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Orthopaedics (equine) > Head and neck disease (Yr3) > Flashcards

Head and neck disease (Yr3) Flashcards

1
Q

where can unilateral nasal discharge be localised to?

A

sinus or nasal passage

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2
Q

where can bilateral nasal discharge be localised to?

A

guttural pouch, larynx, pharynx, lower respiratory tract

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3
Q

what innervates the motor control of the nares?

A

facial nerve

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4
Q

what are the typical causes of facial nerve paresis/paralysis?

A

recumbency where there is pressure on nerve (GA) or iatrogenic (surgery)

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5
Q

what is another name for a nasal atheroma?

A

epidermal inclusion cyst

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6
Q

what anatomical region do epidermal inclusion cysts (nasal atheroma) form?

A

nasal diverticulum

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7
Q

what is the clinical signs associated with epidermal inclusion cysts (nasal atheroma)?

A

non-painful swelling at nasoincisive notch

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8
Q

how can epidermal inclusion cysts (nasal atheroma) be treated?

A

surgical removal (often carries a good prognosis)

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9
Q

what are the signs associated with alar fold collapse?

A

respiratory noise at exercise (fluttering) and poor performance

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10
Q

how is collapse of the alar folds treated?

A

resection

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11
Q

what is a progressive ethmoid haematoma?

A

encapsulated non-neoplastic locally invasive mass that grows in the nasal passage and paranasal sinuses

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12
Q

how are progressive ethmoid haematomas treated?

A

nasal passage - intralesional formalin or laser excision
sinuses - sinus flap surgery

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13
Q

what are the clinical signs of fungal rhinitis?

A

unilateral purulent/haemorrhagic nasal discharge
malodorous smell
nasal stertor

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14
Q

how is fungal rhinitis treated?

A

removal of plaques and necrotic bone
topical enilconazole lavage

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15
Q

how many paranasal sinuses are there?

A

7 pairs (2 functional groups - rostral and caudal)

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16
Q

what are the rostral paranasal sinuses?

A

rostral maxillary
ventral conchal

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17
Q

what are the caudal paranasal sinuses?

A

caudal maxillary
frontal
dorsal conchal
sphenopalatine
ethmoid sinus

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18
Q

what are the main two clinical signs associated with paranasal sinus disease?

A

nasal discharge
facial swelling

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19
Q

how should primary sinusitis be treated?

A

TMPS for 7-14 days
phenylbutazone
feed from ground, dust free environment, turn out

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20
Q

what is the one cause of primary sinusitis that shouldn’t be treated with antimicrobials?

A

strangles (Streptococcus equi var equi)

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21
Q

what is the most common cause of secondary sinusitis?

A

dental disease

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22
Q

what is responsible for abduction of the arytenoids to open the glottis?

A

cricoarytenoideus dorsalis (CAD) muscle

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23
Q

what innervates the cricoarytenoideus dorsalis (CAD) muscle?

A

recurrent laryngeal nerve

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24
Q

what are the two types of dorsal displacement of the soft palate?

A

intermittent
persistent

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25
Q

when does intermittent dorsal displacement of the soft palate occur?

A

during intense exercise only

26
Q

when will the soft palate return to normal after intermittent dorsal displacement of the soft palate?

A

when the horse swallows

27
Q

what are the signs seen with intermittent dorsal displacement of the soft palate?

A

expiratory obstruction causing gurgling/vibrating noise, possibly causing the horse to pull up

28
Q

what disease states can often lead to persistent dorsal displacement of the soft palate?

A

epiglottic entrapment
sub-epiglottic ulcers
sub-epiglottic cysts

29
Q

what is needed to diagnose intermittent dorsal displacement of the soft palate?

A

exercising endoscopy (will only occur with strenuous exercise)

30
Q

what conservative treatments are available for intermittent dorsal displacement of the soft palate?

A

often resolves with age
get horse fitter (stronger respiratory muscles)
change tack
tongue tie (prevent caudal movement)

31
Q

what surgical techniques are available for managing dorsal displacement of the soft palate?

A

tie forward (best)
palatoplasty

32
Q

how is a tie forward procedure done?

A

sutures placed between basihyoid bone and thyroid cartilage to position the larynx more rostrally and caudally

33
Q

how does palatoplasty work to treat dorsal displacement of the soft palate?

