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Respiratory diseases Flashcards

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1
Q

What is the function of the nasal cavity in respiration?

A
  1. Conduction
  2. Warms + moistens inhaled air
  3. Filters air
  4. Allows O2 to pass into body + olfactory system (respiratory tract)
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2
Q

What is the function of the trachea + bronchi/bronchioles in respiration?

A
  1. Efficent air flow
  2. Transports air
  3. Passage in + out of the lungs
  4. Part of conducting air towards the lungs, from upper airway + nasal cavity
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3
Q

What is the function of the alveoli in respiration?

A
  1. Conduction
  2. Gas exchange
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4
Q

What 3 main characteristics of the alveoli allows for gas exchange of respired gases?

A
  1. Large surface area
  2. Thin walls
  3. Lots of surrounding capillaries
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5
Q

What is URTD?

A

Upper Respiratory Tract Disease

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6
Q

What defines URTD?

A

Anything that occurs between the nares + the bronchi
(before the lungs)

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7
Q

Define URTD

A

Diseases affecting the nasal passages + pharynx/layrnx/trachea

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8
Q

Identify the 4 potential structures of the respiratory system that is involved with URTD

A
  1. Nasal passages/nares
  2. Pharynx
  3. Larynx
  4. Trachea
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9
Q

13..

List as many potential clinical signs of URTD as you can

A
  1. Dyspnoea
  2. Coughing
  3. Sneezing
  4. Nasal discharge
  5. Facial swelling
  6. Eye discharge (seen in cat flu)
  7. Conjuncitivitis
  8. Stertor (snoring)
  9. Stridor (high pitched whistle, seen w/layrngeal paralysis)
  10. Sinusitis
  11. Cyanosis (complete obstruction)
  12. Rubbing face
  13. Rhinitis (Inflammation)
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10
Q

What measures can be taken to aid patients with Dyspnoea?

A
  • Oxygen support - flow-by, O2 tent/kennel, mask
  • Keep calm + in a quiet area
    (Like anaemic px care)
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11
Q

What are the 2 forms of nasal discharge?

A
  1. Unilateral
  2. Bilateral
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12
Q

What is unilateral nasal discharge a potential sign of?

A
  1. Localised infection
  2. Tumour
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13
Q

What is biilateral nasal discharge a potential sign of?

A

Generalised infection

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14
Q

What does serous nasal discharge indicate?

A

Allergies

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15
Q

What does serous discharge look like?

A

Serum-like

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16
Q

What does mucoid/mucus nasal discharge indicate?

A

Upper respiratory infection

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17
Q

What does mucoid discharge look like?

A

Clear + viscous

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18
Q

What does mucopurulent nasal discharge indicate?

A

Infection

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19
Q

What does mucopurulent discharge look like?

A
  • Mucus
  • Contains pus
  • Very viscous
  • Yellow or green colour
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20
Q

What does epistaxis indicate?

A

Bleeding from the nares or bloody dischargee

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21
Q

What can epistaxis indicate?

A
  • Deep-seated nasal cavity infection
    or
  • Nasal cavity tumour
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22
Q

List 10 potential causes of URTD!

A
  1. FURD (Feline Upper Respiratory Disease)
  2. Foreign body
  3. Tumour (neoplasia)
  4. Allergies
  5. Trauma
  6. CCRD (Canine Contagious Respiratory Disease)
  7. Bacterial or fungal infections (Aspergillosis)
  8. UROS (Upper Respiratory Obstructive Airway Syndrome) - Brachycephalics
  9. Layrngeal paralysis
  10. Tracheal collapse
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23
Q

Plot twist…

What does this cat have?

A

Feline Herpes Virus!

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24
Q

What type of disease is Laryngeal paralysis?

