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3. Equine 2 > EQUINE RESPIRATORY SYSTEM: OVERVIEW AND DIAGNOSTICS > Flashcards

EQUINE RESPIRATORY SYSTEM: OVERVIEW AND DIAGNOSTICS Flashcards

1
Q

how can a horse modulate upper airway resistance?

A
  • Dilation of external nares
  • Vasoconstriction
  • Dilation/ stabilization of pharynx
  • Increase area of rima glottidis
  • Extension of head
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2
Q

how can a horse modulate lower airway resistance?

A
  • Inhalation → dilates airways
  • Exhalation → narrows airways
  • Airway smooth muscle
    > Most important > Regulating resistance
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3
Q

pulmonary physiology review?
- resp rate
- tidal volume

A
  • Respiratory rate= 8-24 brpm
  • Resting tidal volume= 4-5 liters
  • Exercising tidal volume= 13 liters
  • Maximal exercise= 75L O2/min
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4
Q

horse lung field

A

epaxial muscles, scapula, curvilinear line to 16th ICS

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5
Q

where in the resp system does resistance occur?

A

50% in nose, 25% trachea, 25% bronchioles

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6
Q

locomotor respiratory coupling mechanism

A
  • when they are in contracted phase, stomach contents move backwards, head goes up, they inhale
  • then legs go out, stomach contents go forward, head goes down, they exhale
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7
Q

Normal respiratory rate for adults, foals, neonates

A
  • Adults- 8-24 breaths/ minute
  • Foals- 20-40 breaths/ minute
  • Neonates- 60-80 breaths/ minute
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8
Q

Abnormal respiratory patterns to watch out for

A
  • “Heave line” > expiratory distress, working hard to push air out
  • Paradoxical respiration > inspiratory and expiratory distress, common with pleuropneumonia
  • Synchronous diaphragmatic flutter > severe electrolyte abnormalities, diaphragm contracts in time with heart, rhythmic noise
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9
Q

Abnormal upper airway sounds

A
  • Stridor > High pitched inspiratory noise
  • Stertor > Low pitched, raspy inspiratory noise
  • Tracheal rattle > Oscillation of mucus
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10
Q

normal airway/beath sounds
- origins, where are they loud vs quiet
- when are they easy vs hard to hear?

A
  • Created by airway turbulence
  • Loudest → base of lung and on inspiration
  • Quietest → diaphragmatic lobes and on expiration
  • Difficult to hear
    > Noisy environments
    > High body condition score
  • Easy to hear
    > Foals
    > Underweight horses
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11
Q

Abnormal lower airway sounds? when we heat them?

A

Crackles
* Short, popping sounds
* Sudden pressure equalization when collapsed airways open
<><><><>
Wheezes
* High or low-pitched musical sounds
* Oscillation of airway walls
<><><><>
Pleural friction rubs
* Rubbing or creaking sound
* End of inspiration and beginning of expiration
<><><><>
Expiratory grunt
* Loud sound at end of expiration
* Indicates pain
<><><><>
Absent or diminished sounds
* Most common ventrally
> something blocking, eg. consolidation, etc.

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12
Q

rebreathing exam procedure, utility? contraindications?

A
  • Place bag over both nostrils
  • Inhalation of increasing levels of CO2
    > Increased respiratory rate and depth
    <><><><>
    Utility
  • Enhance breath sounds
  • Reveal abnormal sounds
    <><><><>
    Contraindications
  • Respiratory distress/ unstable
  • Severe or diffuse abnormalities
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13
Q

ultrasonography for thorax
- what is it good for?
- limitations?
- what is it bad for?

A

Ultrasonography utility
* Non-invasive
* Stall-side or in the field
<><><><>
Sensitive for
* Pleural surface/ superficial abnormalities
* Pleural space disease
* Some diaphragmatic hernias
<><><><>
Limitations
* Poor contact= poor image
* Aerated lung is not penetrated
<><><><>
Not sensitive for
* Deep (axial) pulmonary disease
* Caudal mediastinal disease
* Axial diaphragmatic hernias

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14
Q

what do comet tails represent on ultrasound?

A

disruption of pleural surface

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15
Q

thoracic radiograph utility? indications and limitations?

A
  • Portable units- foals and small ponies
  • Evaluate lesion pattern
    <><>
    Indications
  • Thoracic trauma
  • Unresponsive or recurrent disease
  • Extrapulmonary disease
  • Deep lung disease
    <><>
    Limitations
  • Portable units
    > Not capable in most ponies and horses
  • Summation
  • Lack of orthogonal views
  • Low sensitivity for small lesions
  • Pleural fluid obscures underlying structures
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16
Q

endoscopic exam for thorax - utility, indications, limitations

A
  • Stall-side or in field
    <><>
    Indications
  • Poor performance
  • Abnormal respiratory noise
  • Nasal discharge
  • Epistaxis
  • Coughing
  • Facilitate sample acquisition
    <><>
    Limitations
  • Size and maneuverability
  • Sample collection
  • May need sedation
  • May induce respiratory distress
17
Q

dynamic endoscopy use

A

poor performance at higher speed, or intermittent issues
- evaluate function of upper airway

18
Q

upper airway sampling methods? one to watch out for?

A

Swab
* Nasal swabs
* Nasopharyngeal swabs
<><>
Fluid collection
* Guttural pouch
<><>
Biopsy
* Superficial lesions of URT
* Except fungal plaques on large arteries!

19
Q

transtracheal wash indications? percutaneous technique and its pros and cons?

A

Indications
* Infectious lower respiratory disease
<><>
Percutaneous technique
* Minimizes contamination
* More invasive
* Complications (are minimal and rare)
> Subcutaneous emphysema
> Abscess or cellulitis

20
Q

tracheobronchial aspirate indications? endoscopic technique pros and cons?

A

Indications
* Infectious lower respiratory disease
<><>
Endoscopic technique
* Minimally invasive
* Minimal complications
* Risk sample contamination (based on how you deploy your scope - don’t let it touch your sample!)
> Upper airway
> Endoscope

21
Q

bronchoalveolar lavage
-indications, techniques, complications

A

For Diffuse or chronic disease > end up in some part of the lung, but you wont know where
- not a sterile sample! not something you should culture!
- for cytology
<><><><>
Techniques
* Blind
* Endoscopic
> technique is the same either way - wedge into section of lung > then infuse fluid and rapidly draw back
<><><><>
Complications (usually mild)
* Coughing
* Trauma
* Bronchospasm
* Fever

22
Q

lower airway cytology
- what cells do we expect in tracheal aspirate?
- what about bronchoalveolar lavage?

A

TRACHEAL ASPIRATE
* 40-80% macrophages
* (1-50% epithelial cells)
* < 20% neutrophils
* < 10% lymphocytes
* < 1% eosinophils
<><><><>
BRONCHOALVEOLAR LAVAGE
* TNCC- <530 cells/uL
* 40-70% macrophages
* 30-60% lymphocytes
* < 5% neutrophils
* < 2% mast cells
* < 0.5% eosinophils
<><><><>
- note difference in neutrophils, lymphocytes

23
Q

what tells us we have upper airway contamination

A
  • squamous epithelial cells
    > if we see bacteria with these, esp. outside cells, these bacteria are likely from upper airway and contamination > dont culture this sample

3. Equine 2 (16 decks)

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