Respiratory Stridor Flashcards

(38 cards)

1
Q

T/F: stridor may/may not be associated with distress

A

True!

Stridor w/o distress shows no CS @ rest

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2
Q

Do dynamic airway obstructions cause distress?

A

No - they are temporary obstructions that usually only occur @ intense exercise

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3
Q

Which form do DDSP is most common: intermittent or persistent?

A

DDSP = dorsal displacement of soft palate

Intermittent is most common [often @ exercise]

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4
Q

Pathophysiology of intermittent DDSP:

A
  • can be many factors that cause this!!

Inflammation, upper/lower resp dz, extensive head flexion, thyroid muscle dysfunction, etc…

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5
Q

Pathophysiology of persistent DDSP:

A

Neuro dz/issue

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6
Q

What are 3 major CS for DDSP:

A
  1. Exercise intolerance
  2. Noise
  3. Cheek puffing
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7
Q

Is the DDSP noise inspiratory/expiratory?

A

Can be both but MOSTLY EXPIRATORY

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8
Q

T/F: if you see cheek puffing in a horse, think DDSP right away

A

True!

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9
Q

What kinds of horses seem to be predisposed to DDSP?

A

Nervous/tense horses

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10
Q

T/F: DDSP horses show obv CS [like cheek puffing and expiratory noise] even at rest

A

False!

May not have any obvious CS, especially @ rest

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11
Q

How can we diagnose DDSP?

A
  1. Expiratory noise

2. Endoscopy - we can see the displacement

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12
Q

Differentiate DDSP vs EE endoscopy findings:

A

DDSP: wall flows straight down to floor

EE: wall stops and new structure begins

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13
Q

How must we perform the DDSP endoscopy? What must the horse be doing?

A

Needs to be running high speed on treadmill to see this!

”ventral placement of epiglottis relative to soft palate for greater than 8 seconds during high speed treadmill endoscopy”

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14
Q

There is conservative vs Sx tx for DDSP. Describe them:

she didn’t really talk about these in class

A

Conservative = TSD throat support device, loosen head carriage

Sx: laryngeal tie-forward, staphylectomy

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15
Q

Name 3 main CS of EE [epiglottic entrapment]

A

Exercise intolerance
Respiratory noise
Coughing

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16
Q

What kind of noise do we hear with EE?

A

Both inspiratory and expiratory

17
Q

How do we diagnose EE?

A

Endoscopy @ rest usually

18
Q

What does EE endoscopy show us?

A

Wall + new structure

19
Q

How do we treat if we see significant epiglottic entrapment?

A

Surgery - transendoscopic laser correction

20
Q

How do we treat is we see partial epiglottic entrapment?

A

Medical - local/topical anti-inflammatories

likely to recur though once training resumes

21
Q

What is the most common side to see Laryngeal Hemiplasia [LH] on?

Is there another name for it?

A

Left!

Also called idiopathic LH

22
Q

Why do ILHs occur?

A

Damage to the left recurrent laryngeal nerve

23
Q

If we see a right LH, what do we look for?

A

Look for underlying neuro dysfunction

24
Q

What is the signalment for LH?

A
Young
Male
Tall
Working draft horses
Some genetic component too
25
Name a few proposed etiologies to LH:
- mechanical stress - ischemic nerve damage - pressure damage - toxins - perivascular injections
26
T/F: we only see LH @ rest
False! Only seen @ exercise!! Exercise intolerance is a big CS
27
Name the noise LH makes: [ins vs ex]
“Roar” Inspiratory noise!!
28
How do we diagnose LH?
- CS/history - endoscopy - US - advanced imaging
29
With endoscopy, we can grade LH into 4 groups. Do we scope @ rest or while running?
We mostly see problem in grade 3 [“significant dysfunction @ exercise”] We must scope while running!
30
What does LH treatment depend on?
All depends on level of exercise! We treat differently if there is/is not impedance to exercise
31
How do we treat a horse who only has a noise issue?
Ventriculocordectomy *does not improve airway mechanics, only noise*
32
How do you treat a horse with LH and exercise intolerance?
Do BOTH a laryngoplasty AND ventriculocordectomy This will help open up the rima glottis and decrease noise
33
Is there ever an indication to just do the laryngoplasty without the ventriculocordectomy?
No, do both together.
34
How do we treat upper vs lower emergent respiratory distress?
Upper = tracheostomy Lower = O2
35
T/F: upper airway obstruction = inspiratory distress
True
36
Name a few examples of UPPER airway obstructions
- Strangles - lymphosarcoma - HyPP - Tracheal collapse
37
Name some LOWER airway obstruction examples:
ARDS RAO Acute Viral Pneumonia Etc...
38
What age group gets infected with rhodococcus equi?
Young horses