Resp sx

Question 1

what are the C/S for a nasal obstruction?

Answer 1

nasal d/c, sneezing, epistasis (uni or bilateral), stertorous inspiration

Question 2

what are the C/S for an elongated soft palate?

Answer 2

stertorous breathing, inspiratory stridor, resp distress, cyanosis, collapse

Question 3

what are the C/S for laryngeal collapse?

Answer 3

stertor, stridor, coughing, gagging, dyspnea, regurg, vomiting, exercise intolerance, syncope/collapse

Question 4

what are the C/S of laryngeal paralysis?

Answer 4

change in voice/phonation, gagging/coughing, exercise intolerance, inspiratory stridor, dyspnea, cyanosis, syncope/collapse

Question 5

what are the C/S for a tracheal obstruction?

Answer 5

cough, dyspnea, cyanosis, collapse

Question 6

what surgical solutions do you have for upper airway diseases?

Answer 6

• create a bigger opening: open nares, turbinates , shorten soft palate, pexy the epiglottis, tie back the larynx
• bypass the upper airway completely (tracheostomy): only if the above doesn’t work

Question 7

what are the C/S for tracheal rupture?

Answer 7

subq emphysema, anorexia,. lethargy, stridor, coughing

Question 8

what are the C/S for tracheal collapse?

Answer 8

honking goose cough, dyspnea (waxing/waning), exercise intolerance, cyanosis, syncope/collapse

Question 9

what can you do surgically to treat tracheal disease?

Answer 9

do something to keep the trachea open, bypass the upper airway completely with tracheostomy, otherwise resect and anastomose

Question 10

what are the C/S for consolidated lung lobe and abscesses?

Answer 10

resp distress (varying degrees), low grade fever, exercise intolerance

Question 11

what are the C/S for bronchiectasis?

Answer 11

cough, repeated bouts of pneumonia

Question 12

what are the C/S for lung lobe torsion?

Answer 12

dyspnea, tachypnea, lethargy. cough, hemoptysis

Question 13

what are the C/S for pulmonary neoplasia?

Answer 13

increased resp effort, exercise intolerance, cough

Question 14

what are the solutions for lower airway diseases surgically?

Answer 14

cut what ever is causing disease out and remove it

Question 15

what are the C/s for pleural space disease

Answer 15

depends on vol and rapidity of fill

restrictive breathing pattern (rapid and shallow to maintain minute vol)

rapid onset

Question 16

how can you treat pleural space disease surgically?

Answer 16

drain the air/fluid and treat inciting cause

Question 17

what does BOAS stand for?

Answer 17

brachycephalic obstructive airway syndrome

Question 18

what are the factors involved in BOAS?

Answer 18

• stenotic nares
• aberrent turbinates
• elongated, thickened soft palate
• oversized tongue
• everted laryngeal saccules
• hypoplastic trachea
• laryngeal collapse, tracheal collapse

Question 19

what are the C/S of BOAS?

Answer 19

• resp noise
• stenotic nares
• GI signs (difficulty swallowing, regurg, gastroesophageal reflux)
• obstructive sleep apnea
• heat intolerance
• cyanosis and collapse

Question 20

how do you diagnose BOAS?

Answer 20

• PE
• laryngoscopy/endoscopy
• CT, rads

Question 21

how do you manage BOAS?

Answer 21

• weight mgmt
• avoid overheating
• open nares (rhinoplasty)
• open turbinates (endoscope guided turbinectomy)
• shorten soft palate (staphylelctomy) or also thin it (folded flap palatoplasty)
• partial tonsillectomy
• laryngeal sacculectomy
• ongoing observation…

we do not cure BOAS!!!!!

Question 22

what are the risks of BOAS treatment?

Answer 22

post-op airway inflammation/swelling

aspy pneu pneu

Question 23

what is a hiatal hernia?

Answer 23

when stomach herniates through diaphragm (alongside esophagus in esophagus hiatus) into the thoracic cavity

Question 24

what is the general pathophys of laryngeal paralysis? who gets it?

