Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

RUSVM Small Animal Surgery > Upper Airway > Flashcards

Upper Airway Flashcards

1
Q

when is nasal planum recection used

A

Nasal Neoplasia - SCC

complete or unilateral removal of the nose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

most common complication with nasal planum resection

A

local recurrence due to imcomplete excision

esp in dogs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what type of suture technique is used to decrease the size of the wound and allow healing by second intention with nasal planum resections

A

purse-string

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

complications associated with nasal planum resection

A

dehiscence - tension on flaps

stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what happened to this dog

A

Nasal Planectomy and Maxillectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

common surgical conditions of the nasal cavity

A

nasopharyngeal stenosis

trauma (i.e gunshot)

neoplasia (adenocarcinoma, SCC, lymphoma, MCT, polyps)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

important diagnostic for nasal disease

A

CT

other diagnostics include: MDB, thoracic rads, sedated oral exam, skull/dental rads, MRI, rhinoscopy, cytology, biopsy, fungal/BacT culture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

when should rhinoscopy and nasopharyngoscopy be performed

A

AFTER imaging

guided or blind biopsies

BacT culture unlikely helpful - PCR for Bartonella and Mycoplasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

types of nasal surgery

A

Rhinotomy - Dorsal (most common) and Ventral

Sinusotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

risks and complications of nasal surgery

A

hemorrhage (dorsal, lateral and major palantine arteries)

flap necrosis

oronasal fistula

dehiscence

stenosis of airway

incomplete resection/local recurrence (neoplasia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

primary components of brachycephalic airway syndrome

A

elongated soft palate

stenotic nares

shortened, flattened nasal cavity

+/- hypoplastic trachea (can’t fix)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

secondary/acquired components of brachycephalic airway syndrome

A

everted laryngeal saccules/stage I laryngea collapse

pharyngeal/laryngeal mucosal edema

tonsillar eversion

macroglossia

stage II/III laryngeal collapse

tracheal collapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

pathophysiology of upper airway obstructive disease

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is the most common component of brachycephalic airway syndrome

A

elongated soft pallate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

elongated soft pallate results mainly in ______

A

inspiratory dyspnea - STERTOR!

extension into rima glottidis - severe obstruction, loss of protective laryngeal function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

air passage through nasal cavities accounts for _____ of airway resistance

A

air passage through nasal cavities accounts for 76.5% of airway resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

stage I largyngeal collapse

A

everyted laryngeal saccules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

stage II laryngeal collapse

A

collapse of cuniforme cartilage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

stage III laryneal collapse

A

collapse of corniculate cartilage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

stage II and III laryngeal collapse results in …

A

loss of cartilage rigidity - chondromalacia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

hypoplastic trachea

A

irregular, thick/firm cartilage rings

overlap of rings

increased airflow resistance

common in english bulldogs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

GI comorbidities with brachycephalic airway syndrome

A

reguritation

vomitting

hiatal hernias

pyloric hypertrophy

ulceration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

why is it important to diagnose GI comorbidites in BAS dogs

A

can have lesions and clinical signs go undetected by owners

risk factor for aspiration pneumonia in pre and peri-operative peroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

CV changes with BAS

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

signalment for BAS

A

~2-3 years (younger in english bulldogs)

M > F

breeds - depends on region of country

26
Q

mild/moderate BAS clinical presentation

A

exercise intollerance

increased noise, “snoring,” “snuffing,” reverse sneezing

+/- GI signs

may have mild secondary changes

27
Q

severe clinical presentation of BAS

A

present on emergent basis in acute resp distress

+/- heat stroke

+/- GI signs

+/- lower airway disease (non-cardiogenic pulmonary edema, aspiration pneumonia)

likely to have numberous significant secondary changes

28
Q

DDx of BAS

A

space occupying mass of upper airway

neoplasia, abscess, granuloma, foreign body, epiglottic retroversion

29
Q

diagnosis of BAS

A

upper airway exam under light anesthesia

+ALSO+

thoracic radiographs

+/- lateral cervical views, abdominal rads, blood work

30
Q

what drugs should be avoided when performing a sedated upper airway exam

A

ketamine

diazepam (midazolam ?)

large does of pure µ agonist

drugs that affect laryngeal function!!

