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158 Cards in this Set
- Front
- Back
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What is the most important function of the respiratory system?
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Gas Exchange
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What are the functions of the respiratory system?
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1. Gas exchange
2. Airway protection 3. Filtration of blood borne emboli 4. Metabolic functions |
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How do inhalant anaesthetics effect the airways?
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Stop alveolar macrophages and mucociliary escalator
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The lower airways have what kind of surface area and resistance?
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High surface area and low resistance
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How many times more soluble is CO2 compared to O2?
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20 times
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On what does the patency of the bronchioles depend?
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Elastic recoil
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Heaves is an inflammatory condition characterised by what?
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bronchospasm, mucus plugs and chronic fibrosis in bronchiolar walls leading to terminal airway obstruction.
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Heaves is thought to be due to what?
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Allergy to inhaled antigens e.g. dust from feed and bedding
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Heaves presents as what?
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coughing, exercise intolerance, increased respiratory rate and effort, flared nostrils.
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What is the Heave line?
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The latissimus dorsi muscle atrophies and leaves a line on the horses side
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What diagnostic techniques would you use to check for Heaves?
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Thoracic ausculation - re-breathing bag. Will hear wheezes and crackles
BAL = >10-15% neutraphils and mucus Blood gas = hypoxaemia |
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Name the causes of hypoxaemia
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Low PIO2
Alveolar hypoventilation Diffusion disequilibrium V/Q mismatch R-L shunt |
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What is PIO2?
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Partial pressure of inspired oxygen
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A PaCO2 of >40mmHg means?
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Animal is hypoventilating
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A PaCO2 of <40mHg means?
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Animal is hyperventilating
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A high V/Q means?
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Too much ventilation
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A low V/Q means?
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Too little ventilation - bronchoconstriction, mucus, pulmonary oedema. decreased CO
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R-L shunt is what?
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Blood passing from right ventricle to left atrium w/o passing ventilated alveoli
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Which muscle is the sole dilator of the nasopharynx in a horse? and in which direction does it pull?
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The stylopharyngeus muscle
Dorsally |
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What happens when the stylopharyngeus muscle doesn't work?
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Inspiratory obstruction and nasopharyngeal collapse
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Which muscle is responsible for abduction of the larynx?
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Cricoarytenoideus Dorsalis muscle
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What is the only muscle of the larynx NOT innervated by the recurrent laryngeal nerve?
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Crycothroideus muscle
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When an obstruction is only present during exercise is is called?
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A dynamic obstruction as opposed to a static one
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When the horse breaths faster the increase in flow increases the driving pressure. This creates increased negative pressure in the airways. What is essential for preventing collapse?
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Contraction of abductor muscles of nose, pharynx and larynx. These muscles also dilate the airway
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Resistance is mostly affected by what?
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Airway diameter
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What is the gold standard for the diagnosis of Dorsal Displacement of the Soft Palate in horses?
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Treadmill endoscopy/telemetric endoscopy
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Which side is most common for recurrent laryngeal neuropathy (roaring)?
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The left
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What is stridor?
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A pharyngeal/laryngeal noise
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What is stertor?
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A nasal/pharyngeal noise
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For a nasal or paranasal disorders what must you palpate?
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The face and carry out a complete oral exam - teeth, eyes, air passages
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What is the most common fungal infection to affect the nasal passages of dogs and cats respectively?
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Dogs - Aspergillas
Cats - Cryptococcus |
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What are some advanced diagnostics for nasal disorders?
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Rx, CT, MRI, rhinoscopy and exploratory rhinotomy
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What is the most common laryngeal diseases in dogs and cats?
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Laryngeal paralysis
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What are the most common pharyngeal diseases in cats and dogs?
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Brachycephalic airway syndrome, elongated soft palate, nasopharyngeal polyp
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What is the most common sign of lower respiratory disease?
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A cough
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What is a "goose honk" cough indicative of?
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Tracheal Collapse
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What is a soft cough indicative of?
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Pneumonia or pulmonary oedema
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What is a harsh and paroxysmal cough likely to be?
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Bronchitis
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True or False
50% of pneumonias will have a neutrophilia with a left shift |
TRUE
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In the lungs the oxygen dissociation curve shifts to which side?
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The left
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A CT or MRI are good for seeing what?
