Upper Respiratory Tract

Question 1

What is the “gold standard” for diagnosing and treating an upper respiratory tract problem?

Answer 1

Endoscopy

Question 2

What is the indication for a permanent tracheostomy?

Answer 2

To by-pass obstruction

Question 3

Where should you incise the trachea?

Answer 3

Transversely along the annular ligament

Question 4

How big should your tube be if you place a tube tracheostomy?

Answer 4

No larger than 50% of the tracheal lumen

Question 5

What are the 3 indications for a tracheal resection and anastomosis?

Answer 5

1. Stenosis
2. Tumor
3. Mass

Question 6

How much of the tracheal is resettable?

Answer 6

20-60% (20% best)

Question 7

What are the 3 indications for a ventriculocordectomy?

Answer 7

1. Voice alteration
2. Mass removal
3. To enlarge the glottis

Question 8

After a ventriculocordectomy, for how long should you discourage vocalization and exercise?

Answer 8

6-8 weeks

Question 9

What is brachycephalic syndrome?

Answer 9

An upper respiratory obstruction in brachycephalic breeds caused by stenotic nares, elongated soft palate, or everted laryngeal saccules.

Question 10

How might you medically manage a brachycephalic syndrome?

Answer 10

1. Corticosteroids
2. Weight reduction
3. Sedation
4. Cooling
5. Exercise restriction
6. GI drugs

Question 11

In which 4 breeds is brachycephalic syndrome most common?

Answer 11

1. English bulldog
2. Boston terrier
3. Pug
4. Peikenese

Question 12

What are the 5 conditions most commonly seen with brachycephalic syndrome?

Answer 12

1. Laryngeal collapse
2. GI ulcers
3. Hypoplastic trachea
4. Aberent turbinates
5. Abnormal tonsils

Question 13

What is the definition of an elongated soft palate?

Answer 13

Extension of the soft palate > 1-3 mm caudal to the tip of the epiglottis

Question 14

What is stage 1 laryngeal collapse?

Answer 14

Eversion of laryngeal saccules

Question 15

What is stage 2 laryngeal collapse?

Answer 15

Median deviation of aryepiglottic folds

Question 16

What is stage 3 laryngeal collapse?

Answer 16

Median deviation of corniculate process

Question 17

To what two things is laryngeal collapse secondary?

Answer 17

1. Increased negative pressure

2. Increased airway resistance

Question 18

What is laryngeal paralysis?

Answer 18

Complete or partial failure of the arytenoid cartilages and vocal folds to abduct during inspiration

Question 19

Is laryngeal paralysis most commonly unilateral OR bilateral?

Answer 19

Bilateral - unless surgically acquired

Question 20

What is the prognosis of a partial laryngectomy?

Answer 20

Poor - high failure rate, including obstruction and aspiration. 50% die.

Question 21

What is the prognosis of unilateral lateralization?

Answer 21

Good - 90% improve

Question 22

What noises are associated with tracheal collapse?

Answer 22

Honk, wheeze, hack

Question 23

What types of stimuli would exacerbate the clinical signs of a tracheal collapse?

Answer 23

1. Exercise
2. Eating/drinking
3. Palpation
4. Infection
5. Noxious stimuli (smoke)
6. Hot/humid weather

Question 24

Which breeds are more predisposed to tracheal collapse?

Answer 24

Toy and miniature breeds: Toy poodles, Yorkshire terriers, Pomeranians, Maltese, Chihuahuas