Intro final Flashcards
Respiratory physiology and structures
Respiratory system (Brings oxygen from the air to body, where it is delivered to the hemoglobin on the red blood cells. At the level of the cells: RBCs with bound hemoglobin deliver oxygen to the tissues within the capillaries RBC picks up carbon dioxide deoxygenated blood returned to the lungs CO2 and O2 exchanged at the level of the capillaries at the lungs CO2 exhaled into air); Respiration: diffusion of gases between the atmosphere and cells of the body (Internal/cellular: exchange between blood and cells; External - absorption of atmospheric oxygen by blood in lungs and diffusion of carbon dioxide from blood in lungs to outside air; Ventilation (intake of fresh air; Natural or assisted)
Structures - Two portions of the respiratory tract: Upper respiratory tract (URT: Nose, mouth, pharynx, epiglottis, larynx); Lower respiratory tract (LRT: trachea, lungs (bronchi, bronchioles, alveoli))
URT - nose
swine = snout) - Nas/o and rhin/o combining forms; Opening consists of nares (nostrils); Divided by wall of cartilage (nasal septum); Lined with mucous membranes & cilia; Example term: “rhinitis” – inflammation of the mucous membranes of the nasal passageways
Anatomy review - Nasal passages - Turbinates (conchae: Scroll-like structures that warm, humidify and filter air); Passageways (openings: Dorsal meatus Middle meatus Ventral meatus (nasogastric tubes are passed through here) Common meatus
Spell check - What spelling is used for the lining for the upper respiratory system? Mucous membranes; What is the spelling used for the glandular secretion that helps moisten the air and warm it as it filters into the nose? Mucus
URT - sinuses and pharynx
Sinuses - Combining form sinus/o: Example “sinusitis”; Air filled or fluid filled space in bone; Function (Provide mucus; Make bone lighter; Help produce sound); Look at table 9-1 on page 222 (Sinus location in species; All domestic species have a frontal and a maxillary sinus)
Pharynx - Combining form is pharyng/o AKA: throat; Common pathway for the upper respiratory and gastrointestinal tracts; Extends from caudal nasal passages/mouth larynx (voice box), connects the nasal passages to the larynx and the mouth to the esophagus
—- Three divisions: Nasopharynx ; Oropharynx ; Laryngopharynx
—- What structure moves dorsally to close off the nasopharynx when swallowing food? What structure covers the larynx during swallowing?
**URT - larynx, laryngeal hemiplegia, laryngeal paralysis, stridor vs stertor
Combining form is Laryng/o AKA: “voice box”; Located between pharynx and trachea Vocal apparatus is found within the glottis Glottis is the space between the vocal cords
What disease did we talk about in dogs that causes a paralysis of one side of the larynx? We can see this in horses too!
Laryngeal hemiplegia - “Roaring” in horses; Caused by paralysis of one or both arytenoid cartilage (Left side affected 95% of time); Primarily racing Thoroughbreds (Also Warmbloods, Draft horses, Standardbreds and Quarter horses Higher prevalence in taller male horses >15 hands); Treatments (“Tie Back” ; Ventriculectomy/Cordectomy ; Arytenoidectomy (Greater risks post op; reserved for ‘Tie Back’ failures)
Laryngeal paralysis in dogs - “Lar Par”; Causes (Damage or degeneration of nerves controlling the laryngeal muscles; Age related; Trauma)
—- Pathology - Trauma, neoplasia, congenital; Acquired: Myasthenia gravis - neuromuscular junctions are diseased = muscle weakness and fatigue.; Geriatric onset laryngeal paralysis and polyneuropathy (GOLPP); Hormonal diseases (cushings, hypothyroidism)
—- Primarily dogs - Middle to older, large or giant breed dog; Common breed: Labrador
—- Tx - Mild cases: Medical management; NSAIDS; Weight loss; Limit activity; Treat underlying cause (myasthenia gravis, hypothyroidism, etc).
