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handout: respiratory system definitions
Dr corrine sweeney

we're starting on time, so those of you who are not here, oh well. 
actually, it looks like everyone is ditching class today to study for 
pathology. ptui.

the one page handout includes all the info we need to know for today's 
lecture, we're just going to ENRICH those definitions during the lecture. 
this should complement dr king's lecture that we just had.

this list of definitions is not ALL the words that have to do w/the resp 
system, but is an introduction. will hear them all again when we discuss 
diseases. this time next year in med/surg one...

need to make sure you know the anatomy
endoscopy teaching video:

nares, nasal passages, nasal septum and soft palate are seen, turbinates 
are seen (ethmoids), entering wide nasopharynx, at 10 and 2 o clock see 
openings to guttural pouches. see larynx in the distance. through the 
larynx into the trachea. back out of there. into the esophagus, out of 
the esophagus. into the guttural pouch. see the white strand - nerve. can 
see the stylohyoid bone separating the pouch into medial and lateral 
parts. enough of anatomy.

horse nose with blood on the skin of the nares.
remember to lift alar folds when passing tubes through the nose.

argh. slide projector is dead again, and jack isn't here. someone is 
trying to jiggle it. poor dr sweeny is coming down to check it out. 
*sigh* what a drag.

ok, it's fixed. 

slide of ethmoids, turbinates, opening to guttural pouch, dorsal pharynx 
with inflammation, larynx, trachea, and bifurcation of trachea.

Auscultation: art of listening to sounds within the body
Breath sounds: sounds associated wtih air movement in tracheobronchial 
tree. normal sounds. not wheezes, crackles
bronchoscopy: visualization of bronchi with an endoscope...can go pretty 
far down there in a sedated horse.
Chest drain: tube allowing continuous or intermittent draining of the 
pleural cavity. what should pleural fluid look like? should be clear, 
serous in normal animal.
Cough: sudden noisy expulsion of air from lungs
Dyspnea: difficult or labored breathing. really, a sensation of 
breathlessness. flared nostrils often seen in horses with dyspnea
Endoscopic exam: visual inspection of the body using an endoscope. can do 
this in awake horse.
Epistaxis: hemorrhage from the nostril. not any one disease. any 
hemorrhage from the nostril. often indicative of pulmonary hemorrhage, 
though. lots of horses have exercise induced pulmonary hemorrhage.
Expiratory Dyspnea: difficulty getting air out of the lungs. seen with 
chronic obstructive pulmonary disease - airways constricted, hard to get 
air out.

Guttural pouch empyema: accumulation of pus in the guttural pouch. can 
cause pus to leak from nostril.

Guttural pouch mycosis: fungal infxn in guttural pouch. on slide, we see 
big black disgusting clot - it's a blood clot. endoscopic exam shows this 
yellow plaque of fungal growth over the carotid artery. it's pretty 
gross.

Heave line: hypertrophy of the abdominal muscles in response to forced 
expiration. we're looking at the COPD horse again. hypertrophy of 
abdominal muscles occurs after animal spends a lot of time working to 
breathe out.

Hemothorax: blood in the pleural cavity. you drain this out with a chest 
drain.

Inspiratory dyspnea: difficulty getting air into the lungs or 
transferring O2 to RBCs

Nasal discharge: a nongaseous material escaping the respiratory tract 
through the external nares. may be purulent, serous, hemorrhagic, etc and 
unilateral or bilateral.

Nasal swabbing: obtaining a swab specimen eg for culture from the nasal 
cavity

Necrotizing pneumonia: pneumonia associated with tissue death. nasty 
pneumonia. bad disease. kills lung tissue. slide of one dead lung with 
one real lung. dead/necrotic lung is all sloughing off.

penetrating chest wound: injury resulting in disruption of chest wall, 
often resulting in pneumothorax. slide of horse with some kind of tree 
limb or something sticking out of the chest - oh, a big fence post went 
in there. 

percussion: striking a body part with short, sharp blows as a diagnostic 
aid - you listen to the sound produced - should be able to tell air 
filled space from fluid filled space by the sound.

pleural adhesions:  fibrous bands connecting the pleura to another 
structure (lung or chest wall or other pleura). slide shows adhesions all 
over the intrathoracic surfaces. yellow-white shaggy stuff.

pleural effusion: liquid in the pleural space. can drain with a chest 
drain. can see on ultrasound - the white lung is pushed away from the 
chest wall by the black fluid.

pleural friction rub: sound generated during inspiration or expiration 
originating from abnormal pleural surfaces

pleurodynia: pain within the pleura/ intercostal pain. lots of pulmonary 
diseases involve PAIN.

pneumonia: inflammation of the lung (usually used to mean infection of 
lung)

pneumothorax: accumulation of air/gas in pleural cavity, usually due to 
penetrating chest wound. animal will be dyspneic. need to suck the air 
out and allow lungs to reinflate.  on radiographs, you will see that one 
lung edge is pushed away from chest wall more than another.

pyothorax: accumulation of purulent material in thoracic 
cavity...thoracic empyema. most of these horses do ok...expensive to 
treat,but they usually survive.

retropharyngeal lymphadenopathy: enlargement of the retropharyngeal LN 
(not the submandibular...)

rhinitis: inflammation of the mucous membranes of the nose - inside the 
nose. will often be accompanied by a serous nasal discharge. if you look 
at nasal passage, will see inflammation of mucosa... nasty looking

Roaring:  this is a lay term used for laryngeal hemiplegia, but refers to 
laryngeal stenotic sound most pronounced during inspiration. see atrophy 
of cricoarytenoid dorsalis muscle.

sinusitis: inflammation of the sinus. may be accompanied by nasal 
discharge. will see asymmetry on radiographs. can drain pus by draining 
sinus with a needle/pin, and then flushing the sinus. most of the 
sinusitis is in the maxillary region.

submandibular lymphadenopathy: enlargement of submandibular LN. strangles 
causes this.

Tachypnea: increased respiratory rate

thoracocentesis: surgical puncture of chest wall for drainage of fluid. 

tracheal secretions: material found in trachea usually moving from lungs 
up toward the larynx. can be collected and viewed for cytology or 
cultured or whatever.

VIDEO:
four minutes. promise :)
a little montage, if you will, showing some of these things we just 
discussed.
no. wait. problem with VCR. needs to warm up for 30 sec.
dyspneic horse - abdominal muscles really pumping, nostrils flaring, this 
horse has severe COPD and has dyspnea at rest. horse with pleurodynia - 
biting person who touches chest. some guy percussing chest of horse. 
tracheal aspirate: removing tracheal secretion with a syringe and needle. 
could also do this endoscopically. video of transtracheal wash done 
endoscopically. clip of student doing a thoracocentesis. 

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