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Respiratory System

VTT 235/245 Anatomy &
    Pathology Lab
Introduction
 The body’s cells need a constant
  supply of oxygen to produce energy.
 Carbon dioxide is a waste product of
  these energy-producing reactions and
  must be eliminated.
Types of Respiration
 External- occurs in the lungs and is the
  exchange of O2 and CO2 between the air in
  the lungs and the blood flowing through the
  pulmonary capillaries.
 Internal- occurs all over the body.
   It is the exchange of O2 & CO2 between the blood
    and the cells & tissues.
 Both types of respiration are constantly
  taking place.
Secondary Functions
 **Voice Production- “phonation”
   The process begins in the **larynx (voice
    box).
   Vocal cords stretch across the lumen of
    the larynx and vibrate as air passes over
    them.
Secondary Functions…
 Body Temperature Regulation-
   A network of superficial blood vessels just
    under the epithelium of the nasal
    passages helps warm inhaled air before it
    reaches the lungs.
   The respiratory system prevents over-
    heating by panting.
Secondary Functions…
 Acid-base Balance Regulation-
   For normal chemical reactions to occur, the
    relative acidity or alkalinity of their environment
    must be controlled carefully.
   The unit used to express acidity or alkalinity is
    pH.
   The respiratory system uses its ability to
    influence the amount of CO2 in the blood.
   The more CO2 there is in the blood, the lower the
    blood pH.
Structures

Upper Respiratory System
Nose
 Begins with the nostrils (nares) which lead
  to the nasal passages.
 The nasal passages are located between
  the nostrils and the **pharynx (throat).
 A midline wall separates the right from the
  left nasal passage called the nasal septum.
 The hard & soft palates separate the
  nasal passages from the mouth.
Nose
 Turbinates-
   Thin, scroll-like
    bones that help
    warm and humidify
    inspired air.
   They also filter
    particulate matter,
    such as dust and
    pollen, before it can
    reach the lungs.
Nose
 Paranasal Sinuses-
   Contained within the spaces of the
    maxillary and frontal bones of the
    skull.
Pharynx
 The nasal passages lead back into the
  pharynx .
 It is the common passageway for the
  respiratory and digestive systems.
 The soft palate divides the pharynx
  into the dorsal nasopharynx
  (respiratory passageway) and the
  ventral oropharynx (digestive
  passageway).
Pharynx…
 At the caudal end, the
  pharynx opens
  dorsally into the
  esophagus and
  ventrally into the
  larynx.
 The larynx & pharynx
  work together to
  prevent swallowing
  from interfering with
  breathing.
Larynx
 “Voice box”
 A short, irregular
  tube that connects
  the pharynx with the
  trachea.
 The larynx is
  supported in place
  by the hyoid bone.
Larynx…Contents…
 Vocal folds- the most lateral
  structures, located on the lateral edges
  of the glottis.
 Epiglottis- a triangular flap of tissue
  that covers or protects the glottis when
  in the “up” position.
 Glottis- the most ventral opening of
  the larynx.
Larynx…Functions
 Voice production
 Keeps foreign material out of the lungs
  by the trapdoor action of the epiglottis.
 It controls airflow to the lungs by
  adjusting the diameter of the glottis.
Glottis
 Closure of the glottis even aids in non-
  respiratory functions that involve
  straining such as: urination, defecation,
  and parturition.
   Straining begins with the animal holding
    the glottis closed while applying pressure
    to the thorax with the breathing muscles.
Glottis…
 This stabilizes the thorax and allows the
  abdominal muscles to effectively
  compress the abdominal organs when
  they contract.
 Without the closed glottis, contraction of
  the abdominal muscles merely forces air
  out of the lungs.
Trachea
 A short, wide tube that extends from
  the larynx to the thorax where it divides
  into the two main bronchi that enter the
  lungs.
 This division is called the bifurcation of
  the trachea and it occurs at the level of
  the base of the heart.
Trachea
 The trachea is composed of
  fibrous tissue and smooth
  muscle held open by hyline
  cartilage rings.
 If nothing held the trachea open,
  it would collapse each time the
  animal inhaled as a result of the
  partial vacuum created by the
  inhalation process.
 Each tracheal ring is C-shaped
  with the open part of the C
  facing dorsally.
 The gap of each ring is bridged
  by smooth muscle.
