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Eq SX Final > Upper airway/sinus/GP/trachea/Thorax - Bauck > Flashcards

Upper airway/sinus/GP/trachea/Thorax - Bauck Flashcards

1
Q

Maxillary sinus anatomy

A

Rostral and caudal maxillary sinuses separated by septum

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2
Q

Infraorbital canal separates

A

Cranial maxillary sinus from ventral conchal sinus
and
Caudal maxillary from sphenopalatine

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3
Q

Dorsal conchal sinus communicates with

A

frontal sinus

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4
Q

Frontal sinus communicates with

A

caudal maxillary sinus through frontomaxillary opening

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5
Q

Maxillary sinus drains into

A

nasal cavity

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6
Q

Primary sinusitis caused by

A

URT infection

-ush strep species

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7
Q

Secondary sinusitis caused by

A

Dental disease usually

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8
Q

Sinusitis

A

Can be localized or extensive

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9
Q

Sinusitis DX

A 
HX
PE
Endoscopy
CS
Rads
CT
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10
Q

Primary Sinusitis TX

A
  1. Drainage, irrigation (trephination)
  2. abx
  3. surgical debridement
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11
Q

Secondary Sinusitis TX

A
  1. Address primary cause
    - tooth removal
    - mass removal
  2. Then treat as primary sinusitis
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12
Q

Progressive Ethmoid Hematoma

A
  1. Unknown etiology
  2. Capsule is respiratory epithelium
  3. Arises from ethmoid labyrinth, or floor of sinus
  4. Horses > 6 yrs old
  5. Classically unilateral
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13
Q

Progressive Ethmoid Hematoma CS

A
  1. Mild, intermittent epistaxis
  2. +/- upper respiratory noise
  3. Facial deformity uncommon
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14
Q

Progressive Ethmoid Hematoma DX

A

Endoscopy, rads, CT (SX planning)

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15
Q

Progressive Ethmoid Hematoma TX

A
  1. Intralesional 10% formalin - q 3-4 weeks until gone
  2. Laser photoablation if < 5 cm diameter
  3. Possible recurrence (esp. if bilateral)
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16
Q

Paranasal sinus cyst

A
  1. single or loculated fluid-filled cavitis
  2. maxillary and conchal sinuses
  3. Unknown etiology
  4. Any age
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17
Q

Paranasal sinus cyst CS

A
  1. Nasal d/c
  2. Facial swelling
  3. airway obstruction
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18
Q

Paranasal sinus cyst DX

A
  1. Endoscopy
  2. Radiographs
  3. CT (SX planning)
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19
Q

Paranasal sinus cyst TX

A

Responds well to surgical removal

  • Frontal flap or
  • Maxillary sinus flap
  • Must remove cyst lining
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20
Q

Dzs that obliterate normal paranasal sinus anatomy (ethmoid labrynth, concha, etc)

A
  1. Ethmoid hematomas

2. Cysts

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21
Q

If a fracture is into a sinus it is

A

open

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22
Q

Biggest factor for fx reconstruction

A

being able to elevate it

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23
Q

Neoplasia

A

Squam most common

prognosis generally poor

24
Q

Frontal sinus sinoscopy/sinocentesis landmarks

A

-60% from midline and 0.5 cm caudal to line drawn from midline to medial canthus

25
Q

Caudal maxillary sinus sinoscopy/sinocentesis landmarks

A

-2 cm ventral to medial canthus

26
Q

Rostral maxillary sinus sinoscopy/sinocentesis landmarks

A
  • halfway between medial canthus and rostral extent of facial creast
  • 1 cm ventral to line from medial canthus to infraorbital canal
27
Q

Sinus sx prep considerations

A
  1. cross-matches for equine blood donors
  2. Pre-op/intra-op abx and antiinflammatories
  3. Blood donor avail
28
Q

Frontonasal bone flap

A

Preferred

-good access to maxillary sinus via frontomaxillary opening

29
Q

Frontonasal bone flap margins

A
  1. Caudal: perpindicular line from midline to midway point between surpaorbital foramen and medial canthus
  2. Lateral: begins at caudal margin, 2.5 cm medial to medial canthus of eye and extends 2/3 the distance from medial canthus of eye to infraorbital foramen
  3. Rostral: perpindicular line from dorsal midline to rostral extension of lateral margin
30
Q

Maxillary bone flap should avoid

A
  1. infraorbital canal

2. nasolacrimal duct

31
Q

For bone flaps, skin closure should be

A

Intradermal

32
Q

Post-op bone flap

A
  1. Pull packing after 24-36 hours
  2. Change bandage q2-3 days
  3. IV abx 24-48 hrs, can d/c with 10-14 days TMS
  4. Flunixin 7-10 days
  5. Confined to stall with hand walking 3-4 weeks for bone flap to stabilize
33
Q

Medial compartment of guttural pouch

A
  1. Internal carotid artery
  2. Cranial cervical ganglion
  3. Cervical sympathetic trunk
  4. CN 9, 10, 11, 12
  5. Ventral straight muscles
34
Q

Lateral compartment guttural pouch

A

External carotid -> maxillary artery

35
Q

Nerves close to GP

A

CN 5, 7, 8

36
Q

Guttural pouch tympany

A 
Air in pouch
Foals
Ush unilateral
fillies > colts
Nonpainful, can cause dyspnea
PE, Rads
37
Q

Guttural pouch tympany TX

A 
Indwelling foley cath
Surgical
1. enlarge internal plica
2. stoma in median septum
3. salpingopharyngeal fistula-comm btwn GP and pharynx
4. laser/sharp dissection
*prognosis is good, can recur
38
Q

Guttural pouch empyema

A 
Purulent infection ush secondary to URT infection, S. equi
Bilateral mucopurulent nasal discharge
IDDSP, dyspnea, dysphagia
Endoscopy, rads
ABX, NSAIDS, lavage
prognosis good if no neuro defects
39
Q

Guttural pouch mycosis

A

Aspergillus, ush medial compartment

  • arteries (ICA, ECA, MA)
  • nerves (cranial 9-12, sympathetic)
40
Q

Guttural pouch mycosis CS

A
  1. Epistaxis - most common
  2. Dysphagia - most serious
  3. Horner’s syndrome
  4. Abnormal resp noise
  5. Nasal d/c, corneal ulcer, abn head post, colic
41
Q

Guttural pouch mycosis tx

A
  1. Medical tx of fungus - not ush effective, too slow
  2. NSAIDS - for inflammation and neuritis
  3. transfusions/fluids
  4. nutritional support if dysphagia
  5. surgical debridement
  6. vascular occlusion
42
Q

Guttural pouch mycosis prognosis

A
  1. 50% of horses with hemorrhage die
  2. 90% of horses survive after vascular occlusion of affected arteries
  3. Neuropathies
    - Horner’s - good
    - Dysphagia - very poor
    - Laryngeal hemiplasia - poor
43
Q

DDX for huge neck swelling

A
  1. Guttural pouch mycosis

2. Ventral straight m.m.

44
Q

Rupture of ventral straight muscles

A
  1. Longus capitus and rectus capitus ventralis m.m.
  2. Avulsion fx of basisphenoid bone
  3. trauma (flipping over)
  4. severe epistaxis, neuro signs, ataxia, hemorrhage into retropharyngeal tissues, dyspnea
45
Q

Rupture of ventral straight m.m. DX/TX

A 
Endoscopy/rads
TX:
-stall rest
-prophy abxs
-NSAIDS
46
Q

Temperohyoid osteoarthropathy (THO)

A
  • Progressive dz of squamous portion of hyoid bone and stylohyoid bone
  • causes ankylosis of THO, callus, repeated fractures
  • wide age range affected
47
Q

THO possible etiologies

A
  1. Middle/inner ear infection (hematogenous origin)

2. Degenerative changes with age

48
Q

THO TX

A

Ceratohyoidectomy, prog good

49
Q

Important things at approach to ceratohyoidectomy

A
  1. Lingual a.
  2. Hypoglossal n.
  3. Facial a.
  4. Parotid duct
50
Q

Surgical approaches to GP

A
  1. Hyovertebrotomy-no ventral drainage
  2. Viborg’s triangle
    - linguofacial vein
    - ramus of mandible
    - sternomandibularis tendon
  3. Modified Whitehouse
    - most popular
    - good ventral drainage
  4. Whitehouse
51
Q

Viborg’s triangle

A
  1. linguofacial vein
  2. ramus of the mandible
  3. sternomandibularis tendon
52
Q

Trachea anatomy

A
  1. 48-60 hyaline cartilage rings
  2. Rings incomplete dorsally
  3. Four layers
    - tracheal adventitia
    - musculocartilagenous layer
    - submucosa
    - mucosa
53
Q

Tracheotomy complications

A
  1. cellulitis
  2. emphysema
  3. cartilage damage
  4. stricture
54
Q

Tracheotomy layers

A
  1. Skin
  2. cutaneous colli m.
  3. sternothyrohyoideus m.
  4. trachea
55
Q

Incision length should not exceed

A

1/2 circumference of rings

56
Q

Permanent tracheostomy indications

A

Permanent impairment laryngotracheal apparatus

  • cicatrix
  • bilateral hemiplagia
  • bilateral arytenoid chondritis
57
Q

Permanent tracheostomy performed in cranial

A

1/3 of cervical region (more cranial than a temp)

Good long term prognosis

Eq SX Final (16 decks)

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