Respiratory Disease Flashcards
Exam IV (26 cards)
Most common causes of coughing
Acute or Chronic Bronchitis Asthma (especially cats) Tracheal/airway collapse or compression Airway obstruction Left sided congestive heart failure Parenchymal lung disease (neoplasia, pneumonia, infectious)
True or False:
Heart murmur + cough = heart failure
FALSE
True or False:
Heart murmur + crackles does NOT = heart failure
TRUE
Stertor and Stridor
Discontinuous sounds and wheezes heard WITHOUT a stethoscope
Localizes airway disease above thoracic inlet
Normal sound in brachiocephalic dogs
Crackles
Nonmusical, discontinuous sounds (crumpled paper)
Inspiratory crackles = airway disease
End-inspiration/initial expiration = parenchymal disease
Wheezes
Musical, continuous sounds
Airway or bronchial constriction/narrowing
Only diagnosed with stethoscope
Respiratory Exam
Most patients with parenchymal disease are often sick (systemic, pneumonia, CHF, neoplasia)
Pateitns with parenchymal disease are often tachypenic (decreased O2 exchange)
Pronounced inspiratory effort with airway diseases
Crackles throughout inspiration; airway/bronchial disease
Normal heart rate than NOT CHF (usually have sinus tachycardia)
Respiratory effort = airway disease
Extrathoracic PE findings
Noisy breathing
Stertor/Stridor
Do NOT need stethoscope to hear respiratory sounds
Intrathoracic (end bronchiole, parenchyma/alveoli)
PE findings
Tachypnea (could see open mouth breathing)
Soft cough
Soft crackles
Harsh/quite sounds (stuff in the parenchyma)
End-Inspiratory
+/- expiratory
Need stethoscope to hear the abnormalities
Intrathoracic (Trachea/bronchi)
PE Findings
Loud/harsh cough Terminal gag Crackles/wheezes Inspiratory phase Can palpate trachea and elicit a cough Productive cough
Need stethoscope to hear abnormalities
Thoracic Inlet Disease DfDx
Stenotic nares Brachiocephalic syndrome Laryngeal paralysis Rhinitis Pharyngeal disease or obstruction Tracheal collapse (cervical) Airway obstruction above TI (masses, toy, stick)
Intrathoracic Disease DfDx
Canine chronic bronchitis/COPD types a, b
Tracheal collapse below TI
Feline bronchitis (asthma)
Allergic bronchitis
Infectious tracheobronchitis
Airway compression or inflammation (masses)
Parenchyma disease
Radiographic Findings
Diffuse interstitial pattern
Parenchymal Disease
DfDx
Pneumonia (bacterial, mycotic, viral) Pulmonary neoplasia Pulmonary Edema Non-cardiogenic edema (ARDS) Asthma, end-bronchiolar constriction Eosinophilic lung disease Toxoplasmosis Lung contusion Pulmonary parasites
Note: often tachypneic and ill
Pleural Space Disease
What is it?
Restrictive airway disease (lungs cannot fully expand)
Between chest wall and lung
Both inspiratory and expiratory effort
Tachypnea
Pleural Space Disease
DfDx
Restrictive airway disease
Pneumothorax
Pleural effusion (see fluid line, quite lung sounds)
Pericardial effusion (compression of lungs)
Intrathoracic mass
Extrathoracic compression (ascites)
Tachypnea
DfDx
Respiratory disease Anemia Methemoglobinemia (toxins) Acidosis Pain Neurologic disease
Cough; Heart? Lung?
History
Heart Failure: Cough with exercise or excitement Soft cough with tachypnea Decrease in activity/lethargy Weight loss/inappetence
Airway Disease: Cough with exercise/excitement Loud or honking +/- terminal gag No activity change No weight loss
Cough; Heart? Lung?
PE/auscultation
Heart Failure: Tachypnea/dyspnea Increased effort and crackles (end-inspiratory and expiratory) Murmur, usually mitral Heart rate; elevated (sympathetic tone)
Airway disease: No tachypnea Increased inspiratory effort \+/- crackles (inspiratory) or normal lung sounds \+/- murmur Heart rate; normal to slow (vagal tone)
Cough; Heart? Lung?
ECG
Heat failure:
Sinus tachycardia (sympathetic tone), rapid arrhythmias
+/- p mitrale (wide P wave)
Airway Disease:
Pronounced respiratory arrhythmia (vagal tone)
Normal to slow HR
+/- P pulmonale
Cough; Heart? Lung?
Thoracic Radiographs
Heart Failure:
Cardiac enlargement (LA)
Interstitial edema (adjacent to large vessels and hilar region)
Venous distension
Airway Disease: \+/- cardiac enlargement Bronchial infiltrate, doughnuts Airway collapse Normal radiographs
Cough; Heart? Lung?
Bronchial wash
Heart Failure:
Normal cytology
Airway Disease:
Inflammatory or other infiltrate
Cough; Heart? Lung?
Medical therapy
Heart Failure:
Diuretic responsive
Airway Disease:
Incomplete or non-responsive to diruetics
Airway Disease
Above TI and Below TI
Clinical Signs
Above TI:
Noisy breathing
Inspiratory effort much greater then expiratory
Sterdor/Stridor
Below TI:
Harsh cough, gag, +/- wheeze
Inspiratory greater than expiratory effort
Crackles/Wheezes