Structures

Lower Respiratory Tract
Lower Respiratory Tract
 Starts with the bronchi, ends with the
  alveoli, and includes all the air
  passages in between.
 Most of the structures in the lower
  respiratory tract are located within the
  lungs.
Bronchial Tree
 The air passages that lead from the
  bronchi to the alveoli.
 After it enters the lungs, each main
  bronchus divides into smaller and
  smaller bronchi until they become
  tiny bronchioles.**
 The smallest air passageways are
  called alveolar ducts.**
Bronchial Tree…
 The alveolar ducts end in groups of
  alveolar sacs.
 The diameter of each bronchi can be
  adjusted by smooth muscle-
   Bronchiodilation
   Bronchioconstriction
Alveoli
 External respiration
  takes place in the
  alveoli.
 They are tiny, thin-
  walled sacs that are
  surrounded by
  networks of capillaries.
 The wall of each alveoli
  is composed of thin
  epithelium.
Alveoli…
 The capillary walls
  are composed of
  the same thin
  epithelium.
 These two thin
  layers allow oxygen
  and carbon dioxide
  to diffuse back and
  forth.
Lungs
 The base of each lung lies directly on top of
  the diaphragm.
 Between each lung is an area called the
  mediastinum, which contains:
     Heart
     Large blood vessels
     Nerves
     Trachea
     Esophagus
     Lymphatic vessels & lymph nodes
Lungs…
 **The left lung has 2 lobes-
   Cranial and Caudal
 **The right lung has 4 lobes-
   Cranial, middle, caudal, & accessory.
 Each lung has a well-defined area on
  its medial side called a hilus where
  blood, lymph, and nerves enter and
  exit the lung.
Lungs…
 Physically the lungs are very light and
  have a spongy consistency.
 If a piece of lung from an animal that
  has taken one breath was placed
  under water, it would float.
Thorax
 A thin membrane called pleura lines
  the thoracic cavity and its organs.
   Organs- visceral pleura
   Cavity- parietal pleura
 The diaphragm is the thin sheet of
  skeletal muscle that forms the caudal
  boundary of the thorax.
Physiology
Physiology…
 The process of respiration requires
  effective movement of air in and out of
  the lungs at an appropriate rate and
  sufficient volume.
Negative Intrathoracic Pressure
 The pressure within the thorax is
  negative with respect to the
  atmospheric pressure.
 A partial vacuum exists within the
  thorax.
 That partial vacuum pulls the lungs
  against the thoracic wall and aids in
  the return of blood to the heart.
Inspiration
 The basic mechanism for inspiration is
  enlargement of the thoracic cavity by
  the inspiratory muscles.
 The main muscles of inspiration are
  the diaphragm and the external
  intercostals.
Expiration
 The main muscles of expiration are the
  internal intercostals and the abdominal
  muscles.
 When abdominal muscles contract, they
  push abdominal organs into the diaphragm.
 Expiration does not require as much work
  because gravity pulls the ribs down helping
  to decrease the thoracic cavity volume.
Respiratory Volumes
 Tidal Volume- the amount of air
  inspired and expired in one breath.
 Minute Volume- the amount of
  volume inspired and expired in one
  minute.
Gas Exchange
 Occurs in the alveoli.
 Gas exchange follows
  the laws of simple
  diffusion.
 Basically, gas
  molecules from areas
  of a high concentration
  like to move to areas of
  low concentration.
Gas Exchange…
Control of Breathing
 Breathing is controlled by an area of the
  brain stem known as the respiratory center.
 The body has two main systems that control
  breathing:
   Mechanical system
   Chemical system
Mechanical Control
Mechanical Control…
Chemical Control
Pathology
Sinusitis
 Usually involves the frontal or maxillary sinus
  in the dog.
 It can manifest as a collection of pus in the
  area, resulting in a swelling over the sinus.
 It can be a result of the openings of the
  nasal passages swelling shut or becoming
  plugged.
    This results in the fluid from the sinuses having
     nowhere to go.
Sinusitis…
 A common cause of this problem is a
  tooth root abscess.
Kennel Cough
 Infectious Canine Tracheobronchitis
 Caused by the bacteria Bordatella
  bronchiseptica.
 The disease is characterized by a dry,
  hacking cough that can be stimulated
  by palpating the throat.
Tracheal Collapse
 This defect involves tracheal rings that lose
  their ability to remain firm, subsequently
  collapsing during respiration.