Answer 24

typically older large breed dogs, idiopathic acquired

vagus –> recurrent laryngeal nerve –> caudal laryngeal nerve

cricoarytenoideus dorsalis (CAD) fails to abduct the arytenoid cartilage

problem when bilateral

Question 25

what are the C/S of lar par? (laryngeal paralysis)

Answer 25

- change phonation, gagging/coughing esp when E/D - exercise intolerance - heat intolerance - laryngeal stridor - acute dyspnea - cyanosis, syncope - regurg (megaesophagus) progressive disorder

Question 26

how do you diagnose lar par (laryngeal paralysis?)

Answer 26

rads laryngoscopy under light plane anesthesia

Question 27

how do you manage laryngeal paralysis? lar pars

Answer 27

- cooling, O2 therapy, anxiolytics - emergency tracheostomy - mild: weight loss, stress reduction, exercise restriction, avoid heat (progression) - mod/severe: **unilateral cricoarytenoid lateralization** (unilateral "tie-back") we do not sure lar par :(

Question 28

what are the risks for lar par intervention?

Answer 28

- GOLPP (geriatric onset laryngeal paralysis polyneuropathy) - aspy pneu pneu = life long risk

Question 29

tracheostomy can be used for any obstruction... where?

Answer 29

forward of larynx BOAS, laryngeal collapse, lar par, granulomas

Question 30

what can you do to surgically treat tracheal collapse? what should you do first?

Answer 30

first, try medical management!!! stending (intraluminal > extraluminal) dogs with severe, refractory tracheal collapse benefit from earlier stenting malformation type collapse is more likely to require tracheal stenting

Question 31

what is spontaneous pneumothorax?

Answer 31

leakage of air from lung without evidence of trauma

Question 32

what are the C/S of pneumothorax?

Answer 32

mild: asymptomatic mod/severe: restrictive breathing pattern, hypoventilation, diminished lung sounds can be fatal

Question 33

how do you diagnose pneumothorax

Answer 33

- PE - rads (once stable) - CT (?)

Question 34

how do you tx pneumothorax?

Answer 34

- thoracocentesis - thoracostomy tubes for animals requiring ongoing drainage - continuous suction - autologous blood patch? [last ditch effort, fibrin from this "helps"] - surgery

Question 35

pyothorax: 1. typical signalment? 2. what type of bac t?

Answer 35

1. young. hunting/working breed dogs over represented 2. obligate anaerobes or mix of obligate and facultative anaerobes; bac t tend to reflect oral cavity and URT

Question 36

what are the C/S of pyothorax?

Answer 36

tachypnea, dyspnea, cough, lethargy, weight loss, anorexia, restrictive breathing pattern, muffled breath & heart sounds may be afebrile SIRS, sepsis... often often fatal

Question 37

how do you diagnose pyothorax?

Answer 37

- thoracocentesis --> cytology - imaging

Question 38

how do you medically treat pyothorax?

Answer 38

- drainage and Abx (fluoroquinolone & penicillin or clindamycin to start, then based on C&S) - thoracic drainage - thoracic lavage??

Question 39

when/why do you surgically treat pyothorax?

Answer 39

- primary cause that requires surgical resection - thoracostomy tube complications - failure of medical mgmt

Question 40

how do you surgically treat pyothorax?

Answer 40

medial sternotomy

Question 41

what is the most common cause of diaphragmatic hernias? what organ is most commonly included in the hernia?

Answer 41

trauma liver

Question 42

what are the C/S of diaphragmatic hernias?

Answer 42

resp distress, exercise intolerance, potentially GI signs, muffled heart sounds, lung sounds, borborygmi depends on what is herniated and state that organ is in

Question 43

how do you diagnose diaphragmatic hernia?

Answer 43

rads or US

Question 44

how do you correct a diaphragmatic hernia?

Answer 44

- surgery *ASAP* in stable pt (hernias trump fx) - hernia reduction (abdominal approach)

Question 45

what does PPDH stand for?

Answer 45

peritoneopericradial diaphragmatic hernia

Question 46

PPDH's are ____. what are they? what is the typical signalment involved?

Answer 46

congenital gap in ventral diaphragm such that pericardial sac and peritoneal cavity communicate Weimaraners and long haired cat breeds, any age

Question 47

what are the clinical signs ofperitoneopericradial diaphragmatic hernias?

Answer 47

GI, CV, resp signs muffled heart sounds, borborygmi

Question 48

how do you diagnose PPDH?

Answer 48

rads or US

Question 49

how do you manage PPDHs?

Answer 49

asymptomatic incidental: conservative mgmt midline ceiliotomy