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68 Cards in this Set
- Front
- Back
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What paired muscle do you cut between when performing a tracheotomy?
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Sternothyrohyoideus muscles
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What are the landmarks of the maxillary sinus?
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Facial crest
Medial canthus Infraorbital foramen |
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What structures are in the lateral compartment of the guttural pouch?
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Maxillary artery
Maxillary vein CN VII branch |
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What divides the medial and lateral compartments of the guttural pouch?
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Stylohyoid bone
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What structures are in the medial compartment of the guttural pouch?
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Internal carotid artery
CNs 9, 10, 11, 12 Sympathetic trunk Cranial cervical ganglion Common medial septum |
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What are the clinical signs of an ethmoid hematoma?
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Mild epistaxis
Exercise intolerance Dyspnea |
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What is the treatment for an ethmoid hematoma?
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Repeated formalin injections
Surgical excision Laser excision |
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What are the clinical signs seen with sinonasal cysts?
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Progressive airway obstruction
Bony distortion Nasal discharge |
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How do you treat a sinonasal cyst?
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Removal of cystic lining by excision
Formalin injection into cyst |
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What are two common types of nasal tumor?
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Squamous cell carcinoma
Adenocarcinoma |
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What are treatment options for nasal neoplasias?
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Radiation therapy - $$$$
Laser excision Cisplatin injections Formalin injections (may not be effective) |
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What is an Atheroma?
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Epidermal inclusion cyst/nasal inclusion cyst
Benign cysts in false nostril/alar fold Filled with mucoid material |
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What is the treatment for nasal inclusion cysts?
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Complete surgical excision of cyst
Formalin infusion |
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Why is it important to remove redundant alar folds?
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They flutter and cause airway interference, expiratory noise, partial obstruction
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What are clinical signs of guttural pouch mycosis?
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Epistaxis
Dyspnea Dysphagia Shock Anemia Cranial nerve deficits |
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What is the treatment for guttural pouch mycosis?
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Supportive care
Surgical ligation of affected vessels Balloon catheterization (Prevents retrograde bleed from Circle of Willis) Coil embolization Conservative treatment only if no epistaxis - lufenuron, anti-fungals, preventative ligation |
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What bacteria typically causes guttural pouch empyema
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Streptococcus
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What are the clinical signs of guttural pouch empyema?
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Unilateral or bilateral nasal discharge
Swollen throatlatch region |
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What is the treatment for guttural pouch empyema?
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Saline/K pen/Dilute betadine lavage
Multiple catheterizations Indwelling catheters Endoscopic snare for condroids |
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What surgical approach is used for draining the guttural pouch?
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Modified Whiteouse approach
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What is guttural pouch tympany?
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Air accumulation within guttural pouch
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What horses are most likely to be diagnosed with guttural pouch tympany?
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Young foals
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What are clinical signs of guttural pouch tympany?
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Swelling in throatlatch area, either unilateral or bilateral
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What is the treatment for guttural pouch tympany?
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Surgical excision into pharyngeal opening of guttural pouch
Laser surgery to create stoma between guttural pouches - only works if unilateral. |
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What is stylohyoid osteoarthropathy?
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Progressive enlargement of stylohyoid bone
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What can become traumatized by stylohyoid osteoarthropathy?
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CN VII and VIII
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What are clinical signs of stylohyoid osteoarthropathy?
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Head shaking
Neurologic deficits Nebulous behavior changes |
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What is the treatment for stylohyoid osteoarthropathy?
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Ceratohyoid ostectomy (better outcome, gradual resolution of clinical signs after surgery)
Supportive care for neurologic signs May need temporary tarsorrhaphy |
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What are clinical signs of dorsal displacement of the soft palate?
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Exercise intolerance
Respiratory noise Gurgling or "choking down" Dysphagia if persistent form |
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How do you diagnose DDSP?
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Treadmill endoscopy or endoscopy immediately after exercise
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What is the conservative treatment for DDSP?
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Conditioning unfit horse
Tack changes including figure-8 noseband Tongue ties |
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What is the surgical treatment for DDSP?
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Tie-forward procedure: basihyoid to thyroid cartilage sutures, moves larynx dorsal and rostral
Staphylectomy Myectomy/Tendinectomy of sternothyroideus insertion Epiglottic augmentation |
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What occurs during pharyngeal collapse?
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Dorsal or rostral collapse of pharyngeal walls
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What are the clinical signs of pharyngeal collapse?
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Dyspnea
Respiratory noise Exercise intolerance |
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What is the treatment for pharyngeal collapse?
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No surgical treatment available
Rest, NSAIDS, throat spray |
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What are some clinical signs of cleft palate?
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Milk or feed out both nostrils
Coughing Aspiration pneumonia Ill-thrift |
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What is the treatment and prognosis for cleft palate?
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Surgical correction via pharyngotomy or mandibular symphysiotomy
Prognosis guarded |
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What horses commonly get pharyngeal lymphoid hyperplasia?