 ***Obese toy and miniature breeds of dogs
  are predisposed.
 The usually narrow space between the ends
  of several of the C-shaped tracheal rings is
  wider than normal.
Tracheal Collapse…
 When the animals inhales, the widened area of the
  smooth muscle gets sucked down into the lumen of
  the trachea and partially blocks it.
 This can cause a dry, honking cough and difficulty
  breathing (dyspnea).
Tracheal Collapse…
 Therapy includes:
   Weight loss for
    obese animals
   Exercise restriction
   Reduction of
    excitement & stress
   Surgical therapy
Feline Asthma p. 255
 A disease characterized by
  spontaneous bronchioconstriction &
  airway inflammation.
 Clinical signs include:
   Coughing
   Wheezing
   Labored breathing
Feline Asthma…
 Airway epithelium may hypertrophy,
  goblet cells and submucosal glands
  may produce excess mucus, and the
  bronchial mucosa can become
  infiltrated with inflammatory cells.
Feline Asthma…
 All these changes result in decreased
  air flow.
 A 50% decrease in the lumen of the
  trachea is possible.
Feline Viral Rhinotracheitis
 A highly contagious disease that is
  extremely severe in young kittens.
 Infections occur year-round in both
  vaccinated and un-vaccinated cats.
 Transmission occurs through aerosolization
  (sneezing) and direct contact.
   Queens may transmit the disease to their kittens
    during grooming.
Pleural Effusion
 The build-up of fluid in the pleural
  space which results in respiratory
  distress.
 Right-sided CHF is the principal cause
  of pleural effusion in both canine &
  feline patients.
Pleural Effusion…
 As systemic venous hypertension
  increases, significant amounts of the
  fluid accumulates in the pleural space,
  causing respiratory difficulty.
Pleural Effusion…
 All pleural effusions produce symptoms
  of respiratory distress, dyspnea,
  cough, & circulatory compromise.
Pneumothorax & Lung Collapse p. 258

   Pneumothorax: the presence of free air
    in the pleural space.
Pneumothorax & Lung Collapse…
  Without negative intrathoracic
   pressure, normal breathing cannot take
   place.
  If air leaks into the pleural space, that
   negative pressure is lost.
  This results in the lung falling away
   from the thoracic wall.
 The dark black region on the right side of this CT
  image clearly shows where the lung has separated
  from the chest wall.
 Note the difference between the two lungs.
 One is fully expanded and fills up the chest cavity,
  the other is shrunken (i.e. collapsed) and only fills up
  part of the chest cavity.
Pneumothorax & Lung Collapse…
  The general cause is the air comes
   either from the outside, as in the case
   of a penetrating wound, or from the
   lung itself due to the rupture of the
   alveoli as a result of lung disease or
   injury.
Pneumothorax & Lung Collapse…
  Treatment consists of re-establishing
   the partial vacuum within the pleural
   space by:
    Sucking out the air with a needle.
    Placement of a chest tube.
Coughs, Sneezes, Yawns, Sighs, & Hiccups
                 p. 262
   All Are temporary interruptions in the
    normal breathing pattern.
   They can be:
      Responses to irritation (coughs &
       sneezes)
      Attempts to correct imbalances (yawns &
       sighs).
      Or they may occur for unknown reasons
       (hiccups).
Coughs, Sneezes, Yawns, Sighs, & Hiccups

   A cough is a protective reflex that is
    stimulated by irritation of foreign matter
    in the trachea or bronchi.
      It consists of a sudden, forceful expiration
       of air.
Coughs, Sneezes, Yawns, Sighs, & Hiccups

   A sneeze is similar to a cough, but the
    irritation originates in the nasal passages.
      The burst of air is directed through the nose and
       mouth in an effort to eliminate the irritant.
   A yawn is a slow, deep breath taken
    through a wide-open mouth.
      It may be stimulated by a slight decrease in the
       oxygen level of blood, or it may just be due to
       boredom, drowsiness, or fatigue.
Coughs, Sneezes, Yawns, Sighs, & Hiccups

   A sigh is a slightly deeper than normal
    breath.
      It may be a mild corrective action when
       the blood level of oxygen gets a little low.
      It may also serve to expand the lungs
       more than the normal breathing pattern
       does.
Coughs, Sneezes, Yawns, Sighs, & Hiccups

   Hiccups are spasmodic contractions
    of the diaphragm accompanied by
    sudden closure of the glottis, causing
    the characteristic “hiccup” sound.
Other Respiratory
       Pathology
 Aspiration pneumonia (p. 253)-
   An inflammatory condition of the lungs
    produced by inhalation of foreign material.
 Reverse Sneeze-
   Asthmatic symptoms, usually from post
    nasal drip.
Other Respiratory Pathology…
  Emphysema-
    The alveoli sacs loose elasticity, remain
     stretched and full, CO2 bulids up in the
     blood and can lead to cardiac arrest.
Other Respiratory Pathology…
  Pulmonary Hypertension-
    Left CHF, the left side of the heart can’t
     pump fast enough,
    Pressure rises, no gas exchange can
     occur.
  Pulmonary Edema-
    Increase in fluid in the alveoli resulting in
     compromised gas exchange.
Other Respiratory Pathology…
  Diaphragmatic Hernia
    A break in the diaphragm allows the
     protrusion of abdominal viscera into the
     thorax.
Parasites of the Respiratory
          System
Aleurostrongylus abstrusus
 Nematode
 Feline lung worm
 Lives in the
  alveolar ducts
 Recovered by
  tracheal wash
Capillaria aerophila
             Nematode
             Often confused with
              Trichuris (whipworm
              found in the
              intestine)
             Diagnosed by
              standard fecal
              floatation
Paragonimus kellicotti
 Trematode
 “Lung fluke” of dogs
 Found in sputum &
  feces
 Single operculated
Laboratory
Pleural Fluid

Collection & Analysis
Collection
 By thoracocentesis
 Review in the McCurnin
Indications
 Air or fluid is present in the pleural
  space causing the lungs to not expand
  completely
 Diagnostic and therapeutic
Analysis
   Volume- subjective
   Color- colorless to straw or yellow
   Turbidity- transparent to slightly turbid
   Odor- none
   Total Nucleated Cell Counts
   Cytologic Examination
   Total Protein- refractometer
   Fibrinogen Concentrations
Tracheal Fluid

Collection & Analysis
Collection- Tracheal Wash
 Orotracheal- directly through an
  endotracheal tube
 Nasotracheal-
   Via the nasal passages
 Transtracheal-
   Through the skin and trachea
   Infuse sterile saline as a wash solution
   May collect tracheal, bronchial or
    bronchioalveolar washes
   Collect into RRT and LTT
Tracheal Wash Specimens
Tracheal Wash Specimens
Tracheal Wash Specimens
Tracheal Wash Specimens
Tracheal Wash Specimens
Tracheal Wash Specimens
Tracheal Wash
  Specimens
Tracheal
  Wash
Specimens
Analysis
 Record cell numbers during smear
  evaluation
 Little mucous-
   Decreased cell numbers
   Prepare smear from sediment
 Heavy mucous-
   Increased cell numbers
   Don’t centrifuge, make an impression smear
THE END
Lp 13 respiratory system 2008
Lp 13 respiratory system 2008

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Lp 13 respiratory system 2008

  • 1. Respiratory System VTT 235/245 Anatomy & Pathology Lab
  • 2. Introduction  The body’s cells need a constant supply of oxygen to produce energy.  Carbon dioxide is a waste product of these energy-producing reactions and must be eliminated.
  • 3. Types of Respiration  External- occurs in the lungs and is the exchange of O2 and CO2 between the air in the lungs and the blood flowing through the pulmonary capillaries.  Internal- occurs all over the body.  It is the exchange of O2 & CO2 between the blood and the cells & tissues.  Both types of respiration are constantly taking place.
  • 4. Secondary Functions  **Voice Production- “phonation”  The process begins in the **larynx (voice box).  Vocal cords stretch across the lumen of the larynx and vibrate as air passes over them.
  • 5. Secondary Functions…  Body Temperature Regulation-  A network of superficial blood vessels just under the epithelium of the nasal passages helps warm inhaled air before it reaches the lungs.  The respiratory system prevents over- heating by panting.
  • 6. Secondary Functions…  Acid-base Balance Regulation-  For normal chemical reactions to occur, the relative acidity or alkalinity of their environment must be controlled carefully.  The unit used to express acidity or alkalinity is pH.  The respiratory system uses its ability to influence the amount of CO2 in the blood.  The more CO2 there is in the blood, the lower the blood pH.
