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Small Animal Surgery > Unit 2: 8 - Upper Respiratory > Flashcards

Unit 2: 8 - Upper Respiratory Flashcards

1
Q

What are the 4 major nasal conditions?

A

Tumors, fungi, FB, trauma

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2
Q

What are the 2 most common nasopharyngeal/laryngeal conditions?

A

Brachycephalic syndrome and laryngeal paralysis

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3
Q

What is the major tracheal condition?

A

Tracheal collapse

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4
Q

What diagnostic is relied on a lot for upper respiratory conditions?

A

endoscopy

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5
Q

What is the most common CS for upper respiratory issues?

A

Respiratory distress

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6
Q

What CS indicate moderate to severe respiratory distress?

A

Open mouth breathing, abducted forelimbs, labored breathing, and restlesness

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7
Q

What color are MM in mild respiratory distress?

A

normal

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8
Q

What color are MM in moderate respiratory distress?

A

normal

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9
Q

What color are MM in severe respiratory distress?

A

pale, gray, cyanotic

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10
Q

What is the status of air entry in mild respiratory distress?

A

slightly reduced

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11
Q

What is the status of air entry in moderate respiratory distress?

A

moderately restricted

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12
Q

What is the status of air entry in severe respiratory distress?

A

severe restriction

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13
Q

What is the animal’s awareness in mild respiratory distress?

A

normal, restless

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14
Q

What is the animal’s awareness in moderate respiratory distress?

A

anxious, restless

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15
Q

What is the animal’s awareness in severe respiratory distress?

A

delirious, obtund, semicomatose

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16
Q

Does the animal use accessory muscle in mild respiratory distress?

A

no

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17
Q

Does the animal use accessory muscle in moderate respiratory distress?

A

maybe

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18
Q

Does the animal use accessory muscle in severe respiratory distress?

A

Has generalized use

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19
Q

What is the ideal environment for pre-op management of upper airway issues?

A

cool, calm, quiet

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20
Q

What are primary sedation agents for upper resp issues?

A

Butorphanol + acepromazine

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21
Q

How can supplemental O2 be given?

A

Nasal tube or oxygen cage

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22
Q

What should patients be pretreated with to minimize inflammation and edema?

A

corticosteroids (Dexamethasone)

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23
Q

What muscle is used to abduct the airway? In what condition is this affected?

A

Dorsal cricoid arytenoideus;

Affected in laryngeal paralysis

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24
Q

How does the larynx heal if the mucosa is apposed?

A

By re-epithelialization

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25
Q

How does the larynx heal if there are wounds with gaps?

A

By second intention - may cause scarring of the glottis

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26
Q

How do superficial wounds of the trachea heal?

A

By re-epithelialization

27
Q

How do full-thickness wounds in the trachea heal?

A

By second intention - protruding granulation tissue and subsequent scar formation (may narrow lumen)

28
Q

A 20% reduction in diameter of the trachea may reduce mucociliary clearance by ___% or more.

A

50

29
Q

What are 4 major complications that may occur after upper resp sx?

A
  1. Collapse
  2. Laryngeal spasms, paresis, paralysis
  3. Aspiration pneumonia
  4. Death
30
Q

When would you perform a rhinotomy?

A

Rarely;

Tumors, fungal dz, FB, trauma

31
Q

What is the most common approach in a rhinotomy?

A

dorsal

32
Q

What are 3 indications for a tracheotomy?

A
  1. Remove obstruction
  2. Sample
  3. Facilitate airflow
33
Q

What muscle is cut through for a tracheotomy?

A

Sternohyoideus

34
Q

What 5 structures should be avoided when doing a tracheotomy?

A
  1. Recurrent laryngeal n.
  2. Carotid artery
  3. Jugular vein
  4. Thyroid vessels
  5. Esophagus
35
Q

What is the indication for a tracheostomy?

A

Bypass obstruction

36
Q

What is the biggest concern post-op with a tube tracheostomy?

A

Tube obstruction or disruption –> asphyxiation

37
Q

What is brachycephalic syndrome?

A

Upper resp obstruction in brachycephalics caused by stenotic nares, elongated soft palate, everted laryngeal saccules

38
Q

What breeds commonly have brachycephalic syndrome?

A

English Bulldogs, Boston Terriers, Pug, Pekingese

39
Q

What are stenotic nares?

A

Nostrils with abnormally narrow openings; cartilages lack rigidity

40
Q

Stenotic nares account for ____% of total airway resistance.

A

76-80%

41
Q

What is an elongated soft palate?

A

Extension of the soft palate > 1-3 mm caudal to the tip of the epiglottis

42
Q

What is stage 1 laryngeal collapse?

A

Eversion of the laryngeal saccules

43
Q

What is stage 2 laryngeal collapse?

A

Medial deviation of aryepiglottic folds (cuneiform processes)

44
Q

What is stage 3 laryngeal collapse?

A

Medial deviation of corniculate process

45
Q

What is laryngeal paralysis?

A

Complete or partial failure of the arytenoid cartilages and vocal folds to abduct during inspiration

46
Q

What form of laryngeal paralysis is more common?

A

Acquired – Labradors

47
Q

What is a CS with laryngeal paralysis that can be different than the other upper airway issues?

A

Voice change - ask owner about barking

48
Q

What is the prognosis for laryngeal paralysis?

A

If asymptomatic to mild = good

If moderate to severe = may progress to collapse and has a worse prognosis

49
Q

What is tracheal collapse?

A

Tracheal obstruction caused by cartilage flaccidity and flattening

50
Q

What breeds and age are prone to tracheal collapse?

A

Toy and mini breeds; Middle aged or older more likely

51
Q

How is tracheal collapse assessed on palpation?

A

Flaccid cartilages with prominent lateral borders may elicit cough;

Hepatomegaly on abd palpation

52
Q

How is tracheal collapse assessed on auscultation?

A

Tracheal noise, soft end-expiratory snapping together of the tracheal wall with intrathoracic collapse, abnormal heart sounds

53
Q

Cervical trachea collapses during _____, which is why this is the ideal time to snap a radiograph.

A

inspiration

54
Q

Grade 1 tracheal collapse is ___% occlusion.

A

<25%

55
Q

Grade 2 tracheal collapse is ___% occlusion.

A

25-50%

56
Q

Grade 3 tracheal collapse is ___% occlusion.

A

50-75%

57
Q

Grade 4 tracheal collapse is ___% occlusion.

A

75-100%

58
Q

How often is there concurrent laryngeal paralysis or collapse with tracheal collapse?

A

~30%

59
Q

How often is there concurrent bronchial compression or collapse with tracheal collapse?

A

~40-45%

60
Q

How many patients improve with surgical correction of a collapsing trachea?

A

80-90%

61
Q

What are 2 surgical techniques for tracheal collapse?

A

Prosthesis or stent

62
Q

What is tracheal hypoplasia?

A

Congenital stenosis of the trachea characterized by a narrow lumen, rigid cartilages that overlap or appose, and an obscured or narrow dorsal tracheal membrane

63
Q

What is tracheal stenosis?

A

Abnormal narrowing of the tracheal lumen due to congenital malformation or trauma

64
Q

What things can cause tracheal stenosis?

A

Penetrating wounds, FB, indwelling tubes, tracheal surgery (2nd intention healing)

Small Animal Surgery (17 decks)

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