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Small Animal Surgery > Unit 2: 9 - Lower Respiratory > Flashcards

Unit 2: 9 - Lower Respiratory Flashcards

1
Q

What is pneumothorax?

A

Loss of negative pressure in the thoracic space

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2
Q

How should the site for a thoracocentesis be prepped?

A

Clip, aseptic scrub, sterile gloves

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3
Q

What samples can be taken with a thoracostomy tube placement?

A

Air/fluid, cytology, PCV/TP, culture

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4
Q

What are 4 surgical approaches to the thoracic cavity?

A

Lateral thoracotomy, median sternotomy, thoracoscopy, thoracoscopic-assisted

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5
Q

What are 4 considerations for thoracotomy?

A
  1. All animals with resp distress require O2 supplementation
  2. All animals with open chest cavities require IPPV, including diaphragmatic hernias
  3. High ventilatory pressures should be avoided in patients with chronic collapsed lung lobes, pneumonia - reperfusion injury
  4. Thoracotomy procesures cause substantial pain, will require adequate post-op analgesia
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6
Q

What are advantages to an intercostal (lateral) thoracotomy?

A

Good access to dorsal structures and specific structures directly under the intercostal space

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7
Q

What are disadvantages to an intercostal (lateral) thoracotomy?

A
  1. Poor access to contralateral hemithorax
  2. Limited access to ipsilateral structures not directly under the intercostal space
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8
Q

Where are the nerves and vessels of the ribs located?

A

caudal to each rib

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9
Q

What is the general landmark for an intercostal thoracotomy?

A

4th to 5th ICS

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10
Q

What are advantages to a median sternotomy?

A
  1. Access to entire thoracic cavity
  2. Can combine with abdominal approach
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11
Q

What are disadvantages to a median sternotomy?

A

Difficult to access dorsal structures

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12
Q

What are advantages to a thoracoscopy?

A
  1. Magnification, illumination
  2. Visualization of difficult to reach places
  3. Less pain faster recovery in short term
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13
Q

What are disadvantages to a median sternotomy?

A
  1. Technically challenging, needs training
  2. Specialized equipment needed
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14
Q

What are the 2 approaches to a partial lobectomy and which is preferred?

A
  1. Suture method
  2. Surgical stapler = PREFERRED
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15
Q

When is a pneumonectomy indicated?

A

For lesions that have extended to all lobes of one side, but spare the contralateral

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16
Q

Animals can survive ___% loss of total lung volume, but die after ___% loss.

A

50, 75

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17
Q

What pleural effusions can occur?

A

Chylothorax, hemothorax, pyothorax, neoplastic, transudative

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18
Q

What are the 3 main space-occupying lesions of the thorax that restrict lung expansion?

A

Fluid, air, cells

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19
Q

What are the 2 more common surgical indications with a pleural effusion?

A

Chylothorax, pyothorax

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20
Q

What is usually the cause of chylothorax?

A

idiopathic

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21
Q

What is chyle?

A

Milky fluid consisting of lymph, emulsified fats, and free fatty acids

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22
Q

What color is chyle?

A

white/pink

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23
Q

What is the TP of chyle?

A

>2.5 g/dL

24
Q

What is the WBC count of chyle?

A

>5000/uL

NPs and LCs

25
Q

In chyle, triglycerides in effusion will be _____ than peripheral blood.

A

higher

26
Q

In chyle, cholesterol in effusion will be _____ than peripheral blood.

A

less

27
Q

What other diagnostics should be done to rule out a chylothorax/the cause for it?

A

Chest rads, CT, U/S, cardiac workup (echo, ECG)

28
Q

What are 3 procedures used to surgically correct a chylothorax?

A
  1. Thoracic duct ligation (TDL)
  2. Pericardectomy (subtotal/partial)
  3. Cisterna chyli ablation (CCA)
29
Q

What is the TP of pyothorax effusion?

A

>3.0 g/dL

30
Q

What is the cell count for pyothorax?

A

>3000/uL

31
Q

What is commonly found in cytology for pyothorax?

A

Gram+, acid fast, filamentous rods:

Nocardia, Actinomyces

32
Q

Medical management of pyothorax needs _____ treatment.

A

aggressive

33
Q

What is the gold standard for pyothorax treatment?

A

Surgery

34
Q

What is the short-term vs. long-term survival of dogs with pyothorax?

A

Short = 92%

Long = 70%

35
Q

What should always be performed following high impact trauma?

A

Thoracic rads

36
Q

What type of pneumothorax is life threatening?

A

Tension pneumothorax = air enters pleural space during inspiration and is unable to escape during expiration

37
Q

What is the etiology for spontaneous pneumothorax?

A

Pumonary blebs/bullae rupture

38
Q

What breed gets spontaneous pneumothorax?

A

Siberian Huskies

39
Q

What can spontaneous pneumothorax lead to?

A

Bullous emphysema

40
Q

Which are more common, pulmonary blebs or bullae?

A

blebs

41
Q

What treatment is recommended for spontaneous pneumothorax?

A

Surgery

42
Q

What are 3 pleural and mediastinal masses that can occur?

A
  1. Mesothelioma
  2. Thymoma
  3. Thymic branchial cysts and mediastinal cysts
43
Q

Lung lobe torsion is rotation of the lung along the _____ axis.

A

long

44
Q

What does lung lobe torsion lead to?

A

Twisting of bronchus and pulm vessels at hilus –> congestion, edema, pleural effusion

45
Q

What is the treatment for lung lobe torsion?

A

Lung lobectomy - NOT de-rotation

46
Q

What type of neoplasia is common in the lungs?

A

Metastatic

47
Q

What is the main primary tumor seen in the lung?

A

Carcinoma (97%)

48
Q

What is the treatment for primary lung neoplasia?

A

Lung lobectomy - complete or partial

49
Q

What is a patent ductus arteriosus?

A

Failure of ductus arteriosus to close following birth (PA –> aorta)

50
Q

What is the direction blood is shunted in a PDA?

A

Left to right

51
Q

What are 3 treatments for PDA?

A
  1. Left 4th thoracotomy
  2. Percutaneous coil embolization
  3. Amplatz ductal occluder
52
Q

What does pericardial effusion lead to?

A

cardiac tamponade

53
Q

What are 3 causes of pericardial effusion?

A

Transudative, exudative, sanguinous

54
Q

What is the most common vascular ring anomaly?

A

Persistent right aortic arch with left ligamentum arteriosum

55
Q

What is the CS for a PRAA?

A

Frequent regurgitation, poor BCS after weaning

56
Q

Dilation of the esophagus occurs ____ to ring in a PRAA.

A

cranial

Small Animal Surgery (17 decks)

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