  • 8. Nose  Begins with the nostrils (nares) which lead to the nasal passages.  The nasal passages are located between the nostrils and the **pharynx (throat).  A midline wall separates the right from the left nasal passage called the nasal septum.  The hard & soft palates separate the nasal passages from the mouth.
  • 9. Nose  Turbinates-  Thin, scroll-like bones that help warm and humidify inspired air.  They also filter particulate matter, such as dust and pollen, before it can reach the lungs.
  • 10. Nose  Paranasal Sinuses-  Contained within the spaces of the maxillary and frontal bones of the skull.
  • 11. Pharynx  The nasal passages lead back into the pharynx .  It is the common passageway for the respiratory and digestive systems.  The soft palate divides the pharynx into the dorsal nasopharynx (respiratory passageway) and the ventral oropharynx (digestive passageway).
  • 12.
  • 13. Pharynx…  At the caudal end, the pharynx opens dorsally into the esophagus and ventrally into the larynx.  The larynx & pharynx work together to prevent swallowing from interfering with breathing.
  • 14. Larynx  “Voice box”  A short, irregular tube that connects the pharynx with the trachea.  The larynx is supported in place by the hyoid bone.
  • 15. Larynx…Contents…  Vocal folds- the most lateral structures, located on the lateral edges of the glottis.  Epiglottis- a triangular flap of tissue that covers or protects the glottis when in the “up” position.  Glottis- the most ventral opening of the larynx.
  • 16. Larynx…Functions  Voice production  Keeps foreign material out of the lungs by the trapdoor action of the epiglottis.  It controls airflow to the lungs by adjusting the diameter of the glottis.
  • 17. Glottis  Closure of the glottis even aids in non- respiratory functions that involve straining such as: urination, defecation, and parturition.  Straining begins with the animal holding the glottis closed while applying pressure to the thorax with the breathing muscles.
  • 18. Glottis…  This stabilizes the thorax and allows the abdominal muscles to effectively compress the abdominal organs when they contract.  Without the closed glottis, contraction of the abdominal muscles merely forces air out of the lungs.
  • 19. Trachea  A short, wide tube that extends from the larynx to the thorax where it divides into the two main bronchi that enter the lungs.  This division is called the bifurcation of the trachea and it occurs at the level of the base of the heart.
  • 20. Trachea  The trachea is composed of fibrous tissue and smooth muscle held open by hyline cartilage rings.  If nothing held the trachea open, it would collapse each time the animal inhaled as a result of the partial vacuum created by the inhalation process.  Each tracheal ring is C-shaped with the open part of the C facing dorsally.  The gap of each ring is bridged by smooth muscle.
  • 22. Lower Respiratory Tract  Starts with the bronchi, ends with the alveoli, and includes all the air passages in between.  Most of the structures in the lower respiratory tract are located within the lungs.
  • 23. Bronchial Tree  The air passages that lead from the bronchi to the alveoli.  After it enters the lungs, each main bronchus divides into smaller and smaller bronchi until they become tiny bronchioles.**  The smallest air passageways are called alveolar ducts.**
  • 24. Bronchial Tree…  The alveolar ducts end in groups of alveolar sacs.  The diameter of each bronchi can be adjusted by smooth muscle-  Bronchiodilation  Bronchioconstriction
  • 25. Alveoli  External respiration takes place in the alveoli.  They are tiny, thin- walled sacs that are surrounded by networks of capillaries.  The wall of each alveoli is composed of thin epithelium.
  • 26. Alveoli…  The capillary walls are composed of the same thin epithelium.  These two thin layers allow oxygen and carbon dioxide to diffuse back and forth.
  • 27. Lungs  The base of each lung lies directly on top of the diaphragm.  Between each lung is an area called the mediastinum, which contains:  Heart  Large blood vessels  Nerves  Trachea  Esophagus  Lymphatic vessels & lymph nodes
  • 28. Lungs…  **The left lung has 2 lobes-  Cranial and Caudal  **The right lung has 4 lobes-  Cranial, middle, caudal, & accessory.  Each lung has a well-defined area on its medial side called a hilus where blood, lymph, and nerves enter and exit the lung.
  • 29. Lungs…  Physically the lungs are very light and have a spongy consistency.  If a piece of lung from an animal that has taken one breath was placed under water, it would float.
  • 30. Thorax  A thin membrane called pleura lines the thoracic cavity and its organs.  Organs- visceral pleura  Cavity- parietal pleura  The diaphragm is the thin sheet of skeletal muscle that forms the caudal boundary of the thorax.
