Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Large Animal Surgery > Diseases of the Equine Nasal Passages & Paranasal Sinuses > Flashcards

Diseases of the Equine Nasal Passages & Paranasal Sinuses Flashcards

1
Q

What are the most common causes of unilateral epistaxis?

A
  • dry mucous membranes (cold weather)
  • exertion
  • ethmoid hematoma
  • nasal polyps
  • guttural pouch mycosis
  • neoplasia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the most common causes of bilateral epistaxis?

A
  • EIPH in racehorses and barrel horses
  • head trauma
  • clotting disorders
  • severe pleuropneumonia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the sources of motor and sensory innervation to the nostrils? What keeps them from collapsing?

A
  • MOTOR = facial nerve
  • SENSORY = trigeminal nerve

cartilaginous support over nasoincisive notch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is being pointed to in this picture?

A

nasal diverticulum (false nostril)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are external nares atheromas (epidermal inclusion cysts)? How are they diagnosed?

A

cyst in the false nostril of unknown etiology

  • unilateral spherical nodule within the nasal diverticulum noted on PE
  • FNA and cytology
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How are external nares atheromas treated? What is prognosis like?

A

surgical (cosmetic) removal or drainage into the nasal cavity and destruction of the cyst lining with a roaring burr

excellent —> no recurrence reported

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

External nares atheroma (epidermal inclusion cyst) removal:

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are some causes of general nasal passage problems?

A
  • trauma
  • inflammation
  • infection: abscess, granuloma
  • neoplasia
  • congenital: Wry Nose = crooked, deviated nasal septum (can affect nursing and ability to become an athelete)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are common clinical signs associated with nasal septum problems?

A
  • respiratory noise
  • decreased outflow
  • nasal discharge
  • facial deformity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the most helpful view when radiographically diagnosing nasal septum abnormalities? What other modalities can be used?

A

DV —> able to view thickening, malformation, and septal deviation

  • CT
  • endoscopy (not as helpful)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How are nasal septum problems most commonly treated? What must occur?

A

resection of the septum

leave rostral section intact to avoid collapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is a nasal polyp? What are the most common clinical signs? How is it treated?

A

pedunculated growths from the mucosal of the nasal cavity or septum

  • inspiratory dyspnea
  • nasal discharge
  • odor

surgical excision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is a progressive ethmoid hematoma?

A

usually unilateral, non-neoplastic mass that originated from the submucosa of the ethmoid labyrinth or paranasal sinuses that is able to slowly expand down the nasal passages and/or into the sinuses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the most common clinical sign seen with ethmoidal hematomas? What else is seen?

A

unilateral, mild, intermittent, epistaxis of serosanguinous discharge

  • respiratory noise
  • dyspnea
  • head shaking
  • halitosis
  • facial deformity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What definitive diagnostic is used for ethmoidal hematomas?

A

endoscopy —> greenish-yellow to purplish-red mass with a smooth surface +/- fungal plaques (can be biopsied!)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Ethmoidal hematoma, radiograph:

A

ST opacity

17
Q

What surgical treatment is performed for ethmoidal hematomas?

A

excision - mass removal and destruction of origin, commonly by frontonasal bone flap

18
Q

What are 2 options for transendoscopic treatments of ethmoidal hematomas?

A
  1. laser
  2. intra-lesional 4% formaldehyde injection repeated 3-4 week intervals
19
Q

What sinuses are in the anatomical sites in this picture?

A

BLUE = conchofrontal

YELLOW = rostral maxillary

ORANGE = caudal maxillary

20
Q

How are the compartments of the paranasal sinuses connected? Where do they drain?

A

all communicate directly or indirectly

nasomaxillary opening

21
Q

What sinuses have tooth roots within them?

A

rostral maxillary - 8, 9

caudal maxillary - 10, 11

22
Q

What are the most common causes of primary and secondary sinusitis? What clinical sign is most commonly associated?

A

PRIMARY = URT infection, most commonly Strep sp

SECONDARY = tooth root abscess, trauma (facial fracture), neoplasia

unilateral purulent or serous nasal discharge - odorous = tooth root abscess

23
Q

What are some additional signs of sinusitis?

A
  • epiphora
  • conjunctivitis
  • enlarged submandibular LNs
  • respiratory noise
  • facial deformity (rare, more common with cysts)
24
Q

What are the most common causes of unilateral and bilateral nasal discharge?

A

UNILATERAL = sinuses, nasal cavity

BILATERAL = guttural pouches, nasopharynx, lungs, both paranasal sinuses (primary sinusitis)

25
Q

How are radiographs, endoscopy, and sinocentesis used to diagnose sinusitus?

A

opacity and fluid lines within the sinus

purulent discharge at nasomaxillary opening, unable to see into sinus

aspirate purulent material from sinus

26
Q

What 3 modes of diagnostics are used to evaluate refractory cases of sinusitis?

A
  1. sinocentesis - cytology, culture, lavage
  2. sinoscopy - visualize with minimal invasion
  3. CT - best for complicated cases
27
Q

What needs to be considered when performing sinus trephination?

A

AGE - younger horses have longer tooth roots within the maxillary sinuses

28
Q

How is primary and secondary sinusitis treated?

A

PRIMARY - copious lavage with 5-10 L of sterile, warm saline, systemic antibiotics based on C&S

SECONDARY - same as above, correct underlying causes

29
Q

What are the 4 most common causes of treatment failure incases of sinusitis?

A
  1. inspissated pus common in the ventral conchal sinus too hard and unable to be flushed
  2. failure to treat primary problem
  3. fungal infection
  4. neoplasia
30
Q

How are refractory cases of sinusitis treated?

A

sinusotomy with sinus flap giving direct access to sinus with removal of exudate to improve sinonasal drainage

31
Q

What are sinus cysts? What is the most common clinical sign? What else is seen?

A

fluid-filled structure lined by epithlium of unknown etiology (possibly congenital)

facial deformation

  • unilateral mucoserous nasal discharge with NO ODOR
  • reduced airflow on affected side
32
Q

What are the best diagnostics for sinus cysts? How are they treated? What is prognosis like?

A
  • radiographs** - space-occupying mass WITHOUT bone destruction
  • CT

sinusotomy to remove (must remove lining to avoid recurrence!)

good if fully removed

33
Q

What is the most common sinus neoplasia? How does it act? What are the most common clincial signs?

A

SCC —> malignant and invasive

  • nasal discharge
  • facial deformity
  • loose teeth
  • epiphora
34
Q

How are sinus neoplasias diagnosed? Treated?

A
  • diagnostic imaging - soft tissue in sinus with osseous changes
  • aspirate fluid for cytology
  • biopsy

radiation, high likelihood of recurrence and poor prognosis commonly leads to euthanasia

35
Q

What is the most common approach to sinusotomies?

A

frontonasal or maxillary bone flaps —> 3-sided and hinged on fourth side

36
Q

How is the patient situated for a sinusotomy? How is the bone flap created?

A

standing sedation or GA

  • mallet and osteotome (angle for a beveled edge so flap doesn’t fall in)
  • oscillating saw
37
Q

Sinusotomy:

A
38
Q

What are 3 important strategies for managing patients following sinusotomies?

A
  1. make a large opening into the nasal cavity to facilitate drainage
  2. post-op lavage - plan to place a foley catheter
  3. pack the sinus to control hemorrhage and remove within 48-72 hours
39
Q

What are the 3 most common complications associated with sinusotomies?

A
  1. hemorrhage - especially with ethmoid hematomas
  2. recurrence
  3. failure to resolve clinical signs

Large Animal Surgery (32 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions