Term
| What are some dz of conducting airways that causes airway lumen narrowing? |
|
Definition
-paralysis
-constriction: bronchi
-collapse
-mass
-edema or hemorrhage
-stricture or stenosis |
|
|
Term
| What are some common causes of irritation to the conducting airways? |
|
Definition
-infectious
-non-infectious inflammatory: allergy, collapse, noxious gas, FB |
|
|
Term
| What is laryngeal paralysis? |
|
Definition
| -loss of innervation & function by caudal laryngeal n (except cricothyroideus m) |
|
|
Term
| What is the typical signalment of laryngeal paralysis? |
|
Definition
-dogs >>> cats
-large dogs >> smaller
-acquired >>> congenital |
|
|
Term
| Describe acquired laryngeal paralysis. |
|
Definition
-slowly progressive
-clinically apparent: middle to older age
-predispositions: labs, st bernards |
|
|
Term
| Describe congenital laryngeal paralysis. |
|
Definition
-predispositions: Bouvier des Flandres, Siberian husky, labs, English setters
-autosomal dominant in Bouvier |
|
|
Term
| What are the CS of laryngeal paralysis? |
|
Definition
-strigor, gagging/coughing after drinking
-inspiratory dyspnea
0exercise intolerance
-voice change ***
-cyanosis
-hyperthermia
-collapse |
|
|
Term
| What are some common sequelae of laryngeal paralysis? |
|
Definition
-laryngitis & edema
-aspiration pneumonia
-non-cardiogenic pulmonary edema
-heat-related illness |
|
|
Term
| How do we diagnose laryngeal paralysis? |
|
Definition
-laryngeal exam
-neuro exam
-thoracic rads: pulmonary edema, aspiration pneumonia, mediastinal or cervical masses
-if generalized wakness/megaesphagus: ACHr (MG), ACTH stim (addison's) |
|
|
Term
| How do we treat the dyspnea that occurs w/ laryngeal paralysis? |
|
Definition
-O2 supplementation
-sedation: Ace, Butorphanol
-short-acting corticosteroid: dec laryngeal edema
-cooling: room temp IV fluids, urinary bladder lavage, wetting paw pads, fans
-anesthesia, intubation, +/- tracheostomy |
|
|
Term
| Why would we not perform a cold water enema to cool a laryngeal paralysis patient? |
|
Definition
| -then rectal temps are fake |
|
|
Term
| How do we medically treat laryngeal paralysis? |
|
Definition
-exercise rstriction
-avoid hot & humid environments
+/- sedation if expected excitation
Doxepin: tricyclic antidepressant |
|
|
Term
| How do we surgically treat laryngeal paralysis? |
|
Definition
|
|
Term
| What is the typical signalment of tracheal collapse? |
|
Definition
-dogs >> cats
-small dogs >> large dogs
-middle-aged: 3-8y |
|
|
Term
| What induces CS of tracheal collapse? |
|
Definition
-exercise
-excitement
-P from neck lead |
|
|
Term
| Briefly describe the pathophys of tracheal collapse. |
|
Definition
-primary >> secondary
-primary: tracheomalacia: hypocellular, dec GAG/chondroitin sulfate, Ca
-secondary: trauma, tracheal masses, extraluminal masses
-concurrent bronchial collapse
-secondary tracheitis & bronchitis |
|
|
Term
| What are the CS of tracheal collapse? |
|
Definition
-dry, honking cough
-dyspnea
-exercise intolerance
-cyanosis
-syncope
-stridor
-hyperthermia
-progressive over mm to yy |
|
|
Term
| How does dyspnea help to localize tracheal collapse? |
|
Definition
-inspiratory = extrathoracic
-expiratory = intrathoracic |
|
|
Term
| How do we diagnose tracheal collapse? |
|
Definition
-easily inducible cough, trachea flattened dorsoventrally
-thoracic rads (exp AND insp): include entire trahcea
-fluoroscopy
-tracheoscopy: GOLD STANDARD |
|
|
Term
| How do we medically manage tracheal collapse? |
|
Definition
-anti-tussives: hydrocodone
-wt loss
-avoid neck leads
-remove environmental pollutants
-bronchodilators: if smaller aiways affected
-corticosteroids: anti-inflamm dose
-abx for secondary infections |
|
|
Term
| How do we surgically manage tracheal collapse? |
|
Definition
-tracheal stent: self expanding metallic stent (SEMS)
-patient will require meds long-term |
|
|
Term
| What are some common complications of tracheal stent? |
|
Definition
-excess granulation tissue
-stent migration
-stent fracture |
|
|
