Week 1 - Breathlessness ('dysponea') Flashcards
What are common cardiorespiratory problems?
Dyspnoea (+/- cough, +/- cyanosis)
Sneezing/nasal discharge
Respiratory noise
Collapse, weak, exercise intolerance
Heart murmur +/- other clinical signs
Dysrhythmia +/- other clinical signs
What are the two respiratory noises that are heard?
Stridor
Stertor
What is a stridor?
Stridor is a high-pitched sound that results from rigid tissue vibrations.
Problem at the level of or below the larynx
It is typically associated with laryngeal or tracheal disease.
- Laryngeal paralysis
- Tracheal collapse
What is a stertor
Stertor is noisy breathing that occurs during inhalation.
It is a low-pitched, snoring type of sound that usually arises from the vibration of fluid, or the vibration of tissue that is relaxed or flabby.
Problem is above the larynx and noise created at the back of the throat.
It usually arises from airway blockage in the throat (pharynx).
What part of ‘signalment’ can impact the order of differentials the most?
Age
e.g An older dog would move neoplasia up the list, but a younger dog would move neoplasia down and grass seed FB up the list.
With a dyponeic animal, what should be assessed in the consult room?
Observe = clinically stable or emergency admission?
Condition
Breathing (rate, pattern, regularity, depth, effort)
MM colour (pale, cyanotic, normal)
Behaviours that are worrying to the owner.
What is a normal breathing pattern and effort?
Inspiratory phase is longer than expiratory.
Effort is minimal
How is the breathing pattern and effort effected in upper respiratory tract disease?
Slow respiratory rate
Exaggerated inspiratory effort (longer phase)
Inspiratory effort increased
How is the breathing pattern and effort effected in lower respiratory tract disease?
Fast and shallow breathes
Both phases of breathing altered.
Expiratory phase can become longer than inspiratory -> less elasticity -> harder to push air out.
Fibrotic lung disease = increases inspiratory effort due to reduced long compliance.
How is the breathing pattern and effort effected in pleural disease?
Loss of pleural adhesion increased required effort to breathe.
Inspiratory and expiratory effort increased.
Define tachypnea
Increased respiratory rate
Define hyperpnoea
Increased respiratory effort
Define orthopnoea
Dyspnoea in any position other than standing or erect sitting.
Lying down can push abdomen forward making it difficult to breathe.
Common cause: bilateral pulmonary oedema.
Define trepopnoea
Dyspnoea in one lateral recumbency but not the other.
Common cause: unilateral lung or pleural disease, unilateral airway obstruction, unilateral pleural effusion.
What three things should be done on a thoracic examination?
- Thoracic palpation
- Look for presence of apex beat (displaces to R = mass in the L), rhonchi, masses deformities, pain (e.g rib fractures) - Thoracic auscultation
- hindered by purring/panting
- both sides of stethoscope - Normal sounds
- Inspiratory = soft, low pitched
- Expiratory = none or softer/lower pitched
