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BVetMed3 - Respiratory > Signs Of Respiratory Disease > Flashcards

Signs Of Respiratory Disease Flashcards

1
Q

What does the respiratory system defend against?

A

Inhaled non-infectious particulates

Infectious agents

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2
Q

What non-infectious agents must the respiratory system defend against?

A

Dust, LPS, allergens

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3
Q

What are the respiratory defence mechanisms?

A 
Airway smooth muscle tone
Mucous production and mucociliary clearance 
Coughing 
Infiltrating cells 
Mediators
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4
Q

How can airway smooth muscle tone be altered?

A

Bronchostriction - prevent pathogens getting further down the respiratory tract

Bronchodilation - physiological e.g. exercise induced

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5
Q

How is airway smooth muscle tone mediated?

A

Neural mechanisms
Hormones
Mediators

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6
Q

How does the parasympathetic nervous system influence airways?

A

Smooth muscle contracts - airway constricts

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7
Q

What is the effect of epinephrine on airways?

What receptor does it use ?

A

Relaxes smooth muscle - dilates airways

B2 receptors

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8
Q

What effects do anti-cholinergics and beta 2 agonists have on airways?

A

Dilation

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9
Q

How can excess mucous production be treated therapeutically?

A

Mucolytics

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10
Q

Briefly outline the cough reflex.

A

Irritant receptors in the respiratory tract stimulated by particulate matter

Vagus nerve transmits to cough centre in brain stem

Efferent motor n. Transmission and cough.

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11
Q

What effects do endorphins and enkephalins have on the cough reflex?

What receptors do they act on?

Where are these located?

A

Suppress reflex

Opioid receptors in cough centre of brain stem

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12
Q

How can the cough reflex be targeted pharmacologically?

A

Demulcents (not common)

Opioid receptor agonists

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13
Q

Give examples of opioid receptor agonists which can be used to suppress the cough reflex.

A

Butorphanol

Codeine

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14
Q

What are the resident cells in the lungs?

A

Alveolar macrophages

Mast cells

Lymphocytes

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15
Q

What is the role of alveolar macrophages?

A

—Phagocytosis of foreign particles
—Antigen presentation to lymphocytes
—Formation/ release of mediators
—Clearance of effector cells to turn off inflammation at the end of an infection

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16
Q

What immunoglobulins are involved in respiratory defence?

A

IgA

IgG

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17
Q

What is the role of IgA in respiratory defence?

A

Upper airways

Inhibits adherence of bacteria to epithelium

Binds and neutralises foreign particles

Initiates immune response via leukocytes

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18
Q

What is the role of IgG in respiratory defence?

A

Lower airways

Binds and neutralises foreign particles

Activates compliment cascade

Involved in antibody dependent cytotoxicity

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19
Q

What are the infiltrating cells?

A 
Neutrophils 
Eosinophils 
Basophils 
Lymphocytes 
Monocytes
Platelets
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20
Q

What is the physiological role of mediators in host defence?

A 
Airway smooth muscle tone 
Blood flow and vascular permeability 
Cell accumulation and activation
Mucous production
Neural reflex mechanisms 
Antibacterial activity
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21
Q

Which drugs are best for addressing problems associated with the presence of excessive mediators in the respiratory tract?

A

CORTICOSTEROIDS

Anti-inflammatory drugs - steroids better than NSAIDs

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22
Q

What are the clinical manifestations of respiratory disease?

A 
Coughing and bronchoconstriction 
Sneezing 
Tachypnoea and hyperpnoea 
Respiratory distress (dyspnoea)
Nasal discharge
Epistaxis 
Haemoptysis 
Cyanosis 
Abnormal Respiratory Noise - STRIDOR
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23
Q

What is the definition of ‘cough’?

A

Sudden noisy expulsion of air through the glottis to clear mucous and other material from the larger airways.

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24
Q

How does coughing aid in mucous clearance?

A

High velocity of air flow creates shear forces to separate mucous from airway

  • helps the mucociliary escalator
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25
Q

What are the stimuli for coughing?

A 
Bronchoconstriction
Excessive mucous 
Inhaled particles 
Hot or Cold air 
Intramural or extramural pressure 
Epithelial sloughing (due to damage)
Enhanced epithelial permeability
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26
Q

What type of cough MIGHT you associate with an upper airway problem?

A

Harsh, loud, non-productive

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27
Q

What type of cough MIGHT you associate with a lower airway condition?

A

Soft muted, productive

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28
Q

What type of cough MIGHT you associate with painful conditions?

A

More muted cough

Animal tries not to cough as it hurts

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29
Q

What behaviours would indicate a productive cough?

A

Swallowing after coughing

Coughing up mucous

30
Q

How would bronchoconstriction present on auscultation?

A

Wheezing

31
Q

How does bronchoconstriction relate to cough?

A

Separate reflex

Slower onset and longer lasting - may improve the efficiency of coughing

32
Q

What is meant by the term tachypnoea?

A

Increased respiratory rate

33
Q

What is the normal resp rate for a dog?

