URT Dz and Sx

Question 1

How does UAResist change with normal horse, exercising insp and exp

Answer 1

normal 66% UAR
ex - insp - 80%
ex - ex - 50%

Question 2

Ddx for mass sitting in the back of the false nostril

Answer 2

atheroma
neoplasia
foreign body/abscess
erupting tooth

Question 3

How do you deal with the atheroma?

Answer 3

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

Question 4

why would we do a nasal septum resection

Answer 4

to remove a mass that impedes. secondary to trauma causing thickening, nasal deviation like wry nose

Question 5

What are the indications for nasal septum resection

Answer 5

respiratory noise at rest

palpable thickening of the septum

Question 6

methods to remove the nasal septum

Answer 6

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.

Question 7

A history of sinusitis will include

Answer 7

smelly unilateral or bilateral discharge

recent URT infection

Question 8

How to dx sinocentesis

Answer 8

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

Question 9

CLinical signs of sinusitis

Answer 9

afebrile
palpation of paranasals
facial deformity
epiphora
percussion

Question 10

Tx of primary sinusitis

Answer 10

take sinus sample to send off
get rid of as much debris as possible - lavage
use the steinman pin

Question 11

Tx of secondary sinusitis

Answer 11

remove the problem - hematomas, sinus cyst, neoplassia, infected teeth

Question 12

What is PEH

Answer 12

expanding mass of blood from ethmoid plate

Question 13

recurrence of PEH

Answer 13

43%

Question 14

CLinical signs of PEH

Answer 14

just s trickle of blood

sometimes stidor

Question 15

Tx of PEH

Answer 15

nasofrontal flap and inject formalin. injet until full at 3-4 week intercals and then take out

Question 16

DX of PEH

Answer 16

endoscopy
defin - histopath
CT, MRI

Question 17

Ddx of PEH

Answer 17

Fungal granuloma
neoplasia - SSC
nasal polyps - not there though

Question 18

position of the SP is determined by which cranial nerves?

Answer 18

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

Question 19

which muscle lifts the SP dorsally?

Answer 19

the levator veli palatini

Question 20

Who does pharyngitis hit most?

Question 21

Pharyngitis is also called

Answer 21

pharyngeal lymphoid hyperplasia

Question 22

Grading system for PLH

Answer 22

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

Question 23

Tx of PLH

Answer 23

rest
anti-inflamm (not AM)
rest, bute will go away

Question 24

cause of pharyngeal collapse

Answer 24

dysfunction of CN 9

Question 25

What is the cause of choanal atresia

Answer 25

failure of the foal to absorb the bucconasal membrane

Question 26

Potential etiologies for DDSP

Answer 26

``` 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 ```

Question 27

CLinical signs/history of DDSP

Answer 27

exercise intolerance hypercarbia/.hypoxia horses look like choking down or swallowing their tongue.

Question 28

Dx of DDSP

Answer 28

endoscopy

Question 29

Tx of DDSP

Answer 29

1. figure8 nose band, tongue tie, etc. 2. staphylectomy - partial SP resection - 60% success 3,. myectomy - sternohyoideus resection with the tendon to cartilage (thyroid) - 60% 4. combined 2 and 3. 5. epiglottic augmentation - inject teflon 60% success 6. palatoplasty - 60-70% surgery to scar up the epiglottis 7. tie-forward - from caudal wings of thyroid to basihyoid bone. 80-82%

Question 30

Dx of Epiglot entrap

Answer 30

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

Question 31

Tx of Epiglot entrapments

Answer 31

1. axial deviation via laser 2. transnasal or transoral axial deviation with curved bistoury - but make sure you know what you have 3. axial deviation via electrocautery 4. laryngotomy or pharyngotomy - but high rate of DDSP

Question 32

Complications of the EPig Entrap correction

Answer 32

some peiople have gone right through the epiglottis and severed it. others have come all the way and made an iatrogenic cleft palate

Question 33

what is tricky about the sub-epiglottic cysts

Answer 33

may be concurrent with epig entrap

Question 34

Tx of the sub-epiglottic cysts

Answer 34

loop, cautery, wire, snare, formalin

Question 35

What is laryngeal hemiplegia

Answer 35

laryngeal paralysis of the recurrent laryngeal nerve (left usually) causing atrophy of the CAD muscle

Question 36

A sueable cause of Lar Hemi

Answer 36

IV injections on the left side. Carmalt had trouble that time

Question 37

Hx of Laryng hemi

Answer 37

whislte or roar, ex intolerance

Question 38

Grades of laryn hemiplegia

Answer 38

``` 1 - normal 2 - will abduct but not synchronously 3a - asynchronous at rest 3b - same asynchronous at rest and exercise 4 - none at all ```

Question 39

what grade of laryng hemi does we surgerize

Answer 39

grade 3B but 3a will progress

Question 40

Tx for laryng hemiplegia

Answer 40

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.

Question 41

maind ddx for arytenoid chondritis

Answer 41

laryngeal hemiplegia

Question 42

Tx of arytenoid chond

Answer 42

AM? barely get in | excision of affected cartilage

Question 43

Difference between partial and subtotal artyenoidectomy

Answer 43

partial - ***** good***** removes all but the muscular process subtotal leaves the corniculate process - stupid

Question 44

What is done with excision of the arytenoid in the chondritis?

Answer 44

make incision in the mucosal fold

Question 45

complications of excision from the arytenoid chondritis

Answer 45

dyspnea from trauma/bleeding | dysphagia from aspiration