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190 Cards in this Set
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What are some indications for oxygen therapy?
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-impaired pulmonary function
-hyperventilation -ineffective delivery of O2 within the body --increased tissue O2 demand -inadequate inspired concentrations of O2 |
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What is the hallmark sign of dyspnea?
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Cynosis
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What are signs of dyspnea?
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-cynosis
-anxiety as a reult of "air hunger" -Tachypnea -panting, exaggerated manner -Open mouth breathing in cats -Excessive respiratory effort -extended head and neck as they try to breath -tachycardia -aggression and thrashing |
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What is PaO2?
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Partial pressure O2 concentration
-It is an analysis of arterial sample for O2 concentration. -Most accurate measure of O2 tissue diffusion -Reflects how lungs are functioning -Normal is 80-105mm of mercury |
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What does pulse oximetry measure?
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-The % of hemoglobin that is saturated with oxygen
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What are some limits of pulse oximetry that lead to false readings?
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-BODY TEMP-hypothermia will show a false low reading
-MOVEMENT -LIGHT -SKIN PIGMENT -THIN TISSUE |
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How could you double check the pulse oximeter's reading to make sure the reading is accurate?
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Double check the reading by comparing pulse reading on pulse Ox with the ECG or asculatation. IF the readings match, the O2 reading is most likely accurate.
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What is the percentage of oxygen in normal room air?
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21%
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An oxygen rich environment has what percentage of oxygen?
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>40%
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What is used to measure O2 concentration?
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O2 analyzer
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Prolonged exposure to high concentrations of oxygen can result in
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O2 toxicity
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What are signs of O2 toxicity?
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O2 toxicity is partially due to production of free radicals
-Pulmonary edema -hemorrhage -atlectasis -fibrosis of lungs -blindness due to sensitivity of retinal vessels |
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What are 6 methods of delivering O2?
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-Mask
-Flow by (short term) -Oxyhood -Nasal catheter -Intra-tracheal catheter -O2 cage |
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What is an Oxyhood?
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Brand name of a type of oxygen hood. There are a variety of methods for replicating this type of O2 delivery method.
-Plastic bag or shower cap over most of e-collar -Can reach O2 concentrations of 80% -MUST MONITOR O2 with analyzer -Over heating is a concern |
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Describe placing a nasal catheter for O2 delivery
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-Use a red rubber catheter inserted into the nose
-Long term use -Inserted to the point of medial canthus of the eye in regards to length of insertion -Will use a local for placement -Will be sutured in -Will attach a disposable humidifier to and O2 flowmeter - |
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Describe placing a intra-tracheal catheter for O2 delivery.
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-Used for long term O2 delivery
-Surgically placed under anesthesia -Inserted through the tracheal rings -Flow rate is adjusted according to breathing rate -Tracheitis is a potential concern |
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Describe O2 cages for oxygen delivery.
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-For long term needs
-Are Expensive -Monitors O2, CO2 levels, temperature and humidity |
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What are 4 general things a tech needs to know regarding fluid therapy?
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-Basic understanding of physiologic requirements of patients being treated
-Available replacement solutions -Fluid dosing and delivery systems -Patient response and monitoring |
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What are 5 uses of fluid therapy in clinical medicine?
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-Replace dehydration deficits
-Maintain normal hydration -Replace lost blood volume -Replace essential electrolytes & nutrients -Infusing IV meds |
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In an adult animal, how much of the total body weight is Water?
In neonates? |
60%
70-80% |
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Of the 60% total body weight that is water in an adult:
How much is ICF? How much is ECF? How much is in the vasculature? |
ICF- 40%
ECF-20% 0f this 20%, -interstitial fluid is 15% -5% is fluids in the blood stream |
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How much fluid loss typically results in death?
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15-20%
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What are considered sensible losses?
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This refers to measurable losses.
-urine -blood -vomiting -diarrhea |
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What are considered insensible losses?
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Not measurable losses
-Perspiration -Respiration -Normal fluid material |
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What are the 5 basic categories of fluids?
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-Crystalloids
-Colloids -Hemoglobin -Blood products -IV nutrition |
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Crystalloids are the main types of fluids used in clinics and consists of:
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Water with a varying amounts of electrolytes, sodium and glucose
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What are 4 types of cystalloid fluids?
