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92 Cards in this Set
- Front
- Back
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What divides the nasal passages? Describe it.
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Nasal septum
-Cartilaginous dorsally and boney (vomer bone) ventrally |
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Compare the nasal septum in horses to that of cats and dogs.
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Horses: whole nasal passage divided into two halves & at nasopharynx the openings are separate choanae
Dogs & cats: single opening into the nasopharynx |
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The nasal passages contain _____, which the respiratory epithelium is attached to and the meatuses, which are ________.
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Conchae
meatuses: cavities b/w the conchae |
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The dorsal, middle and ventral conchae of the more rostral nasal passages become the _________, that overly the _______.
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ETHMOID CONCHAE which overly the CRIBIFORM PLATE
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What separates the nasal passages from the calvarium (dome of the skull)?
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cribiform plate
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Where is olfactory neuroepithelium found?
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Inside the ethmoid turbinates
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What lines the nasal and ethmoid conchae?
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Ciliated pseudocolumnar epithelium
-cilia are present in nasal passages |
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Why is it diagnostically relevant that nasal passages contain cilia?
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Nasal biopsies can be used to diagnose ciliary dyskinesia
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What happens to large particles (5- 30 um) that enter the airways? small particles? Smallest particles (<1 um)?
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-Large particles: trapped by mucociliary apparatus in nasal passages and cilia carry them towards nasopharynx
-smallest: settle out in alveoli and are removed by alveolar macrophages -Small particles: settle in bronchioles |
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The sense of smell is an important component of appetite in what species?
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Carnivores
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Different species have different numbers of sinuses that drain into the nasal passages at the ______ meatus.
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middle
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What is the major sinus?
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Frontal sinus
-has several components or recesses |
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What sinus is unique to the cat?
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a functional sphenoid sinus that communicates w/ nasal passages
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True or false. Maxillary sinuses are true sinuses.
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False, not true sinuses
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Other than trapping particles what is the function of the nasal passages?
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Warms and humidifies air via rich capillary network in nasal epithelium
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Inspired air is warmed and humidified in the nasal passages, what happens to expired air in the nasal passages? Why?
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Cooled and dried to preserve both heat and moisture
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What causes nasal congestion?
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Capillaries become distended w/ blood
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______ and _______ secretions moisten the nose and nasal passages and contribute to cooling.
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Nasal glands
Nasolacrimal secretions |
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Do animals preferentially breathe through their mouth or nose? Can they breathe through one nostril?
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Nose preferably and can breathe through one nostril
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When sneezing occurs it indicates that disease is present in ______ and/or ______.
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Nasal passages and/or sinuses
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What is the purpose of sneezing?
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Protect the lower airways from noxious and infectious substances
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What nerve is located in the nasal mucosa and is stimulated by noxious substances in the nasal passages?
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Subepithelial myelinated endings of the trigeminal nerve
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Other than noxious stimuli, what can trigger a sneeze?
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Strong light
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Explain the sneeze reflex.
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-rapid inspiration
- contraction of thyroarytenoideus muscles --> closes vocal folds -abdominal muscles contract--> increasing pressure of trapped air -caudal aspect tongue pushes up against soft palate & prevents air from entering oral cavity -vocal folds abduct and air is forcibly released |
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Reverse sneezing is a ______ reflex.
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Aspiration reflex
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With reversed sneezing there is a paroxysmal ____ phase that often occurs in an animal standing w/ head and neck extended.
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Inspiratory phase
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Other than being an aspiration reflex, what can cause reverse sneezing?
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Stimulation of trigeminal nerve endings in the nasal mucosa, with a heavy concentration on the lateral aspects of nasopharyngeal mucosa
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Explain the mechanism of reverse sneezing.
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-Stimulation of CN V
- rapid contraction of inspiratory muscles and muscles of the larynx resulting in vocal fold adduction and narrowing of larynx -increases air pressure w/in trachea and pleura -glottis opens --> sudden rapid inspiration of air |
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What is the function of reverse sneezing?
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Sudden rapid inspiration of air helps move debris from nasopharynx into oropharynx to be swallowed or expectorated
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What prevents debri from moving into the lower airways during reverse sneezing?
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Subsequent narrowing of the glottis and coughing
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Reverse sneezing is suggestive of disease in the _______.
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Nasopharynx
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What are the 4 traits used to describe nasal discharge?
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1) Type
-serous, mucoid, purulent, mucopurulen, sanguinous, epistaxis 2) Amount -scant, copious 3) Location -unilateral, bilateral 4) Frequency -intermittent, continuous |
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What are the 2 characteristics of serous discharge?
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Clear and acellular
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How does a mucus discharge appear? What produces it?
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Clear or more opaque than serous and results from increased mucus production by goblet cells.
-acellular |
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What are the characteristics of purulent discharge?
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Contains abundant neutrophils and bacteria that gives it a white, yellow or green appearance
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What are the only 2 acellular discharges?