——– Moderate to severe cases: Surgical intervention ; Unilateral Arytenoid Lateralization ; “Tieback”
Stridor vs stertor - Stridor: High pitched musical tone; Example: laryngeal hemiplegia; Tracheal partial obstruction; “lower airway” disease; Stertor: sounds like snoring; “upper airway” disease
**bronchi and alveoli, what is surfactant
Bronchi - Combining form is bronch/o; Tracheal bifurcation splits into bronchi; Each bronchus leads to separate lung and divides into smaller portions, creating the “bronchial tree”; Example term: Bronchoscopy; Bronchoscope: a fiber-optic cable that is passed into the windpipe in order to view the bronchi.
—- Trachea ; Tracheal Bifurcation ; Left or Right Primary Bronchus ; Secondary/Lobar Bronchi ; Tertiary/Segmental Bronchi (aka Bronchioles) ; Terminal Bronchioles ; Respiratory Bronchioles (final branches of bronchioles that branch into alveolar ducts)
—- Dyspnea= difficulty breathing; Bronchitis= inflammation of the bronchioles or bronchi
—- Dont typically see bronchi on rads bc they are filled with air; see them when they are diseased
Alveoli - Combining form alveol/o; “Air sacs” where most of the gas exchange takes place ; Functional unit of the lung!!!; Connected to bronchiole via alveolar duct; Alveoli are surrounded by capillaries (O2 and Co2 exchange; What does O2 bind to?)
—- Surfactant - layer of fluid that allows lungs to expand
thorax
Combining form thorac/o Contains: Lung: main organ of respiration; Combining forms for lung- pulm/o and pulmon/o; Combining forms for lung or air - pneum/o, pneumon/o, and pneu ; Divided into lobes; What do you think a pneumothorax would be? Air in thorax
Thoracocentesis - Used to collect fluid or gas from the chest cavity; EMERGENCY
Mediastinum: Region between the lungs that holds the heart, aorta, lymph nodes, esophagus, trachea, bronchial tubes, nerves, thoracic duct and thymus.; Encased in pleura (membranous sac)
Parietal pleura - Outer layer lining the inner wall of the thoracic cavity
Visceral pleura - Inner layer lining the outside of the lung
Pleural space - Potential space between the parietal pleura and visceral pleura
Surfactant holds the visceral and parietal layers together
Example: pleuritis, pleural effusion
Pleural effusion - Would the name of the procedure change if we were removing fluid? No! Still thoracocentesis. HOWEVER, the position you will use to remove this air or fluid will change; Air-dorsal; Fluid- ventral
diaphragm
Combining form diaphragmat/o and phren/o; Separates thoracic and peritoneal cavities; Contraction causes air pressure in the lungs to drop below atmospheric pressure, which creates a vacuum.; Relaxation of the diaphragm stops the negative pressure and air is forced out of the lung
brachycephalic airway syndrome
“The Perfect Storm” of respiratory pathology
Brachycephalic breeds Typically exhibit: Stenotic nares; Narrowed nasal passages; Elongated soft palate; Everted laryngeal saccules; Narrow trachea
Signs and symptoms - History of noisy breathing, especially upon inspiration Retching or gagging, especially while swallowing Exercise intolerance Cyanosis
breathing
Combining form spir/o, -pnea; Inhalation/inspiration:drawing in of breath Exhalation/expiration: release of breath; Combining forms for O2 are ox/i, ox/o and ox/y; for CO2 are capn/o
Examples in anesthesia: Hyperventilation can lead to hypocapnia… what does this mean?; - hyperventilation (increased breathing…not the same as panting); -hypocapnia= decreased levels of CO2
Hypoventilation may lead to hypercapnia… what does that mean?
