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upper airway Flashcards

1
Q

general steps to work up a case

A

history pe
ddx
upper airway endoscopy
revise ddx
further diagnostics

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2
Q

what breathing noise is always considered pathologic

A

inspiratory noises

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3
Q

serous nasal discharge

A

viral or allergy

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4
Q

mucoid to purulent nasal discharge

A

bacterial, sinusitis

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5
Q

hemorrhagic nasal discharge

A

GP mycosis, trauma, EIPH
ethmoid hematoma

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6
Q

unilateral nasal discharge vs bilateral

A

unilateral seen in ethmoid turbinates, drainage angle or mild GP disease

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7
Q

what causes nasal fold collapse

A

large negative pressure during inspiration collapses the folds

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8
Q

nasal fold collapse common treatment

A

nasal strips decrease negative inspiratory pressure

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9
Q

there is a laceration to the nostrils. what do you need to remember

A

do not allow them to heal by second intention. it will stricture

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10
Q

collapse of the nostrils, nasal cavity or nostril flutter. can be unilateral or bilateral

A

facial nerve paralysis

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11
Q

what causes choanal atresia

A

failure of the buconasal membrane to rupture in utero

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12
Q

how do we treat a nasal polyp

A

cut off with OB wire

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13
Q

what is the general treatment for fungal rhinitis

A

sx debridement and systemic antifungals. long course

zoonotic

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14
Q

theres a nasal septal defect. what do you need to rule out

A

mass effect vs congenital

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15
Q

you remove a nasal foreign body. now what

A

find potential inciting cause for FB

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16
Q

what is the sinus cavity 3D image of choice

A

CT— but does not allow for definitive diagnosis

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17
Q

what sinuses normally communicate

A

rostral maxillary and ventral conchal bulla

frontal sinus and dorsal conchal sinus

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18
Q

what is the structure we rupture to allow the three sinus compartments to communicate

A

maxillary septal bullae

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19
Q

what is the most common bone flap

A

frontonasal bone flap

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20
Q

most common lication for a sinuscopy

A

frontochonchal

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21
Q

what is the most common cause of sinusitis

A

dental disease 08-11

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22
Q

what causes primary sinusitis

A

obstruction of the drainage angle. this causes mucus and bacteria to build up in the sinus cavities

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23
Q

treatment for acute sinusitis vs chronic

A

acute- broad spec abx

chronic- sinus lavage +- sinuostomy

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24
Q

facial bone deformation, +- airway obstruction +- sinusitis

A

sinus cyst

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25
how to diagnose a sinus cyst
round fluid filled structure on radiographs
26
treatment for sinus cyst
sx removal is 80% curative
27
most common sinus neoplasia
SCC-- need sinuostomy and biopsy to confirm
28
prognosis of sinus neoplasia
<6mo survival time with sx removal
29
young horse lump on face +- history of trauma
suture periostitis
30
treatment for suture periostitis
topical antiinflam, TIME, +- abx if theres a history of trauma
31
when do we perform bony repair surgery in a sinus fracture
only if the fracture is endented. if it is level we can treat conservatively
32
what steps of our PE need to be added for a sinus fracture
assess bony orbit neuro exam endoscopy
33
how do we diagnose an ethmoid hematoma PEH
endoscopy to look for mass. rads to check involvement
34
treatment for PEH (hematoma)
formalin injection series or laser ablation
35
why does PEH recur in 67% of cases
involvement with the sphenopalatine sinus. formalin could cross the cribriform
36
general clinical signs of a guttural pouch issue
nasal discharge +- blood cranial nerve deficits dyspnea +- horners
37
what causes guttural pouch tympany
salpingopharyngeal ostia acts as a one way valve for air. young animals
38
treatment for GP tympany
stop the one way valve- catheter +- sx fenestration if recurrent
39
GP empyema- what causes it
URT infection that extends into the GP --- or LN ruptures in the GP
40
what to remember about GP empyema
screen for strangles
41
scary amount of blood coming from the nose
GP mycosis
42
GP mycosis treatment
leave the blood clot alone. SEDATE the horse coils or nitinol plugs to affected artery
43
what does DDSP cause
obstruction on inspiration
44
what are the three pathophys to DDSP
neuromuscular junction reduced larynx elevation hypoglossal N dysf
45
most common cause of airway obstruction in racehorses
DDSP
46
treatments for DDSP
treat inflam cornell collar laryngeal tie
47
issue that causes respiratory distress in foals. often secondary to FPT
nasopharnygeal dysfunction
48
prognosis for nasopharyngeal dysfunction
good. SC and will resolve in a month
49
treatment for cleft palate without aspiration pneumonia
conservative therapy if minor.
50
treatment for more severe cleft palate.
sx repair, but high rate of recurrence. also you cant do this to the hard palate
51
when do we choose a dynamic endoscopy
normal standing endoscopy or abnormal standing endoscopy and we what to further eval
52
why would some conditions only be present in dynamic endoscopy
negative pressure created in exercise causes collapse.
53
what are the four effects of negative pressure on the soft tissues
vocal fold collapse, pharyngeal collapse, axial deviation of aryiepiglottic folds DDSP
54
roaring
LLH laryngeal hemiplagia
55
what causes L Laryngeal hemiplagia
neurogenic atrophy of the cricoarytenoid dorsalis m CAD
56
two goals of conservative or tie back procedures in LLH
decrease noise and improve exercise intolerance
57
how do we ddx laryngeal hemiplagia from arytenoid chondropathy
US looking at CAD muscles.
58
early vs chronic treatment for arytenoid chondropathy
early- antiinflammatories, +- resect granulomas chronic- arytenoidectomy
59
what tissues are causing entrapped epiglottis
ariepiglottic folds and subepiglottic mucosa
60
treatment for entrapped epiglottis
axial midline incision. excellent prognosis
61
how to remove a subepiglottic mass
snare off the mass via the mouth

EQ BCM (10 decks)

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