Resp.&Thoracic SX- LA

Question 1

What is the primary source of upper airway resistance.

Answer 1

Nasal valve, rostral nasopharynx & larynx

• oral cavity has tremendous resistance

Question 2

What are 2 signs of upper airway dysfunction?

Answer 2

1. Poor performance (d/t decreased ventilation)

2. Increased noise (dt increased turbulence)

Question 3

Aside from a resting endoscopy, how can you gauge laryngeal function at rest?

Answer 3

Nasal occlusion

Swallow reflex

Slap test (slap wither while feeling muscular process)

Question 4

What are you evaluating with an exercising endoscopy?

Answer 4

Dynamic dysfunction (high speed treadmill or overground)

Question 5

What age is sinoscopy not useful?

Answer 5

Young horse because teeth in the maxillary sinus

Question 6

Diagnostics- rads

Answer 6

Observe paranasal sinuses and dental arcade

Question 7

Diagnostics- US

Answer 7

Laryngeal US (muscular atrophy & abnormal anatomy) 
- Bone limits other locations

Question 8

Diagnostics- CT

Answer 8

Method of choice for dental arcades &paranasal sinus

No superimposition

Question 9

What causes flow artifact in MRI?

Answer 9

Blood flow from large vessels

Question 10

What is a false diverticulum in horse nare?

Answer 10

Alar fold

Question 11

Can you see redundant alar folds on endoscope?

Answer 11

No, because not in nostril

Its often in standard breeds

Question 12

Horners syndrome in horses

Answer 12

Engorged nasal mucosa limits airflow

Question 13

Wry nose

Answer 13

Occurs when maxillary and mandibular teeth dont line up

Often does not need surgery if can still eat/drink

Question 14

Where do all sinus drain?

Answer 14

Into nasal cavity via nasomaxillary aperture/ middle meatus

Question 15

Primary and secondary cause of paranasal sinuses?

Answer 15

Primary- strep spp.
Secondary- dental dx, mass, trauma

DX: endoscopy or rads (fluid line)

Question 16

Landmarks for trepination:

Answer 16

Frontal- midline to medial canthus

Caudal maxillary sinus- ventral to medial canthus

Rostral Maxillary Sinus- can use rads to find

Question 17

Paranasal sinus:

Answer 17

When enlarged see facial deformation +/- airway obstruction

Curative with surgical debridement

Good prognosis, but for athlete depends on nasal passage distortion

Question 18

Sinus neoplasia

Answer 18

MC SCC

Causes facial deformity in older horses +/- airway obstruction

Tx: debridement, radiation and chemo

PX: poor

Question 19

Progressive ethmoid hematoma

Answer 19

CS: mild epistaxis (unilat),
Rare- facial deformity &airway obstruction

Tx: intralesional formalin, laser photoablation, sx removal

Question 20

Does the pharynx have rigid support?

Answer 20

No

Question 21

What is lymphoid hyperplasia?

Answer 21

Occurs in young horses dt immune stimulation

-usually no CS or TX needed

Question 22

Dorsal displacement of the soft palate

Answer 22

Intermittent > persistent (rest)

Key: noise during expiration!

Dx: exercising endoscopy (intermittent) or resting endoscope (Persistent)

TX: laryngeal tie forward

Question 23

Recurrent laryngeal neuropathy

Answer 23

Demyelination and axonopathy of RLN, causing paralysis of intrinsic laryngeal muscle [CAD]

CS: inspiratory obstruction & noise at exercise

MC: left side and large horse (draft, TB)

DX: resting endoscopy & laryngeal US

Question 24

What is the sx treatment for RLN?

Answer 24

Prosthetic laryngoplasty (tie-back)

Question 25

Guttural pouch mycosis

Answer 25

Focal fungal infection (aspergilus sp.) targeting arteries and nerves—> hemorrhage/life threatening (50% die)

CS: epistasis, horners, nasal discharge (pus)

DX: scope