A

Degenerative

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25
What is the aetiology of Laryngeal paralysis?
* Common in middle > old age dogs * Larger breeds - Golden retriever * Idiopathic * May be due to nerve damage due to trauma, neoplasa or iatrogenic damage * Sometimes part of wider nervous system dysfunction = Polyneuropathy * Some dogs with hypothyroidism * Less common - congenital
26
What breeds are predisposed to laryngeal paralysis?
* Labradors * Golden retrievers
27
When do larger breeds most commonly present with (Laryngeal Paralysis) LP?
Middle > old age, usually last 1/3 of life
28
True or False. Laryngeal paralysis is not idiopathic.
False - it is!
29
What disease of the URT can be caused either idiopathically or due to nerve damage, from trauma or neoplasia?
Laryngeal paralysis
30
What URTD can some dogs with present with, with Hypothyroidism?
Laryngeal paralysis
31
True or False. LP can be congential.
True! Rare, but it has occured.
32
What URTD may this breed be predisposed to?
LP!
33
Identify the pathophysiology of LP
* Damage to recurrent laryngeal nerve(s) that supply the muscles of the larynx (move vocal cords) * Leads to failure of vocal folds to open fully during inspiration (aryyteenoid cartilages do not abduct fully) * Inspiration becomes difficult as vocal cords remain in closed position > dysponea
34
What URTD occurs due to recurrent damage to the laryngeal nerves that supply the muscles of the larynx?
LP
35
How do patients with LP develop dyspnoea?
Due to damage to the laryngeal nerve(s), the vocal cords can't open fully during insipration and remain in a closed position
36
What are the 5 main clinical signs seen in LP
Cough that progresses to.. 1. Increased resp noise (stridor) = roar/whistle 2. Exercise intolerance 3. Change in voice 4. Problems swallowing food/water 5. Acute collapse + respiratory distress
37
True or False. LP can have an acute onset but may present progressively - particulary in hot or cold weather.
False - slow onset + can present acutely in hot or cold water or after exertion
38
Why may a patient with LP present as hyperthermic?
Because they are unable to cool down as efficently, due to dyspnoea, as struggling to breathe, so the body will compensate to try and gain more oxygen!
39
How is LP diagnosed?
1. Presenting clinical signs 2. Full neurological exam (establish if polyneuropathy present) 3. Laryngoscopy (Sedation, laryngoscope or endoscope to visualise vocal cords during inspiration) 4. Bloods - rule out other metabolic condtions such as hypothyroidism
40
What are the 4 treatment options for **acute** presentations of LP?
1. Oxygen support 2. Potential sedation 3. Cooling down 4. Tracheostomy
41
What are the 2 treatment options for **chronic** presentations of LP?
1. Conservative = weight loss, exercise control + NSAIDs 2. Surgical= 'tie-back' technique or partial laryngectomy ## Footnote Surgery - may require refferal
42
List the methods of **conservative** tx for LP
1. Weight loss 2. Exercise control 3. NSAIDs
43
List the methods of **surgical** tx for LP
1. Tie-back sx 2. Partial laryngectomy
44
What URTD may this dog most likey to suffer from?
BAOS (Bracycephalic Upper Respiratory Obstruction Syndrome)
45
What is the aetiology of BOAS?
* Hereditary * Congenital * Bracycephalic breeds
46
What is the pathophysiology of BOAS?
Related to confromation issues.. 1. Narrowing of layrngeal openings 1. Stenotic nares 1. Elongated soft-palate 1. Varying degrees of tracheal hypoplasia * Narrowing of airway means excess pressure requirued on inspiration * This draws soft tissue into the airway opening ## Footnote Severity of BOAS can be graded from 0 > 3
47
What URTD pathophysiology has stenotic nares + varying degrees of tracheal hypoplasia?
BOAS
48
What is Tracheal hypoplasia?
* Congenital * Cartilaginous rings of trachea fuse + narrow
49
List the 6 potential clinical signs for BOAS
1. Difficulty breathing (dyspnoea) 2. Snoring 3. Poor exercise intolerance 4. Poor heat tolerance 5. Difficulty swallowing food (dysphagia) 6. Regurgitation of food
50
What are the 2 types of tx for BOAS patients?
1. Conservative (medical) 2. Surgery
51
What surgical treatment is there for BOAS?
Surgical correction of the: 1. Nares 2. Laryngeal tissues 3. Soft palate
52
What conservative/medical treatment is there for BOAS?
1. Avoid obesity 2. Use of harness on walks 3. Avoid hyperthermia
53
What type of URTD is this dog the poster child for?
Tracheal collapse!
54
Describe the aetiology for Tracheal collapse
* Toys breeds - specifically Yorkies * Idiopathic * Combo of : 1. Genetics 2. Nutrition 3. Allergies
55
What breeds is Tracheal collapse mostly seen in?
Toys breeds (Small or obese)
56
What is the pathophysiology of Tracheal collapse?
* Incomplete formation or weakened C-shaped tracheal cartilages * Leads to inability to maintain patency of trachea 1. During inspiration = * Cervical portion of trachea collapses > airway obstruction 2. During expiration = * Thoracic portion collapses
57
