Upper Respiratory system Flashcards
signs
(exact complain, duration, progression) nasal discharge, coughing, abnormal sounds associated with breathing, abnormal vocalization, dyspnoe, sneezing, stridor
GENERAL IMPRESSION
level of consciousness behavior posture locomotion nutritional condition grooming state abnormal sounds abnormal respiration
STEPS of the EXAMINATION
- nose and paranasal sinuses 2. coughing 3. larynx and pharynx 4. trachea 5. thorax
EXAMINATION METHODS
-external and internal inspection
-palpation
-percussion
-smelling
FURTHER EXAMINATIONS
-nasal discharge: cytologic, bacter., mycologic and parasitic examination
-X-ray
-endoscopy (rhinoscopy, sinuscopy in horse)
-diagnostic punction
-biopsy
-diagnostic rhinotomy
-CT, MRI
-nasogastric tubing
- NOSE and PARANASAL SINUSES
- Shape, form of the nose 2. Occurrence of nasal stridor 3. Expired air 4. Occurrence of nasal discharge 5. Nasal plane 6. Nasal openings (nostrils), mucous membranes 7. Palate, nasopharynx 8. Paranasal and frontal sinuses
- Stridor
normal: faint regular noise during expiration (in brachycephalic dogs the noise is more intensive) Abnormal sounds:
- stridor(during inspir. or expir. or both)
- narrowed air passages(localization & side of narrowing)
- sneezing (important reflex which protect the resp. syst)
- in dogs: often normal,
- cats: rhinotracheitis -
rabbits: about rhinitis
- snoring, stertor (in brachycephalic dogs)
- reverse sneezing
- singulation ( in puppies)
Nasal stridor => sniffing sound
Pharyngeal stridor => snoring sound
Laryngeal stridor =>soft „sawing” sound
Collapsed trachea => expiratory! tooting sound
Larynx paralysis => inspiratory stridor
Narrow trachea, bronchus => mixed stridor
- 2.1 abnormal sounds
- purring (in cats)
- noises caused pain
- groaning (in dog, horses rarely, in cows often)
- howling (in dogs)
- alteration of voice (rabies)
- noiseless
- panting (in dogs)
- 3+4
3.Expired air
strength symmetry temperature odor, smell
- Occurrence of nasal discharge
continuity (permanent/periodic) side (left/right/both) quantity quality: consistency (watery, mucous, mucopurulent, hemorrhagic, foamy, contains food intake, foreign material, or debris) color odor, smell
- 5+6+7
5.Nasal plane
surface (intactness) colour moistures’ in most animals usually moist, intact, pigmented
6.Nasal openings, nostrils
shape of the nostrils width movability of the nasal alae symmetricy mucous membranes, inside examination
7.Palate, nasopharynx (examination by opening the animal’s mouth)
-with or without optical instruments: dental mirror, endoscopy
abnormalities, mm
- 8.
Paranasal and frontal sinuses
-inspection -palpation -percussion -endoscopy (in horse) -X-ray, CT, MR -diagnostic punction
sinus maxillares - sinus maxillares sinus frontalis - sinus frontalis sinus lacrimalis sinus ethmoidale sinus palatinus sinus sphenopalatinae sinus sphenoidalis
- Physiological finding of the region of the nose
The outline of the nose is characteristic on the breed, symmetrical. The temperature is the same as the surroundings, the palpation is not painful. The percussion sound is sharp, bone-like above the bones Faint regular noise during expiration. The expired air is medium strong, warm, symmetrical, the odor is characteristic on the breed. The nostrils have regular shape and symmetrical width. The nasal alae are not moving during in- and expiration. The outer inspection and palpation of the paranasal sinuses don’t prove any abnormalities, any sign of swelling or asymmetry, the skin is intact, the temperature is the same as the surroundings, the palpation is not painful, the percussion sound of the paranasal sinuses is sharp, bone-like sound. The nasal plane is moist, intact, has black color, there is no nasal discharge. The soft and hard palate are intact, moist, pinkish red. The mm of the nose is intact, smooth, shiny, light pink.
- COUGHING
Important reflex by which the respiratory system protects itself against injury & foreign material
-the reflex can occur via stimulation of the airways anywhere from the larynx to the larger bronchi
Standpoints of examination
- origin(spontaneous or stimulated)
- frequency (rare, frequent, paroxysmal)
- strength (weak, medium intense, intense, with or without snap)
- tone (sharp, dull, barking, rattling, roaring, hoarse)
- occurrence (during night, mornings, in the daytime, continuously, only in special environment)
- duration (short, medium long, long, held)
- secretion content (dry, medium wet, wet)
- painful or painless
- deepness (superficial or deep or medium deep)
- localization of origin
- the quality of sputum
stimulation: pressing the tracheal rings or pressing the thorax very rapidly during expiration
=>Stimulated cough is medium held, unsnapping, medium intensive, medium deep, dry, sharp, painless, does not recur
2.1. Origin
Larynx
episodical, heavy, gagging / retching, tendency to vomit
Larynx paralysis: deep, long, hars
- Trachea
- Tracheitis: loud, explosive barking like
- trachea collapse: goose honking cough
- Bronchi:
- acute phase: pattern m/l tracheitis;
- chronic phase: mucus, pus, wet, rough
- Lung emphysema, chronic bronchitis: short, weak, dry
- Pneumonia -soft
- Cardiac disease -wet, hacking cough
- LARYNX and PHARYNX
PHYSICAL EXAMINATION METHODS
-external and internal examination -inspection -palpation -auscultation
FURTHER EXAMINATION -X-ray -endoscopy -CT, MR
3.1. external exam
inspection
-skin, deformity, swelling, symmetricity
palpation
-form, outline, muscles, surface of larynx, abnormal masses -compressibility and press sensitivity of the arytenoids -temperature, painfulness -fremitus auscultation
normally weak stridor under inspiration and expiration
