Unit 2: 8 - Upper Respiratory

Question 1

What are the 4 major nasal conditions?

Answer 1

Tumors, fungi, FB, trauma

Question 2

What are the 2 most common nasopharyngeal/laryngeal conditions?

Answer 2

Brachycephalic syndrome and laryngeal paralysis

Question 3

What is the major tracheal condition?

Answer 3

Tracheal collapse

Question 4

What diagnostic is relied on a lot for upper respiratory conditions?

Answer 4

endoscopy

Question 5

What is the most common CS for upper respiratory issues?

Answer 5

Respiratory distress

Question 6

What CS indicate moderate to severe respiratory distress?

Answer 6

Open mouth breathing, abducted forelimbs, labored breathing, and restlesness

Question 7

What color are MM in mild respiratory distress?

Answer 7

normal

Question 8

What color are MM in moderate respiratory distress?

Answer 8

normal

Question 9

What color are MM in severe respiratory distress?

Answer 9

pale, gray, cyanotic

Question 10

What is the status of air entry in mild respiratory distress?

Answer 10

slightly reduced

Question 11

What is the status of air entry in moderate respiratory distress?

Answer 11

moderately restricted

Question 12

What is the status of air entry in severe respiratory distress?

Answer 12

severe restriction

Question 13

What is the animal’s awareness in mild respiratory distress?

Answer 13

normal, restless

Question 14

What is the animal’s awareness in moderate respiratory distress?

Answer 14

anxious, restless

Question 15

What is the animal’s awareness in severe respiratory distress?

Answer 15

delirious, obtund, semicomatose

Question 16

Does the animal use accessory muscle in mild respiratory distress?

Answer 16

no

Question 17

Does the animal use accessory muscle in moderate respiratory distress?

Answer 17

maybe

Question 18

Does the animal use accessory muscle in severe respiratory distress?

Answer 18

Has generalized use

Question 19

What is the ideal environment for pre-op management of upper airway issues?

Answer 19

cool, calm, quiet

Question 20

What are primary sedation agents for upper resp issues?

Answer 20

Butorphanol + acepromazine

Question 21

How can supplemental O2 be given?

Answer 21

Nasal tube or oxygen cage

Question 22

What should patients be pretreated with to minimize inflammation and edema?

Answer 22

corticosteroids (Dexamethasone)

Question 23

What muscle is used to abduct the airway? In what condition is this affected?

Answer 23

Dorsal cricoid arytenoideus;

Affected in laryngeal paralysis

Question 24

How does the larynx heal if the mucosa is apposed?

Answer 24

By re-epithelialization

Question 25

How does the larynx heal if there are wounds with gaps?

Answer 25

By second intention - may cause scarring of the glottis

Question 26

How do superficial wounds of the trachea heal?

Answer 26

By re-epithelialization

Question 27

How do full-thickness wounds in the trachea heal?

Answer 27

By second intention - protruding granulation tissue and subsequent scar formation (may narrow lumen)

Question 28

A 20% reduction in diameter of the trachea may reduce mucociliary clearance by \_\_\_% or more.

Answer 28

50

Question 29

What are 4 major complications that may occur after upper resp sx?

Answer 29

1. Collapse 2. Laryngeal spasms, paresis, paralysis 3. Aspiration pneumonia 4. Death

Question 30

When would you perform a rhinotomy?

Answer 30

Rarely; Tumors, fungal dz, FB, trauma

Question 31

What is the most common approach in a rhinotomy?

Answer 31

dorsal

Question 32

What are 3 indications for a tracheotomy?

Answer 32

1. Remove obstruction 2. Sample 3. Facilitate airflow

Question 33

What muscle is cut through for a tracheotomy?

Answer 33

Sternohyoideus

Question 34

What 5 structures should be avoided when doing a tracheotomy?

Answer 34

1. Recurrent laryngeal n. 2. Carotid artery 3. Jugular vein 4. Thyroid vessels 5. Esophagus

Question 35

What is the indication for a tracheostomy?

