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Flashcards in URT Dz and Sx Deck (45):
1

How does UAResist change with normal horse, exercising insp and exp

normal 66% UAR
ex - insp - 80%
ex - ex - 50%

2

Ddx for mass sitting in the back of the false nostril

atheroma
neoplasia
foreign body/abscess
erupting tooth

3

How do you deal with the atheroma?

it's cystlike so do try to get all the secretory lining becuse it will come back anywy. inject with formalin and will fal out. This will prevent the scar

4

why would we do a nasal septum resection

to remove a mass that impedes. secondary to trauma causing thickening, nasal deviation like wry nose

5

What are the indications for nasal septum resection

respiratory noise at rest
palpable thickening of the septum

6

methods to remove the nasal septum

obstetrical wire
guarded chisel ventral
and trephined hole for on dorsum
or osteotomy - make the flap and can see everything, prevents a lot of bleeding, etc.

7

A history of sinusitis will include

smelly unilateral or bilateral discharge
recent URT infection

8

How to dx sinocentesis

don't hit the infraorbital nerve, go above or below
sinoscopy *** - do guttural pouches here too
CT
Multiple rad view - Fluid lines, masses and tooth root disease can frequently be detected radiographically
Clin Exam

9

CLinical signs of sinusitis

afebrile
palpation of paranasals
facial deformity
epiphora
percussion

10

Tx of primary sinusitis

take sinus sample to send off
get rid of as much debris as possible - lavage
use the steinman pin

11

Tx of secondary sinusitis

remove the problem - hematomas, sinus cyst, neoplassia, infected teeth

12

What is PEH

expanding mass of blood from ethmoid plate

13

recurrence of PEH

43%

14

CLinical signs of PEH

just s trickle of blood
sometimes stidor

15

Tx of PEH

nasofrontal flap and inject formalin. injet until full at 3-4 week intercals and then take out

16

DX of PEH

endoscopy
defin - histopath
CT, MRI

17

Ddx of PEH

Fungal granuloma
neoplasia - SSC
nasal polyps - not there though

18

position of the SP is determined by which cranial nerves?

CN 5 -tensor veli palatine - elevating SP
CN 10 - levator veli palatine, SP proper
CN 10 - palatinus - SP proper
CN 10 - palatopharyngeus - along the lateral side connecting the SP and thyroid cartilage

19

which muscle lifts the SP dorsally?

the levator veli palatini

20

Who does pharyngitis hit most?

21

Pharyngitis is also called

pharyngeal lymphoid hyperplasia

22

Grading system for PLH

1 - normal, few inacctive follicles
2 - numerous small inactive with odd hyperemic follicle
3 - numerous active follicles that are pink and close together
4 - large edmatous follicales that coalsce sometimes

23

Tx of PLH

rest
anti-inflamm (not AM)
rest, bute will go away

24

cause of pharyngeal collapse

dysfunction of CN 9

25

What is the cause of choanal atresia

failure of the foal to absorb the bucconasal membrane

26

Potential etiologies for DDSP

long soft palate
epiglottic hypoplasia
nerve dysfunction to muscles (CN 10, 5)
caudal retraction of tongue, causing the tongue to push the SP up
etc

27

CLinical signs/history of DDSP

exercise intolerance
hypercarbia/.hypoxia
horses look like choking down or swallowing their tongue.

28

Dx of DDSP

endoscopy

29

Tx of DDSP

1. figure8 nose band, tongue tie, etc.
2. staphylectomy - partial SP resection - 60% success
3,. myectomy - sternohyoideus resection with the tendon to cartilage (thyroid) - 60%
4. combined 2 and 3.
5. epiglottic augmentation - inject teflon 60% success
6. palatoplasty - 60-70% surgery to scar up the epiglottis
7. tie-forward - from caudal wings of thyroid to basihyoid bone. 80-82%

30

Dx of Epiglot entrap

endoscopy - see obscuring of the blood vessels on the top of the epiglottis. big mass here. Loss of serrated mucosa on ventral epiglottis
SOmetimes associated with hypoplastic trachea as well

31

Tx of Epiglot entrapments

1. axial deviation via laser
2. transnasal or transoral axial deviation with curved bistoury - but make sure you know what you have
3. axial deviation via electrocautery
4. laryngotomy or pharyngotomy - but high rate of DDSP

32

Complications of the EPig Entrap correction

some peiople have gone right through the epiglottis and severed it.
others have come all the way and made an iatrogenic cleft palate

33

what is tricky about the sub-epiglottic cysts

may be concurrent with epig entrap

34

Tx of the sub-epiglottic cysts

loop, cautery, wire, snare, formalin

35

What is laryngeal hemiplegia

laryngeal paralysis of the recurrent laryngeal nerve (left usually) causing atrophy of the CAD muscle

36

A sueable cause of Lar Hemi

IV injections on the left side. Carmalt had trouble that time

37

Hx of Laryng hemi

whislte or roar, ex intolerance

38

Grades of laryn hemiplegia

1 - normal
2 - will abduct but not synchronously
3a - asynchronous at rest
3b - same asynchronous at rest and exercise
4 - none at all

39

what grade of laryng hemi does we surgerize

grade 3B but 3a will progress

40

Tx for laryng hemiplegia

laryngoplasty - this is suture between the midline of crico notch to arytenoid
sacculectomy - cut out a chunk and suture back tighter. prevents noise
partial arytenoidectomy - do if tie-back has failed
NMpedicle graft - in young horses, graft the C1/omohyoid muscle. re-innervation takes a year.

41

maind ddx for arytenoid chondritis

laryngeal hemiplegia

42

Tx of arytenoid chond

AM? barely get in
excision of affected cartilage

43

Difference between partial and subtotal artyenoidectomy

partial - ***** good***** removes all but the muscular process
subtotal leaves the corniculate process - stupid

44

What is done with excision of the arytenoid in the chondritis?

make incision in the mucosal fold

45

complications of excision from the arytenoid chondritis

dyspnea from trauma/bleeding
dysphagia from aspiration