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Mucus and serous
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What are the characteristics of mucopurulent discharge?
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opaque w/ some neutrophils & bacteria giving it a yellow or green tinge
-differs from purulent which has abundant neutrophils |
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What are the characteristics of a sanguinous discharge appear?
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Blood mixed w/ serous, mucoid or purulent discharge
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How is epistaxis different from a sanguinous discharge?
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Epistaxis is just blood
Sanguinous is mixed w/ serous, mucoid or purulent discharge |
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What are 9 infectious differential diagnoses for sneezing and nasal discharge in dogs & cats?
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1) feline upper respiratory infection complex
2) canine infectious tracheobronchitis 3) B. bronchiseptica 4) Aspergillosis 5) Cryptococcus neoformans 6) Pneumonyssus caninum 7) Cuterebra 8) Capillaria aerophilia 9) Linguat. serrata |
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What are 6 types of neoplasia in dogs and cats that could result in sneezing and nasal discharge?
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1) Adenocarcinoma
2) Squamous cell carcinoma 3) Lymphosarcoma 4) Fibrosarcoma 5) Chondrosarcoma 6) Osteosarcoma |
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What are 3 inflammatory causes of sneezing and nasal discharge in cats and dogs?
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1) Allergic rhinitis
2) Lymphoplasmacytic rhinitis 3) Chronic hyperplastic rhinitis |
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What are some infectious causes of sneezing and nasal discharge horses and ruminants? (there's a ton!)
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Influenza, EHV-1, EHV-4, rhinovirus, early strangles, gutteral pouch mycosis, early bacterial pneumonia/pleuritis, Manheimia hemolytica, P. multocida, H. somnus, IBR, BHV-1, PIV3, Mycoplasma, abscess, septicemia, nasal bots, lungworm
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What are some inflammatory and other causes of sneezing and nasal discharge in horses and ruminants?
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Overflow nasolacrimal ducts
Cysts Polyp Tumor COPD Trauma Decreased cleaning Choke Cleft palate Megaesophagus |
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What are some "other" causes of sneezing and nasal discharge in cats and dogs?
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Foreign body
Nasopharyngeal polyp Oronasal fistulae Truama Nasopharyngeal stenosis Dysphagia Ciliary dyskinesia Cleft palate |
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In general, what type of nasal discharge does inflammatory diseases cause?
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Serous to mucoid discharge
-can get secondary infection resulting in a purulent discharge |
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What are 2 infections that can result in epistaxis (not sanguinous discharge)?
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1) Nasal aspergillosis**
-commonly presents w/ epistaxis 2) Nasal Cryptococcus |
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What are the most common discharges caused by a nasal tumor?
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Mucoid, mucopurulent, sanguinous and epistaxis
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What does a persistently unilateral discharge indicate about location of the lesion?
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Likely rostral to choanae
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What does a foul odor to nasal discharge suggest?
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Presence of primary or secondary bacterial infection
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What are 6 local diseases that can result in epistaxis in a dog or cat?
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1) Trauma
2) Neoplasia 3) Aspergillosis 4) Oronasal fistula 5) Foreign body 6) Severe infection/ inflammatory disease |
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What are 7 systemic diseases that can cause epistaxis in dogs and cats?
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1) Hypertension
2) Vasculitis 3) Coagulopathy 4) Thrombocytopenia 5) Hyperviscosity syndromes 6) Multiple myeloma 7) Polycythemia |
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What are 3 systemic diseases that can result in epistaxis in ruminants and horses?
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1) Purpura hemorrhagica
2) EIPH 3) Caudal venal thrombosis |
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What are some local diseases that can cause epistaxis in horses and ruminants?
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1) Guttural pouch mycosis
2) Ethmoid hematoma 3) Trauma 4) Retropharyngeal abscess 5) Polyp 6) Tumor 7) Foreign body 8) sinus infection 9) nasal bots 10) dehorning |
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What is a suspected cause of nasal discharge and sneezing in a young dog with recurrent pneumonias?
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ciliary dyskinesia
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What animals typically get nasopharyngeal polyps and stenosis?
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Younger cats
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What breeds more commonly get nasal aspergillosis?
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Young large breed dogs w/ a predisposition for german sheps
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Nasal tumors are more common in _____ dogs.
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Older
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What is high on your differentials for a young cat w/ a history of viral upper respiratory infections and chronic nasal discharge w/ or w/o respiratory distress?
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Polyp
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What is high on your differentials for a cat that was recently adopted from a humane society with chronic nasal discharge?
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Likely has or had feline upper respiratory infection complex
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What is high on your differentials for a 12 year old golden w/ chronic nasal discharge of 5 months that has recently developed exophthalmus?
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Nasal tumor
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What is high on your differentials for a dog with acute onset of sneezing and facial rubbing?