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Bullae or blebs <3mm
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Name some of the pulmonary sample collection techniques
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Transtracheal/endotracheal wash
Transthoracic aspiration/biopsy Bronchoscopy - BAL, biopsy Thoracotomy/ostomy |
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Name pleural space disease/effusions
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Transudate
Blood Pus Chyle/pseudochyle Neoplasia |
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Pure and modified transudates can be from what?
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RHS heart failure
Pericardial disease Hypoalbuminaemia Neoplasia Diaphragmatic hernia |
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Non-septic exudate from?
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FIP
Neoplasia Diaphragmatic hernia Lung lobe torsion |
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What causes haemorrhagic effusion?
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Trauma
Bleeding disorders Neoplasia Lung lobe torsion |
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Pyothorax produces what kind of fluid?
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A septic exudate
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What are some of the signs of Brachycephalic Airway Syndrome?
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Stenotic nares, elongated soft palate, everted laryngeal saccules, +/- hypoplastic trachea. +/- end stage laryngeal collapse
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What do you need to consider when administering fluids to ruminants?
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Assess hydration status
Route of administration Type of fluid to give How much fluid to give Rate of administration How to monitor patient |
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How can you assess hydration status?
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Eye position
Skin tent Mucous membranes CRT Heart rate |
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What are the signs of mild dehydration? (5%)
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Slight decreased elasticity of skin
Slightly sunken eyes Moist, warm mms |
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Moderate (8%) dehydration?
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Decreased skin elasticity
Slightly sunken eyes Dull attitude Tacky mms |
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Severe (10%) dehydration?
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No skin elasticity
Deeply sunken eyes, dry corneas Prolonged CRT and dry mms |
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SQ fluids can only be given in small amounts and what is the other parameter?
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Must be isotonic, non-irritating
NOT dextrose or calcium products |
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How much oral fluid can an adult ruminant be given?
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10-20 gallons
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When should you not administer hypertonic saline?
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When dehydration is >8%
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What parameters should you monitor when administering IV fluids?
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Hypoproteinaemia
Pulmonary oedema Electrolytes - Ca & K Glucose |
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How do you calculate the amount of fluid to give?
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body weight (kg) x % dehydration
= Fluid deficit (l) |
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What are some of the ongoing losses in a ruminant?
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Diarrhoea, urination, milk production, salivation (choke)
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How do you calculate bicarb deficit?
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body weight (kg) x 0.3 (adult 0.6 neonate) x base deficit
= bicarb deficit (mEq) |
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What is the fluid rate for the first hour in a hypovolaemic calf?
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80ml/kg
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What is the maintenance?
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1ml/1lb/1 hour
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What are the values of isotonic bicarb and saline?
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1.3% bicarb
0.9% saline |
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What percentage of total body water is in the ICF?
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66%
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ECF?
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33%
--------25% intravascular --------50% interstitial --------25% transcellular |
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What is the main electrolyte in the ICF and ECF?
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ICF = potassium
ECF = sodium |
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Which compartment bears the brunt of a pure water loss?
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ICF
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What is the daily fluid requirement of a dog and a horse?
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Dog - 60ml/kg/day
Horse - 50ml/kg/day |
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Hypovolaemia is due to?
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Isotonic fluid loss - loss of water AND electrolytes
Dehydration is just a water loss |
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Give some examples of isotonic fluid loss
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GI losses and blood loss
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Which compartment gives up fluid in a dehydrated animal?
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ICF - leads to a contracture
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What is a hallmark of dehydration?
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Hypernatremia
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Which compartment is effected in hypovolaemia? why?
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ECF - isotonic loss so no effect on tonicity of ECF therefore no water moves across from ICF
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Increased serum sodium triggers what?
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Central osmoreceptors - activates thirst centre
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What are the homeostatic mechanisms for volume depletion?
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Decreased ECF = decreased cardiac output
Decreased CO leads to activation of RAAS/ADH |
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Exhaustion of homeostasis leads to?
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Hypovomaemic shock
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What are the signs of dehydration?
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Tachycardia
Tacky mms Prolonged skin tent Sunken eyes Increased urine SP |
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What are the signs of hypovoaemia?
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Tachycardia
Decreased pulse pressure Reduced jugular fill Tachypnoea Cold extremities Decreased urine output Depression |
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When is hypertonic saline indicated?
