Disorders of the respiratory system Flashcards
(45 cards)
1
Q
What groups can respiratory disorders be split into and what are they associated with?
A
- Upper respiratory tract = associated with inspiratory dyspnoea and an externally audible noise
- Lower respiratory tract = associated with expiratory dyspnoea and wheeze generally audible on thoracic auscultation
- Extrapulmonary disease
2
Q
What are the components of the upper respiratory tract?
A
- Nasal cavity
- Pharynx
- Larynx
- Trachea
3
Q
What are some clinical signs associated with nasal disease?
A
- Sneezing
- Snorting
- Facial swelling
- Facial rubbing
- Dyspnoea
- Nasal discharge
4
Q
What could nasal discharge possible look like?
A
- Serous
- Mucoid
- Mucopurulent (green)
- Bloody
5
Q
What are some possible causes for nasal disease?
A
- Viral/bacterial/fungal
- Allergies
- Neoplasia
- Ethmoid haematoma
- FB
- Polyp/cysts
- Trauma
- Coagulopathy
- Dental disease
- Sinusitis
- Dacryocystitis (infection of the nasolacrimal sac)
6
Q
What diagnostics can be done for a patient with suspected nasal disease?
A
- History and clinical examination
- Blood tests (haematology, biochemistry, clotting profile)
- Imaging (X-rays/CT/MRI/Rhinoscopy/Endoscopy)
- Bacteria and fungal culture
- Nasal flush for cytology
- Biopsy and histopathology
7
Q
What treatment and nursing care can be done for a patient with nasal disease?
A
Dependent on cause
- Barrier nurse and isolate (if infectious)
- Monitor vitals and clinical signs including comfort
- Cleaning/grooming including nasal orifices (apply vaseline)
- Assist with feeding
- Humidifier may be required
- Medication under VS direction (ABs for bacterial infections and antifungals for fungal infections)
- Assist with surgical procedure/removing FB
8
Q
What are some common causes of laryngeal disease?
A
- Persistant barking
- Respiratory tract infections
- Paralysis of arytenoid cartilage
9
Q
What are some clinical signs of laryngeal disease?
A
- Change in vocal ability
- Coughing/gagging
- Stridor (audible whistling noise) on inspiration
- Exercise intolerance
- Cyanosis
- Hyperthermia
- Dyspnoea (often with paradoxical abdominal movement)
10
Q
What diagnostics can be done for a patient with suspected laryngeal disease?
A
- History
- Clinical examination
- Endoscopy
11
Q
What stabilisation and management his required for a patient with laryngeal disease?
A
- O2 therapy
- Sedation and rest (reduce stress and inspiratory effort)
- Cooling
- Tracheostomy (severe cases)
- Hobday in mild cases
- Tie-back in severe cases
- Swap collar for harness
12
Q
What is epiglottic entrapment?
A
Aryepiglottic folds become abnormal and envelopes the apex and lateral margins of the epiglottis
13
Q
What clinical signs may be seen with epiglottic entrapment?
A
- Stridor (audible whistling noise) on inspiration
- Dyspnoea
- Coughing
- Cyanosis
14
Q
What diagnostics can be done for a patient with suspected epiglottic entrapment?
A
- History
- Endoscopy
15
Q
What stabilisation and management is required for a patient with epiglottic entrapment?
A
- Surgical correction
- Systemic anti-inflammatories
- ABs
16
Q
What does the lower respiratory tract consist of?
A
- Bronchi
- Bronochioles
- Alveoli
17
Q
Orthopnoea
A
dyspnoea or shortness of breathing in lateral recumbency (usually improves in sternal recumbency)
18
Q
What is acute respiratory disease?
A
- Interruption or failure of normal respiratory function
- Reduced O2 to the circulation
- Increased CO2
19
Q
What are some possible causes of acute respiratory disease?
A
- Trauma (ruptured diaphragm and flail chest)
- Pneomothorax/haemothorax/pyothorax/chylothorax (lymphatic fluid build up in thorax)
- Neoplasia
- Obstruction (FBV/tracheal collapse)
- Infections
- Pulmonary oedema
- Pulmonary haemorrhage
- Paraquat poisoning (plantkiller)
- Gastric torsion
20
Q
What clinical signs are associated acute respiratory disease?
A
- Tachypnoea/dyspnoea/orthopnoea
- Mouth breeding
- Cyanosis
- Tachycardia
- Collapse
21
Q
What treatment and nursing care can be done for a patient with acute respiratory disease?
A
- Inform VS and set up O2
- Keep patient calm and in quiet area
- Minimal restraint
- Replace collar with harness
- Support in sternal if recumbent
- Have crash box ready
- Monitor closely
22
Q
What is flail chest?
A
Destabilisation of a portion of the ribs (often multiple)
23
Q
What clinical signs are associated with flail chest?
A
- Tachypnoea/dyspnoea
- Thoracic pain
- Paradoxical inward displacement during inhalation and outward displacement during exhalation
- Sub-cut emphysema
- Hypoxaemia
24
Q
What diagnostics can be done for a patient with suspected flail chest?
A
- Usually visually obvious
- Radiograph to confirm nature of the ribs
25
What stabilisation and management is required for a patient with flail chest?