What should you do about it? |
Young horses
Tx: rest, NSAID's |
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What is choanal atresia, and what are the two types?
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Congenital abnormality associated with failure of the bucconasal membrane to resorb
Membanous or bony types |
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What are the clinical signs of choanal atresia?
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Dyspnea
Loud respiratory noise |
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How do you treat choanal atresia?
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Excision of membrane via nasal bone flap or endoscopy
Poor prognosis for bony choanal atresia |
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What muscle is paralyzed in idiopathic laryngeal hemiplegia?
This is due to damage to what nerve? |
Cricoarytenoid dorsalis
Left recurrent laryngeal nerve |
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What are clinical signs of idiopathic laryngeal hemiplegia?
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Exercise intolerance
Poor performance Noise on inspiration (roars) Inspiratory dyspnea Muscle atrophy on palpation |
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How do you diagnose idiopathic larygeal hemiplegia?
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Endoscopic exam with treadmill evaluation (grade 1-4)
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Choose grade 1-4 idiopathic laryngeal hemiplegia:
Symmetrical synchronous abduction and adduction |
Grade 1
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Choose grade 1-4 idiopathic laryngeal hemiplegia:
Some asynchronous movement of left arytenoid Full abduction when swallowing or nasal occlusion |
Grade 2
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Choose grade 1-4 idiopathic laryngeal hemiplegia:
Asynchronous movement of left arytenoid Partial but not full abduction of arytenoid |
Grade 3
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Choose grade 1-4 idiopathic laryngeal hemiplegia:
Complete paralysis of left arytenoid Dynamic collapse during exercise |
Grade 4
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What is the slap test?
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A method of testing laryngeal function:
-Light to moderate slap on withers - Reflex via accessory nerve XI causes brief adduction of opposite arytenoid cartilage -Look for symmetry -Does not replace dynamic testing |
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How can nasal occlusion help to test laryngeal function?
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Use fingers over bridge of the nose to temporarily occlude airflow
Abduction of arytenoid cartilages with increasing effort-mimicks dynamic condition |
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What is the treatment for grade I or II laryngeal hemiplegia?
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No treatment needed
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What is the treatment for grade III or IV laryngeal hemiplegia?
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Laryngoplasty (tie-back)
Removal of vocal cord +/- ventricle or saccule Neuromuscular pedicle grafts |
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What is performed during a tie back procedure?
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Lateral approach ventral to linguofacial vein
One or two prosthetic sutures from cricoid notch of the cricoid cartilage to the muscular process of the arytenoid cartilage Use non-absorbably suture |
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What are some possible complications of a tie back procedure?
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Aspiration
Coughing Dysphagia Wound drainage/infection Failure |
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Where are neuromuscular pedicals removed from in order to do a pedicle graft for a horse with laryngeal hemiplegia?
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Grafts from first cervical nerve and omohyoideus m.
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What is arytenoid chondritis?
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Inflammation of the arytenoid cartilage that is probably related to chronic low grade infection.
Results in decreased airflow due to abnormal thickening +/- paralysis |
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What is the treatment for arytenoid chondritis?
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- Rest, abx, NSAIDS
- Laser removal of granulation tissue - Permanent tracheostomy - esp. if bilateral chondritis |
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What are complications of arytenoidectomy?
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Postoperative swelling for 3-5 days
Excessive granulation tissue Inadequate airway for athletic function Coughing Aspiration |
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What is epiglottic entrapment?
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Entrapment occurs when the aryepiglottic fold displaces dorsally to entrap the epiglottis.
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What are clinical signs of epiglottic entrapment?
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Exercise intolerance
May cause a respiratory noise Coughing No clinical signs |
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What is the treatment for epiglottic entrapment?
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-Laser excision of aryepiglottic fold via endoscopy
-Transnasal or transoral excision under general anesthesia using a curved bistoury -NSAIDS -Throat spray to reduce inflammation |
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What age of horse is most commonly affected by subepiglottic cysts?
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Foals, but any age can be affected
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What are the clinical signs of subepiglottic cyst?
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Exercise intolerance
Dysphagia Coughing Respiratory stridor |
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What is the treatment for subepiglottic cyst?
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-Laryngotomy or laser excision
-Diode or Nd: YAG laser via endoscope -Electrocautery snare -NSAIDS -Throat spray -Alternative: 10% formalin injections |
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What is rostral displacement of the palatopharyngeal arch due to?
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Congenital abnormality due to defect of 4th branchial arch.
Complex of laryngeal and pharyngeal abnormalities -Secondary to arytenoid chondritis |
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What is the treatment for rostral displacement of the palatopharyngeal arch?
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No surgical treatment.
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What is epiglottic retroversion?
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Epiglottis obstructs airway during inspiration
Secondary to lymph node abscessation, respiratory disease, pharyngotomy incision No surgical treatment option |
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What is the treatment for tracheal collapse?
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Surgical tracheal reconstruction:
-External prosthesis -Internal prosthesis -Anastomosis |
