Surgical conditions of the nasal passages and sinuses Flashcards Preview

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What is laminar flow

the absolute flow in linearity through a body/structure


where is the majority of resistance to airflow?

in the upper airway


If you change airflow, what do you change?

gas exchange-and thus performance


What are the features of the nares?

1. cartilaginous support over nasoincisive notch
2. muscles innervated by facial nerve
3. major site of upper airway resistance
4. fake nostril/alar folds


What can affect the facial nerve? what is a consequence?

gutteral pouch dz. cannot flare nostrils--cannot open up when exercising


What is an issue with redundant alar folds?

cause expiratory flutter
no abnormalities on clin exam
Dx: rule out DDSP--dorsal displacement of the palate

Dx. temporary suture--suture to side of nostril to confirm diagnosis
Tx. excision
beware of referred noise--just b.c hear in trachea, doesn't mean in trachea


What is a ddx for reduandant alar folds?

dorsal displacement of the palate


How do you confirm diagnosis of redundant alar folds?

temporary suture to side of nostril--does noise go away


What is a problem with excising the false nostril?

if not careful can enter the rostral maxillary sinus when remove
can bleed profusely


What are atheromas?

in false nostrils
floctuant circular mass in nasal diverticulum
not painful or warm


How are atheromas diagnosed?

clinical appearance????look up


What is a ddx for atheroma?

1. neoplasia
2. foreign body
3. abscess


How do you treat atheromas?

1. remove the entire thing! including the entire secretory lining
2. inject formalin (first)


What does the nasal septum do?

supports nasal bone
separates the nostrils
important in prolongation of maxilla during development


What is the implication of the fact that the nasal septum is important in prolonging maxilla during development?

cannot remove it in a foal with nasal septum issues because need maxilla to continue to grow. also if remove the nostrils can collapse


Why do you have to pack nasal septum removal?

bleeds a lot. Give it a tracheostomy in surgery


What are the features of nasal septum resection

presents due to noise/exercise intolerance
clin exam: resp noise at resep, palpable lesions, nasal bone deformation


How is nasal septum issues diagnosed?

1. exam/history
2. endoscopy NEED
3. DV radiographs
4. CT (usually don't need)


What is the treatment for nasal septum issues?



How can you tell a head radiograph shot is a true DV?

only see a thin line of gas where three meatuses are lined up on both sides and see upper cheek teeth because maxilla wider


What are the paranasal sinuses?

frontal (1)
--dorsal conchal (6)
rostral maxillary (2) (lateral)
--ventral conchal (7) (medial)
caudal maxillary (3)
sphenopalatine (4)
ethmoidal (5) (part blood, part air)


How does the ventarl contral sinus fluid get into the nose?

it has to first go into rostral maxillary sinus and through a dorsal hole into the nose
This is why the majority of nasty exudate comes from the ventral conchal sinus b/c difficulty draining


What is the problem with sinuses?

they are always in communication with airway so they get infected easily


What is the history with sinusitis?

nasal discharge (foal?) resp tract infection


What is seen on clinical exam?

facial deformity (trapped fluid), pain on palpation, dull resonance
As soon as get changing in bone, get change in nasolacrimal duct and get epiphora (overflow of tears onto face)


Why might a horse get a small red lesion that looks like ulcer?

Nasal discharge! may or may not be bilateral. May be only indication of nasal discharge


What does clear nasal discharge possibly with ocular discharge mean?

likely due to viral dz


How can you perform percussion in good way?

put fist in mouth--open mouth allows resonance, can tell difference between left and right


How is sinusitis diagnosed?

1. exam
2. endoscopy-nasomaxillary aperture--where sinuses drain, gutteral pouches--harbor infectious agents
3. multiple radiographs
4. sinocentesis (kral tap)
5. sinoscopy
6. CT


Which mandible will appear larger than the other on radiograph?

the one farther away from the plate?