Bryan - Sa Surgery - Respiratory - Fall 3Rd Year

Front 1

What divides the airway into upper and lower regions?

Back 1

Cricotracheal junction (from the trachea down is lower respiratory)

Front 2

ID the following structures:

Back 2

A - Arytenoid
B - Rima Glottis
C - Corniculate process
D - Cuneiform process
E - Epiglottis
F - Vocal fold

Front 3

What is the swollen area of the ventral nasal concha known as?

Back 3

Alar fold

Front 4

How should a NG tube be placed?

Back 4

Initial dorsomedial then direct it ventral along the ventral nasal concha

Front 5

What is one of the main points of resistance in the upper airway? What structures influence this point?

Back 5

Rima Glottis (affected by motion of arytenoids via Cricoarytenoideus dorsalis)

Front 6

Which nerve innervates most of the muscles of the larynx?

Back 6

Recurrent laryngeal (Cricothyroideus is innervated by vagus)

Front 7

ID 4, 5, 6, and 7

Back 7

4 - Muscular process
5 - Arytenoid cartilage
6 - Thyroid cartilage
7 - Cricoid cartilage

Front 8

T or F:
Increased inspiratory effort or restrictive breathing = upper airway disease.

Back 8

False!
Increased inspiratory effort IS indicative of upper airway disease but restrictive breathing is LOWER airway disease.

Front 9

What are the 4 components of brachycephalic airway syndrome? How is each corrected?

Back 9

Stenotic nares (wedge resection)
Elongated soft palate (Partial staphylectomy)
Everted laryngeal saccules (sacculectomy)
Hypoplastic trachea (maybe tracheostomy)

Front 10

Which parameter assesses ventilation?

Back 10

PaCO2 (gold standard); also PvCO2 and expired CO2 work

Front 11

A bulldog with stertor probably has...

Back 11

...brachycephalic airway syndrome

Front 12

What makes-up the primary palate? The secondary palate?

Back 12

Lips + premaxilla (primary)
hard and soft palates (secondary)

Front 13

T or F:
Surgery of secondary palate defects should delayed until 8 weeks.

Back 13

True! Earlier surgery will lead to facial malformation.

Front 14

What happens in the advanced form of brachycephalic airway syndrome?

Back 14

Complete laryngeal collapse leading to cor pulmonale and R-CHF

Front 15

What is the most common complication of cleft palate surgery?

Back 15

dehisence

Front 16

Surgery of the nasal passages and sinuses is always accompanied by...

Back 16

..HEMORRHAGE

Front 17

What does GOLPP stand for?

Back 17

Geriatric
Onset
Laryngeal
Paralysis
Polyneuropathy

Front 18

Congenital laryngeal paralysis is common in which breeds?

Back 18

Bouviers, Bull Terriers, Rotties, Dalmations, Huskies

Front 19

What is a common signalment for GOLPP? What are common clinical findings?

Back 19

9yo golden, lab, st. bernard, irish setter
Findings include raspy breathing, hypothyroid

Front 20

Describe paradoxical arytenoid motion.

Back 20

Paralyzed arytenoids move IN on inspiration (should move out normally)

Front 21

T or F:
Emergency tracheostomy is common in a lar-par emergency!

Back 21

False!
Sedate (Ace/Torb), give O2, and cool them down!

Front 22

How is lar-par treated surgically? What is a common complication? What is the prognosis?

Back 22

Tx - unilateral arytenoid lateralization;
30% aspiration pneumonia; 80% do well (pretty good prognosis)

Front 23

Where does the trachealis muscle attach in dogs?

Back 23

On the external surface

Front 24

What runs alongside (lateral to) the trachea?

Back 24

Carotid sheath (vagosympathetic trunk, internal jugular, carotid, lymphatics); recurrent laryngeal too

Front 25

What are the types of pneumocytes in the lungs? What is the function of each? Which is most abundant?

Back 25

Type I pneumocytes (most abundant; line alveoli)
Type II pneumocytes (produce surfactant)

Front 26

Where can the pleural cavity be entered without danger of penetrating the lungs?

