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LAS - RUSS > Equine Respiratory > Flashcards

Equine Respiratory Flashcards

1
Q

Indications for Equine Respiratory Surgery:

1.
2.
3.
4.
5.
6.
A
  1. Exercise intolerance
  2. Poor performance
  3. Abnormal respiratory noise
  4. Mucopurulent nasal discharge
  5. Serosanguineous nasal discharge
  6. External distortion of fascial region
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2
Q

Epidermal inclusion cyst:

Tx method?

A

standing sedation, local block, carve it out

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3
Q

Redundant alar folds:

  1. Clinical sign?
  2. Best way to dx?
A
  1. Expiratory noise

2. attach a large temporary mattress suture. If the noise goes away, you’ve confirmed it.

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4
Q

Sx to treat Redundant alar folds:

  1. What position should horse be in?
  2. What instrument is vital?
A
  1. Lateral or dorsal recumbency

2. Carmalt forceps

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5
Q

Etiologies of diseases of the nasal septum

1.
2.
3.
4.
5.
6.
A
  1. Malformation
  2. abscesses
  3. trauma
  4. neoplasms
  5. hematoma
  6. infectious
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6
Q

Clinical signs of wry nose:

1.
2.
3.
4.

A
  1. Decreased or complete obstruction
  2. Stridor
  3. discharge
  4. facial distortion
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7
Q

Sx for wry nose correction (is/is not) an emergency surgery?

A

is not

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8
Q

Preoperative considerations for corrections of wry nose

1.
2.

A
  1. collect 4-8 L of blood (they will lose a lot)

2. Tracheotomy

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9
Q

Nasal septum resection for wry mouth:

  1. Where do you make initial incision?
  2. What do you place into the incision?
A
  1. Draw imaginary line from each medial canthus of the eye. right in the center is where you make the incision
  2. Trephine
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10
Q

T/F: The nasal septum resection requires a trephine due to the thick bone in the area you need to get through

A

False, it’s pretty thin. 2-3mm at most.

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11
Q

Two options to remove bone during nasal septum resection as treatment for wry mouth?

A

A large chisel that you run along the floor of the nasal septum.
OR
gigli wire.

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12
Q

Nasal septum resection: Aftercare:

1.
2.
3.
4.
5.
A
  1. 5-6 days systemic antibiotics
  2. 10 days NSAIDs
  3. Remove packing 2 days post op
  4. remove tracheotomy tube
  5. Clean and flush with saline
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13
Q

Progressive ethmoid hematoma: Definition:

A

Progressively enlarging, soft tissue mass originating from the mucosa of the ethmoid turbinates

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14
Q

Clinical signs of progressive ethmoid hematoma:

1.
2.
3.

A
  1. Epistaxis (bilateral)
  2. Serosanguineous nasal exudate
  3. Stridor
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15
Q

Ways to diagnose progressive ethmoid hematoma:

1.
2.
3.
4.

A
  1. Radiology
  2. CT
  3. Arthroscope in trephine hole
  4. Endoscopy
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16
Q

Histopath of progressive ethmoid hematoma:

  1. Outer surface =
  2. Inner parts =
A
  1. respiratory epithelium

2. hemosiderin-filled macrophages

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17
Q

Transendoscopic chemical ablation for tx of progressive ethmoid hematoma:

  1. Describe the technique?
A
  1. 4% formalin via biopsy channel of endoscope
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18
Q

Differential diagnosis for progressive ethmoid hematoma:

1.
2.
3.
4.
5.
6.
A
  1. Guttural pouch mycosis
  2. septic pneumonia
  3. pulmonary neoplasia
  4. pharyngeal neoplasm
  5. laryngeal neoplasm
  6. paranasal neoplasm
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19
Q

Sinusitis:

  1. Primary = due to?
A
  1. upper respiratory tract infection (URTI)
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20
Q

Sinusitis: Secondary is due to:

1.
2.
3.
4.

A
  1. dental disease
  2. facial fractures
  3. cysts
  4. neoplasia
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21
Q

Sinusitis: CxS:

1.
2.
3.

A
  1. Nasal discharge - serosanguneous
  2. Coughing
  3. Fascial deformity
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22
Q

When trying to diagnose sinusitis: what would you be looking for on a skull radiograph?

A

looking for the fluid lines

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23
Q

Best way to find the septum / trephination site in a sinusitits case:

A

fine the medial canthus, draw an imaginary line from medial canthus to the cranial edge of the facial crest. Find the halfway point of that imaginary line, and go 1 cm above it.

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24
Q

How do you cut through the bone during a sinusitis surgery?

A

Drill holes, than use a saw or wire.

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25
Q

T/F: Sinusitis surgery is not a sterile procedure

A

T. Whatever is in there will drain out

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26
Q

Aftercare for sinusitis surgery:

1.
2.