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Replacement
Maintenance Hypertonic Dextrose and water |
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What are indications for replacement crystalloid fluids?
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Dehydration
Surgery Normal support during anesthesia Shock |
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What are Replacement crystalloids made up of?
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Solutes found in this solution similar to those found in the water portion of plasma
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What are some brand names of replacement crystalloids?
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Normasol R
Plasmalyte Ringers, which is lactated NaCl 0.9% which is non-lactated |
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Lactated ringers refers to a replacement crystalloid that is
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a solution that is isotonic with blood
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What are maintenance cystalloids made up of?
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they are similar to replacement crystalloids with added glucose, and varying amounts of electrolytes
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What are indications for Maintenance crystalloid therapy?
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**infused at maintenance rates, no bolus
-Keep patient hydrated -Cellular support during periods of NPO -Support normal daily losses |
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What are some brand names of replacement crystalloids?
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Plasmalyte 56
LRS + Dextrose 0.45% NaCL + Dextrose |
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What is a hypertonic crystalloid fluid?
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a 7.2% NaCL
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What are some indications for using hypertonic crystalloid solutions?
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-Emergency situations where there are concerns about cardiovasular collapse:
-Shock -hemorrhage -low bp |
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How does a hypertonic crystalloid work?
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Draws fluids into cardiovascular system from tissues. This is a transient effect that only lasts for 30 minutes maximum. Will need to follow up with Replacement crystalloid.
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What are the qualities of 5% Dextrose in water crystalloid?
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-not commonly used
-When used, it is often as a vehicle for other meds. |
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What are the qualities of colloids/colloidial fluids?
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A high molecular weight compound that does not readily leave the intravascular space.
-hold fluids and keep them in the vascular space with the aid of water holding/drawing proteins ---->This EXPANDS IV VOLUME |
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What are the indications for colloidial fluids?
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-hemorrhaging
-Sepsis -Pancreatitis -Gastroenteritis |
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What are the 4 types of colloidial fluids?
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-Plasma
-Hetastarch -Dextrans -Oxyglobin |
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What are the 3 contraindications for the use of colloidial fluids?
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-coagulopathies
-Patients with heart disease -patients with pulmonary disease |
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What is Oxyglobin and when is it indicated?
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-A colloidial fluid
-Synthetic compound composed of Hemoglobin -Universally compatible -Can be used in any patient that needs RBCs-anemia, hypovolemia |
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What are advantages of Oxyglobin?
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-Universally compatible
-More effective than RBC's for off loading O2 to tissues -Has a long shelf life, especially compared to blood products -Better for patients with liver disease compared to blood products |
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What are some disadvantages of using Oxyglobin colloid therapy?
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-$$$ expensive
- Turns RBC and MM brownish color -Does have a colloidial effect and can be overdone |
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What is the half-life of Oxyglobin?
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18-24 hours
out of the body completely in 4-9 days |
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What are some indications for the use of blood products?
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-Replace RBC's
-Plasma protein replacement -Platelet replacement -Coag factor replacement |
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Parenteral nutrition can be used partial or full time and is used for patients where__________.
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enteral nutrition is not feasible such as:
-Pancreatitis -Protracted vomiting -Intestinal malabsorption -Severe GDV |
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Parenteral nutrition is formulated for each patient individually taking what into consideration/
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Weight
Duration of supplementation Type needed-partial or full nutrition -All will need to be refridgerated |
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Although it is preferred that fluids be taken in orally, what is the most common way of giving therapeutic fluids?
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IV
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What are other methods of IV fluid administration from most common to least?
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SQ
IP IO Rectal |
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What are some signs of overhydration?
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-Generalized edema
-pitting edema -Pulmonary edema -fluid from the nose -Restlessness -Excessive urination -Possible dyspnea -Chemosis-swelling of eye conjunctiva |
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What are the 3 catagories to determine how much fluid you need to give to the patient?
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-maintenance needs-basic bodily needs
-Dehydration % replacement -Continuing losses-due to vomiting, diarrhea etc |
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What are the formulas for figuring the amount for dehydration?
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(body weight) in pounds
times percent dehydrated times 454 equals milliliters needed OR (body weight) in kilograms times percent dehydrated times 1000 = millilters needed |
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What are the daily maintenance requirements for fluids in dogs? Cats
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dogs-20-30mls/lb/day
cats 10-20mls/lb/day |
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What are some items that should be monitored during fluid administration?
