Signs of respiratory disease

Question 1

List signs of respiratory disease - 7

Answer 1

Coughing and bronchoconstriction
Sneezing
Tachypnoea and hyperpnoea
Respiratory distress (dyspnoea)
Nasal discharge, epistaxis and haemoptysis
Cyanosis
Abnormal respiratory noise (stridor)

Question 2

Define bronchoconstriction

Answer 2

constant component of cough but separate reflex. slower onset and longer lasting may increase efficiency of coughing

Question 3

What 2 main drugs can target coughing?

Answer 3

Demulcents - to soothe irritant receptors

Opioid-R agonists - butorphanol, codeine

Question 4

What is the neural basis of coughing?

Answer 4

Irritant receptors through tracheobronchial tree. Afferent input carried in vagus. Cental cough centre in brainstem. Efferent motor side: vagus, phrenic, intercostal, lumbar, trigeminal, facial hyoglossal and accessory nerves/

Question 5

List stimuli for coughing - 7

Answer 5

bronchoconsctriction
excessive mucous
inhaled particles
cold or hot air
intramural/extramural pressure
epithelial sloughng
enhanced epithelial permeability

Question 6

Typical cough - upper airway problem

Answer 6

harsh, loud, non-productive

Question 7

Typical cough - lower airway problem

Answer 7

soft, muted, productive

Question 8

Typical cough - painful conditions

Answer 8

more muted cough

Question 9

What else indicates a productive cough?

Answer 9

swallowing after coughing

Question 10

Where does sneezing originate?

Answer 10

MM of nasal cavity

Question 11

What is sneezing a sign of?

Answer 11

Nasal disorders (usually) or can be secondary to more distal disorders

Question 12

Define tachypnoea

Answer 12

increased RR

Question 13

Define hyperpnoea

Answer 13

increased RR and depth

Question 14

Normal RR horse

Answer 14

8-15

Question 15

Normal RR cow, sheep, pigs

Answer 15

10-30

Question 16

Normal RR goats

Answer 16

25-35

Question 17

Normal RR - foal and calf

Answer 17

20-40

Question 18

Normal RR dog

Answer 18

10-30

Question 19

Normal RR - cat

Answer 19

24-42

Question 20

Normal RR - rabbit

Answer 20

30-60

Question 21

Physiological causes - tachypnoea and hyperpnoea - 4

Answer 21

pain, exertion, heat, anxiety

Question 22

Pathological causes - tachypnoea and hyperpnoea

Answer 22

high CO2
low pH
low O2
compensation (metabolic acidosis)
excessive environmental heat
damaged/diseased CNS (resp centres)
pain/restriction in breathing

Question 23

Define dyspnoea

Answer 23

subjective feeling (therefore should be humans only) of respiratory distress

Question 24

Define respiratory distress

Answer 24

laboured breathing, abnormal rate, rhythm and character, nostril flaring, exaggerated intercostal/abdominal effort, abducted elbows, stridor, anxious expression, inactivity.

SOME SPECIES (not horse) - extended head and neck, mouth breathing

Question 25

Broad causes - inspiratory distress

Answer 25

Extrathoracic non-fixed airway obstruction | Restrictive diseases

Question 26

What is an Extrathoracic non-fixed airway obstruction?

Answer 26

as negative pressures of inspiration suck them into airway (upper airway obstructions including laryngeal hemiplegia, soft palate disorders)

Question 27

Give an example of a restrictive disease

Answer 27

pleural effusion - limits lung expansion

Question 28

What is expiratory distress caused by? Example?

Answer 28

intra-thoracic airway obstruction - such as bronchoconstriction caused by RAO, farmer's disease (cattle), tracheal collapse (dogs and horses)

Question 29

What are heaves lines?

Answer 29

in cases of chronic expiratory distress, body wall muscles hypertrophy and this becomes visible as heaves lines.

Question 30

What is combined inspiratory and expiratory distress caused by?

Answer 30

an extra-thoracic fixed obstruction (intraluminal mass, FB)

Question 31

Define orthopnoea

Answer 31

difficulty breathing whilst recumbent - pleural fluid accumulation, neonates (pliable ribs), diagphragmatic hernia, CHF

Question 32

How is nasal discharge characterised?

Answer 32

``` Serous, mucoid, purulent, sanguinous Combination Ingested food/fluid Scant-profuse Continuous-intermittent Unilateral-bilateral ```

Question 33

Where does unilateral nasal discharge tend to originate?

Answer 33

structures rostral to the caudal end of the nasal septum, although low volume discharges from lower in the RespT can be unilateral too.

Question 34

Where does bilateral nasal discharge tend to originate? 2

Answer 34

Caudal structures OR bilaterally affected rostral structures

Question 35

What does a foul odour of discharge indicate?

Answer 35

anaerobic infections, necrotising conditions, or connection to oral cavity - tooth root infections

Question 36

What may food/fluid indicate?

Answer 36

dysphagia or communication between oral and nasal cavities

Question 37

Define epistaxis

Answer 37

presence of blood in the external nares. Commonest cause in horses = tram

Question 38

Define haemoptysis

Answer 38

presence of blood in the sputum (i.e. coughed up blood).

Question 39

Causes - epistaxis and haemoptysis

Answer 39

Trauma Coagulopathies Erosive/invasive conditions EIPH - equines Look for accompanying signs - stridor (SOL), discharge (purulent or malodorous) and lung disease (cough or auscultate).

Question 40

Define cyanosis

Answer 40

blue discolouration - skin, conjunctivae, MM - i.e. reflection of RespT problem in the CVS

Question 41

How low does PaO2 have to fall for cyanosis?

Answer 41

<50mmHg

Question 42

When is cyanosis present?

Answer 42

Only if [Hb] is normal or near normal. Not with anaemia.

Question 43

Define polycythaemia

Answer 43

higher than normal [Hb]

Question 44

Whenare polycythaemic patients cyanotic?

Answer 44

at higher PaO2

Question 45

When can peripheral cyanosis occur?

Answer 45

poor peripheral perfusion (shock, HF).

Question 46

Define pulmonary cyansis

Answer 46

= hypoxaemia. (V/Q mismatch, alveolar hyperventilation, shunting, diffusion impairment)

Question 47

When does cardiac cyanosis occur?

Answer 47

shunting

Question 48

What is acquired cyanosis?

Answer 48

usually reducing chemical - e.g. acetaminophen, nitrates, red mapleleaf-methaemoglobin

Question 49

Define stridor. What should be determined?

Answer 49

abnormal, intense respiratory sound heard without a stethoscope. Determine if inspiratory OR expiratory.

Question 50

What is linked gait and respiration in horses?

Answer 50

expiration when leading forelimb contacts the ground(bt at trot, breathing and stride rate are independent)

Question 51

Causes - stridor. Examples?

Answer 51

Fixed or dynamic obstructions (laryngeal paralysis, stenotic/paralysed nares, nasal masses, soft palate elongation)