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In hypovolaemia to rapidly increase blood volume from ICF
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In the horse 1 litre of hypertonic saline should be followed by how much isotonic crystalloid?
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10 litres
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What are some of the disadvantages of using frozen plasma?
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Need to give it slowly due to risk of reaction
Needs to be thawed and cross matched |
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Hetastarch cannot be measured on which piece of equipment?
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A refractometer
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What does giving oral fluids stimulate? and what is their contraindication?
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gastro-colic reflux
Contraindicated in horses with nasogastric reflux |
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When placing a catheter for IV fluid administration what is most important?
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The size (radius) of the catheter - always use the largest gauge for emergency resusitation
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True or false: In the horse is there is a thrombus in the left jugular you should always try the right jugular
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FALSE - risk blowing that one = pumpkin head
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Which type of catheter would you use in the long term?
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Polyurethane (3-7 days) over-the-wire single or double lumen
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As well as monitoring the catheter for signs of infection or thrombi what else should you do?
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Flush with heparinized saline 4x daily
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What types of diet increase a horses water comsumption?
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High in fibre (decreases urine, increases faecal water)
High protein/calcium (increases urine) |
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Which 2 electrolytes are diet dependent in horses?
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Potassium and calcium
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Horses with anorexia can lead to what?
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K and Ca deficient
Drink less water = dehydration and electrolyte imbalance |
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What is a shock dose of fluids?
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One blood volume = 8% body weight
or 60-80ml/kg Give 1/4 dose and reassess |
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What is the goal of fluid replacement in horses?
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To see the animal urinate
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How much of the crystalloid remains in circulation after 30mins?
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25%
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What would the best fluid for a horse be?
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Containing K+, Ca+ and Mg+
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Potassium values in the fluid should never exceed which value?
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Never exceed 0.5mEq/kg/hour of KCl
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What are some ways of encouraging a horse to drink more?
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Add salt to the diet
Change the water source Change the water temperature |
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How much fluid can you give a horse enterically?
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Can give up to 10L/hr but only 4-6l per dose
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How much pure water can you give a horse via NG tube?
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One dose - after that make up and isotonic solution with salt
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The forebrain consists of what 3 areas?
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Cerebrum
Thalamus Hypothalamus |
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The brainstem consists of what 3 areas?
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Midbrain
Pons Medulla |
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Know the areas of the spinal cord
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Cervical - C1-C5
Cervicothoracic - C6-T2 Thoracolumbar - T3-L3 Lumbosacral - L4-S2 |
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True or False:
Lesions cranial to the pons will show up as contralateral defects |
TRUE
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How can you differentiate central from peripheral vestibular disease?
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Peripheral disease will show up with ataxia and circling but with NO paresis
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Upper Motor Neuron signs consist of what?
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Spastic Paresis
Increased muscle tone Increased spinal reflexes Firm bladder, late mild muscle atrophy |
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Lower Motor Neuron signs consist of what?
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Flaccid paralysis
Decreased muscle tone Decreased spinal reflexes Flaccid bladder, rapid sever muscle atrophy |
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What is the Tensilon test for?
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Myasthenia Gravis - dog jumps back up after collapse
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What do you examine on a neurologic exam?
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Mental state and behaviour
Posture and gait Postural reactions Muscle tone/size Spinal reflexes Pain sensation Cranial nerves |
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When would you not want to do a cisternal CSF tap?
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When there is high ICP
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What are CT and MRI good for?
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CT = bone
MRI = soft tissue |
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What are EMG, ERG, BAER & EEG used for?
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EMG - electromyography - tests nerve conduction
ERG - electroretinography BAER - auditory function EEG - electroencephalography - intracranial lesions |
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Define a seizure
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Excessive or hypersynchronous abnormal electrical activity in the cerebral cortex
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What are the stages of a seizure?
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Prodrome - before
Aura - seen during a seizure Ictal Period - seizure Post-ictal period - after |
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What is the only functional form of intracranial seizure?
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Epilepsy
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What is a number one cause of hypoxia related extracranial seizures?
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Anaesthetic accidents
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What are some conditions that can be confused with seizures?
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Syncope
Hypoglycaemia MG Vestibular disease OCD Sleep and movement disorders |
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Type 1 disk disease is compressive and concussive, which breed does is effect most?