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-Monitor lung sounds
-skin turgor- improving? -PCV -TP Urinary output CVP-Central venous pressure |
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How do you determine an animal is <5% dehydrated?
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Primarily due to a history of fluid loss such as vomiting and diarrhea.
Will see normal turgor, MM, CRT, PCV, Total plasma protein, enophthalmus but a decrease in urine volume |
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What are signs of 5-7% dehydration?
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-decreased urine volume
-Skin Turgor-slight delay -MM-moist -CRT-<2sec -PCV-no change -TPP-slight increase -ENOPHTHALMUS-none |
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What are signs of 8-9% dehydration?
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-decreased urine volume
-Skin Turgor-moderate delay -MM-dry -CRT-2-3 seconds -PCV-slight increase -TPP-mild increase -ENOPHTHALMOS-mild +/- tachycardia |
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What are signs of 10-12% dehydration?
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-Decreased urine output
-Skin Turgor-severe delay -MM-dry -CRT->3 seconds -PCV- increase -TPP- marked increase -ENOPHTHALMOS-severe Extremities-Cold Tachycardia-yes |
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What are signs of >12% dehydration?
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**LIFE THREATENING**SHOCK**
-Decreased/absent urine output, concentrated -Skin Turgor-severe delay -MM-dry -CRT->3sec -PCV-increase -TPP-marked increase -Enophthalmos-severe -Extremeties-cold Tachycardia shock |
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What are some triage questions for medical situations to ask when a client calls?
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-How is animal breathing?
-What color are the gums? -Is the pet awake and alert? Aware of surroundings? -V/D? How much? How often? -Any abdominal distention? -Can the pet urinate? -What medications is the pet taking? Herbal supplements? |
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What are some triage questions for a trauma related situation?
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-Nature of the injury?
-How is the animals breathing? -What color are the gums? -Is there any bleeding? How much? -Is the animal awake, alert, aware of surroundings? -Can the animal move on its own? -Are there any obvious fractures or wounds? |
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What are some clinical signs that require immediate attention by the veterinary health care team?
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-Respiratory distress
-Pale MM/Any abnormally colored MM -Neurologic abnormalities -Severe coughing -bleeding from orifices -rapid abnormal distention -inability to urinate -ingestion of toxins -severe hypo or hyperthermia -excessive bleeding -Open Fx -Snake bite -Prolapsed organs -Dystocia -Trauma -burns |
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During hospital traige, what 3 major body systems are assessed?
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Respiratory, Cardiovascular, Neurologic
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As you approach the triage patient, what should you assess before you even get there?
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-Ventilation-pattern, effort, rate
-Presence of blood -Patients posture-aggressive, alert, quiet -Consciousness level |
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What is torticollis?
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animals head is turned back towards their flank
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What is opisthotonos?
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a condition in which the body is held in an abnormal posture. It usually involves rigidity and severe arching of the back, with the head thrown backward.
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What are the ABC's of triage?
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A-airway
B-Breathing C-circulation D-Dysfunction, disability, deficits of a neurological nature |
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What does A CRASH PLAN stand for?
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Airway
Circulation Respiratory Abdomen Spine Head Pelvis Limbs Arteries/veins Nerves |
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What items are assessed with the Airway part of the plan?
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Ventilation, ascultation, palpation
Patent airway adequate ventilitation -respiratory rate, pattern, flared nares. open mouth breathing -postural position--exaggerated efforts -cynosis |
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Assessment of breathing and breath sounds involves?
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Is there loud breathing or stridor (can be heard w/o a stethoscope)
-on inspiration or expiration? -Rapid shallow breathing -labored breathing in & out -moist lung sounds -Dry course lung sounds -Total absence of lung sounds |
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What items are assessed with checking circulation in a triage situation?
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Heart rate
- Tachycardic-shock, stress, fear -Bradycardic-hypothermic, hypoglycemia, hyperkalmia, hypothyroidism -Heart Rhythm- -abnormal ECG pattern -Asculate both left and right sides -Muffled heart sounds: -Fluid in lungs, pericarditis, severe hypovolemia, abdominal contents in thoracic cavity -Pulse deficits-VPC/PCV |
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What items are assessed when evaluating perfusion parameters?
