L22: Respiratory and Thoracic Surgery (Morton) Flashcards Preview

Surgery (Spring 2015) > L22: Respiratory and Thoracic Surgery (Morton) > Flashcards

Flashcards in L22: Respiratory and Thoracic Surgery (Morton) Deck (17):
1

roles of respiratory tract

-olfaction
-phonation (producing sound)
-thermoregulation
-filtering and conditioning air
-preventing aspiration

2

R ~

1/r^4
*a small decrease in radius has a huge effect on ability to breathe*

3

URT diagnostic techniques

-exercise intolerance
-abnormal respiratory noise (inspiratory v. expiratory)
-nasal discharge
-halitosis
-anatomical distortions (swelling, bony abnormalities, m. atrophy)
-cough
-dysphagia
-fever, inappetence, weight loss
-PE: assess anatomy, nasal d/c and flow, ocular discharge, percussion of sinuses, scars, thorough thoracic auscultation, oral exam
-imaging

4

Imaging: endoscopy

-resting and/or high speed treadmill to assess dynamic dysfunctions
-evaluate: nasal passages, nasopharynx, larynx, guttural pouches, cervical trachea, nasal occlusion, swallow reflex, slap test

5

Imaging: Radiography

+/- contrast
-metallic markers for magnification
-evaluate: pharynx, larynx, trachea, guttural pouches, paranasal sinuses, dental arcades
-superimposition
-fluoroscopy: "dynamic" radiography

6

Imaging: Computed Tomography

-eliminates superimposition
-superior for dental arcades and paranasal sinuses

7

Imaging: MRI

-ST and bone detail
-differentiation of tumors
-less commonly performed in animals; expensive

8

components of URT

-nasal passages
-paranasal sinuses
-pharynx
-larynx
-guttural pouches
-trachea

9

components of nares (nostrils)

-alar cartilages
-alar fold
-nasal diverticulum

10

components of nasal cavity

nasal septum
dorsal and ventral concha
dorsal, middle, ventral meatus
nasomaxillary opening
ethmoid turbinates

11

dz of the nares and nasal cavity

epidermal inclusion cysts (atheromas)
redundant alar folds
diseases of the nasal septum (cystic, neoplastic, traumatic)

12

anatomy of paranasal sinuses

paired sinuses
dorsal conchal
ventral conchal
sphenopalatine
frontal
maxillary (rostral and caudal)
size and shape change w/ age
all communicate directly or indirectly`

13

diseases of the sinuses

Sinusitis
Progressive Ethmoid Hematoma
Paranasal Sinus Cyst
Neoplasia
Trauma (wounds/fractures)

14

Sinusitis

-1ary (caused by URT infection) or 2ary (dental dz, mass, trauma, etc.)
-localized or extensive
-dx via Hx, PE, endoscopy, rads, CS, CT

15

tx of 1ary sinusitis

irrigation
abx
+/- surgical debridement

16

tx of 2ary sinusitis

address 1ary cause
sx then tx as 1ary

17

Progressive Ethmoid Hematoma

-progressive tumor-like mass
-lies in ethmoid labyrinth or floor of sinus
-mild, intermittent epistaxis, usually unilateral
-horses >6yo
-endoscopy, rads, CT
-intralesional 10% formalin, surgical removal via sinus flap (or LASER photoablation)
-recurrence can occur