31
Q

what drugs can be used in upper airway exam

A

propofo +/- butorphanol or buprenophine

can utilize doxapram @ 1.1 mg/kg to imporve rate and strength of respiration

use same protocol every time - have a set plan so know how to address complications

32
Q

possible thoracic radiograph findings with BAS

A

Rt heart enlargement

assess for hypoplastic trachea (tracheal lumen:thoracic inlet ratio)

non-cardiogenic pulmonary edema

aspiration pneumonia

hiatal hernia

megaesophagus

33
Q

whats included in the upper airway exam

A

tonsils

soft palate

arytenoid cartilages (symmetry/evidence of collapse, everted saccules)

additional - laryngeal function, mucosal lesions, excess mucous/saliva, masses

evaluate nares

34
Q

when is treatment necessary with BAS

A

presence of any of the components of BAS

- upper airway exam of brachycephalic dogs at time of spay/neuter; early surgical intervention to prevent secondary changes

any animal presenting with clinical signs of BAS

35
Q

surgical treatment of laryngeal collapse

A

stage I - excision of everted laryngeal saccules

stage II - above + vocal fold excision, partial arytenoidectomy

stage III - permanent tracheostomy

36
Q

per-operative considerations for BAS

A

Gi protectants and promotility agents

anti-inflammatories

anti-emetic at time of pre-medication for anesthesia

pre-oxygenation prior to induction

37
Q

T/F endotracheal intubation of BAS it is important to ensure cuff is adequately inflated

A

True

high volume, low pressure - protect trachea

38
Q

which soft pallate resection technique is easier for novices to perform

A

clamp (crush) technique

most traumatic

39
Q

what are some advantages of the laser freehand technique of soft pallate resection

A

rapid

virtually no blood loss; excellent visualization

minimal post-op inflammation

reduced post-op discomfort

40
Q

complications of palatectomy

A

acute: hemorrhage, inflammation
chronic: undershortening (redo), overshortening (nasal reflux, aspiration)

41
Q

T/F when excising everted laryngeal saccules, small (4-0/5-0) absorbable suture should be used with a double layer closure

A

False

excise with scissors and let it heal by second intention

42
Q

complication with arytenoidectomy and ventriculochordectomy

A

“webbing” or stricture

  • avoided by: NOT cutting to the ventral and dorsal extents of the corniculate processes and vocal folds*
  • this is also a complication for vocal fold excision for debarking*
43
Q

what is a salvage procedure for stage III collapse

A

permanent tracheostomy

considerations: hypoplastic trachea, loose skin folds

44
Q

why are there so many techniques to correct stenotic nares

A

severity of collapse

static vs dynamic collpase

cosmetic appearance - least important

45
Q

techniques for correcting stenotic nares

A

wedge resection (horizontal, vertical, dorsolateral)

amputation (alar wing +/- alar fold)

alapexy

46
Q

when can a unilateral arytenoid lateralization be used

A

only in cases of laryngeal paralysis and if adequate cartilage rigidity is present

47
Q

medical treatment of BAS

A

weight loss

environmental changes (cool environment, activity changes, exposure of respiratory irritants)

harness

treat underlying GI disease

should be instituted for every brachycephalic patient!

48
Q

severe post-operative complications

A

pharyngeal swelling

vomitting

reguritation

Aspiration pneumonia

49
Q

T/F there is no single component of BAS associated with pooer outcome

A

True

50
Q

treatment of epiglottic retroversion

A

pexy of ventral aspect of epiglottis and the dorsal base of the tongue

51
Q

clinical signs of laryngeal disease

A

respiratory stridor

exercise intollerance

gagging/dysphagia

dysphonia

coughing

dyspnea that does not improve with open mouth breathing

52
Q

T/F rottweilers have onsets of clinical signs with congenital laryngeal paralysis at younger ages that huskies, bull terriers, dalmations and bouvier de flanders

A

True

rottweilers - 11-13 weeks of age

other breeds - before 1 year

53
Q

what is the most common cause of acquired laryngeal paralysis

A

idiopathic

other causes: hypothyroidism, truama, immune mediated (m. gravis), infectious, toxins (lead, organophosphates)

54
Q

T/F you should be prepaired to proceed immediately with further diagnositics or surgery based on findings of laryngeal exam

A

True

55
Q

surgical treatment of laryngeal paralysis

A

unilateral arytenoid lateralization

56
Q

what can be used to help acheive appropriate abduction with unilateral arytenoid lateralization

A

oversized ET tube

careful: excessive tension may increase risk of aspiration pneumonia due to poor wpiglottic coverage of rima glottidis

57
Q

post op care with unilateral arytenoid lateralization

A

maintain ET tube until sufficiently awake

avoid heavy sedation/ med that may induce vomitting

NPO 24 hrs post op

monitor for signs of aspiration pneumonia (hyperthermia, C+, dyspnea, increased respiratory effort, arterial and venous blood gas and rads to confirm Dx)

58
Q

complications associated with unilateral arytenoid lateralization

A

aspiration pneumonia

recurrent or persistent signs (may require Sx on contralateral side)

seroma, intramural hematoma, coughing, gagging, dysphagia

59
Q

T/F some phonation ability may persist/return overtime with devocalization (ventriculocordectomy) procedure

A

True

60
Q

what type of approach is taken with a ventriculocordectomy

A

transoral and ventral

61
Q

why is it important to leave 1-2 mm ventral cord intact with venticulocordectomy

A

decreases the risk of webbing

RUSVM Small Animal Surgery (41 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions