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cardiopulmonary test 2 > Upper airway surgery > Flashcards

Upper airway surgery Flashcards

1
Q

sources of nasal discharge

A

nasal passageway

sinus

guttural pouch

LRT-trachea, lungs

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2
Q

if in front of _________, discharge will be unilateral

A

nasal septum

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3
Q

DDx for sinusitis in equine

A

primary infection

tooth root infection

facial fracture

mass within sinus

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4
Q

Primary sinusitis in horses

A

viral infection

fungal infection-aspergillus

bacterial infection-strep equi

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5
Q

which sinus is likely to get sinusitis secondary to tooth root infection

A

especially maxillary sinus

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6
Q

sinusitis due to tumor

A

necrosis occurs

blockage of nasomaxillary aperture

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7
Q

DDx for sinusitis in cows

A

primary infection

dehorning infection

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8
Q

Clinical signs of sinusitis in large animals

A

nasal d/c-intermittent or unilateral

ADR

fever

facial distortion

neurological abn-blindness, optic atrophy from sphenopalatine

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9
Q

diagnostic tests for sinusitis

A

oral exam

other sites (LN, chest rads, titers)

rads

endoscopy -+/- deep cultures, bx

flush (via trephination)

CT scan

MRI

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10
Q

sinus trephine

A

bx

aspirate (c&s)

contrast rads

flush

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11
Q
A
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12
Q

tx for sinusitis

A

abx, NSAIDs, sinus drainage (on own, lavage via trephine, new hole into nasal cavity)

get rid of primary cause-remove tooth, tumor, sequestrum

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13
Q

Ethmoid hematoma

A

benign tumor-like mass originating from ethmoid turbinates

unknown etiology

thoroughbreds, warmbloods>quarter horses

geldings

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14
Q

Ethmoid hematoma clinical signs

A

nasal d/c: pus + blood, intermittent, smelly, unilateral,

bad breath

nasal obstruction: decreased airflow

more like dog neoplasia

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15
Q

ethmoid hematoma diagnostics

A

endoscopy, radiographs, CT

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16
Q
A

Ethmoid hematoma radiograph

17
Q
A

ethmoid hematoma CT scan

18
Q

ethmoid hematoma treatment

A

remove via sinus flap, +/- cryo/laser sx

do sx standing due to blood loss

laser ablation

formalin injection

comes back

19
Q
A

endoscopic view of guttural pouch normal anatomy

20
Q

guttural pouch empyema

A

uni/bilateral discharge from guttural pouch openings

usually secondary to URT infection, extension of Strep inf

ISOLATE horse

cnodroids form

21
Q

guttural pouch empyema clinical signs

A

intermittent nasal d/c

swelling of adjacent LNs

parotid swelling and pain

extended head carriage due to pain

22
Q

guttural pouch empyema diagnosticcs

A

endoscopy, radiographs, C&S

23
Q
A

guttural pouch empyema

24
Q
A

radiograph of chondroids

guttural pouch empyema

25
Q

Guttural pouch empyema treatment

A

medical: daily irrigation, +/- abx, +/- acetylcysteine
surgical: create drainage, remove chondroids

if approaching ventrally, be careful of the hypoglossal nerve

26
Q

which disease is least likely to show fluid line on radiograph?

guttural pouch empyema

nasal adenocarcionma

dehorning sinusitis

maxillary tooth root infection

A

nasal adenocarcinoma

27
Q

a sinus flap can be useful for all but:

treating an ethmoid hematoma

treating guttural pouch empyema

diagnosing conchal cyst

diagnosing a maxillary sinus tumor

A

treating guttural pouch empyema

28
Q

guttural pouch mycosis

A

hemorrhagic nasal discharge

fungus enters pouch

grows over an artery for nutrition

erodes artery

29
Q

guttural pouch mycosis

clinical signs

A

uni/bilateral epistaxis

anemia

nerve damage: IX, X, XII

dysphagia

laryngeal hemiplegia

horner’s syndrome

death due to exsanguination

30
Q

guttural pouch mycosis diagnostics

A

endoscopy

+/- culture

PCV/TPP

31
Q
A

guttural pouch mycosis

32
Q

guttural pouch mycosis treatment

A

medical: mechanil removal of plaques, cryotherapy, lavage system + antifungals, blood transfusion
surgical: occlude affected artery so fungus dies

33
Q

surgical tx of guttural pouch mycosis

A

circle of Willis–>directional blood flow

need to occlude from both directions

50% fatal hemorrhage if only one side

34
Q

prognosis

A

dysphagia may take 6-18 months to recover

laryngeal hemiplegia-often permanent

35
Q

Hemorrhagic nasal discharge DDx

A

guttural pouch mycosis

ethmoid hematoma

trauma

tumor

infection

nasolacrimal gland

coagulopathy

EIPH

atrial fibrillation

cardiopulmonary test 2 (3 decks)

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