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-PULSE-strength and quality of pressure-normal, bounding, weak?
-MM -CRT -Jugular condition |
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What items are assessed when evaluating the jugular?
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Jugular distention-due to right CHF which causes a back up
Jugular pulse-right CHF leads to blood backing up when heart contracts |
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What items are checked/looked for when assessing MM?
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Color is assessed
-Pale/white-anemia, vasoconstriction, low bp, pain -cynotic/blue-due to low O2 tissue perfusion -Icteric/brick red- vasodialation, hyperthermia, septic animals, -Grey-pooling, stagnation of blood |
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What are reasons for prolonged CRT?
Rapid CRT? |
Prolonged-dehydration, hypovolemia
Rapid-hyperthermia, shock |
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Of the ABCD's of trage, what is the D and what is assessed?
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-Dysfunction/disability
Perform a cursory neuro exam to check: -PLR (pupillary light reflex) -Posture -patients level of consciousness -Response to pain -Mentation-appropriate responses, slow to respond -seizure activity- -intracranial is often due to tumors, clots -extracranial is often due to hypoglycemia, toxins |
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The nervous system consists of what 4 items?
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Brain
Spinal cord Nerves Sense Organs |
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What is the basic function of the nervous system?
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It controls, regulates, coordinates body movements and actions.
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What are the 2 main divisions of the nervous system?
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Central nervous system (CNS)
Peripheral nervous system (PNS) |
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What are the main components of the CNS?
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Brain & Spinal cord
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What are the main components of the PNS?
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Peripheral nerves
Spinal nerves that branch off Sensory nerves Cranial Nerves |
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What are the 2 physiological divisions of the nervous system?
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Somatic
Autonomic |
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What does the somatic division of the NS do?
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Controls voluntary movement, skeletal muscles
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What does the autonomic division of the NS do?
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Controls involuntary function
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What are the 2 divisions of the autonomic portion of the NS?
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Sympathetic-fight or flight
Parasympathetic- rest & digest |
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On the posterior border of the sternocleidomastoid muscle, level with the laryngeal prominence.
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SI-16
天窓, 天窗 tiān chuāng - celestial window |
SKY WINDOW (1 of 2)
ACTIONS Benefits the ears, throat and voice Regulates qi and calms the spirit Activates the channel, alleviates pain and clears heat INDICATIONS • Deafness, tinnitus, ear pain. • Sudden loss of voice, sudden loss of voice following windstroke, hoarseness due to cold in the throat, lockjaw, clenched teeth from windstroke, headache. • Throat pain, goitre, swelling and pain of the cheek, heat sensation of the skin of the face, urticaria. • Manic ghost talk, mania-depression. |
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What is the diencephalon?
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a complex of structures within the brain, whose major divisions are the thalamus and hypothalamus. It functions as a relay system between sensory input neurons and other parts of the brain, as an interactive site for the central nervous and endocrine systems, and works in tandem with the limbic system.
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The diencephalon is made up of what structures?
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Thalamus and hypothalamus
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What is the function of the thalamus?
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Functions as a relay station for incoming sensory info
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What are the functions of the hypothalamus?
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-Body temp control
-Hunger -eating drinking behavior -Sleep patterns -Interface between NS and endocrine system |
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What are the 4 main parts of the brain?
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Cerebrum
Cerebellum Brain stem diencephalon |
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What are the functions of the cerebellum?
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-Coordinates ALL motor activity
-Helps maintain equilibrium |
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What are the 3 parts of the brain stem?
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Midbrain
Pons Medulla oblongata |
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What is the function of the midbrain portion of the brainstem?
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Coordinates movement of eyeballs, head and trunk
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What is the function of the Pons portion of the brainstem?
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helps control breathing
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What are the functions of the medulla oblongota portion of the brainstem?
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-Consciousness & arousal
-regulates heart rate -regulates breathing -regulates blood vessel diameter -coordinates swallowing, vomiting, sneezing and coughing |
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What are the 5 levels of consciousness we discussed in class?
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1) Conscious - normal, bright alert and responsive
2) Hysterical - exaggerated or inappropriate responses 3) Depressed - less responsive to stimulus 4) Stupor- little to no response to stimulus 5) Coma- NO response to stimulus |
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Peripheral nerves enter and exit the spinal cord with 2 types of nerves. What are they?