  1. Prognosis?
A
  1. leave open + flush daily
  2. ABx + NSAIDs
  3. excellent
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27
Q

Potential causes of cribbing:

1.
2.
3.
4.
5.
6
.
A
  1. Boredom
  2. Confinement
  3. isolation
  4. lack of roughage
  5. learn from others
  6. genetics
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28
Q

Potential consequenes of cribbing:

1.
2.
3.

A
  1. colic
  2. abnormal wear of incisors
  3. weight loss
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29
Q

Non-surgical treatment options for cribbing:

1.
2.
3.
4.
5.
6.
A
  1. remove fixed objects
  2. bitter tasting substances
  3. cribbing straps
  4. acupuncture
  5. aversion (shock)
  6. Naloxon (opioid)
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30
Q

Surgical Treatment options for cribbing:

2.

A
  1. removal of sternomandibularis, sternothyrohyoideus, or omohyoideus
  2. neurectomy of ventral branch of spinal accessory nerve (XI)
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31
Q

Modified Forssel’s Procedure:

  1. Entails what?
A
  1. Myoectomy of strernothyrohyoideus and Omohyoideus along with neurectomy of ventral branch of spinal accessory nerve (XI)
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32
Q

4 broad steps of the Modified Forssel’s procedure

1.
2.
3
4.

A
  1. Remove nerves on both sides
  2. Remove muscle tissues
  3. put in drain
  4. skin suture
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33
Q

What position should horses be in for a modified forssel’s procedure?

A

ABSOLUTE dorsal recumbency

34
Q

What structure must you take care to avoid cutting during a modified forssel’s procedure?

A

External jugular vein

35
Q

What muscle do you need to rotate during a modified forssel’s procedure?

A

the sternomandibular muscle

36
Q

Describe the techinque for the neurectomy of the ventral branch of spinal accessory nerve?

A

blunt dissection 10-12 cm long on both sides

37
Q

How much muscle do you remove during the modified forssel’s procedure?

A

10 trahceal rings worth

38
Q

Aftercare for modified forssels procedure?

1.
2
3

A
  1. penrose drain for dead space

2. ABX + NSAIDs if not sterile

39
Q

Most frequent upper respiratory noise = “____”

A

roaring

40
Q

Roarer =

A

Idiopathic laryngeal hemiplegia

41
Q

Idiopathic laryngeal hemiplegia:

Pathogenesis?

A

Unilateral paralysis of left cricoarytenoid muscle d/t progressive neurogenic atrophy of the recurrent laryngeal nerve

42
Q

Idiopathic Laryngeal hemiplegia: Incidence:

  1. age range?
  2. (small/large) breed horses
  3. Breed?
  4. (is/is not) hereditary
A
  1. 1-10 years old
  2. Large
  3. thoroughbred yearling sales
  4. is hereditary
43
Q

Possible etiologies for idiopathic laryngeal hemiplagia

1.
2.
3.
4.
5.
6.
7.
A
  1. perivascular injection
  2. gutteral pouch mycosis
  3. trauma
  4. strangles
  5. organophosphate toxicity
  6. lead toxicity
  7. CNS disease
44
Q

2 common presenting complaints of horses with idiopathic laryngeal hemiplegia

1.
2.

A
  1. noise

2. exercise intolerance

45
Q

Palpation of the neck of a horse with idiopathic laryngeal hemiplegia will reveal what?

A

prominant arytenoid cartilage that bulges out to the side.

46
Q
  1. What does the “slap test” test for?

2. Describe how it’s performed?

A
  1. Evaluates recurrent laryngeal nerve and portions of the spinal cord.
  2. slap withers during endoscopy, observe adduction of CONTRAlateral arytenoid cartilage
47
Q

Describe the pathway the impulse follows during the “slap test”

A

spinal cervical cord –> medulla decussation –> recurrent laryngeal nerve

48
Q

Grading system for idiopathic laryngeal hemiplegia

Grade 1:

Grade 2:

Grade 3:

Grade 4:

A
  1. normal, full abduction of left + right
  2. Asynchronous abduction, but full abduction could not be achieved
  3. asymmetry at rest, some movement, but full abduction cannot be achieved
  4. asymmetry at rest and no movement
49
Q

Larynx at max exercise is maximally (closed/open)?

at rest?

A

open

closed

50
Q

Laryngoplasty aka ___

A

tieback

51
Q

Laryngoplasty:

  1. What position should the horse be in?
  2. Use (smallest/largest) size ETT?
A
  1. right lateral, since the left side is most often affected.
  2. small size
52
Q

Laryngoplasty: Do not penetrate _____. Why?

A

the lumen of the trachea. It will contaminate your suture

53
Q

During a laryngoplasty, the first suture should be under the _____ muscle, and end of the second suture should also be under it.

What do you do after?

A

cricopharyngeus

Dissect the muscular process

54
Q

What instruments are used for suture placement in the muscular process during a laryngoplasty?