Hypercapnia = increased levels of CO2
eye structures
The ocular system is responsible for vision.; The combining forms for the eye or sight are opt/i, opt/o, optic/o, ocul/o, and ophthalm/o.; Extraocular = outside the eyeball; Intraocular = inside the eyeball; Periocular = around the eyeball
Accessory structures - Orbit; Eye muscles; Eyelids or palpebrae (Blepharo- is combining form; Canthus (medial and lateral); Meibomian glands (help with tear production and protective things in eye: line outer surface of lid)); Eyelashes; Conjunctiva (Lines underside of each eyelid; Contains nictitating membrane); Lacrimal apparatus- nasolacrimal duct; OS/OD
Layers of the eye - Cornea and the sclera form the fibrous or outer layer of the eye; Uvea is the vascular middle layer (Contains the iris, ciliary body and choroid; Irid/o; Uve/o; Uveitis- inflammation of the iris and ciliary body); Retina and the optic nerve form the inner layer (Retin/o)
The globe - Fibrous outer layer; Sclera is the fibrous portion that maintains eye shape (“white of the eye”); Cornea is the transparent portion of the anterior part of the sclera (Descemet’s membrane is the deepest layer of the cornea)
—- Descemets membrane - Desmetocele- deepest corneal ulcer; Test to determine depth: fluorescein stain
Cori/o = pupil size… Eg. Anisocoria; Mydriasis- dilated pupils; Miosis- constricted pupils; suffix -tic (describing one pupil)
Uveal tract (vascular middle layer) - Iris: controls amount of light entering the eye (colored portion); Ciliary body: Immediately posterior to the iris, produces aqueous humor; Choroid: thin variably pigmented vascular tissue forming the posterior uvea; Joins the ciliary body and lies between the retina and the sclera
—- Anterior chamber is in front of iris; vitreous humor is behind lens; posterior chamber is behind iris
—- Ciliary body - when it has problems we can get issues like uveitis
Choroid - Thin vascular layer in that makes up the posterior uveal tract; Tapetum lucidum is the bright, reflective portion of the choroid
Retina and Optic Nerve - Innermost/neurologic layer lining posterior chamber; Receives images of the eye via rods (react to light) and cones (react to color and fine detail); Contains optic disc and fundus (back of eye); Ophthalmoscope used to visualize (Direct (directly look at eye) and indirect (use lens and light to look at back of eye))
eye chambers
The eye is divided into parts: Anterior segment contains aqueous humor. (anterior chamber; posterior chamber); Vitreous chamber contains vitreous humor.
Fluid needs to be at a certain pressure; can have problems with fluid not draining correctly and too much fluid (leads to increased pressure which can cause glaucoma)
vision and glaucoma
Vision - Vision occurs when light rays enter the eye through the cornea, pass through the lens, and travel to the retina; The image is focused on the retina and is then transmitted to the optic nerve; Stimulations are transmitted from the optic nerve, to the optic chiasm, to the midbrain, and to the visual cortex of the occipital lobe of the cerebrum
Glaucoma - Glaucoma- increased intraocular pressure (IOP) in the eye; Can result in a larger than normal globe buphthalmos; Exophthalmos vs buphthalmos (Exophthalmos- normal eye size that is being pushed out of the orbit; Buphthalmos= enlarged globe)
**Fluorescein dye stain
corneal ulceration
ophthalmoscope
palpebral reflex
pupillary light reflex
indolent ulcer
anisocoria
blepharospasm
strabismus
Schirmer tear test
Fluorescein dye stain - dx test to detect corneal injury by placing dye on surface of cornea
corneal ulceration - surface depression on the cornea
Ophthalmoscope - instrument used for ophthalmoscopy
palpebral reflex - dx test in which the eye should blink in response to touch the medial canthus of the eye. used to make neurologic assessment of cranial nerves V and VII and to assess depth of anesthesia
pupillary light reflex - response of pupil to light; when light is show n in pupil constriction should occur
indolent ulcer - superficial noninfected chronic corneal ulcers with loose epithelial borders that fail to heal within 1 week
Anisocoria - unequal pupil size
Blepharospasm - rapid involuntary contractions of the eyelid
Strabismus - disorder in which eyes are not directed in a parallel manner; deviation of one or both eyes
schirmer tear test - dx test using a graded paper strip to measure tear production
outer ear
Pinna → External portion of the ear; AKA auricle (AS, AD); Combining form pinn/i means eternal ear; aur/i and aur/o mean ear; Example: Aural hematoma (collection of blood in outer ear)
External auditory canal - Tube that transmits sound from pinna to tympanic membrane; AKA external auditory meatus; Glands lining the external auditory canal secrete cerumen
**tonometry
miosis
mydriasis
entropion
buphthalmos
cataract
epiphora
nuclear sclerosis