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-Dorsal root - brings sensory info TO the spinal cord
-Ventral root-Brings the brains response out to the muscles. Exits spinal cord ventrally and SENDS motor info out to muscles. |
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What is the vertebral formula for dogs and cats?
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C7 T13 L7 S3 Cy3-24
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What is the Brachial plexus?
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A collection of spinal nerves from C5 to T2 and these are responsible for innervating the front limbs
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What is the lumbosacral plexus?
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Collection of nerves from L4 to S3 that innervate the hind limb
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What is the response of nervous tissue to injury?
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Does not respond well
Very slow to heal Has a high metabolic rate-high 02 and glucose requirements Low mitotic rate=low regeneration rate |
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What is ataxia?
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Muscle incoordination
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What is paresis?
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muscle weakness that may lead to paralysis
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What are the postures discussed in class in relation to the nervous system?
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Ataxia
Paresis Circling-head tilt Decerebrate rigity Decerebellate rigidity Opisthotonus Schiff-sherrington Proprioception |
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What does Decerebrate rigidity involve
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All 4 limbs are hyper extended
Patient is unconscious Indicates a brain stem injury POOR prognosis |
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What is decerebellate rigidity?
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Front legs are rigid and extended
hind legs are flexed or relaxed Patient is unconscious POOR prognosis |
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What is opisthotonus?
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A spasm in which the head and neck are arched backwards.
-POOR prognosis |
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What is a Schiff-Sherrigton posture?
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-Only happens in dogs
-Related to a severe spinal cord injury in the T2-L4 region. -Front legs are extended and rigid -hind legs are paralyzed |
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What is proprioception?
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The sense of where your body is in relation to the ground.
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In relation to nervous system postures, what does a delayed proprioception posture response indicate?
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A delay in righting in the "foot knuckling" test indicates cerebellar injury.
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What are are three respiratory signs that indicate a nervous system issue?
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-Cheyne stokes breathing
-Apneustic -Agonal |
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What is cheyne stokes breathing?
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-Cyclic hyperventilation followed by periods of apnea
-indicative of cerebrum damage |
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What is apneustic breathing?
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Long inspiration with a pause
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What is agonal breathing?
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Terminal gasps
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What are reflexes and what are the 5 types discussed in class?
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-Rapid, automatic responses that protect the body from injury.
1. Somatic-contraction of skeletal muscles 2. Autonomic - regulates smooth & cardiac muscles 3. Reflex arc - 4. Stretch reflex 5. Withdrawal reflex |
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What is the reflex arc?
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A reflex that originates from sensory receptors, then---
Sends that action potential to target organ-- ends in contraction or inhibition |
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What is the stretch reflex?
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Afferent(sensory) & Efferent (motor) neurons are involved.
-Ex-tapping patellar ligament - Tapping the tendon stretches the thigh muscle. -This activates stretch receptors within the muscle called muscle spindles. |
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What is the Withdrawal reflex?
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-Flexor reflex
-Withdrawal from unpleasant stimuli |
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What are 6 vision reflexes we discussed in class?
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-Corneal
-palpebral pupillary light reflex menace reflex Nystagmus Strabismus |
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What is the corneal reflex?
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blink reflex
last reflex to go Should always be present, even under anesthesia |
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What is the Palpebral reflex?
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blinking of the eye in response to touching of the medial canthus. Sensory and motor nerves of eyelids
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What is the pupillary light reflex?
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-Only test for functioning of autonomic control of pupils.
-Afferent and efferent pathways NORMAL-responsive ABNORMAL-delayed response or fixed and dilated MIOSIS-pinpoint MYDRIASIS-dialated **reflexes may be normal in a blind animal even with damage |
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What is the menace reflex?
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Movement towards the eye causes blinking and possibly moving away
NORMAL-blink ABNORMAL-not responsive, could indicate cerebellar disease -response not usually present in babies |
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What is nystagmus?
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involuntary movement of the eyes
-may be up and down or side to side -Causes-cerebrum injury, drugs and vestibular disease |
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What is strabismus?
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Cross eyed
one or both eyes may be affected -Due to damage of ocular muscles OR cranial nerves |
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What are the 2 main generalized types of brain trauma?
