Flashcards in Respiratory Deck (113):
Nasal discharge is commonly seen with which type of airway disorder, upper or lower?
Sneezing and reverse sneezing are often seen with which type of respiratory disorder, upper or lower?
Coughing is a hallmark sign of what 2 types of disorders?
- Lower respiratory
- Heart disease
What are 3 audible sounds that can be heard with an upper respiratory disorder?
Respiratory distress is seen with which type of airway disorder, upper or lower?
An inability to breathe easily if mouth is closed is seen with which type of respiratory disorder, upper or lower?
With lower airway disorders, is there an increased effort seen on inspiration or expiration?
Pawing at the face can be a sign of which type of respiratory disorder, upper or lower?
What is almost always seen with nasal cavity disease?
What are 2 examples of pulmonary parenchymal diseases where mucopurulent nasal discharge can be seen?
- Eosinophilic bronchopneumopathy
What are 3 examples of systemic coagulopathies with which bloody nasal discharge can present?
- Warfarin toxicity
- Pulmonary thromboembolism (PTE)
What are 4 types of nasal discharge?
What are 3 questions to ask when characterizing nasal discharge?
- Uni- or Bi- lateral?
- Changes over time?
Acute nasal discharge is often accompanied by what?
What are 6 assessments that should be performed when examining an animal with nasal discharge?
- Nasal airflow
- Ocular retropulsion
- Depress soft palate
- Regional lymph nodes
- Oral examination
What are 2 techniques that can be used to examine nasal airflow?
- Glass slide technique
- Wisp of cotton technique
What type of regional lymph nodes are examined when nasal discharge is present?
An oral exam might uncover what possible cause of nasal discharge?
Sneezing localizes disease to where?
What is considered a protective mechanism of the upper airway?
What type of dogs are more pre-disposed to reverse sneezing?
Small breed dogs
Loud breathing can localize an obstruction to what two general areas?
- Nasal cavity
- Upper airway
A "gurgling or snoring" sound is known as what?
Stertor is caused by rapid air flow past what type of obstruction?
"Soft tissue" obstruction
Narrowing of the nasal cavity, elongated soft palate and edematous or everted laryngeal saccules can all cause what type of respiratory sound?
A high pitched noise or whine usually heard on inspiration is known as what?
Expiratory stridor can occur with what condition?
Intrathoracic tracheal collapse
Is stridor more commonly heard on inspiration or expiration?
Stridor is caused by rapid air flow past what type of obstruction?
Laryngeal paralysis and nasopharyngeal stenosis can cause what respiratory sound?
It may be necessary to auscult over the neck region to hear which respiratory sound?
Can laryngeal paralysis be life threatening?
What is considered a hallmark of trachea/lung disease (lower airways) or cardiac failure?
What 4 things are used to distinguish between the two?
- Signalment, history, PE findings, thoracic radiography
Pneumonia and emphysema are 2 examples of what type of respiratory disease?
Pulmonary parenchymal diseases
A forceful expiratory effort is known as a what?
What are 3 possible triggers of a cough?
- Inflammatory products of neutrophils or eosinophils
- Excessive secretions
- Airway collapse
What are the 2 general classifications of a cough?
- Dry, non-productive
- Moist, productive
How can a cough be determined non-cardiogenic?
Absence of cardiac enlargement on thoracic radiographs.
If thoracic radiographs show abnormal lungs, what 2 areas should be looked at?
- Lower airways
- Pulmonary parenchyma
If thoracic radiographs show normal lungs, what area of the respiratory tract should be examined?
A human term describing difficult or labored breathing is known as what?
Conscious perception of "air hunger" is seen with what type of respiratory distress?
Is dyspnea considered an ideal term for animal patients?
An increase in respiratory rate that may or may not be associated with distress is known as what?
Tachypnea should not be confused with what?
What is a breathing pattern that dispels heat?
What are 3 possible meanings of panting?
- Heat not distress
- Respiratory distress
- Stress in cats
With which respiratory condition can an animal can only breathe in an upright position with elbows abducted?
What type of lung diseases are associated with orthopnea?
Respiratory distress is associated most often with what type of airway diseases?
Lower airway diseases
What is an example of an upper airway disease in dogs where respiratory distress is experienced?
Bilateral laryngeal paralysis
What is an example of insufficient oxygen in inspired air causing respiratory distress?
What is an example of insufficient ventilation that can cause respiratory distress?
Pulmonary parenchyma disease
What is an example of insufficient circulation causing respiratory distress?
What is an example of insufficient RBCs that can cause respiratory distress?
What is a source of abnormal hemoglobin that can cause respiratory distress?
Not enough oxygen = what?
What does cyanosis indicate?
What are 5 possible causes of cyanosis/hypoxemia?
