4/2/2024 0 Comments Resonance lung soundsO Cheynes-Stokes breathing – typically the result of severe hypoxemia or CNS disease involving respiratory centers, there are prolonged periods of apnea interspersed with deep compensatory breaths (in response to hypercapnia). However, this pattern usually does not result in respiratory failure due to the competency of the diaphragm to maintain ventilation, unless increased demand beyond quiet breathing is imposed on the diaphragm. Intercostal nerve damage may be the cause at the level of the spinal cord (nerves branch off cord at same level of ribs). O Diaphragmatic breathing – abdominal motion (coincident with diaphragmatic displacement) in synchrony with inspiration or expiration, whereas the rib cage appears to move passively in the wrong direction. This condition can be seen in horses with heaves due to diaphragmatic fatigue or failure. Externally the abdominal component of breathing moves outward passively with exhalation, and is drawn inward passively upon inspiration. Respiratory failure may ensue if increased load (obstruction, stress, exercise) is imposed on this situation. The rib cage moves appropriately / in synchrony with inspiratory and expiratory flow. O Paradoxical breathing – diaphragm is weakened or paralyzed (lesions involving C3-5 or phrenic nerve(s)), so it is displaced cranially rather than caudally during inspiration in opposite phase from rib cage. O Rib cage leads abdomen (uncommon finding)– diaphragmatic fatigue or paralysis, such that intercostals muscles drive ventilation, and abdominal compartment moves in the opposite direction (see Paradoxical breathing). O Abdominal leads rib (common finding) – increased respiratory drive with airway obstruction results in strong dominance of diaphragmatic contraction causing indrawing of chest wall in particular where chest wall compliance is high (neonates, for example). Recruitment of accessory inspiratory muscles (scalenus) and expiratory muscles (rectus abdominus). O Synchronous rib and abdominal movement – hyperpnea in response to hypoxemia, hypercapnia, pain, excitement, and hyper-thermia. O it is also heightened with chest wall / pleural restriction (rib fractures, pleuropneumonia, trauma, and after surgical invasion (thoracotomy) of the chest cavity. O typically increased abdominal effort is associated with lower airway obstruction O abdominal effort is typically accentuated during expiration O recruitment of accessory muscles such as the rectus abdominus during expiration O increased force and length of excursions of the diaphragm Head – neck is maintained in a natural (slightly flexed) posture. Nasal flaring is just barely discernible during inspiration. ![]() There is near equal contribution from the rib cage and abdomen, although the abdominal component may be more evident clinically during quiet breathing. In particular, note the contribution of the rib cage and abdomen to ventilation, the animal's head position (e.g., is it extended to promote air intake), and the extent of nasal flaring. It is especially useful if the animal is standing during this examination. Stand back from the animal and observe the breathing pattern from both sides and if possible from the top. Previous medications and response to treatments.Exposure to healthy animals (on or off premise).tobacco smoke, ventilation, dust exposure, heat, moisture, mold, fresh water) Hygiene of the indoor environment (e.g.Outdoor environment –dust, particulates, pollutants, toxins.Duration (hrs, days, weeks, months, years).Involvement of individual or multiple animals.You should make sure to note the following. You can often make your preliminary diagnosis before you ever touch or see the horse. Loss or increase in chest resonance (with percussion). ![]() (Age, Breed, Sex): In examining the equine respiratory system, the only one of these that really matters is age. Specificity is also poor, as many diseases share similar signs such as cough. Sensitivity is poor – diseases such as IAD can be clinically silent for many years.
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