What is the normal resp rate for cows, and pigs?

A

10-30

10-30

34
Q

What is the normal resp rate for a cat?

A

24-42

35
Q

What is the normal resp rate for a horse?

A

8-16

36
Q

What is the normal resp rate for a rabbit?

A

30-60

37
Q

What is the normal resp rate for a foal or calf?

A

20-40

38
Q

What are the physiological causes of tachy/hyperpnoea?

A

Pain, exertion, heat, anxiety

Stimulation of autonomic nervous system

39
Q

What are the pathological causes of tachy/hyperpnoea?

A 
High CO2, low pH, low O2
Metabolic acidosis 
Excessive environmental heat 
Damaged or diseases CNS (resp. Centres)
Pain or restriction in structures involved in breathing
40
Q

What are the signs of respiratory distress?

A

-Abnormal rate, rhythm and character
-Nostril flaring
-Exaggerated intercostal and/or abdominal effort,
-abducted elbows,
-stridor,
-Anxious expression,
Inactivity

41
Q

When would you not expect to see mouth breathing in respiratory distress?

A

HORSES

Obligate nasal breathers

42
Q

What are the causes of inspiratory distress?

A

Extrathoracic non-fixed airway obstruction

Restrictive disease

43
Q

How can extrathoracic non fixed airway obstructions cause inspiratory distress?

A

The negative pressure of breathing in draws the obstructing thing into the airway to obstruct them.

This is then pushed away when breathing out.

44
Q

Give an example of an extrathoracic non-fixed airway obstruction

A

Upper airway obstructions
Laryngeal hemiplegia
Soft palate disorders

45
Q

How can restrictive diseases lead to inspiratory distress?

Give an example

A

Limit lung expansion

Pleural effusion

46
Q

What can cause intrathoracic airway obstruction?

A

Severe Equine Asthma in horses

Farmers disease in cattle

Tracheal collapse in dogs and horses

47
Q

What can cause expiratory distress?

A

Intathoracic airway obstruction

Hypertrophy of the body wall

48
Q

What can cause both inspiratory and expiratory distress?

A

Extrathoracic fixed obstruction

49
Q

Give examples of an extrathoracic fixed obstruction

A

Fb

Intraluminal mass

50
Q

What is orthopnoea?

A

Difficulty breathing while recumbent

51
Q

What might cause orthopnoea?

A

Pleural fluid accumulation

Neonates

Diaphragmatic hernia

CHF

52
Q

How can you avoid orthopnoea in neonates?

A

Place them in sternal recumbency if lying down

53
Q

How can you describe the appearance of nasal discharge?

A

Serous
Mucoid
Purulent
Sanguinous

(Or a combination of these)

54
Q

How can nasal discharge be characterised?

A

Serous/mucoid/purulent/sanguinous

Profuse or scant

Continuous or intermittent

Unilateral or bilateral

55
Q

When might you see ingested food in nasal discharge?

A

GI disease
Dysphagia
Communication between oral and nasal cavities e.g. cleft palate

56
Q

When do you tend to see unilateral nasal discharge?

A

Originates in structures rostral to the caudal end of the nasal septum
— easier to drain forward due to gravity

57
Q

When do you tend to see bilateral discharge?

A

From caudal structures or bilaterally affected rostral structures

58
Q

What might a foul odoured nasal discharge indicate?

A

Anaerobic infections
Necrotising conditions
Connection to the oral cavity e.g. tooth root infections in horses

59
Q

What can cause epistaxis and/or haemoptysis?

A 
Trauma 
Coagulopathies 
Vasculitis 
Erosive or invasive conditions  (parasites, fungi)
EPIH in horses
60
Q

What is EPIH?

What region does it tend to affect?

A

Exercise induced pulmonary haemorrhage

Caudo-dorsal lung lobe

61
Q

What arterial oxygen concentration is required for cyanosis to be seen?

A

Less than 50 mmHg

62
Q

What is the normal arterial oxygen concentration?

A

100 mmHg

63
Q

When is cyanosis evident?

A

When Hb is normal or near normal

64
Q

When would low arterial O2 not be evident as cyanosis?

A

Anaemic patients - has to fall lower than 50

Polycythaemic patients - may appear cyanosic at higher O2 concentrations

65
Q

When can peripheral cyanosis occur?

A

Poor peripheral perfusion - e.g. shock, heart failure

66
Q

What can cause pulmonary cyanosis?

A

Ventilation/ perfusion mismatch
Alveolar hypoventilation
Shunting
Diffusion impairment

67
Q

What can cause cardiac cyanosis?

A

Shunting (R-L)

68
Q

What can cause acquired cyanosis?

A

Reducing chemical e.g. nitrates, red maple leaf

69
Q

What is the term for abnormal respiratory noise?

A

Stridor

70
Q

What can cause respiratory stridor?

A

Fixed or dynamic obstructions

E.g.
Laryngeal paralysis 
Stenotic/paralysed nerves 
Nasal masses 
Soft palate elongation - BOAS

BVetMed3 - Respiratory (5 decks)

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