glaucoma
hypopyon
Tonometry - procedure using an instrument to measure intraocular pressure
Miosis - excessive constriction of the pupil of the eye
Mydriasis - dilation of the pupil of the eye
Entropion - inversion or turning inward of eyelid
Buphthalmos - abnormal enlargement of eye
Cataract - cloudiness or opacity of the lens
Epiphora - excessive tear production
nuclear sclerosis - drying out of the lens with age
Glaucoma - group of disorders resulting from elevated intraocular pressure
Hypopyon - pus in the anterior chamber of eye
**keratitis
nictitating membrane
nictitating gland prolapse
nystagmus
photophobia
scleritis
uveitis
keratoconjunctivitis
Keratitis - inflammation of the cornea
nictitating membrane - conjunctival fold attached at medial canthus that moves across cornea when eyelids close
nictitating gland prolapse - hypertrophy and protrusion of the conjunctival fold of the medial canthus; occurs in puppies and more commonly in some breeds (cherry eye)
nystagmus - involuntary constant movement of the eye
Photophobia - fear or intolerance of light
Scleritis - inflammation of the sclera
Uveitis - inflammation of the uvea
Keratoconjunctivitis - inflammation of the cornea and conjunctiva
**middle ear
Eardrum = tympanic membrane (Separates external ear from middle ear and transmits sounds to ossicles; Combining forms tympan/o and myring/o; Auditory ossicles: Three bones that transmit sound vibrations (Malleus: “hammer”; Incus: “anvil”; tapes: “stirrup”, smallest bone in the body)
Eustachian tube (Auditory tube extending from middle ear to nasopharynx); Oval window (Membrane at base of stapes that separates middle and inner ear); Round window (Membrane allowing movement of fluid through cochlea, allowing hearing to occur)
**mechanisms of equilibrium
Equilibrium is the state of balance; Combination of static and dynamic equilibrium → Static equilibrium (Maintaining position of head relative to gravity; Controlled by organs in the vestibule of the inner ear); Dynamic equilibrium (Maintaining balance in response to rotational or angular movement; Controlled by organs in the semicircular canals of the inner ear)
**inner ear
Bony labyrinth - Vestibule (Balance and position/equilibrium); Semicircular canals (Regulation of position/equilibrium); Cochlea (Organ of hearing)
Membranous labyrinth - Perilymph (Water-like fluid filling bony labyrinth); Endolymph (Membranous sac following shape of bony labyrinth filled with thicker fluid)
cytology
otoscope
aural hematoma
otitis interna
total ear canal ablation
otopathy
otitis externa
vertigo
Cytology - study of cells; ear cytology involves taking sample of exudate or cerumen and detect for bacteria, yeast, leukocytes, or abnormal cells
Otoscope - used for otoscopy (examine ear)
aural hematoma - collection or mass of blood on outer ear
otitis interna - inflammation of inner ear
total ear canal ablation (TECA) - involves the complete removal of the ear canal and tympanic bulla (middle ear), leaving only the pinna (ear flap) remaining
Otopathy - disease of ear
otitis externa - inflammation of outer ear
Vertigo - sense of dizziness
secondary purposes of medical records
Not clinically based; Includes evaluations of medical information for business, legal and research purposes → Lists all services rendered to the pet owner; Also used to assess the workloads of staff, formulate income analyses/make budgetary plans, maintain inventory, and generate a marketing strategy; Supports hospital accreditation; Used as a legal document in a court of law and is valuable during litigation. (In a court of law, the prevailing view is “not recorded, not done.”; In addition, insurance companies may require the medical record to assess whether a claim is to be paid.); Preparation of case studies and presentations for conferences, retrospective studies; Used to teach veterinary medical and veterinary technician students
primary purposes of a medical record
- Supports excellent medical care → Assists in correctly identifying the patient and owner; Aids in effective diagnostic and treatment plans; PE findings; Documenting response to therapy; Documents results of diagnostic tests; Supports continuity of care
- Documents communication - Most helpful with client communication (discharge instructions, reminder cards, financial restraints, etc); Terms: DDX (differential diagnosis), DX, TX, PE, VCPR,
informed consent
Extremely common complaint from owners (esp. euthanasias/expensive Dx tests or Tx); ALL forms of communications with clients should be recorded in the medical record, including: Face-to-face consultations; E-mail communications; Conversations on the phone (have a witness confirm)
CRITICAL for owners to sign and date a consent form after the services have been explained by an employee.; Be aware that consent for medical Tx must be given by legal adults 18 years of age or older
