Clinical Evaluation of the Respiratory System

Question 1

true/false: tachypnea is a sensitive indicator if hypercapnia or hypoxia

Answer 1

true

Question 2

how much of a reduction of Hb/100ml does cyanosis indicate?

Answer 2

> 5g- severe hypoxia

Question 3

what are the terms stertor and stridor used for?

Answer 3

audible abnormal breath sounds without a stethoscope
upper airway

Question 4

what does hemoptysis usually indicate?

Answer 4

bleeding from lungs or airways

Question 5

what is a tension pneumothorax?

Answer 5

when breathing, the patient pulls air in through a laceration and then the breathing out keeps it in

Question 6

what does percussing the sinuses in large animals allow you to assess?

Answer 6

potential fluid or tumor tissue accumulation

Question 7

how does consolidation of the lung parenchyma affect how you hear lung sounds?

Answer 7

more consolidation makes it louder

Question 8

true/false: anything in the pleural space dampens lung sounds

Answer 8

true

Question 9

what causes crackles?

Answer 9

explosive reopening of lung areas (previously collapsed)
also excess secretions in airways or rupture of fluid films

Question 10

what causes wheezes?

Answer 10

constricted airway walls or intraluminal airway masses

Question 11

what are pleural friction rubs?

Answer 11

sliding inflamed pleural surfaces during inspiration and expiration

Question 12

what are the normal lung field parameters for horses?

Answer 12

tuber coxae: 17th space
tuber ischii: 16th space
mid-thorax: 13th space
shoulder: 11th space
olecranon: 6th space

Question 13

what are the normal lung field parameters for bovine?

Answer 13

tuber coxae: 11th space
mid-thorax: 9th space
olecranon: 5th space

Question 14

what are the normal lung field parameters for ovine?

Answer 14

tuber coxae: 11th space
mid-thorax: 8th space
olecranon: 5th space

Question 15

what is transtracheal aspiration?

Answer 15

sterile saline is introduced via tracheal puncture and a variable amount is aspirated back

Question 16

what is bronchoalveolar lavage?

Answer 16

a distal area is flushed with saline and sampled

Question 17

what are the normal constituents of a transtracheal aspiration or bronchoalveolar lavage?

Answer 17

mucus, columnar epithelial cells, macrophages, and rare neutrophils

Question 18

what can be used to evaluate how a disease impacts the respiratory system of a patient?

Answer 18

arterial blood gases
pulmonary function testing

Question 19

what would you expect in a transtracheal aspiration or bronchoalveolar lavage from a patient with an allergic reaction or parasitic infection?

Answer 19

macrophages
neutrophils

Question 20

what would you expect in a transtracheal aspiration or bronchoalveolar lavage with mucopurulent inflammation?

Answer 20

abundant neutrophils
increased mucus
bacteria

Question 21

what are some important things to distinguish when taking a history for a respiratory complaint?

Answer 21

environment and use (athlete or not)
contact with other animals- healthy or not
recent travel
previous and concurrent illness
presenting complaint

Question 22

what are some potential adverse effects of coughing?

Answer 22

removal mucous layer and less effective mucociliary transport
dissemination of infection
emphysema
pneumothorax
exhaustion

Question 23

what does rapid shallow respiration suggest?

Answer 23

restrictive disease or pain

Question 24

what does accentuated expiratory effort suggest?

Answer 24

obstructive disease

Question 25

what should you check before auscultation in a large animal with respiratory signs?

Answer 25

examine upper respiratory tract: conformation, symmetry, mucous membranes, +/- discharge percuss sinuses palpate trachea and larynx intermandibular and retropharyngeal lymph nodes

Question 26

when you percuss the sinuses of a large animal, what are you checking for?

Answer 26

fluid or tumor tissue accumulation

Question 27

where are bronchial sounds generated and heard?

Answer 27

airways and when you auscultate over these airways

Question 28

true/false: fluid in the lung or pleural space will make lung sounds louder

Answer 28

false: only louder when consolidated lung muffled with fluid OR AIR in pleural space

Question 29

when are inspiratory sounds heard more loudly and when are expiratory sounds heard more loudly?

Answer 29

inspiratory: extrathoracic airway obstruction expiratory: constriction of intrathoracic airways

Question 30

what can be delineated by percussion?

Answer 30

lungs just beneath chest wall large intrathoracic masses pleural effusion

Question 31

what is the greatest advantage of ultrasound in the respiratory system?

Answer 31

evaluation of pleural space and peripheral masses in lung parenchyma pleural fluid accumulation and pleural adhesions can be evaluated

Question 32

how are nuclear imaging or lung scans made?

Answer 32

gamma emitting isotopes to assess regional ventilation and perfusion

Question 33

what is used in rhinoscopy?

Answer 33

arthroscope in small animals

Question 34

can you do quantitative sample analysis for protein or cell numbers using fluid from bronchoalveolar lavage or transtracheal aspiration?

Answer 34

no- flush fluid in and get some back

Question 35

what are some complications of an indwelling chest tube?

Answer 35

sepsis pneumothorax

Question 36

should a diagnostic post mortem be performed on an animal that died previously or one you euthanized?

Answer 36

one you euthanized- do not want post mortem necrosis

Question 37

how can a lung biopsy be obtained?

Answer 37

percutaneously bronchoscope surgical thoracotomy

Question 38

what kinds of diagnostics and procedures can be done from a post mortem?

Answer 38

bacterial culture virus isolation parasite identification and counts morphologic identification

Question 39

what anticoagulants are acceptable for blood gas samples?

Answer 39

heparin

Question 40

what is the difference between bronchial sounds and vesicular sounds?

Answer 40

bronchial sounds generated in airways and heard when auscult over these vesicular sounds are generated in the large airways but heard over periphery: attenuated during transmission through aerated parenchyma

Question 41

what does bronchoscopy allow us to assess in small animals?

Answer 41

airway lesions foreign bodies mucosal edema mucous plugs dynamic airway changes collect samples

Question 42

what is the downside of bronchoalveolar lavage in large animals?

Answer 42

requires short term light anesthesia may induce hypoxemia sample analysis is not quantitative

Question 43

is a lung biopsy more useful for diffuse disease or focal/multifocal disease?

Answer 43

diffuse: could miss it with focal/multifocal