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45 Cards in this Set
- Front
- Back
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What is included in the upper airway?
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paranasal sinuses
nasopharynx larynx |
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What are the functions of the upper airway?
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-olfaction
-regulation of air flow -protection during swallowing -phonation -thermoregulation |
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What two things will allow you to determine the location of the obstruction?
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breathing pattern
auscultation |
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What three things will help you determine the degree of compromise?
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-rate and character of breathing
-posture -state of consciousness |
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How do you manage an emergency with the upper airway?
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supplemental oxygen by nasal, mask or cage
-cooling (water, enema, bladder lavage) -anxiolytics -corticosteroids -establish an airway (intubation, tracheostomy) |
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What is a fixed obstruction?
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It is usually an anatomic abnormality; there will be no change during breathing phases
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What is a nonfixed obstuction?
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can be anatomic or functional; it does change during different breathing phases
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Upper airway will be harder on inspiration or expiration?
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inspiration, expiration will not be as hard
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Where is stridor usually located?
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usually larynx-distal
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What does an outside the thorax change tell you in regards to the locations of nonfixed obstructions?
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INSPIRATION
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What does an outside the thorax change tell you in egards to the locations of nonfixed obstructions?
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EXHALATION
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What are three common obstructions?
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brachycephalic syndrome
laryngeal paralysis tracheal collapse |
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What breeds are associated with brachycephalic syndrome?
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-bulldogs
-boston terriers -pekingese -shih tzu -lhasa apso -persian |
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What are the components of brachycephalic syndrome?
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Stenotic Nares
Elongated Soft Palate Everted Laryngeal Saccules Hypoplastic Trachea |
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What are some of the signs of brachycephalic syndrome?
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-inspiratory stridor, dyspnea
-cough, gag -exercise intolerance -cyanosis, collapse -pregressive -acute decompensation -progressive -acute decompensation |
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What are some things involved in the primary pathophysiology of brachycephalic syndrome?
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stenotic nares
elongated soft palate |
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What are some things involved in the secondary pathophysiology of brachycephalic syndrome?
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-epithelial and secretory hyperplasia
-laryngeal collapse |
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What is the medial management of brachycephalic syndrome?
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-weight loss
-avoid stress, heat -emergency therapy (oxygen, sedate, cool, bypass with trach) |
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What is the treatment for stenotic naries?
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enlarge them
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What is the treatment for the everted laryngeal saccules?
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laryngeal sacculectomy
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What is laryngeal collapse?
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It means the saccules have gone between stage I and are now in stage III
-it may follow brachycephalic syndrome or other upper airway lesions -It is a progressive weakening and collapse of the laryngeal structures |
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Can you fix a hypoplastic trachea?
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-you can't treat this
-you must treat concurrent diseases/ anomalies |
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What is the prognosis for brachycephalic syndrome?
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It is usually good if no other abnormalities and/or anesthetic complications (recovery)
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What breeds are associated with a congenital laryngeal paralysis?
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Bouvier
Husky Dalmation |
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What are some reasons for an acquired laryngeal paralysis?
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neoplasia
surgery trauma hypothyroidism |
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What dogs get idiopathic laryngeal paralysis?
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older, large breed dogs
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What are some signs of laryngeal paralysis?
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-change in voice
-inspiratory stridor -cough, gag -exercise intolerance -cyanosis, collapse SEVERE INSPIRATORY DYSPNEA |
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How do you make a diagnosis of laryngeal paralysis?
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-rule out concurrent/other cervical, systemic, or pulmonary disease (such as aspiration pneumonia)
-examine the airway under sedation (LACK OF ARYTENOID ABDUCTION WITH INSPIRATION) -Beware of paradoxical movement (pulling larynx closed on inspiration...bad) |
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What is the medical management for laryngeal paralysis?
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-emergency measures may be needed in an acute crises
-weight loss -pneumonia (antimicrobials, nebulization, coupage, etc.) |
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What is the surgical treatment for laryngeal paralysis?
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-arytenoid lateralization-suture the muscular process to the dorsolateral aspect of the cricoid cartilage
-it mimics the natural function of the cricoarytenoideus dorsalis (the arytenoid abductor muscle) |
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laryngeal paralysis -post-surgical care?
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-monitor water consumption (carefully for the first 1-2 days after surgery
-strict rest for 2 weeks -feed "meatballs" for 2 weeks |
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What are the possible surgical complications of laryngeal paralysis?
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-cough 1-2 weeks post-surgery
-aspiration pneumonia -breakage of the suture or cartilage -seroma, hematoma |
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What causes tracheal collapse?
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weakening of the tracheal cartilages and redundancy of the dorsal tracheal membrane causing luminal compromise
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What breeds are usually affected by tracheal collapse?
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-miniature and toy breeds
-pomeranian -yorkshire terrier -poodle -maltese -chihuaha |
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What age dogs are usually affected by tracheal collapse?
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5-7 years of age
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What are some signs of tracheal collapse?
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Honking cough, stridor, exercise intolerance, cyanosis, collapse
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What are some things you see on physical exam associated with tracheal collapse?
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-cough with tracheal palpation
-stridor -flattened trachea -hepatomegaly --> chronic hypoxemia can cause hepatomegally |
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How do you make a diagnosis of tracheal collapse?
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-inspiratory and expiratory radiographs
-fluoroscopy -airway examination -tracheobronchoscopy |
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What are some concurrent conditions seen with tracheal collapse?
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hepatomegaly
cardiac disease small airway disease |
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What is the medical management of tracheal collapse?
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-alter environment, avoid stress
-bronchodilator - theophylline -cough suppressant - butorphanol, hycodan -antimicrobials - best per C/S -emergency measures in acute crisis |
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What are the indications for surgical intervention in the case of tracheal collapse?
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-severe clinical signs
-grade II or worse collapse -worse despite medical managment |
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What surgical options are available for tracheal collapse?
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-extraluminal splinting with total or spiral ring prosthetics
-support and open the cartilagenous and membranous trachea |
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What are some complications of tracheal collapse?
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laryngeal paralysis
-continued cough, medical therapy -small airway disease -tracheal vascular compromise -surgical treatment protects against acute life-threatening airway compromise |
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Is stenting intraluminal?
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yes
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What are some stent complications?
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-relapse - stent slowly shortens as it widens
-stent migration or fracture -granulation tissue -laryngospasm -air - subcutaneous or mediastinal |