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Chondrodystrophic breeds - Dachshaunds
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What about type 2?
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Usually a compressive force and it can affect any breed, usually older than type 1
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What is it called when cord degeneration progresses cranially up the spinal cord?
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Myelomalacia
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Which stage of the action potential is calcium dependent?
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Second stage
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How is cardiac output calculated?
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CO = SV x HR
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What are the priorities of the heart?
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1. Maintain systemic arterial pressure
2. Maintain normal tissue blood flow 3. Maintain normal systemic and pulmonary capillary pressures |
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What is the number one cause of heart failure?
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Mitral valve endocardiosis
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With what condition can you get enlarged jugular pulses?
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Heart worm
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Which stage of the action potential is calcium dependent?
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Second stage
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How is cardiac output calculated?
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CO = SV x HR
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What are the priorities of the heart?
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1. Maintain systemic arterial pressure
2. Maintain normal tissue blood flow 3. Maintain normal systemic and pulmonary capillary pressures |
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What is the number one cause of heart failure?
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Mitral valve endocardiosis
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With what condition can you get enlarged jugular pulses?
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Heart worm
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In CHF what are the signs of left and right?
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Left = pulmonary oedema
Right = ascites In cats get pleural effusion in both |
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When do the coronary arteries get blood?
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During diastole
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What is the main hormone involved in milk synthesis?
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Prolactin
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Which hormone is responsible for milk let down?
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Oxytocin
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What chemical blocks oxytocin from binding to the myoepithelial cells?
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epinephrine
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Which part of the udder makes up its primary defense?
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The teat canal - muscle sphincter and keratin plug when dry
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Macrophages are present in a healthy udder but when are neutrophils present?
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Bacterial infection but don't work as well as in blood
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What is it about parturition that makes the cow more susceptible to infection?
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Immune system and teat sphincter overwhelmed at calving
Laying in fluids/manure Mammary gland not seen as often so early signs are missed |
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What are the cardinal signs of mastitis?
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Redness
Heat Loss of function Painful |
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Where is udder rot found in a older cow? in a heifer?
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Older cow = front 2 quarters
Heifer = b/w udder and hind legs |
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What are the macroscopic alterations of the secretions?
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Flakes, clots, gargot, clumps, watery or bloody
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What is gargot?
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Flakes of fibrin, cells and calcium which produce chunks
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What is a quantitative test for mastitis?
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California Mastitis test
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What does CMT measure?
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The somatic cell count - with inflammation more cells enter the udder
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What are the classifications of acute mastitis?
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Contagious
Gangrenous Environmental |
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What are the metabolic events in the pathogenesis of bovine ketosis?
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Negative energy balance
Negative glucose balance Adipose metabolism Elevations of plasma NEFA conc |
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NEFAs are mobilised from where? and transported to?
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Mobilised from adipose tissue and transported to the liver where they are converted to ketone bodies in hepatic mitochondria
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What are the 2 primary metabolic fates of NEFA in the liver?
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Ketogenesis and triglyceride synthesis
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When does ketogenesis predominate?
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Peak-lactation ketosis
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When does triglyceride synthesis predominate?
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Post-partum ketosis
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True or false:
It is possible to distinguish post-partum ketosis from fatty liver |
FALSE
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What is triglyceride converted into?
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3 NEFA & 1 Glycerol
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Increased concentrations of ketones does what?
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Reduces feed intake
Increases fat metabolism Increases fat in liver |
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When does hepatic lipidosis form?
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When hepatic triglyceride formation exceeds the formation and release of lipoproteins into circulation
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What is the liver biopsy field test?
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Test for fat content of liver sample - Severe if floats in water and CuSO4
- Moderate if only floats in CuSO4 - Mild if only in high conc CuSO4 |
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Can pregnancy toxaemia occur in any body condition?
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Yes
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Pathogenesis of pregnancy toxaemia is?
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Disruption of glucose homeostasis - foetal uptake of glucose is independent of dam - rumen cannot take in any more feed
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What are some of the causes of fatty liver in cats?
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Diabetes mellitus
Toxins obesity, stress, fodd deprivation |
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What is a result?
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Severe, complete anorexia
Lethargy Vague CNS signs Icterus |
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What is elevated in feline hepatic lipidosis?
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Bilirubin and ALP
Biopsy is needed for specific Dx |
