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SAMS 1 > Lecture 25: Upper Airway and Pulmonary Parenchymal disease > Flashcards

Lecture 25: Upper Airway and Pulmonary Parenchymal disease Flashcards

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1
Q

What is considered upper airway

A

Nose to larynx

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2
Q

what is considered lower airway

A

trachea to alveoli

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3
Q

describe Stridor

A

continuous high pitched noise due to restriction of airflow

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4
Q

what phase of respiration is stridor heard

A

inspiratory most commonly but can be both

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5
Q

where does stridor localize to

A

larynx or extra thoracic trachea

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6
Q

stridor Is exacerbated with __ and __

A

exercise, panting

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7
Q

describe stertor

A

discontinuous low pitched sound

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8
Q

think _ and __ with stertor

A

snoring, brachycephalics

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9
Q

Stertor is more pronounced at

A

rest

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10
Q

describe crackles

A

discontinuous popping sounds most audible during inspiration

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11
Q

popping in crackles=__

A

alveoli opening

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12
Q

what causes crackles

A

due to fluid in alveoli leading to decreased surface tension—> collapse

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13
Q

what diseases is crackles associated with

A

lower airway disease; bronchopneumonia, pulmonary edema, pulmonary hemorrhage, pulmonary fibrosis

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14
Q

describe wheezes

A

continuous low volume high pitched sound on expiration

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15
Q

what are some diseases associated with wheezes

A

asthma, chronic bronchitis

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16
Q

if you hear no resp sounds ventrally what wrong

A

fluid accumulation

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17
Q

if you hear no resp sounds dorsally what wrong

A

air accumulation- pneumothorax

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18
Q

what is an obstructive respiratory pattern

A

increased airway resistance or pressure necessary to generate airflow

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19
Q

What are some causes of obstructive breathing pattern

A
  1. Extrathoracic obstruction- laryngeal mass, laryngeal paralysis, nasal/nasopharyngeal mass
  2. Intrathoracic obstruction- asthma/bronchitis, mucus plug, intrathoracic tracheal collapse
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20
Q

if there is an extrathoracic obstruction causing obstructive resp pattern what phase of respiration is affected

A

increase inspiratory effort, time and noise

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21
Q

if there is an intrathoracic obstruction causing obstructive resp pattern what respiratory phase is affected