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Direct injury-HBC, kicked in head
Secondary-disease process causing increased intercranial pressure. Ex-meningitis, seizures, hypoxia |
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What are some clinical signs of brain trauma?
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-Hx indicates a traumatic event
-Posturing -seizures -blood from eyes, ears, nose -level of consciousness -pupil size -head tilt -nystagmus -irregular breathing pattern |
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What are some basic treatments for brain trauma?
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-Elevate head
-Diuretics to reduce swelling *Mannitol commonly used-can cross the BBB, Lasix does NOT -For seizures -Valium first -then phenobarbitol -possibly will use steriods -Do radiographs, CBC, chem panels to find primary cause |
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What are a few basic things you may want to tell an owner of a pet with a brain trauma?
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-Pet can be saved but most likely will never be the same mentally or physically
-Animal in a coma longer than 48 hours usually dies -For animals showing deteriorating signs, GRAVE prognosis |
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What is idiopathic epilepsy?
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Repeated episodes of seizures without a demonstrated cause. Is a diagnosis of rule out after check other possible causes.
-Diagnostics not usually done unless there is more than one seizure per month. -Generally seen in animals between 1 & 3 years of age -Will be normal between seizures. |
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What is the treatment for idiopathic epilepsy?
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-Only treat if more than one seizure per month because meds tend to have significant side effects
-Phenobarbitol BID or TID for life ---will need regular vet visits to monitor side effects on the liver. May also prescribe Potassium bromide as well |
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There is a higher incidence of seizures in what population of animals?
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Intact animals, both male and female
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What breeds are predisposed to idiopathic epilepsy?
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GSD, Cockers, Boxers, Goldens,
Minature and Toy poodles, St. Bernards, Irish Setters, labs |
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What is status epilepticus?
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It is a state of seizing, not a disease.
Animal is in a continually seizing state True EMERGENCY!! Seizures lasting LONGER than 10 minutes result in DEATH! |
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What is the first concern for treatment for status epilepticus?
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STOP the seizure
-Valium-drug of choice -pentobarbital -phenobarbitol -these 2 may be given with valium or after - these have a longer onset of action and a longer duration of effect -Propofol or thiopental-to INDUCE ANESTHESIA, calms electrical activity when valium does not work -May leave under as long as 12 hours |
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Once the seizure is stopped, what is the next concern for treatment of status epilepticus?
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+/- endotrach tube to secure patent airway
-O2 therapy by mask or flow by -Place an IVC in Lateral saphenous---away from the BITING end in event of another seizure -Check the blood glucose and calicium -Cool bath if over 105 degrees F ------seizures increases body temp +/- diuretics and steriods |
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Intervertebral Disc disease (IVDD) has 2 types of herniations, what are they?
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Type 1- Acute onset
-Younger dogs -can be linked to traumatic events Type 2- Chronic occurrence -Older dogs -larger breed dogs, long back dogs - Builds over time - |
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What are clinical signs of IVDD?
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-Pain
-sensory deficits -Unilateral or bilateral paresis/ paralysis -decreased panniculus response ( sides twitching in response to pinching) -Altered deep pain response |
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What is the treatment for type 1 IVDD?
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-Medical treatment is reasonable if they have 0 to mild neurological deficits.
-Strict cage rest for 2 weeks minimum -Steroids for inflammation Surgical treatment for animals with multiple episodes with ataxia, paralysis or no deep pain response --laminectomy or partial discectomy. |
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What is is a laminectomy?
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Removal of dorsal spinal processes to relieve pressure on spine
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What is a partial discectomy?
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a surgery done to remove a part of a herniated disc from the spinal canal. When a disc herniation occurs, a fragment of the normal spinal disc is dislodged. This fragment may press against the spinal cord or the nerves that surround the spinal cord. This pressure causes the symptoms that are characteristic of herniated discs.
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How is a type 2 chronic IVDD treated?
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Chronic damage to nerves is more of an issue
Damage may not be reversible Cage rest -Laminectomy -partial discectomy |
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What is some info you may give a client for a pet that has IVDD?
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-Keep animal at a lean healthy weight
-Avoid back straining activities such as stairs and jumping -Poor prognosis for those w/o deep pain response -prognosis fair-good for those patients w/deep pian response before Sx or regained after Sx. -40% chance of repeat episodes -Extensive nursing care at home for weeks to months will be needed. |
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What is the vestibular apparatus?
