pulmonary Vasoconstriction Reduced Mucus Production
40
Which receptor do anticholinergics antagonise?
M3
41
What are the SEs of anticholinergics?
Tachycardia Dry MMs Decreased GI motility Hypertension
42
Which anticholinergic is used in veterinary practice?
Ipratropium
43
How do methylxanthines increase bronchial diameter?
PDE Inhibitor
44
Which methylxanthine(s) do we use in veterinary practice?
Theophylline
45
What are the most common SE's of methylxanthines and why?
CNS side effects - cross BBB easily
46
Which drug class is most effective as an anti-tussive?
Opioids - Codeine and Butorphanol
47
Which is the most effective anti-tussive?
Butorphanol
48
What are two commonly used mucolytics in veterinary practice?
N acetylsysteine | Bromhexine HCl
49
Which mucolytic may cause bronchoconstriction and airway irritation?
N-acetylcysteine
50
Which mucolytic increases alveolar capillary permeability?
Bromhexine HCl
51
Which mucolytic is given orally/IM?
Bromhexine HCl
52
Which mucolytic is nebulised?
N-acetylcysteine
53
Which class of drug is used as a decongestant in veterinary medicine?
Sympathomimetics
54
Give 3 examples of decongestant used in veterinary medicine.
Ephedrine Pseudoephedrine Phenylephrine
55
Which is the only respiratory stimulant used in veterinary medicine?
Doxopram
56
How does Doxopram hydrochloride work?
Increased sensitivity of chemoreceptors --> inc RR and TV
57
Why shouldn't opioids be used alongside doxopram?
Convulsions
58
Why shouldn't doxopram be given to patients with arrhythmias?
Increases adrenaline --> precipitates arrhythmias
59
What is the difference between nasal discharge in acute and chronic Dz?
Acute: serous Chronic: Mucopurulent
60
What causes fungal rhinitis in the dog and cat?
Dog: Aspergillus Cat: Cryptococcus
61
What are the clinical signs of fungal rhinitis?
Pain Depigmentation/ulceration of nares Mucopurulent to sanguineous discharge
62
What 3 ways can we apply topical antifungals to cases of fungal rhinitis?
Non-surgical flush 1h surgical flush 10-14d catheter flush
63
What are the two main presentations of nasal neoplasia?
Destructive (epistaxis) | Obstructive (snorting)
64
How is inflammatory rhinitis treated?
Antibiotics Mucolytics Steroids Diet Trial
65
What is the main differential for acute onset violent sneezing?
Nasal FB
66
What is the most common nasal FB in the cat and how is it treated?
Grass blade in nasopharynx: retract SP and retrieve with foreceps
67
What are the 4 primary factors predisposing dogs to BOAS?
Relative oversize of SP Stenotic Nares Tracheal hypoplasia Laryngeal Hypoplasia
68
What are the 4 secondary factors predisposing dogs to BOAS?
Eversion of laryngeal ventricles Tonsillar Enlargement Laryngeal/Tracheal collapse
69
How would you manage a dog in acute episodes of BOAS?
``` Oxygen Cool, quiet environment Sedate Steroids GA + intubate ```
70
What does BOAS surgery consist of?
SP resection Remove saccules Nasoplasty Tonsillectomy Poss permanent tracheostomy
71
Which disease causes altered phonation, gagging when eating and inspiratory stridor?
LAryngeal Paralysis
72
What is the Tx for laryngeal paralysis?
Laryngeal tieback (arytenoid lateralisation)
73
Which dogs are predisposed to tracheal collapse?
TOy breeds
74
What are the 4 grades of tracheal collapse?
25% decrease of tracheal diameter with each grade inc
75
What surgery can be used to treat tracheal collapse?
Intraluminal stenting
76
What is the maximum number of tracheal rings that may be removed in tracheal resection?
5-6
77
Give 4 indications for a lung lobectomy
Lobe torsion Local abscess/ cyst/neoplasia Severe lung trauma Broncho-oesophageal fistula
78
What are the 3 indications for a tube thoracostomy?
Thoracotomy Post-Op care Ongoing Pneumothroax Large Volume PLeural effusion
79
How are rib fractures treated?
conservative management