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Module 15 > Upper Resp Tract: BOAS Surgery > Flashcards

Upper Resp Tract: BOAS Surgery Flashcards

1
Q

what is stertor

A

snoring noise

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2
Q

what does stertor indicate

A

reverberant airflow in upper airway

excessive or redundant soft tissue

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3
Q

when does stertor get worse

A

when sleeping or excited

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4
Q

what is stertor commonly seen with

A

commonly seen with BOAS

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5
Q

what is brachycephalia

A
  1. shorted nasal cavity
  2. soft tissue obstruction of nasal and pharyngeal cavities
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6
Q

what are the consequences to brachycephalia (3)

A
  1. increased effort to move air
  2. turbulent airflow leads to stertor and inflammation + thickening of soft tissue
  3. mobile soft tissues to collapse into the airway
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7
Q

how does inflammation + thickening of the soft tissues occur in brachycephalic dogs

A

microtrauma with turbulent airflow which causes tissues to hypertrophy and swell

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8
Q

how do soft tissues collapse into the airway in brachycephalic dogs

A

As resistance to airflow increases (as airway gets narrower) then requires more effort which puts more negative pressure on walls of the airway and mobile structures such as the laryngeal lumen, glottis, tonsils, soft palate get pulled and stretched and collapse into the airway and exacerbate the problem

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9
Q

what are the primary disorders of BOAS (5)

A
  1. elongated soft palate
  2. stenotic nares
  3. excess pharyngeal mucosa
  4. narrowed nasal passages
  5. reduced airflow URT
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10
Q

what are the secondary disorders of BOAS (5)

A
  1. soft palate thickening
  2. laryngeal saccule eversion
  3. laryngeal collapse
  4. tonsillar prolapse
  5. inflammmation and swelling of soft tissues
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11
Q

how does BOAS cause regurgitation

A
  1. pressure effects
  2. hiatal hernia
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12
Q

what primary disorders are able to fixed by simple surgery (2)

A
  1. elongated soft palate
  2. stenotic nares
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13
Q

what secondary disorders can be fixed by simple surgery (2)

A
  1. laryngeal saccule eversion
  2. tonsillar prolapse
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14
Q

what surgeries can be considered in BOAS but are more risky

A
  1. laryngeal collapse
  2. hiatal hernia
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15
Q

how does BOAS present

A
  1. stertor (exacerbated by sleeping/excitement/exercise)
  2. exercise intolerance exacerbated by heat
  3. dyspnea
  4. cyanosis
  5. collapse
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16
Q

how can BOAS be managed in chronic cases (4)

A
  1. weight loss
  2. modify lifestyle: stress, exercise, heat
  3. harness not lead
  4. surgery: early invertention
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17
Q

what should you do with an emergency presentation of BOAS (6)

A
  1. cage rest
  2. cool
  3. oxygen therapy
  4. corticosteroids (dexamethasone NaP)
  5. cautious sedation: butorphanol
  6. consider aspiration pneumonia
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18
Q

how do emergency BOAS cases present

A

history of stertor, exercise intolerant, dyspnea

worked up into an increased resp rate and effort and increased turbulence of airflow has caused trauma and swelling of the airway tract which obstructs the airway furhter –> viscous cycle

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19
Q

what surfery is used to correct stenotic nares

A

vertical wedge resection

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20
Q

how do you diagnose an elongated soft palate

A

evaluate under GA

laryngoscope

stylette to depress epiglottis

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21
Q

what is an elongated soft palate

A

glottis opening to the larynx and the soft palate should stop earlier and not extend or obscure the laryngeal opening