What URTD results in a collapse of the thoracic portion of the trachea during expiration and cervical portion during inspiration?
Tracheal Collapse
58
List the 3 main clinical symptoms of Tracheal collapse
1. Coughing during exercise 2. 'Goose honk' 3. Progressive signs of respiratory distress Can be paroxysmal* ## Footnote *Other diseases present; heart disease, cushings etc
59
Define Paroxysmal
Other diseases are also present at the same time, such as; heart disease, cushings etc
60
What type of URTD can a **goose honk** be indicative of?
Tracheal collapse
61
What are the diagnostic options for Tracheal collapse?
1. Endoscopy of trachea (**bronchoscopy**, graded) 2. **Fluroscopy** (video x-ray for real time diagnosis) 3. **Chest radiographs** (less reliable) 4. Affected breed signalment
62
What are the 6 **conservative** treatment options for tracheal collapse?
1. Weight loss 2. Rest 3. NSAIDs 4. Bronchodilators 5. Cough suppressants 6. Use of a harness
63
What surgery is performed to treat tracheal collapse?
Insertion of a tracheal stent to reinforce the weakened cartilage
64
What surgery has been performed here?
Tracheal stent! for the URTD, Tracheal Collapse
65
What 3 structures does LRTD affect?
1. Trachea 2. Bronchii 3. Lungs
66
True or False. LRTD can be either acute or chronic.
True
67
True or False. Acute LRTD can be life-threatening.
True - as it can lead to hypoxia!! ## Footnote Remember = hypoxia = low o2 in the tissues!!
68
List the potential signs of LRTD a patient may present with, upon clinical exam
1. Wheezing on expiration 2. Harshness or crackles over lung fields, upon ausculation 3. Lung sounds may be reduced or absent if pleural space disease is present
69
Why does hypoxia occur in acute LRTD?
Due to lack of oxygen being recieved by the tissues
70
True or False. Acute LRTD has a rapid deterioration, leading to unconsciousness + collapse
True
71
If something has a rapid onset....?
It has a rapid deterioration!
72
Is Acute LRTD an emergency?
Absloutely!
73
Is Pulmonary failure acute or chronic?
Chronic
74
What does long-term pulmonary failure lead to?
Decreasing ability to oxygenate the blood
75
An owner rings up saying their dog developed a **cough**, which lead to **exercise intolerance** and then **dyspnoea at rest**. What is this indicative of?
LRTD!
76
# 10.. List as many causes of LRTD as you can
1. Pulmonary neoplasia 2. **Feline asthma** 3. Chronic bronchitis 4. Heatstroke 5. Abscess due to foreign body 6. Pulmonary oedema 7. Pleural effusion 8. Parasitic infestation (A.vasorum, C.vulpis) 9. Pneumonia 10. Secondary to anaemia
77
List as many clinical signs of LRTD as you can!
1. Coughing 2. Exercise intolerance 3. **Wheezing** 4. Dyspnoea 5. Restlessness 6. Tachypnoea 7. **Mucous production** 8. **Retching** 9. Tachycardia 10. **Cyanosis**
78
# 11.. How can LRTD be diagnosed?
1. History + clinical signs 2. Clinical exam (**auscultation of lungfields**) 3. Radiography 4. Rhinoscopy 5. **Bronchoscopy** 6. Ultrasonography 7. Blood testing (A. vasorum) 8. Bacterial/fungal culture 9. Nasal flush 10. **Bronchoalveolar lavage for cytology** 11. **Faecal testing for lungworm larvae**
79
What are the treatment options avaliable for LRTD?
1. Treat cause 2. Provide drug therapy * Antibiotics * Bronchodilators (theophylline) * Diuretics (frusemide) * Cough suppressants (butorphanol) 3. Oxygenate 4. Interventions * Thoracocentesis * Tracheotomy * Thoracic cannulae
80
List the 4 types of drugs that can potentiially be used to treat LRTD
1. Antibiotics 2. Bronchodilators 3. Diuretics 4. Cough suppressants
81
List 3 potential nursing interventions, prescribed by the VS that can be given to patients for treating LRTD
1. Thoracocentesis 2. Tracheotomy 3. Thoracic cannulae
82
What is this a grading of?
Nostril Grading Examples in Pugs, French Bulldogs + Bulldogs
83
What is this surgery an example of?
Surgical widening of stenotic nares
84
85
What type of surgery has occurred here?
Soft-palate surgery
86
What are these pictures of?
Tracheal stents
87
What does this fluoroscopy indicate?
Tracheal collapse!
88
What is LRTD does this diagram represent?
Tracheal collapse
89
Graded in severity, if there are 4 grades of Tracheal collapse, and no.1 = 25%, what is grade 4?
100%
90
Describe the aetiology of Feline Asthma
* Similar to human asthma - environmental facttors act as an allergic trigger * Can be caused by **type I hypersensitivity**
91
What is the pathophysiology of Feline asthma?
1. Presence of irrittant/allergen 2. Leads to inflammatory reaction, in small airways of lung 2. Increased mucous production in airway 3. Causes irritation > dyspnoea 4. Contraction of small bronchioles > further dyspnoea
92
Identify the main clinical signs of Feline asthma
1. Persistant cough or bouts of coughing 2. Dyspnoea 3. Tachypnoea 4. Noisy breathing or **wheezing** Can be persistant or occur episodically
93
True or False. Feline asthma can be persistant or occur episodically
True
94

SA Disease Yr2 (26 decks)

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