- Lack of oxygen: upper or lower airways
- Abnormal hemoglobin: toxins
- Heart disease
- Lung disease
- Potentially fatal event, such as the stopping of heart and lung function (cardiopulmonary arrest)
An increased inspiratory effort would indicate what 2 possible causes?
- Upper airway obstruction
- Pleural disease
An increased expiratory effort could be caused by what?
Lower airway obstruction
Shallow breaths with an increase in respiratory rate and effort indicate what?
What type of posture is often associated with this?
- Restrictive pattern associated with lung parenchymal or pleural disease
- Orthopneic posture
Discordant motions of the chest and abdominal muscles are known as what?
Flail chest or respiratory muscle fatigue
What should be checked for with an upper airway obstruction?
Which lung sound is loudest over the hilus?
Which lung sound is best heard on inspiration at the periphery of the chest?
Which normal lung sound resembles the "wind blowing"?
Which normal lung sound resembles the "rustling of leaves"?
When are bronchial sounds heard the loudest?
A mixture, but mostly expiratory sounds that increase in intensity at central airway area are known as what?
The snapping open of airways that have closed due to fluid either in or around them cause what abnormal lung sound?
Which abnormal lung sound resembles "rice krispies"?
Which abnormal lung sound is caused by airflow through a narrow opening?
When are wheezes usually heard?
A loud snap over the hilus at the end of expiration indicates what?
Collapse of the intrathoracic trachea, carina or main stem bronchi
What type of sound indicates a tracheal collapse?
"Goose honks" or "kazoo"
When roughened pleural surfaces are rubbing against each other what abnormal lung sound is created?
Creaking/grating sounds (bed springs)
What is most important diagnostic test for signs of respiratory system disease in many cases?
What needs to be done before rads are taken for respiratory system disease?
Patient needs to be stabilized.
What has become the standard for evaluation of nasal cavity and paranasal sinuses?
What are 3 indications for a nasal flush?
- Foreign body suspect
- Cleanse airways prior to rhinoscopy
- Obtain samples for cytology
What needs to be used with a nasal flush?
General anesthesia and cuffed endotracheal tube
When flushing saline into one nostril for a nasal flush, what needs to be done with the other one?
It needs to be held closed with a finger.
What position should cats be put in for a nasal flush?
Dorsal recumbency with a small rolled towel placed under the neck.
What type of catheter should be used of antegrade and retrograde flushes?
What are 3 limitations of using an otoscope for examining a nasal cavity?
How do you enter the nare with a rhinoscope?
- In a medial and dorsal direction
- Otherwise end up in a blind pouch
What is an advantage on a rhinoscope?
Can see and biopsy abnormal areas
What needs to be put on the biopsy forceps when performing a blind biopsy?
- So cribiform plate will not be penetrated
What part of the respiratory tract is examined with bronchoscopy?
Lower respiratory tract
What are 3 things that bronchoscopy can help with the diagnosis of?
- Collapsing trachea
- Foreign Body
When is bronchoscopy contraindicated?
What is the exception?
- Severe respiratory tract compromise
- Unless it is therapeutic (ex. removal of foreign body)
What are 3 indications for the use of bronchoalveolar lavage (BAL)?
- Small airway lung disease
- Alveoli lung disease
- Lung disease involving interstitium
What can be used to sample specific disease lung lobes?
Bronchoalveolar lavage (BAL)
Transtracheal washes and aspirates are used in what size dogs?
Medium-larger breed dogs
What is the anatomical landmark that can be felt through palpation for a transtracheal wash?
Endotracheal or transoral washes are used in what size animals?
Cats and tiny dogs
General anesthesia is required for what type of wash?
Endotracheal or transoral
How is an endotracheal or transoral wash administered?
Catheter down an ET tube
What are 2 indications for a transthoracic lung aspiration?
- Intra-thoracic mass lesions in contact with thoracic wall
- Diffuse disease
What can improve the diagnostic yield and safety of a transthoracic lung aspiration?
What are 3 possible complications of a transthoracic lung aspiration?
- Pyothorax later on
What is a contraindication of a transthoracic lung aspiration?
Should a transthoracic lung aspiration be taken during inspiration or expiration?
What is a technique that can be used for removing pleural effusion and air from the thoracic cavity?
What is used in the treatment of pyothorax?
What can be used for the management of pneumothorax when air is continually accumulating?
What are 4 things to consider when choosing an antibiotic to treat a respiratory condition?
- What oraganisms are likely?
- What antibiotics penetrate respiratory tissue?
- Which part of the respiratory system are you treating?
- Which species of animal are you treating?
What are bronchodilators usually used for?
What is used mainly in dogs with a dry and non-productive cough due to airway collapse or irritant tracheitis?
When should it be avoided?
- Avoid with moist coughs
What can improve hydration of the lower airways?
Nebulization followed by coupage
What are 2 indications for the therapeutic use of oxygen?
- Treatment of hypoxemia
- Decrease workload of heart and lungs