A

increase expiratory effort, time and noise

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22
Q

what is a restrictive resp pattern

A

decreased lung compliance/difficulty expanding lungs during inspiration

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23
Q

what are some diseases associated with restrictive resp pattern

A

bronchopneumonia, pulmonary fibrosis, pleural space disease, neoplasia

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24
Q

what is breathing like with restrictive resp pattern

A

rapid and shallow breathing, increased inspiratory and expiratory effort

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25
what are the 5 mains causes of hypoxemia
1. Low FIO2 2. Hypoventilation 3. Diffusion impairment 4. Ventilation/perfusion mismatch (V/Q mismatch) 5. Pulmonary shunting
26
what are some examples that can cause low FIO2
1. High altitude 2. Anesthetic accident 3. Suffocation
27
what are some causes of hypoventilation
1. Resp depression 2. Neurologic disease 4. Upper airway obstruction
28
what is clue for hypoventilation causing hypoxemia
high PaCO2 with normal CXR
29
what is cause of diffusion impairment
pulmonary Fibrosis
30
what is clue that pulmonary fibrosis causing hypoxemia
severe interstitial pattern on CXR
31
what are some causes of V/Q mismatch
1. Pneumonia 2. Pulmonary edema 3. PTE
32
what is clue for V/Q mismatch
most common cause of hypoxemia
33
what is cause of pulmonary shunting leading to hypoxemia
right to left shunt (PDA, TOF)
34
what is clue that pulmonary shunting causing hypoxemia
failure to improve with O2 supplementation
35
what is pulse ox measuring
oxygen saturation of Hgb
36
what is normal SPO2 and PaO2
SPO2: 95-100% PaO2: >80
37
what SPO2 is consider mild to moderate hypoxemia
91-94%
38
what SPO2 and PaO2 is considered severe hypoxemia
SPO2: <90% PaO2: <60
39
oxygen cage you are able to control __, __ and __
FIO2, temp and humidity
40
identify 1-4
1. Corniculate process 2. Cuneiform process 3. Vocal folds 4. Epiglottis
41
laryngeal paralysis is an upper airway __disease
obstructive
42
what breed is congenital laryngeal paralysis most common in
bouviers des Flanders
43
what breed is acquired laryngeal paralysis most common in
lab
44
what are causes of acquired laryngeal paralysis
1. Idiopathic 2. Geriatric onset laryngeal paralysis polyneuropathy
45
what are some signs of laryngeal paralysis
1. Stridor 2. Exercise intolerance 3. Voice change 4. Cough 5. Gagging 6. Dysphagia
46
what is tx for acute crisis of laryngeal paralysis
1. O2 2. Steroids- Dex-SP 3. Sedatives- butorphanol, ace 4. Cooling 5. +/- intubation o temp tracheostomy
47
what is medical management for laryngeal paralysis
weight loss, sedatives to decrease excitement, decrease exercise, avoid heat
48
what is sx tx for laryngeal paralysis
unilateral arytenoid lateralization
49
what wrong in pic on right
epiglottal retro version/ entrapment
50
what are most common clinical signs for epiglottal retroversion/ entrapment
1. Stridor 2. Dyspnea
51
what is sx tx for epiglottal retroversion/ entrapment
epiglottopexy +/- subtotal epiglottectomy
52
what is medical management for epiglottal retroversion/entrapement
Cough suppressants, steroids, sedatives
53
what is pulmonary compliance
ability of lungs to expand
54
what diseases can cause decrease pulmonary compliance
1. Pneumonia 2. Pulmonary edema 3. Pulmonary fibrosis 4.pneumothorax
55
what disease can cause increased pulmonary compliance
emphysema
56
Bacterial pneumonia is secondary disease what things can lead to it
immunosuppression, aspiration, viral, age, recumbency
57
what are some signs of bacterial pneumonia
cough, nasal d/c, exercise intolerance, resp distress
58
what does CBC for bacterial pneumonia show
neutrophilia
59
what do thoracic rads show with bacterial pneumonia
alveolar pattern with ventral distribution most common
60
what lung lobes with aspiration pneumonia/ bacterial pneumonia are most common
right middle and right cranial
61
how do you definitively dx bacterial pneumonia
airway wash- cytology and culture
62
what is tx for mild bacterial pneumonia
1. Clavamox 2. Doxycycline if dog exposure
63
what Is tx for moderate bacterial pneumonia
1. Clavamox or clindamycin 2. Fluoroquinolone (Enro-dogs, prado-cats)
64
what is tx for severe bacterial pneumonia
1. Clavamox 2. Fluoroquinolone 3. Meropenem 1. Fluoroquinolone 2. Aminoglycosides
65
t or f: cough suppressants are useful for bacterial pneumonia
false! Do not use
66
how long tx for bacterial pneumonia
10-14 days
67
what are some causes of viral pneumonia in dogs
distemper, influenza, parainfluenza, coronavirus, canine infectious hepatitis, herpes
68
what are some causes of viral pneumonia in cats
herpes, FIP, calicivirus
69
How do you dx viral pneumonia and what are their limitation
1. Serology- difficult to differentiate from vaccine and false negative in early disease 2. PCR: only positive when viral shedding
70
what is tx for viral pneumonia
1. Time and support 2. Isolation
71
what are some examples of non-lungworms that travel through lungs
1. Toxocara (roundworms) 2. Ancylostoma (hookworms)
72
how do dogs get lungworm- Paragonimus kellicotti
eating crayfish
73
what is pathogenesis in body for P. Kellicotti
GI—> peritoneum—.> cross diaphragm—> pleural space—> pleural parenchyma—> cough and swallow
74
what do you see on CXR with P. Kellicotti
cysts or bullae that can lead to pneumothorax or hemoptysis
75
where does filaroides reside
alveoli and terminal bronchi
76
t or f: filaroides can be spread from dog to dog
true
77
how do you dx P. Kellicotti and filaroides
PK: sedimentation F: zinc sulfate float
78
what is tx for P. Kellicotti and filaroides
PK and F: fenbendazole PK: praziquantel
79
what causes pulmonary edema
1. Increase hydrostatic pressure 2. Decrease oncotic pressure 3. Increase vascular permeability 4. Impaired lymphatic drainage
80
what are some causes of non-cardiac pulmonary edema
1. Seizures 2. Electrocution 3. Drowning 4. Low protein 5. Airway obstruction 5. Vasculitis 6. Pneumonia 7. Lung lobe torsion
81
what are some signs of mild and severe pulmonary edema
mild: exercise intolerance, increase RR, cough Severe; resp distress, increase RR, cyanosis
82
what do you hear on auscultation with pulmonary edema
harsh and loud bronchovesicular sounds +/- crackles
83
what do chest rads show with pulmonary edema
interstitial to alveolar pattern Caudo-dorsal most common
84
what is tx for pulmonary edema
1. Time 2. Oxygen if SPO2 <94%
85
what should you not use in tx of pulmonary edema
1. Abx 2. Steroids 3. Furosemide

SAMS 1 (26 decks)

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