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LAM1 > Respiratory Stridor > Flashcards

Respiratory Stridor Flashcards

1
Q

T/F: stridor may/may not be associated with distress

A

True!

Stridor w/o distress shows no CS @ rest

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2
Q

Do dynamic airway obstructions cause distress?

A

No - they are temporary obstructions that usually only occur @ intense exercise

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3
Q

Which form do DDSP is most common: intermittent or persistent?

A

DDSP = dorsal displacement of soft palate

Intermittent is most common [often @ exercise]

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4
Q

Pathophysiology of intermittent DDSP:

A
  • can be many factors that cause this!!

Inflammation, upper/lower resp dz, extensive head flexion, thyroid muscle dysfunction, etc…

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5
Q

Pathophysiology of persistent DDSP:

A

Neuro dz/issue

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6
Q

What are 3 major CS for DDSP:

A
  1. Exercise intolerance
  2. Noise
  3. Cheek puffing
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7
Q

Is the DDSP noise inspiratory/expiratory?

A

Can be both but MOSTLY EXPIRATORY

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8
Q

T/F: if you see cheek puffing in a horse, think DDSP right away

A

True!

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9
Q

What kinds of horses seem to be predisposed to DDSP?

A

Nervous/tense horses

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10
Q

T/F: DDSP horses show obv CS [like cheek puffing and expiratory noise] even at rest

A

False!

May not have any obvious CS, especially @ rest

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11
Q

How can we diagnose DDSP?

A
  1. Expiratory noise

2. Endoscopy - we can see the displacement

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12
Q

Differentiate DDSP vs EE endoscopy findings:

A

DDSP: wall flows straight down to floor

EE: wall stops and new structure begins

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13
Q

How must we perform the DDSP endoscopy? What must the horse be doing?

A

Needs to be running high speed on treadmill to see this!

”ventral placement of epiglottis relative to soft palate for greater than 8 seconds during high speed treadmill endoscopy”

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14
Q

There is conservative vs Sx tx for DDSP. Describe them:

she didn’t really talk about these in class

A

Conservative = TSD throat support device, loosen head carriage

Sx: laryngeal tie-forward, staphylectomy

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15
Q

Name 3 main CS of EE [epiglottic entrapment]

A

Exercise intolerance
Respiratory noise
Coughing

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16
Q

What kind of noise do we hear with EE?

A

Both inspiratory and expiratory

17
Q

How do we diagnose EE?

A

Endoscopy @ rest usually

18
Q

What does EE endoscopy show us?

A

Wall + new structure

19
Q

How do we treat if we see significant epiglottic entrapment?

A

Surgery - transendoscopic laser correction

20
Q

How do we treat is we see partial epiglottic entrapment?

A

Medical - local/topical anti-inflammatories

likely to recur though once training resumes

21
Q

What is the most common side to see Laryngeal Hemiplasia [LH] on?

Is there another name for it?

A

Left!

Also called idiopathic LH

22
Q

Why do ILHs occur?

A

Damage to the left recurrent laryngeal nerve

23
Q

If we see a right LH, what do we look for?

A

Look for underlying neuro dysfunction

24
Q

What is the signalment for LH?

A 
Young
Male
Tall
Working draft horses
Some genetic component too
25
Q

Name a few proposed etiologies to LH:

A
  • mechanical stress
  • ischemic nerve damage
  • pressure damage
  • toxins
  • perivascular injections
26
Q

T/F: we only see LH @ rest

A

False!

Only seen @ exercise!!
Exercise intolerance is a big CS

27
Q

Name the noise LH makes: [ins vs ex]

A

“Roar”

Inspiratory noise!!

28
Q

How do we diagnose LH?

A
  • CS/history
  • endoscopy
  • US
  • advanced imaging
29
Q

With endoscopy, we can grade LH into 4 groups. Do we scope @ rest or while running?

A

We mostly see problem in grade 3 [“significant dysfunction @ exercise”]
We must scope while running!

30
Q

What does LH treatment depend on?

A

All depends on level of exercise!

We treat differently if there is/is not impedance to exercise

31
Q

How do we treat a horse who only has a noise issue?

A

Ventriculocordectomy

does not improve airway mechanics, only noise

32
Q

How do you treat a horse with LH and exercise intolerance?

A

Do BOTH a laryngoplasty AND ventriculocordectomy

This will help open up the rima glottis and decrease noise

33
Q

Is there ever an indication to just do the laryngoplasty without the ventriculocordectomy?

A

No, do both together.

34
Q

How do we treat upper vs lower emergent respiratory distress?

A

Upper = tracheostomy

Lower = O2

35
Q

T/F: upper airway obstruction = inspiratory distress

A

True

36
Q

Name a few examples of UPPER airway obstructions

A
  • Strangles
  • lymphosarcoma
  • HyPP
  • Tracheal collapse
37
Q

Name some LOWER airway obstruction examples:

A

ARDS
RAO
Acute Viral Pneumonia
Etc…

38
Q

What age group gets infected with rhodococcus equi?

A

Young horses

LAM1 (7 decks)

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