A

uses thermal/laser cautery to stiffen the soft palate (poor evidence of efficacy)

34
Q

when would pharyngeal lymphoid hyperplasia be of clinical significance?

A

when associated with dorsal displacement of the soft palate

35
Q

when is treatment of pharyngeal lymphoid hyperplasia indicated?

A

when associated with intermittent dorsal displacement of the soft palate treat with anti-inflammatories

36
Q

when is dynamic pharyngeal collapse seen?

A

yearling (2 year olds)
sports horses (neck flexion)

37
Q

what is the typical clinical sign of a cleft palate?

A

milk coming from nostrils

38
Q

which is the most common side for recurrent laryngeal neuropathy?

A

left (unilateral paralysis of arytenoid cartilage)

39
Q

what is the typical signalment of recurrent laryngeal neuropathy?

A

large horses (genetic predisposition)

40
Q

what is the classic clinical signs of recurrent laryngeal neuropathy?

A

abnormal inspiratory noise (roaring) at exercise
poor performance

41
Q

how can resting laryngeal function be graded?

A
  1. normal
  2. can fully abduct but asynchronous
  3. can’t fully abduct
  4. complete paralysis
42
Q

what is the treatment options for recurrent laryngeal neuropathy?

A

prosthetic laryngoplasty (tie-back)
ventriculocordectomy (hobday)
laryngeal re-innervation

43
Q

how is tie-back (prosthetic laryngoplasy carried out for recurrent laryngeal neuropathy?

A

sutures placed from cricoid cartilage to muscular process of left arytenoid cartilage to permanently abduct the left arytenoid

44
Q

what complications can be seen with prosthetic laryngoplasty (tie-back)?

A

coughing
seroma formation
infection of implant
dysphagia
chondritis

45
Q

what is a hobday procedure?

A

ventriculocordectomy - laryngeal ventricles (saccules) removed to reduce vibration and noise associated with recurrent laryngeal neuropathy

46
Q

what can cause unilateral laryngeal paralysis?

A

4th brachial arch defect
laryngeal dysplasia guttural pouch mycosis
previous surgery

47
Q

what can cause bilateral laryngeal paralysis?

A

hepatic disease
toxicity (organophosphate, lead…)
post anaesthetic complication

48
Q

what causes congenital laryngeal dysplasia?

A

abnormal laryngeal cartilage development due to 4th brachial arch deformity (right side effected)

49
Q

what laryngeal dysfunctions are seen due to laryngeal dysplasia?

A

limited abduction of right arytenoid cartilage
rostral displacement of palatopharyngeal arch

50
Q

what is the typical clinical sign seen with vocal cord collapse?

A

inspiratory whistle at exercise

51
Q

how is vocal cord collapse treated?

A

vocalcordectomy

52
Q

what is the typical sign of medial deviation of the aryepiglottic folds?

A

thick inspiratory noise (seen in juveniles)

53
Q

how is medial deviation of the aryepiglottic folds treated?

A

laser removal of aryepiglottic folds

54
Q

what clinical signs are seen with epiglottic entrapment?

A

respiratory noise
cough when eating
poor performance

55
Q

what horses is sub epiglottic cysts seen most commonly in?

A

young horses (congenital)

56
Q

how is arytenoid chondrites treated?

A

antibiotics (topical and systemic)
partial arytenoid resection
(guarded prognosis)

57
Q

what clinical signs are associated with guttural pouch disease?

A

epistaxis
dysphagia (nasal discharge)
dyspnoea
external swelling
neurological (ataxia, head tilt, facial paralysis…)

58
Q

what is the main clinical sign of guttural pouch mycosis?

A

severe epistaxis
nasal discharge
nerve dysfunction (dysphagia, horners, laryngeal paralysis)

59
Q

how should guttural pouch mycosis be treated?

A

keep horse calm and prevent further bleeding
referral needed if associated with epistaxis

60
Q

how do guttural pouch chondroids form?

A

chronic infection (guttural pouch empyema) results in inspissated purulent material developing

61
Q

what is guttural pouch tympany?

A

air trapanned by in guttural pouch in foals up to a year old due to a congenital defect

62
Q

what are the clinical signs of guttural pouch tympany?

A

marked retropharyngeal swelling
respiratory stridor
dysphagia

Orthopaedics (equine) (18 decks)

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