  • 32. Physiology…  The process of respiration requires effective movement of air in and out of the lungs at an appropriate rate and sufficient volume.
  • 33. Negative Intrathoracic Pressure  The pressure within the thorax is negative with respect to the atmospheric pressure.  A partial vacuum exists within the thorax.  That partial vacuum pulls the lungs against the thoracic wall and aids in the return of blood to the heart.
  • 34. Inspiration  The basic mechanism for inspiration is enlargement of the thoracic cavity by the inspiratory muscles.  The main muscles of inspiration are the diaphragm and the external intercostals.
  • 35. Expiration  The main muscles of expiration are the internal intercostals and the abdominal muscles.  When abdominal muscles contract, they push abdominal organs into the diaphragm.  Expiration does not require as much work because gravity pulls the ribs down helping to decrease the thoracic cavity volume.
  • 36. Respiratory Volumes  Tidal Volume- the amount of air inspired and expired in one breath.  Minute Volume- the amount of volume inspired and expired in one minute.
  • 37. Gas Exchange  Occurs in the alveoli.  Gas exchange follows the laws of simple diffusion.  Basically, gas molecules from areas of a high concentration like to move to areas of low concentration.
  • 39. Control of Breathing  Breathing is controlled by an area of the brain stem known as the respiratory center.  The body has two main systems that control breathing:  Mechanical system  Chemical system
  • 44. Sinusitis  Usually involves the frontal or maxillary sinus in the dog.  It can manifest as a collection of pus in the area, resulting in a swelling over the sinus.  It can be a result of the openings of the nasal passages swelling shut or becoming plugged.  This results in the fluid from the sinuses having nowhere to go.
  • 45. Sinusitis…  A common cause of this problem is a tooth root abscess.
  • 46. Kennel Cough  Infectious Canine Tracheobronchitis  Caused by the bacteria Bordatella bronchiseptica.  The disease is characterized by a dry, hacking cough that can be stimulated by palpating the throat.
  • 47. Tracheal Collapse  This defect involves tracheal rings that lose their ability to remain firm, subsequently collapsing during respiration.  ***Obese toy and miniature breeds of dogs are predisposed.  The usually narrow space between the ends of several of the C-shaped tracheal rings is wider than normal.
  • 48. Tracheal Collapse…  When the animals inhales, the widened area of the smooth muscle gets sucked down into the lumen of the trachea and partially blocks it.  This can cause a dry, honking cough and difficulty breathing (dyspnea).
  • 49. Tracheal Collapse…  Therapy includes:  Weight loss for obese animals  Exercise restriction  Reduction of excitement & stress  Surgical therapy
  • 50. Feline Asthma p. 255  A disease characterized by spontaneous bronchioconstriction & airway inflammation.  Clinical signs include:  Coughing  Wheezing  Labored breathing
  • 51. Feline Asthma…  Airway epithelium may hypertrophy, goblet cells and submucosal glands may produce excess mucus, and the bronchial mucosa can become infiltrated with inflammatory cells.
  • 52. Feline Asthma…  All these changes result in decreased air flow.  A 50% decrease in the lumen of the trachea is possible.
  • 53. Feline Viral Rhinotracheitis  A highly contagious disease that is extremely severe in young kittens.  Infections occur year-round in both vaccinated and un-vaccinated cats.  Transmission occurs through aerosolization (sneezing) and direct contact.  Queens may transmit the disease to their kittens during grooming.
  • 54. Pleural Effusion  The build-up of fluid in the pleural space which results in respiratory distress.  Right-sided CHF is the principal cause of pleural effusion in both canine & feline patients.
  • 55. Pleural Effusion…  As systemic venous hypertension increases, significant amounts of the fluid accumulates in the pleural space, causing respiratory difficulty.
  • 56. Pleural Effusion…  All pleural effusions produce symptoms of respiratory distress, dyspnea, cough, & circulatory compromise.
  • 57. Pneumothorax & Lung Collapse p. 258  Pneumothorax: the presence of free air in the pleural space.
  • 58. Pneumothorax & Lung Collapse…  Without negative intrathoracic pressure, normal breathing cannot take place.  If air leaks into the pleural space, that negative pressure is lost.  This results in the lung falling away from the thoracic wall.