Back 26

Costodiaphragmatic and costmediastinal recesses

Front 27

Which muscles can be engaged if the diaphragm fails?

Back 27

External intercostal
Sternocleidomasoid
Serratus ventralis
Scalenus

Front 28

Which muscles aid in expiration?

Back 28

Transversus thoracis
Internal intercostal
Rectus abdominus

Front 29

Where is most resistance during inspiration?
a) nasal
b) laryngeal
c) small airway

Back 29

a) nasal

Front 30

Where is most resistance during expiration?
a) nasal
b) laryngeal
c) small airway

Back 30

a) nasal

Front 31

Under what conditions does hemoglobin bind oxygen more?

Back 31

Increased pH
Decreased temperature
Decreased DPG
Decreased PCO2

Front 32

Under what conditions does hemoglobin release oxygen more readily?

Back 32

Decreased pH
Increased temperature
Increased DPG
Increased PCO2

Front 33

Where is respiration controlled?

Back 33

Medulla

Front 34

What obstructive respiratory conditions are common in dogs?

Back 34

Stenotic nares
Nasal tumors
foreign bodies

Front 35

What obstructive respiratory conditions are common in cats?

Back 35

Rhinitis and sinusitis

Front 36

Rapid shallow breaths can be evidence of:
a) decreased lung compliance
b) obstructive conditions
c) pneumothorax
d) stenotic nares

Back 36

a) decreased lung compliance
c) pneumothorax

Front 37

Anything affecting the pleural cavity or pleural space is considered a _____________ disorder.

Back 37

restrictive

Front 38

When performing a thoracocentesis, you feel a "scratching" sensation at the end of your needle. What are your next steps?

Back 38

Stop and withdraw a mm or two...that was just the lungs you were on!

Front 39

What do you do with fluid withdrawn in a thoracocentesis?

Back 39

Measure volume, perform cytology, maybe PCV, total solids, culture

Front 40

What is the next step on an animal that has persistent pleural effusion?

Back 40

Thoracostomy tube

Front 41

What is the common signalment for tracheobronchomalacia?

Back 41

Small breed dog with a honking cough

Front 42

What are some possible complications to surgical tracheal collapse treatment?

Back 42

Tracheal devasculariztaion
Laryngeal paralysis
Breakage at thoracic inlet (stent)
Inhibition of mucociliary clearance (stent)

Front 43

What are two methods for surgically treating tracheal collapse? What is the prognosis?

Back 43

Stent and cervical support rings:
70% success rate

Front 44

When performing a tracheaostomy, how wide should the horizontal slit be made?

Back 44

no more than 50% of tracheal circumference (more like 30%)

Front 45

What vein should be noted when performing a tracheostomy?

Back 45

Cranial thyroid vein

Front 46

What is the signalment for most tracheal tears?

Back 46

Cats, post dental procedure (ET tube trauma)

Front 47

What are the 2 types of lobectomy?

Back 47

Partial or complete

Front 48

How much lung can be removed without major complications?

Back 48

Up to 50%

Front 49

T or F:
The left lung comprises over 50% of overall lung tissue.

Back 49

False! This describes the RIGHT lung

Front 50

Which two dogs typically get lung lobe torsion and which lobe?

Back 50

Narrow, deep-chested dogs (right middle)
Pugs (left cranial)

Front 51

When should a torsed lung lobe be untorsed?

Back 51

NEVER! perform a lobectomy to avoid reperfusion injuries!

Front 52

What are indications for lobectomy?

Back 52

Neoplasia
Infections
Lung lobe torsion

Front 53

What are post lobectomy compensation factors?

Back 53

1) recruitment of existing physiological reserves of diffusing capacity
2) remodeling of alveolar-capillary network
3) new or regenerative alveolar-capillary growth

Front 54

Performing a thoracocentesis on a dog with lung lobe torsion should reveal...

Back 54

...serosanguinous or chylous fluid