Answer 35

Bypass obstruction

Question 36

What is the biggest concern post-op with a tube tracheostomy?

Answer 36

Tube obstruction or disruption --\> asphyxiation

Question 37

What is brachycephalic syndrome?

Answer 37

Upper resp obstruction in brachycephalics caused by stenotic nares, elongated soft palate, everted laryngeal saccules

Question 38

What breeds commonly have brachycephalic syndrome?

Answer 38

English Bulldogs, Boston Terriers, Pug, Pekingese

Question 39

What are stenotic nares?

Answer 39

Nostrils with abnormally narrow openings; cartilages lack rigidity

Question 40

Stenotic nares account for \_\_\_\_% of total airway resistance.

Answer 40

76-80%

Question 41

What is an elongated soft palate?

Answer 41

Extension of the soft palate \> 1-3 mm caudal to the tip of the epiglottis

Question 42

What is stage 1 laryngeal collapse?

Answer 42

Eversion of the laryngeal saccules

Question 43

What is stage 2 laryngeal collapse?

Answer 43

Medial deviation of aryepiglottic folds (cuneiform processes)

Question 44

What is stage 3 laryngeal collapse?

Answer 44

Medial deviation of corniculate process

Question 45

What is laryngeal paralysis?

Answer 45

Complete or partial failure of the arytenoid cartilages and vocal folds to abduct during inspiration

Question 46

What form of laryngeal paralysis is more common?

Answer 46

Acquired -- Labradors

Question 47

What is a CS with laryngeal paralysis that can be different than the other upper airway issues?

Answer 47

Voice change - ask owner about barking

Question 48

What is the prognosis for laryngeal paralysis?

Answer 48

If asymptomatic to mild = good If moderate to severe = may progress to collapse and has a worse prognosis

Question 49

What is tracheal collapse?

Answer 49

Tracheal obstruction caused by cartilage flaccidity and flattening

Question 50

What breeds and age are prone to tracheal collapse?

Answer 50

Toy and mini breeds; Middle aged or older more likely

Question 51

How is tracheal collapse assessed on palpation?

Answer 51

Flaccid cartilages with prominent lateral borders may elicit cough; Hepatomegaly on abd palpation

Question 52

How is tracheal collapse assessed on auscultation?

Answer 52

Tracheal noise, soft end-expiratory snapping together of the tracheal wall with intrathoracic collapse, abnormal heart sounds

Question 53

Cervical trachea collapses during \_\_\_\_\_, which is why this is the ideal time to snap a radiograph.

Answer 53

inspiration

Question 54

Grade 1 tracheal collapse is \_\_\_% occlusion.

Answer 54

\<25%

Question 55

Grade 2 tracheal collapse is \_\_\_% occlusion.

Answer 55

25-50%

Question 56

Grade 3 tracheal collapse is \_\_\_% occlusion.

Answer 56

50-75%

Question 57

Grade 4 tracheal collapse is \_\_\_% occlusion.

Answer 57

75-100%

Question 58

How often is there concurrent laryngeal paralysis or collapse with tracheal collapse?

Answer 58

~30%

Question 59

How often is there concurrent bronchial compression or collapse with tracheal collapse?

Answer 59

~40-45%

Question 60

How many patients improve with surgical correction of a collapsing trachea?

Answer 60

80-90%

Question 61

What are 2 surgical techniques for tracheal collapse?

Answer 61

Prosthesis or stent

Question 62

What is tracheal hypoplasia?

Answer 62

Congenital stenosis of the trachea characterized by a narrow lumen, rigid cartilages that overlap or appose, and an obscured or narrow dorsal tracheal membrane

Question 63

What is tracheal stenosis?

Answer 63

Abnormal narrowing of the tracheal lumen due to congenital malformation or trauma

Question 64

What things can cause tracheal stenosis?

Answer 64

Penetrating wounds, FB, indwelling tubes, tracheal surgery (2nd intention healing)