it can be sucked into the larynx

22
Q

how is an elongated soft palate corrected surgically

A

caudal poles of the tonsils

or

tip of glottis

23
Q

what are everted laryngeal saccules

A

the laryngeal saccules pop out and obstruct the ventral half of the glottis

24
Q

what is laryngeal collapse

A

arytenoid cartilages collapse medially

obstruction of the dorsal glottis

serious sequelae to BOAS

25
what is the first line treatment to laryngeal collapse (2)
1. correct other BOAS issues: palate, nares, saccules 2. instigate lifestyle modification
26
what is the second line treatment to laryngeal collapse (2)
widening procedures for glottis 1. arytenoid lateralization 2. partial arytenoidectomy
27
what are salvage treatments to laryngeal collapse
permanent tracheotomy but there is a high mortality rate in dogs
28
how does regurgitation occur in BOAS
sliding hiatal hernia increased intrathoracic pressure due to dyspnea association with gastritis saliva and food trapped in pharyngeal folds
29
what is stridor and when does it occur
harsh noise on inspiration resolves at rest/sleeping exacerbated by exercise/excitement
30
what does stridor indicate
failure of glottis to open on inspiration
31
what type of dogs is stridor seen in
large breed dogs secondary to laryngeal paralysis
32
what is laryngeal paralysis
glottis doesn't abduct on inspiration dorsal cricoarytenoids muscle failure vocal cords slack and reverberate
33
what is the etiology of laryngeal paralysis
1. idiopathic acquired 2. congenital 3. secondary
34
what are the secondary causes of laryngeal paralysis (4)
1. polyneuropathy 2. polymyopathy 3. neuromuscular junction disorder 4. iatrogenic injury to recurrent laryngeal nerve (thyroidectomy)
35
when is idiopathic acquired laryngeal paralysis seen
older medium to large breed dogs labs over represented
36
what is idiopathic acquired laryngeal paralysis indicative of
progressive mild denegerative polyneuropathy
37
what breeds is congenital laryngeal paralysis
Bouvier des Flandres rottweilers dalmatian white GSD
38
when is secondary laryngeal paralysis seen
uncommon part of wider neuromuscular disorder
39
what are the signs of secondary laryngeal paralysis
1. swallowing disorders 2. ataxia 3. cranial nerve defect 4. muscle weakness
40
how is laryngeal paralysis diagnosed
1. loss of active abduction on inspiration 2. assess as recoerving from light plane of anesthesia 3. avoid premed as suppress normal function
41
how is an emergency laryngeal paralysis managed
1. aspiration pneumonia: systemic antibiotics 2. dyspnea crisis: sedate, cool, oxygen, temporary tracheostomy or refer for surgery
42
what is the surgery for laryngeal paralysis
usually refer for management crico-arytenoid lateralization (tie-back) surgery --\> permanently open one side of glottis, increased risk of aspiration postoperatively
43
what are feline upper respiratory diseases (4)
1. nasopharyngeal polyps 2. neoplasia: squamous cell carcinoma (tonsil, larynx), lymphoma 3. BOAS rare 4. laryngeal paralysis uncommon (iatrogenic, idiopathic)
44
how does acquired laryngeal paralysis present (4)
1. progressive 6m-2 years 2. inspiratory stridor at exercise 3. dysphonation 4. exercise intolerance
45
how does dyspneic crisis present with laryngeal paralysis
1. dyspnea at rest 2. inspiratory stridor 3. cyanosis 4. collapse 5. death exacerbated by stress, exercise, heat common summer presntation
46
how does aspiration pneumonia present with laryngeal paralysis (5)
1. dyspnea at resk 2. inspiratory stridor 3. cyanosis 4. pyrexia 5. productive cough
47
how does laryngeal paralysis increase the risk of aspiration pneumonia
glottis fails to close on swallowing patient inhales food or fluid
48
what are feline nasopharyngeal polyps
originate in the tympanic bulla aural masses: grow out of ear canal nasopharyngeal masses grow down esutachian tube
49
what are nasopharyngeal polyps associated with
respiratory viruses
50
when are nasopharyngeal polyps seen in cats
51
what are the signs of nasopharyngeal polyps in cats
swelling above soft palate stertor swallowing issues
52
what is the treatment of nasopharyngeal polyps in cats
traction and steroids middle ear surgery to currette base

Module 15 (27 decks)

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