problem oriented vet med record (POVMR)
Organized approach to clinical veterinary care (Information grouped by problem; each problem is addressed separately); SOAP stands for Subjective, Objective, Assessment, and Plan; Both veterinarians and veterinary technicians write SOAP (Focus is different for DVM vs. LVT); The American Animal Hospital Association (AAHA) endorses the use of problem-oriented veterinary medical record keeping and insists upon its use in practices seeking AAHA certification.
This is what we use in the NOVA vet tech program
Contains - Database (Client and patient information; Hx (current history, chief presenting complaint, and previous history); PE findings; Pertinent test results (radiography, special imaging, and laboratory reports)); Master Problem and Working Problem Lists; Initial Plan and Progress Notes (Progress forms that include SOAP notes for each problem; Treatment-related forms, medication administration/order record (MAOR) forms, surgical reports, and anesthesia forms); Case summary and discharge instructions
SOAP - Subjective: Non-measurable information ( behavior, FAS score, information from the owner, information from the previous veterinarian, etc); Objective: Measurable information (Weight, temperature, HR/RR/CRT, diagnostic test results, physical exam (some hospitals may use this as subjective, but for our purposes for vet 105 we will use this in the objective section); Assessment: Analysis of Subjective and Objective. (LVT focus: List of patient evaluations that reflect the animal’s physical, psychological, social, and environmental conditions (ex: hypertension, pruritus, tachycardia, hypovolemia, hyperthermia, anxiety, etc).); Plan: LVT develops an intervention for each of the evaluations listed in the assessment portion of the SOAP note. (ex: CE, Rx (ordered by DVM), “at home” instructions, and follow-up appointments); Surgery information, anything done to the patient in hospital; Notations: Any incoming information that is entered in the progress notes but is independent of the SOAP
Client and patient info - Name/contact information (mailing address, home, cell, office phone numbers; email address) (For Sx/Admit For Day, ideal to have client’s schedule.); Patient Identification/Signalment (WHAT IS INCLUDED IN THE SIGNALMENT? - Species, breed, age, sex, and spayed/neutered status); Patient identification (Color and markings, tattoo, microchip, name of the animal)
**source oriented vet med record (SOVMR)
Patient information is kept together by subject matter.; Most recent information is located last and the oldest information is found first.; Easy to learn; takes little time to complete; May lack detailed documentation; Complicated organization, especially if referred to another department within the hospital
Organized by subject matter; Lab reports, Physical exam findings, client communication; Difficult to follow and monitor a patient
MOAR
Medication Administration/Order Record → Ward Tx Sheet; Ensures hospitalized patients are given appropriate Tx, Rx, diet, Dx tests as requested by attending DVM; Dates, times, doses, methods of administration, cautionary notes written for each medication; Patient’s name, ID, signalment, allergies should be listed; Each MAOR should be written just as the DVM wrote it. CLARIFY IF NOT CLEAR!; Person administering Tx initials when Tx given; Mark when Tx not given (NG) and notify attending DVM; Chart when medication given with an “X,” and “Discontinued” if it is discontinued
pericardium
The pericardium is a double-walled membrane that surrounds the heart. (Peri- means around.); The pericardium has two layers: (fibrous layer; serous layer (parietal layer: serous layer that lines the pericardium; visceral layer (aka: epicardium): the serous layer that lines the heart.); Pericarditis- inflammation of the pericardium
The pericardial space is the space between the two serous layers of the pericardium. - This space contains pericardial fluid. (Pericardial fluid prevents friction between the heart and the pericardium when the heart beats.); Terminology → pericardial effusion is fluid in this sac; Cardiac tamponade- buildup of fluid in the pericardium resulting in compression of the heart
management of computerized MR
Digital records are easy to change, so it is important that a historical account of the electronic medical record be automatically collected and stored in the data management system.; Some software programs will allow the veterinary health care team to make entries into a patient record and to make changes to those entries within the first 24 to 48 hours of patient care; this is considered the primary document. (After this period of time the system records the date and time of all subsequent changes and maintains a copy of the primary document)
**blood supply to the heart
what does infarct mean?
