URT Dz and Sx Flashcards
How does UAResist change with normal horse, exercising insp and exp
normal 66% UAR
ex - insp - 80%
ex - ex - 50%
Ddx for mass sitting in the back of the false nostril
atheroma
neoplasia
foreign body/abscess
erupting tooth
How do you deal with the atheroma?
it’s cystlike so do try to get all the secretory lining becuse it will come back anywy. inject with formalin and will fal out. This will prevent the scar
why would we do a nasal septum resection
to remove a mass that impedes. secondary to trauma causing thickening, nasal deviation like wry nose
What are the indications for nasal septum resection
respiratory noise at rest
palpable thickening of the septum
methods to remove the nasal septum
obstetrical wire
guarded chisel ventral
and trephined hole for on dorsum
or osteotomy - make the flap and can see everything, prevents a lot of bleeding, etc.
A history of sinusitis will include
smelly unilateral or bilateral discharge
recent URT infection
How to dx sinocentesis
don’t hit the infraorbital nerve, go above or below
sinoscopy *** - do guttural pouches here too
CT
Multiple rad view - Fluid lines, masses and tooth root disease can frequently be detected radiographically
Clin Exam
CLinical signs of sinusitis
afebrile palpation of paranasals facial deformity epiphora percussion
Tx of primary sinusitis
take sinus sample to send off
get rid of as much debris as possible - lavage
use the steinman pin
Tx of secondary sinusitis
remove the problem - hematomas, sinus cyst, neoplassia, infected teeth
What is PEH
expanding mass of blood from ethmoid plate
recurrence of PEH
43%
CLinical signs of PEH
just s trickle of blood
sometimes stidor
Tx of PEH
nasofrontal flap and inject formalin. injet until full at 3-4 week intercals and then take out
DX of PEH
endoscopy
defin - histopath
CT, MRI
Ddx of PEH
Fungal granuloma
neoplasia - SSC
nasal polyps - not there though
position of the SP is determined by which cranial nerves?
CN 5 -tensor veli palatine - elevating SP
CN 10 - levator veli palatine, SP proper
CN 10 - palatinus - SP proper
CN 10 - palatopharyngeus - along the lateral side connecting the SP and thyroid cartilage
which muscle lifts the SP dorsally?
the levator veli palatini
Who does pharyngitis hit most?
Pharyngitis is also called
pharyngeal lymphoid hyperplasia
Grading system for PLH
1 - normal, few inacctive follicles
2 - numerous small inactive with odd hyperemic follicle
3 - numerous active follicles that are pink and close together
4 - large edmatous follicales that coalsce sometimes
Tx of PLH
rest
anti-inflamm (not AM)
rest, bute will go away
cause of pharyngeal collapse
dysfunction of CN 9
What is the cause of choanal atresia
failure of the foal to absorb the bucconasal membrane
Potential etiologies for DDSP
long soft palate epiglottic hypoplasia nerve dysfunction to muscles (CN 10, 5) caudal retraction of tongue, causing the tongue to push the SP up etc
CLinical signs/history of DDSP
exercise intolerance
hypercarbia/.hypoxia
horses look like choking down or swallowing their tongue.
Dx of DDSP
endoscopy
Tx of DDSP
- figure8 nose band, tongue tie, etc.
- staphylectomy - partial SP resection - 60% success
3,. myectomy - sternohyoideus resection with the tendon to cartilage (thyroid) - 60% - combined 2 and 3.
- epiglottic augmentation - inject teflon 60% success
- palatoplasty - 60-70% surgery to scar up the epiglottis
- tie-forward - from caudal wings of thyroid to basihyoid bone. 80-82%
Dx of Epiglot entrap
endoscopy - see obscuring of the blood vessels on the top of the epiglottis. big mass here. Loss of serrated mucosa on ventral epiglottis
SOmetimes associated with hypoplastic trachea as well
Tx of Epiglot entrapments
- axial deviation via laser
- transnasal or transoral axial deviation with curved bistoury - but make sure you know what you have
- axial deviation via electrocautery
- laryngotomy or pharyngotomy - but high rate of DDSP
Complications of the EPig Entrap correction
some peiople have gone right through the epiglottis and severed it.
others have come all the way and made an iatrogenic cleft palate
what is tricky about the sub-epiglottic cysts
may be concurrent with epig entrap
Tx of the sub-epiglottic cysts
loop, cautery, wire, snare, formalin
What is laryngeal hemiplegia
laryngeal paralysis of the recurrent laryngeal nerve (left usually) causing atrophy of the CAD muscle
A sueable cause of Lar Hemi
IV injections on the left side. Carmalt had trouble that time
Hx of Laryng hemi
whislte or roar, ex intolerance
Grades of laryn hemiplegia
1 - normal 2 - will abduct but not synchronously 3a - asynchronous at rest 3b - same asynchronous at rest and exercise 4 - none at all
what grade of laryng hemi does we surgerize
grade 3B but 3a will progress
Tx for laryng hemiplegia
laryngoplasty - this is suture between the midline of crico notch to arytenoid
sacculectomy - cut out a chunk and suture back tighter. prevents noise
partial arytenoidectomy - do if tie-back has failed
NMpedicle graft - in young horses, graft the C1/omohyoid muscle. re-innervation takes a year.
maind ddx for arytenoid chondritis
laryngeal hemiplegia
Tx of arytenoid chond
AM? barely get in
excision of affected cartilage
Difference between partial and subtotal artyenoidectomy
partial - * good* removes all but the muscular process
subtotal leaves the corniculate process - stupid
What is done with excision of the arytenoid in the chondritis?
make incision in the mucosal fold
complications of excision from the arytenoid chondritis
dyspnea from trauma/bleeding
dysphagia from aspiration
