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Horse Medicine > Surgical conditions of the nasopharynx > Flashcards

Surgical conditions of the nasopharynx Flashcards

1
Q

What is an issue with the pharynx compared to sinuses etc?

A

entirely muscle

strong reliance on proper innervation for structure

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2
Q

What is the pharynx anatomically?

A

mucomembranous tube

conduit between nasal passages and larynx

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3
Q

What are the functions of the pharynx?

A
  1. breathing
  2. deglutition
  3. vocalization
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4
Q

What are the pharyngeal muscles?

A 
genioglossus
gentogyoideus
styloglossus
sternohyoideus
omohyodeus
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5
Q

HO id dilateion and constriction of the pharynx achieved?

A

coordinated function fo the nasopharyngeal muscles

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6
Q

What is the nerve supply to back of through?

A

10, 5 is involved as well

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7
Q

What animals get pharyngitits (pharyngeal lymphoid hyperplasi)

A

young horses

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8
Q

what is the istory of pharyngitits?

A

nasal discharge
cough
decreased performance/noise? (throat hurts)–turbulence over bumps

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9
Q

HOw is pharyngitis dx?

A

endoscopy

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10
Q

What are the grades fof pharyngitits?

A

1-4

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11
Q

What is the treatment for pharyngitis?

A

regular vaccination against virus induced upper airway inflam

  1. anti-inflammatories
  2. rest! rest! rest! 4-5d (owner’s dont want)–oft go away
  3. sx only if large
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12
Q

Why must you rest horses with pharyngitis?

A

turbulent airflow due to the bumps causes more inflammation to the area

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13
Q

What is the cause of pharyngeal collapse?

A

dysfunction of stylopharyngeus muscle (cranial nerve IX)

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14
Q

Is pharyngeal collapse significant?

A

yes, but don’t know why? 9-15yr old warmbloods

some degree of collapse normal in exercising horse

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15
Q

What does the stylopharyngeus msucle do?

A

hold up the dorsal pharyngeal wall

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16
Q

Why do you always scope the gutteral pouches with pharyngeal collapse?

A

because the stylopharyngeus is innervated by cranial nerve IX that runs over gutteral pouch and issues with gutterual pouch can cause neuropraxia of the 9th cranial nerve

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17
Q

Why shouldn’t you sedate a horse that suspect has pharyngeal collapse?

A

because sedation causes pharyngeal collapse

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18
Q

How is pharyngeal collapse diagnosed?

A

endoscopy (at rest of exercise)

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19
Q

What is the treatment for pharyngeal collapse?

A

none

20
Q

Why should you assess how bad the pharyngeal collapse is before exercising a horse?

A

because they may get agitated and stop and come off the back of the treadmill

21
Q

What is the significance of dorsal displacement of the soft palate?

A

performance limiting

22
Q

Is dorsal displacemnt of the softt palate common?

A

yes, often in young raace horses

23
Q

What are two types of dorsal displacement of soft palate?

A

static

intermitent/dynamic

24
Q

What kind of obstruction does dorsal displacement of the soft palate cause?

A

expiratory airway obstruction

25
Q

What is the consequence of dorsal displacement of the soft palate?

A

hypoxia

hypercapnia

26
Q

What are the theories of etiology of dorsal displacement of soft palate?

A
  1. abnormal soft palate
  2. epiglottic hypoplasia
  3. excessive caudal retraction
  4. caudal retactio nof tongue
  5. open mouth
  6. neuromscular dysfunction (pharyngeal branch of vagus)
27
Q

How is dorsal displacement of the soft palate diagnosed?

A
  1. history–they sudden slow down a LOT
  2. endoscopy (rest or nasal occlusion or treadmill–more likely to dorsally displace)
  3. radiographs (permanent)
28
Q

Why have two markers on the horse with radiograph?

A

can account for magnification and measure the length of the epiglottis

29
Q

Does a short epiglottis lead ot DDSP?

A

not necessarily

30
Q

What do you have to be cautious about with DDSP?

A

find if there are other issues–may be causing the DDSP and DDSP may resolve if resolve that issue (e.g. chondroid causing neuropraxia)

31
Q

What is medical treatment of DDSP

A
  1. tying tongue?

2. treat underlying cause?

32
Q

What are the surgical teatments for DDSP?

A
  1. staphylectomy–resection of caudal aspect of soft palate (soft palate too long?–no evidence!)
    success 60%
  2. myectomy–release caudal traction of larynx. success 60%
  3. epiglottic augmentation-teflon injection
  4. palatoplasty: stiffen the caudal aspect of the palate. success 60%
  5. tie-forward. success 80%
33
Q

What are complications of staphylectomy to resolve DDSP?

A

dysphaia, permanent DDSP

and is not better than medical treatment

34
Q

What are complications of myectomy to resolve DDSP

A

incisional seroma, infection, cosmetic defect

35
Q

What is the problem with epiglottic augmentation?

A

can flop all over the place???

36
Q

What is the tie forward technique for DDSP?

A

move the larynx forward and dorsally

37
Q

What is choanal atresia?

A

failure to absorbe the bucconasal membrane during embryonic development

38
Q

is choanal atresia common?

A

no

39
Q

When is choanal atresia a big issue?

A

when both bucconasal membranes fail to absorb and the foal cannot breathe at birth

40
Q

What do you do if have unilateral choanal atresia?

A

laser, punch through,

41
Q

What is the problem of dealing with unilateral choanal atresia?

A

have a tendancy to reoccur!

42
Q

What is a cleft palate?

A

a congenital defect–opening in palate

43
Q

Why would you cut a hole in the nasal septum in a case of unilateral choanal atresia?

A

because membrane has tendancy to reoccur so instead let air go from one side to the other through hole in nasal septum

44
Q

What are clinical signs of cleft palate?

A

milk draining from nose and coughing BUT “normal” foals can do this in the first week

45
Q

how is cleft palate diagnosed?

A

exam
endoscope
check for sequelae like aspiration pneumoniae

46
Q

What is the treatment for cleft palate?

A

surgical repair or euthanasia

  • -difficult b/c
    1. contaminated
    2. has to constantly be moving even under anesthesia–breathing
47
Q

What is the prognosis for cleft palate?

A

if greater than 20% soft palate missing, don’t try surgery

if only soft palate then prognosis

Horse Medicine (14 decks)

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