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Tells us where we are in relation to the ground and how body should move in relation to it.
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What is Idiopathic Vestibular Disease?
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sudden onset of balance loss, disorientation, lack of coordination, reluctance to stand, falling, circling, rapid irregular eye movements and/or head tilt. They typically appear to be in considerable distress and may have accompanying bouts of nausea and vomiting. Despite the startlingly acute onset, affected animals tend to recover from IVD spontaneously in a matter of days, without treatment.
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What are some clinical signs of Idiopathic Vestibular Disease?
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Ataxia
Motion sickness Nystagmus Circling head tilt Falling to one side trouble controlling nerves in head and face |
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Idiopathic Vestibular disc disease is a diagnosis of rule out and tends to happen with what age of dogs and cats?
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Middle age
cats can be seasonal--seen more in summer and fall |
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What is the treatment and outcome for Idiopathic Vestibular Disease?
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Animals tend to recover w/in 72 hours, back to normal w/in 3-6 weeks
Tx: -Tranquilizers to reduce anxiety -anti-nausea meds -confinement -will need assistance with bodily functions -force feeding |
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What is laryngeal paralysis?
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One or both of the arytenoid cartilages are paralyzed.
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What are the 3 types of laryngeal paralysis?
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Acquired
Idiopathic Heriditary |
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What are clinical signs of laryngeal paralysis?
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-Inspiratory stridor
-Respiratory distress -Exercise intolerance -Dyspnea -cynosis |
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What causes acquired laryngeal paralysis?
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Lead poisoning, rabies, trauma, inflammation of vagus nerve
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Where is idiopathic laryngeal paralysis more likely to be seen?
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middle age and older dogs
large and giant breed dogs |
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Where is hereditary laryngeal paralysis more likely to be seen?
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Neutered males
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How is laryngeal paralysis diagnosed?
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Larayngoscopy
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How is laryngeal paralysis treated?
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Arytenoidectomy
tie back surgery *Concerns about aspiration pneumonia Prognosis guarded to good |
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What are the causes of tick paralysis?
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The salivary neurotoxin from the female ticks intereferes with release of acetocolin at the neuromuscular junction.
-Common dog tick and Rocky Mountain wood tick common causes |
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What are the clinical signs of Tick paralysis?
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Paralysis that starts in hind end and MAY progress along with ticks on the dog
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How is tick paralysis diagnosed?
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Ticks found
R/O other NM diseases May just Tx to see if it works |
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What is the treatment for Tick paralysis?
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-Get rid of ticks
-Proban helps get rid of ticks -Once ticks are gone, paralysis will wear off as neurotoxin gets out of system |
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What is the neuro exam rule out acronym and what does it stand for?
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DAMNIT
D-Degenerative type diseases A-anomolies such as hydrocephalus M-Metabolic disease such as lead toxicity, partosytemic shunt N-neoplastic and nutrition based disease I-inflammatory, infectious, infarcts, idiopathic, inherited T-trauma, toxins |
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What are some postural reaction tests that were discussed in class?
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PLACING- paw position corrected when placed back
HOPPING-support body, pick up one leg to see if animal hops while pushed towards that leg HEMI-WALKING-hopping on one side while both legs are held up CATS-placing of paws while insecure or blind folded WHEEL BORROWING-differentiate between front and hind weakness POSTURAL EXTENT OF THRUST-placement of paws when put down |
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What are the 3 tests for vestibular system reflexes that are done on the pelvic limb?
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-PETELLAR-tap petellar tendon-reflex will be present, decreased or absent
-GASTROCNEMIUS-hock is flexed, tapped and semi-mem and tend should flex/twitch -WITHDRAWAL/SCIATIC NERVE-pinch toes |
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What re the 3 tests for vestibular system reflexes that are done for the thorasic limb?
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-TRICEPS-Flex limb, tap olecranon just above and triceps should twitch
-BICEPS-insertion of biceps is tapped should cause them to twitch WITHDRAWAL-Toe pinch |
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What are the 3 somatosensory function tests?
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LOOK for response to pain, not just a withdrawal reflex
-SUPERFICIAL-tested with a toe pinch -DEEP PAIN-pinch toes with blunt part of forceps, squeeze between the shafts. **last reflex to disappear -CUTANEOUS SENSORY TESTING-Double pinch-fingers then forceps look for responses on varipus parts of the legs |
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What is the panniculus response?