- O2 support
- Analgesia
- Sensible positioning
- Bandage chest to reduce movement of the segment
- Surgery (only with penetrating wound)
26
What is chronic pulmonary disease?
Associated with a narrowed bronchial lumen
27
What are some possible causes chronic pulmonary disease?
- Bronchial inflammation with oedema and hyperaemia of bronchial mucosa
- Bronchospasm
- Bronchomalacia
- Mucous accumulation
- Acute anaphylactic reaction (uncommon)
- Infection
- FB
- Trauma
- Collapsed lung
- Tumour
28
What specific diseases are related to chronic pulmonary disease?
- Asthma
- Chronic bronchitis
- Pneumonia
- Pulmonary haemorrhage
- Pulmonary oedema (eg cardiac failure)
- Lungworm
- Neoplasia
29
What clinical signs are associated with chronic pulmonary disease?
- Coughing
- Wheezing
- Tachypnoea
- Exercise intolerance
- Lethargy
30
What diagnostics can be done for a patient with suspected chronic pulmonary disease?
- Thoracic X-rays (bronchial or bronchointerstitial pattern on X-rays, pulmonary hyperinflation and a flattened diaphragm)
- Lower airway cytology (eosinophilic inflammation >17% eosinophils for feline asthma, neutrophilic inflammation evident for chronic bronchitis)
- Heartworm test (ideally both antigen and antibody test)
- Baermann faecal test
31
What management and nursing care is required for a patient with chronic pulmonary disease?
- Bronchodilators, corticosteroids, potential parasite control
- O2 support
- Rest/avoid stress
- Monitor vitals
- Medication under VS direction
32
What clinical signs are associated with BOAS?
- Stertor
- Stridor
- Exercise intolerance/collapse
- Cyanosis
- Syncope
- Gastro-oesophageal reflux/vomiting/regurgitation
33
What diagnostics can be done for a patient with suspected BOAS?
- Observe clinical signs
- Breed disposition
- Examination of upper airway under GA
34
What stabilisation and management is required for a patient with BOAS?
- O2 support
- Sedation to reduce stress and inspiratory effort
- Cooling
- Tracheostomy in severe cases
- Surgical correction of anatomy in severe cases
35
What is tracheal disease?
- Cartilaginous rings are abnormal or degenerate
| - Usually seen in small-breed dogs
36
What clinical signs are associated with tracheal disease?
- Cough like a goose-honk and dyspnoea with stress or excitement
- Cyanosis
- Collapse
37
What diagnostics can be done for a patient with suspected tracheal disease?
- Clinical history and exam
- Clinical signs
- Thoracic x-rays
- Tracheal endoscope
- Tracheal wash
38
What treatment and nursing care can be done for a patient with tracheal disease?
- O2 support
- Intubation if emergency (risk further irritation)
- Quiet environment
- Long term weight management
- Restrict exercise
- Avoid dry, smokey and dusty atmospheres
- Tracheal stent placed (specialist)
- Swap collar for harness
39
What is a tracheotomy?
- Temporary or permanent procedure
- Most often used as a life-saving procedure in an emergency situation to bypass an upper airway obstruction
- Done under GA or sedation and local anaesthetic
- Area below larynx on ventral midline neck is clipped and prepared
- Incision made along midline and between the rings of the trachea
- Tube inserted and secured in place
39
What is a tracheotomy?
- Temporary or permanent procedure
- Most often used as a life-saving procedure in an emergency situation to bypass an upper airway obstruction
- Done under GA or sedation and local anaesthetic
- Area below larynx on ventral midline neck is clipped and prepared
- Incision made along midline and between the rings of the trachea
- Tube inserted and secured in place
40
What is the reason for performing a bronchoalveolar lavage (BAL)?
- Investigate coughing and suspected bronchial or alveolar disease
- Obtain sample for cytology and bacteriology from lower airways
41
What equipment is required for a bronco alveolar lavage (BAL)?
- Bronchoalveolar lavage catheter or a soft urinary catheter
- Syringes (5-30ml)
- Warm sterile saline
- Sample pots (EDTA for cytology and plain for culture)
- Microscope slides for smears of any monoid material present
42
How is a tracheal wash performed?
- Using an endoscope
- Long narrow sterile tube passed through the endoscope lumen
- Sterile water flushed through into the trachea
- Sucked back into the syringe
- Sample sent for cytology and bacteriology
43
What equipment is required for a thoracocentesis?
- Sedation (if necessary)
- Ultrasound
- Clippers
- Cotton wool/swabs and skin disinfectant
- Local anaesthetic
- Sterile gloves
- Blade (number 15)
- IV catheter (butterfly catheter for cats)
- Extension set
- 3-way tap
- Syringe
- Bowl
- Sample pots (EDTA and plain for culture)
44
What is required for a chest drain and how is it performed?
- Use of a fenestrated drain and a trocar
- Insertion can be carried out under GA or local
- Skin incision made between 9th and 12th ribs and a subcutaneous tunnel made to the level off the 7th/8th intercostal space
- Drain is pushed through the intercostal muscles
- Once in place needs to be secured and sealed
- Mechanical suction can be applied as necessary to drain the thorax
