102 Trachea Flashcards by Ericka Jaramillo

What are the two main arteries supplying blood to the trachea?

Cranial thyroid artery
Caudal thyroid artery
At the level of the carina, the Bronchoesophageal arteries also contribute to the blood supply.

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A. Trachealis muscle
B. Mucosa
C. Cartilaginous ring
D. Adventitia and serosa

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What nerves are involved in the innervation of the trachea?

Right vagus nerve
Recurrent laryngeal nerve

These nerves play a crucial role in the function of the trachea.

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What is the tracheal diameter to thoracic inlet distance ratio for non-brachycephalic dogs?

0.2 +/- 0.03

This ratio is important for assessing tracheal size in relation to the thoracic inlet.

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What is the tracheal diameter to thoracic inlet distance ratio for brachycephalic dogs?

0.16 +/- 0.03

This ratio indicates a smaller tracheal size in brachycephalic breeds.

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What is the tracheal diameter to thoracic inlet distance ratio for English Bulldogs?

0.13 +/- 0.38

This ratio reflects the unique anatomical considerations in English Bulldogs.

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What is the most common reasons for performing a permanent tracheostomy in dogs and cats?

Laryngeal paralysis in dogs
Laryngeal masses in cats

To bypass the upper airway in cases of significant laryngeal collapse, brachycephalic airway, laryngeal neoplasia, trauma.

A tracheostomy may also be necessary to bypass upper airway obstructions.

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Why is there increased mucous production after permanent tracheostomy and when do secretions decrease

Tracheal mucosa undergoes squamous metaplasia and excessive mucus production occurs and can result in obstruction.

Secretions are minimal after 1 month

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How long does it typically take for mucosa to heal to skin after a tracheostomy?

Approximately 2 weeks

During this time, tracheal mucosa undergoes squamous metaplasia and excessive mucus production may occur.

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What is the maximum percentage of the trachea that can be removed in adults?
Juveniles?

50%

In juveniles, up to 25% can be removed.

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How long does it take a 1cm x 1cm tracheal defect to heal in dogs

15-20 days to epithelialize

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What are the three factors that can lead to tracheal stricture?

More Tension = more stenosis
Lack of apposition causing granulation
Amount of rings removed

If tension > 750g, stenosis results. Double this and circumferential stricture results

These factors are critical in the healing process after tracheal surgery.

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How to relieve tension when performing tracheal resection and anastomosis

i) Tension relieving sutures placed several rings proximal and distal to the anastomosis

ii) Fixed ventroflexion of the neck

iii) Release of annular ligaments with preservation of mucosa

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How much luminal stenosis must be present for clinical signs to be apparent

50-75% to produce clinical signs

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Tension relieving sutures negate what force

Tension relieving sutures have been shown to negate tension at anastomotic sites subjected to forces greater than 2000g and are theorized to restore tensile strength of the anastomosis to a level like an intact trachea

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Describe the split cartilage tracheal resection and anastomosis technique and its benefits

Split cartilage technique: Placement of suture around divided tracheal rings

Benefits:
Less dorsoventral luminal stenosis and more precise alignment than the annular ligament cartilage technique.

May be a stronger anastomosis because it heals by fibrocartilage rather than fibrous tissue.

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Describe annular ligament cartilage tracheal R&A technique

placement of suture around adjacent tracheal rings through the annular ligament

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Approach for a thoracic tracheal resection and anastomosis

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Intrathoracic trachea: right sided 3rd-5th intercostal thoracotomy

Approach for a cervical tracheal resection and anastomosis

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Cervical trachea – Ventral midline approach + proximal sternotomy if the lesion is at the thoracic inlet

Differentials for tracheal masses in young and older dogs:

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Benign in younger animals: Osteochondroma, Chondroma, ecchondroma, leiomyoma. Granulomatous disease from Onchocerca, Spirocerca, Mycobacterium. Cuterebra in cats. Hematomas

Older animals: OSA, chondrosarcoma, MCT, LSA, SCC, etc

Describe the grades of tracheal collapse

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Grade 1: 25% collapse
Grade 2: 50% collapse
Grade 3: 75% collapse
Grade 4: 100% collapse

Intraluminal tracheal stent fracture has been attributed to what

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persistent cough

What is the best way to diagnose collapsing trachea in dogs?

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Tracheobronchoscopy

This method allows for direct visualization of the trachea and bronchi.

What are the **grades of tracheal collapse**?

* Grade 1: 25% collapse * Grade 2: 50% collapse * Grade 3: 75% collapse * Grade 4: 100% collapse ## Footnote These grades indicate the severity of the collapse.

What material is **intraluminal stenting** made of?

Nitinol, an alloy of nickel and titanium ## Footnote This material is used for its flexibility and strength.