  • 59.  The dark black region on the right side of this CT image clearly shows where the lung has separated from the chest wall.  Note the difference between the two lungs.  One is fully expanded and fills up the chest cavity, the other is shrunken (i.e. collapsed) and only fills up part of the chest cavity.
  • 60. Pneumothorax & Lung Collapse…  The general cause is the air comes either from the outside, as in the case of a penetrating wound, or from the lung itself due to the rupture of the alveoli as a result of lung disease or injury.
  • 61. Pneumothorax & Lung Collapse…  Treatment consists of re-establishing the partial vacuum within the pleural space by:  Sucking out the air with a needle.  Placement of a chest tube.
  • 62. Coughs, Sneezes, Yawns, Sighs, & Hiccups p. 262  All Are temporary interruptions in the normal breathing pattern.  They can be:  Responses to irritation (coughs & sneezes)  Attempts to correct imbalances (yawns & sighs).  Or they may occur for unknown reasons (hiccups).
  • 63. Coughs, Sneezes, Yawns, Sighs, & Hiccups  A cough is a protective reflex that is stimulated by irritation of foreign matter in the trachea or bronchi.  It consists of a sudden, forceful expiration of air.
  • 64. Coughs, Sneezes, Yawns, Sighs, & Hiccups  A sneeze is similar to a cough, but the irritation originates in the nasal passages.  The burst of air is directed through the nose and mouth in an effort to eliminate the irritant.  A yawn is a slow, deep breath taken through a wide-open mouth.  It may be stimulated by a slight decrease in the oxygen level of blood, or it may just be due to boredom, drowsiness, or fatigue.
  • 65. Coughs, Sneezes, Yawns, Sighs, & Hiccups  A sigh is a slightly deeper than normal breath.  It may be a mild corrective action when the blood level of oxygen gets a little low.  It may also serve to expand the lungs more than the normal breathing pattern does.
  • 66. Coughs, Sneezes, Yawns, Sighs, & Hiccups  Hiccups are spasmodic contractions of the diaphragm accompanied by sudden closure of the glottis, causing the characteristic “hiccup” sound.
  • 67. Other Respiratory Pathology  Aspiration pneumonia (p. 253)-  An inflammatory condition of the lungs produced by inhalation of foreign material.  Reverse Sneeze-  Asthmatic symptoms, usually from post nasal drip.
  • 68. Other Respiratory Pathology…  Emphysema-  The alveoli sacs loose elasticity, remain stretched and full, CO2 bulids up in the blood and can lead to cardiac arrest.
  • 69. Other Respiratory Pathology…  Pulmonary Hypertension-  Left CHF, the left side of the heart can’t pump fast enough,  Pressure rises, no gas exchange can occur.  Pulmonary Edema-  Increase in fluid in the alveoli resulting in compromised gas exchange.
  • 70. Other Respiratory Pathology…  Diaphragmatic Hernia  A break in the diaphragm allows the protrusion of abdominal viscera into the thorax.
  • 71. Parasites of the Respiratory System
  • 72. Aleurostrongylus abstrusus  Nematode  Feline lung worm  Lives in the alveolar ducts  Recovered by tracheal wash
  • 73. Capillaria aerophila  Nematode  Often confused with Trichuris (whipworm found in the intestine)  Diagnosed by standard fecal floatation
  • 74. Paragonimus kellicotti  Trematode  “Lung fluke” of dogs  Found in sputum & feces  Single operculated
  • 77. Collection  By thoracocentesis  Review in the McCurnin
  • 78. Indications  Air or fluid is present in the pleural space causing the lungs to not expand completely  Diagnostic and therapeutic
  • 79. Analysis  Volume- subjective  Color- colorless to straw or yellow  Turbidity- transparent to slightly turbid  Odor- none  Total Nucleated Cell Counts  Cytologic Examination  Total Protein- refractometer  Fibrinogen Concentrations
  • 80.
  • 82. Collection- Tracheal Wash  Orotracheal- directly through an endotracheal tube  Nasotracheal-  Via the nasal passages  Transtracheal-  Through the skin and trachea  Infuse sterile saline as a wash solution  May collect tracheal, bronchial or bronchioalveolar washes  Collect into RRT and LTT
  • 89. Tracheal Wash Specimens
  • 91. Analysis  Record cell numbers during smear evaluation  Little mucous-  Decreased cell numbers  Prepare smear from sediment  Heavy mucous-  Increased cell numbers  Don’t centrifuge, make an impression smear