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Pinch skin around wing of ilium, watch for contraction, twitching of cutaneous trunci muscles (hind part of rib cage)
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Spinal palpation test is ALWAYS the last part of a neuro exam. How is it done?
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Animal is supported while palpating spine caudal to cranial. Use thumb to push down on spine and watch for painful withdrawal.
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What are some responses that Sympathetic Stimulation of the Autonomic nervous system will result is?
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***FIGHT OR FLIGHT***
-Pupil dilation- -Salivary production reduced -Mucous production reduced -Heart rate and force increased -Vasoconstriction of bloodflow to gut -Vasodilation of blood flow to muscles -Bronchial muscles relax -Peristalsis reduced -Gut motility reduced -Increased conversion of glycogen to glucose -Decreased urine secretion -Norepinephrine & Epinephrine secreted from adrenal medulla - |
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What are some responses that Parasympathetic Stimulation of the Autonomic nervous system will result is?
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**rest and digest**
-Pupil constriction -Saliva production increased -Mucous production increased -Heart rate and force decreased -Bronchial muscles contracted -Gastric juices secreted, motility of stomach and intestines increased -increased urine secretion |
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What are some key areas that need attention when caring for the neuro patient?
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-understand the disease process
-monitoring constantly -administering of therapeutics -hygiene -environment -nutrition -physical activity -emotional support -client education |
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What are some areas that need extra attention for a neuro patient?
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Skin
immunity urinary and defecation assistance muscles mind bones and joints digestive pulmonary circulatory **TIMELY treatment is EXTREMELY important |
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What are some possible skin complications seen in a neuro patient?
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DERMATITIS- due to unclean skin, urine scald
DECUBITAL ULCERS-pressure sores SURGICAL SITE INFECTION-cleanliness more important as this animal is typically on steroids. |
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How are skin complications prevented?
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-Hygiene
-Padding of cage and bony protuberances -Turning animal regularly -Massage -Thermotherapy-warm packs -Whirlpool therapy-stimulates muscles and blood flow |
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Neuro patients are generally immunocompromised due to?
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Being on steroids
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What is the most common nosocomial infection in neuro patients?
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Urinary tract, followed by Respiratory then surgical site
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Urinary tract complications are often due to 3 items, what are they?
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Incontinence-loss of bladder sphincter tone
Retention-bladder sphincter is overtight Infection-often due to incontinence |
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How do you try to prevent urinary complications in a neuro patient?
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Manual expression
Urethral cathetherization |
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What are some potential complication for muscles and joints in the neuro patient?
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-Atrophy
-Adhesions -Spasm -Weakness -contracture |
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What are some ways to prevent some of the muscle and joint complications seen in a neuro patient?
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Massage
Hydrotherapy ROM -improve joint mobility -increase muscle and tendon flexibility -Minimize muscle contracture -limits joint rigidity -Active exercises -restores strength, stamina and coordination. Improves cardiovascular fitness |
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What are some potential digestive complications seen in the neuro patient?
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-Gastroenteritis
-Gastric ulcers-steroids decrease GI integrity leading to increased ulcers -Incontinence or constipation of bowels -Malnutrition and dehydration -higher calorie need in healing animals |
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What are a few ways to reduce GI complications?
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Meds-Antacids, stool softeners
Good hygine Diet |
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What is a primary pulmonary concern in neuro patients?
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Atlectasis-if animal lays on one side too long, pressure can cause the down side lung to collapse
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What are some ways to prevent pulmonary complications in the neuro patient?
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-Turning
-Ventilatory assistance in cases of -tetanus -botulism -tick paralysis |
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What are 2 possible circulatory complications in a neuro patient?
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Phlebitis-cath will be difficult to flush, and area will show signs of inflammation
Edema-on the periphery of the down side |
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What are a few ways to prevent circulatory issues in a neuro patient?
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Catheter asepsis
Turning of patient Massage and ROM Thermotherapy |
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What are some potential complications of the mind in neuro patient?
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Boredom
loneliness hopelessness |
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What are some ways to prevent the mental complications in neuro patients?
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-Attention, affection
-Distractions -Visits by owner -PT Tv in room |
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