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Nasal foreign body
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What is high on your differentials for a horse w/ copious purulent discharge on lowering of the head?
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Guttural pouch empyema
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Nasal discharge in a horse after exercise suggests the lesion is located where?
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Lower respiratory tract
-animals w/ lower respiratory disease may manifest w/ other signs such as cough, exercise intolerance, cyanosis etc |
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Why is it so important to look at facial symmetry and eye position in an animal with nasal discharge?
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Changes are seen w/ neoplasia
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Why is a good oral exam imperative in animals with nasal discharge?
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Evaluate dental arcade (oronasal fistula) as well as soft palate (nasopharyngeal polyp, cleft palate)
-may be possible to evaluate pharynx -may have to sedate/anesthetize to get better view |
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What may be seen on a minimum database of an animal w/ epistaxis?
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Anemia, polycythemia or thrombocytopenia
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What do you expect to see on a minimum database of an animal with inflammatory disease or vasculitis? parasites?
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Inflammatory or vasculitis: neutrophilia, fibrinogen increase (LA)
Parasites: eosinophilia |
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What does it mean if the chemistry panel of an animal with epistaxis shows hyperglobulinemia?
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Related to diseases that can cause hypertension (hyperadrenocorticism, renal failure) or other causes of epistaxis (liver disease)
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How urinalysis help determine underlying cause of epistaxis?
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Might reflect underlying diseases
-proteinuria, isosthenuria |
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When is a fecal analysis indicated for nasal discharge?
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When its serous, mucoid, or serosanguinous discharge
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Radiographs of what parts of the body can help determine the cause of nasal discharge?
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Skull to evaluate nasal passages, sinuses, bullae, guttural pouches, retropharyngeal area, pharynx & dental arcade
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What diagnostic imaging is preferred to further evaluate boney structures of the head?
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CT
-also good for evlauating integrity of cribiform plate when concern about extension of disease (aspergillus, neoplasia) into calvarium |
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When would you want to perform an MRI to determine the cause of nasal discharge?
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Helpful in evaluating soft tissue structures so can better define tumors in soft tissues as well as differentiate nasal discharge from a tumor
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What is rhinoscopy used for?
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Aid in sample collection and allows visualization of nasal passages, nasopharynx and in some cases the frontal sinus
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What do you call a surgical approach into the nasal passages, which may be necessary for surgical biopsy and removal of foreign bodies?
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Rhinotomy
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What can you use to detect cryptococcal organisms?
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Evaluate nasal discharge
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Why are cultures of nasal discharge not very helpful?
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Often grow a population of mixed commensal organisms
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In large animals, centesis is sometimes performed on the _______ to retrieve diagnostic samples.
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Paranasal sinuses
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How are samples sometimes obtained from the guttural pouch?
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May be catheterized blindly or via endoscopy
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What can you do with nasal biopsies?
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Used for histopathology, culture and electron microscopy (ciliary dyskinesia)
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How are nasal biopsies obtained?
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Blindly, via nasal flushes, endoscopically, guided by cross-sectional imaging or surgically
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What must be done prior to taking a nasal biopsy?
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Biopsy instrument is measured to the level of the medial canthus prior to performing procedures to prevent penetration into calvarium
-also should take BP, clotting times, platelet count, BMBT in cases of epistaxis |
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What are 4 treatments that are non-specific but can help reduce nasal secretions, improve appetite and quality of life?
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1) Humidification
2) Saline nasal drops 3) Decongestants -may increase discharge and congestion when stopped 4) Mucolytics |
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When are antihistamines useful for nasal discharge?
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For allergic rhinitis
-can also try leukotriene antagonists |
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When are antibiotics helpful for treating nasal discharge in dogs and cats?
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Feline upper respiratory and canine infectious respiratory disease (infectious tracheobronchitis) or treat secondary infections
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Are antibiotics most useful for acute or chronic respiratory infections in dogs and cats?
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Acute
-for chronic antibiotics are used to address secondary infections -common for signs to improve but not resolve |
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What is a common treatment for lymphoplasmacytic rhinitis?
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Immunosuppression- glucocorticoids (prednisone, prednisilone)
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When are NSAIDs used for nasal discharge treatment?
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COX inhibitors used for various nasal carcinomas
-may help w/ lymphoplasmacytic rhinitis as well |
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What is Yunnan baiyao and what is it best suited to treat?
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Herbal used for healing and pain relief, best to decrease bleeding associated w/ nasal tumors
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What is the treatment of choice for nasal aspergillosis?
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Topical antifungal treatments w/ clortrimazole and enilconazole
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What is the treatment for nasal cryptococcus?
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Surgical debulking OR
medical management w/ oral azoles (used most commonly) -itroconazole effective in most cases but fluconazole is recommended if there is CNS or ocular involvement -amphotericin B w/ flucytosine in cats w/ severe CNS signs -monitor w/ serology |