Extraluminal tracheal rings

Benefit of extraluminal spiral prosthesis Necessary approach

Uniform rather than segmental support. Maintains tracheal flexibility Lateral thoracotomy

What are **6 potential complications** of intraluminal stenting?

* Stent fracture * Stent migration * Tracheitis * Obstruction of the stent lumen with granulation tissue * collapse beyond the stented region * tracheal rupture ## Footnote These complications can significantly affect the outcome of the procedure.

What is the **approach for thoracic tracheal resection and anastomosis**?

* Cervical trachea: Ventral midline approach + proximal sternotomy if at thoracic inlet * Intrathoracic trachea: Right-sided 3rd-5th intercostal thoracotomy ## Footnote The approach depends on the location of the lesion.

What is the **split cartilage technique** in tracheal surgery?

Placement of suture around divided tracheal rings ## Footnote This technique results in less dorsoventral luminal stenosis and more precise alignment.

What is the **annular ligament cartilage technique**?

Placement of suture around adjacent tracheal rings through the annular ligament ## Footnote This method is used in tracheal surgery but may result in more complications compared to the split cartilage technique.

True or false: **Mild tracheal tears** can be treated with medical management and supportive care unless worsening.

TRUE ## Footnote This approach is often sufficient for minor injuries.

What are the **likely diagnoses** for a tracheal mass in a 1-year-old Golden Retriever?

* Chondroma * Ecchondroma * Leiomyoma * Granulomatous disease * Hematomas ## Footnote These conditions are more common in younger animals.

What is the **healing time** for a 1cm x 1 cm tracheal defect in dogs?

15-20 days ## Footnote Healing time can vary based on tension and surgical technique.

Cats outcomes with permanent tracheostomy

Cats that underwent permanent trache for inflammatory laryngeal disease were 6.6x more likely to die as cats that had it for any other reason.

Grimes, JAVMA 2019 (out of window but GRIMES) “Long-term outcome and risk factors associated with death or the need for revision surgery in dogs with permanent tracheostomies”

Brachycephalic dogs were more likely to require revision surgery than were nonbrachycephalic dogs. Results of the present study indicated that creation of a PT was a viable treatment option for obstructive upper airway diseases in dogs and that long-term survival after receiving a PT was possible; however, a PT may not reduce the risk of aspiration pneumonia in dogs.

Suematsu Vet Surg 2019: Long-term outcomes of 54 dogs with tracheal collapse treated with a continuous extraluminal tracheal prosthesis

Dry harsh cough resolved in 87% dogs Goose honking cough resolved in 96% of dogs

Congiusta JAVMA 2021: Comparison of short-, intermediate-, and long-term results between dogs with tracheal collapse that underwent multimodal medical management alone and those that underwent tracheal endoluminal stent placement

MST from diagnosis of tracheal collapse: Medical management: 3.7 years Stent: 5.2 years Severe dz: Medical mngt: MST 12 days Stent placement: 3.7 years

Gaudio, JSAP 2025 “Clinical outcomes and complications of tracheal resection and anastomosis in dogs and cats: 20 cases (2009-2022) Complication rate Mortality rate Complications

Complications occurred in 15 patients (75%). 20% mortality rate cough (n = 5), self-resolving laryngeal paralysis (n = 1), surgical site infection (n = 1) and septic shock (n = 2) anastomotic dehiscence (n = 1), tracheal stenosis (n = 4) and fatal respiratory failure (n = 2).

Lorenzi, JAVMA 2024 “Dumon silicone stents can improve respiratory function in dogs with grade IV tracheal collapse: 12 cases (2019-2023)”

42% remained alive, while 58% dogs died. Complications occurred in 9 of 12 (75%) cases and included granulation tissue growth (3/12 [25%]

Pieczynski et al, VetSurg 2024 “Description of a cricotracheostomy technique for permanent tracheostomy in eight dogs”

All dogs experienced a routine recovery. The CT provided a robust dorsolateral wall to the stoma from the cricoid cartilage. The stomata did not show any evidence of dorsal wall collapse or stenosis. Four dogs required further skin fold resection. The high position of this stoma also appears to be appropriate functionally with bilateral cervical skin fold resections. The owner questionnaires reported high satisfaction in the postoperative QoL.

What novel technique was described by Piecczynski VS 2024 for permanent tracheostomies in dogs

Title: “Description of a cricotracheostomy technique for permanent tracheostomy in eight dogs”

Kelly, JVIM 2023 “Bronchial collapse and bronchial stenting in 9 dogs”

Bronchial stenting was considered successful in 100%,

Kanemoto JFMS 2023 “Retrospective study of feline tracheal mass lesions”

Kanemoto JFMS 2023 “Retrospective study of feline tracheal mass lesions” MST of 214 days for lymphoma which was significantly longer than that of other types of tumor (21 days) Lymphoma was most often diagnosed

102 Trachea Flashcards

(45 cards)