A

steinman pinns, a drill, and a crochet hook to catch the suture. The other option is just using needle through the muscular process

55
Q

During a laryngoplasty, you tie the knot with a ____ in place. What happens when you tighten the knot?

A

endoscope

it abducts the arytenoid cartilage

56
Q

Larygnoplasty complications:

1.
2.
3.

A
  1. Seroma
  2. Cough (tx by removing suture)
  3. Dysphagia
57
Q

Ventriculectomy aka ____

A

sacculoectomy

58
Q

Ventriculectomy:

  1. Should be in what position?
  2. a (short/quick) surgery?
A
  1. Dorsal recumbency

2. very short! Can do it with injectable anesthesia and remove the ETT entirely

59
Q
  1. Skin incision location for ventriculectomy?
  2. Can use what other tool during incision?
  3. Goal is to incise through what?
A
  1. in ventral midline
  2. Retractors
  3. Cricothyroid membrane
60
Q

After incising into cricothyroid membrane for a ventriculectomy, what is the next step?

A

insert the roaring bur into the ventricle and twist it to grab the ventricle mucosa and evert it, than excise it

61
Q

Complications of ventriculectomy:

1.
2.
3.

A
  1. granuloma formation
  2. mucocele
  3. laryngeal web
62
Q

T/F: You usually leave the incision site open for a ventriculectomy?

A

true

63
Q

Reinnervation of cricoarytenoid muscle is performed via graft of….

A

neuromuscular pedicle

64
Q

Arytenoid chondritis - definition

A

inflammation and thickening of the arytenoid cartilage

65
Q

How does arytenoid chondritis happen?

A

we think its when horses race on dirt tracks, they inhale a lot of dirt, irritating the cartilages and causing inflam

66
Q

Tx of arytenoid chondritis:

  1. Horse should be in what position?
  2. Perform a ______
  3. _____ injection
  4. Incise into _____
  5. Removal of ____
A
  1. dorsal recumbency
  2. tracheotomy
  3. submucosal injection
  4. mucosa
  5. arytenoid cartilage
67
Q

A Total Arytenoidectomy as tx for arytenoid chondritis removes:

1.
2.
3.

  1. A partial appendectomy does not remove the ___
A
  1. arytenoid body
  2. carniculate
  3. muscular process
  4. muscular process
68
Q

Total Arytenoidectomy (is/is not) the preferred tx?

A

is not. Partial is preferred

69
Q

Partial arytenoidectomy:

  1. __% of racehorses return to racing
  2. End result:
  3. ___ may be noted after surgery.
A
  1. 50%
  2. significantly improved upper airway flow dynamics
  3. coughing
70
Q

In Dorsal Displacement of the Soft Palate (DDSP), the soft palate is displaced over the ____ and results in “___”

A

epiglottis

Choking up

71
Q

Why does dorsal displacement of the soft palate cause exercise intolerance?

A

Decreased maximal stretching of the epiglottic folds, so during expiration the air hits the soft palate, blowing it up and preventing air from escaping the trachea/lungs

72
Q

Non-surgical tx options for DDSP

1.
2.
3.

A
  1. NSAIDs
  2. Tongue-tie
  3. Laryngohyoid support device
73
Q

The idea behind using a tongue-tie to treat DDSP is to pull the tongue (caudally/cranially)?

A

cranially

74
Q

Surgical tx for DDSP:

1.
2.
3.
4.
5.
6
.
A
  1. Staphylectomy
  2. Myectomy - removal of sternothyroideus, sternohyoideus, omohyoideus
  3. Epiglottic augmentation
  4. LASER cauterization
  5. Larygneal tie-forward
75
Q

Describe what you are doing during a staphylectomy as tx for DDSP

A

removing a little bit (5-7mm) of the caudal portion of the soft palate

76
Q

What position should the horse be in for staphylectomy as tx for DDSP

A

dorsal recumbency

77
Q

What is the thought process behind myoectomy of the sternothyrohyoideus muscle as tx for DDSP?

A

During excersie the mucle contracts and pulls the larynx caudally, allowing the soft palate to displace. cutting this strap-like muscle makes it so it can’t be pulled caudally anymore

78
Q

Preferred tx method for DDSP?

A

Laryngeal tie-forward

79
Q

What is the thought process behind the laryngeal tie-forward as tx for DDSP?

A

idea is to move larynx cranially so the soft palate can stay tucked under epiglottis

80
Q

Laryngeal tie-forward as tx for DDSP: What do you do?

A

Place a suture in the thyroid cartilage and attach it to the basihyoid bone, tightening the suture as you pull the larynx forward.

81
Q

How do the epiglotic folds get entrapped?

A

the fols get irritated, and fold over the tip of the epiglottis, causing entrapment

82
Q

Special tool for epiglottic entrapment tx?

A

Bistoury- a hook you drag through the folds on the midline

LAS - RUSS (32 decks)

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