The arteries that serve the heart are known as the coronary arteries (they resemble a crown); Coron/o is the combining form meaning crown.; The coronary veins remove waste products from the myocardium.
What happens if one of these vessels occlude? Ischemia; Coronary occlusion ischemia necrosis infarct; Infarct= a small localized area of dead tissue resulting from failure of blood supply
electrical signals of the heart
Sinoatrial node (SA node) is located in the right atrial wall and initiates the heart rhythm. (Is termed the pacemaker of the heart); Atrioventricular node (AV node) is located in the interatrial septum and receives impulses from the SA node. (Sends impulses to the bundle of His); Bundle of His is located in the interventricular septum and continues through the ventricle as the ventricular Purkinje fibers (Purkinje fibers carry impulses through the ventricular muscle, causing the ventricles to contract; Bundle branch block)
heart sounds
Auscultation is listening to body sounds with a stethoscope.; When the heart is auscultated, a lub/dub sound is heard. (lub = closing of the atrioventricular valves (tricuspid and mitral); dub = closing of the semilunar valves (pulmonary and aortic)); Murmur = abnormal sound associated with turbulent blood flow (Where the murmur is heard the loudest is the point of maximal intensity (PMI))
what is the only non-oxygenated artery
pulmonary artery
**systole
asystole
diastole
arrhythmia
bradycardia
tachycardia
normal sinus arrhythmia
gallop
preload
afterload
Systole: contraction
Asystole: without contraction
Diastole: relaxation of ventricles (filling of the ventricles)
Arrhythmia: abnormal heart rhythm (also known as dysrhythmia)
Bradycardia: abnormally slow heartbeat
Tachycardia: abnormally fast heartbeat
Normal sinus arrhythmia: irregular heart rhythm resulting from variation in vagal nerve tone as a result of respiration (a non-pathologic arrhythmia)
Gallop: low-frequency vibrations occurring during early diastole and late diastole.
Preload: Ventricular end-diastolic volume
Afterload: The pressure in the wall of the left ventricle during ejection
**syncope
cardiac tamponade
cardiomegaly
cardiomyopathy
dirofilariosis
embolus
embolism
endocarditis
hemangioma
hemangiosarcoma
Syncope - loss of consciousness for short period of time
Cardiac tamponade - fluid buildup in space around heart putting pressure on heart and preventing it from pumping well
Cardiomegaly - enlarged heart
Cardiomyopathy - disease of heart muscle
Dirofilariosis - heartworm
Embolus - Any foreign material that moves with blood flow to a different site
Embolism - The phenomenom of blockage of arterial or venous blood flow
Endocarditis - Inflammation of heart’s inner lining; Usually due to infection
Hemangioma - Benign tumor of blood vessel origin
Hemangiosarcoma - highly malignant cancer arising from cells that normally create blood vessels
