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What muscles must be transected to remove the entire forelimb, including the scapula?
All the extrinsic muscles of the forelimb
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What is atrophy of supraspinatus and infraspinatus muscles causing a prominent scapular spine called? What causes it?
Sweeney; damage to suprascapular nerve
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What results from radial nerve paralysis to the extensors of the thoracic limb?
Inability to stand, knuckling over of the digits
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What is the most important layer that must be opposed when closing a paramedian midline incision?
External rectus sheath
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What is the most important structure to close in a midline incision?
Linea alba
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How would you locate the trachea for an ER tracheostomy?
Skin incision of the ventral neck, seperate the strap mm.
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What muscle and nerve must be functional to bear weight on the pelvic limb?
Quadriceps m, femoral nerve
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What muscles are paralyzed with obturator nerve damage, resulting in lateral slipping on a slick surface?
Adductor m
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Why does an animal knuckle over on the pelvic limb with fibular nerve damage?
Paralysis of the extensors of the digits
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What muscle does the facial nerve innervate? Which is of clinical significance?
Muscles of facial expression; orbicularis oculi m.
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What muscles are innervated by the mandibular division of the trigeminal nerve?
Muscles of mastication
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What do the 3,4,6 cranial n (oculomotor, trochlear, abducens) innervate?
Extrinsic muscles of the eye
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What muscles are innervated by both cranial n 9 and 10 (glosso. and vagus)?
Muscles of pharynx
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What is the injection of a substance into a muscle? How is it done?
Intramuscular (IM) injection; aspirate the syringe before injecting to make sure needle is not in a vessel
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Why can a broken neck result in resp. paralysis?
Phrenic nerve to the diaphragm arises from the cervical and brachial plexuses
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What is the panniculus (cutaneous trunci) response?
Contraction of the cutaneous trunci m. in response to a pin prick to the trunk
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What is the reflex arc for the panniculus response?
Sensation from the skin passes craniodorsal to the spinal cord --> up the cord to lateral thoracic nerve --> out to the cutaneous trunci m.
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Clinically, what is the panniculus response used to evaluate?
Level of the thoracic spinal cord damage
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Where is the spinal cord damage if the panniculus response is absent caudal to level of 12th vertebrae?
Level of T10
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For standing large animal flank sx, what must be blocked?
Dorsal and ventral branches of the abdominal nerves
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What nerve must be considered when removing the anal glands? why?
The caudal rectal n; damage can cause paralysis of external anal sphincter --> fecal incontinence --> likely leading to early demise
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Define clonus/ clonic muscular spasms?
Rapidly alternating involuntary muscular contraction and relaxation
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How does a tetanic animal present?
Pump handle tail, Saw horse stance, Lockjaw, Sardonic grin
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How does coonhoudn paralysis present?
Ascending flaccid paralysis
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Describe the pathophysiology of tick paralysis
Blocks neuromuscular junctions resulting in flaccid paralysis that ascends the spinal cord
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Describe the pathophysiology of a roarer/recurrent laryngeal n. damage
Paralysis of crico. dor. m. results in a roaring sound when breathing
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What is a common serious injury of all the nerves to the forelimb?
Complete avulsion of the brachial plexus associated with HBC (hit by car)
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What are the signs of complete avulsion of the brachial plexus?
Complete paralysis, extended flaccid limb, unable to support weight and dragging paw
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What is Sweeney?
Damage to suprascapular nerve --> paralysis to supraspinatus and infraspinatous muscles --> lateral instability of shoulder joint
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What is the most common and clinically significant nerve problem of the forelimb?
Radial paralysis
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What are the 2 types of radial nerve injury?
High and low radial nerve injury
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What are signs of high radial nerve paralysis?
Inability to bear wt, dropped elbow, knuckling over the digits
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What are signs of low radial nerve damage?
Knuckling over on digits
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What sensory loss is diagnosed for radial nerve injury?
Loss of sensation on dorsal manus
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What results from femoral nerve injury? why?
Can't bear wt, can't extend stifle - b/c analgesia to saphenous nerve
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Injury to which nerve causes lateral slipping on a slick surface?
Obturator nerve
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What are signs of fibular (peroneal) nerve damage?
Knuckling over, analgesia of dorsal pes
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How does an animal compensate for peroneal nerve damage?
By flipping the paw in advance
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What is peroneal nerve paralysis similiar to in the thoracic limb?
Low radial nerve paralysis
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What is an iatrogenic cause of ischiatic n. damage? What does it result in?
IM injection in rear limb; results in paresis/paralysis of rear limb
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What is the definition of proprioception?
Sensing movements and position of the body parts
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What tests are used to evaluate proprioception? Example.
Postural reactions. ie. placing animal of its dorsal paw should result in immediate adjustment to normal placement
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What is the only part of the nervous system that will not result in weakness?
Cerebellum (& peripheral vestibular system)
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What is the most common postural reaction used to screen for neurological problems?
Proprioceptive positioning (knuckling)
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What is a neuro screening test to indicate there is a neurological problem but doesnt localize where the problem is?
Proprioceptive positioning (knuckling), postural reaction
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For what does proprioceptive positioning (knuckling) test?
Conscious perception of the location of the limbs
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What does loss of proprioception tell you clinically?
Doesn't localize a lesion, but is indication of neurological problem
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What is done once screening indicates a neurological problem?
Procedures to localize the lesion to a specific part of the nervous system
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What is a CSF tap and where is it done?
Removal of cerebrospinal fluid; from the subarachnoid space in the cisterna magna or lumbar cistern
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What is epidural anesthesia, where is it commonly given?
Anesthetize the spinal n, thru the lumbosacral opening into the epidural space
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Define paralysis
Complete loss of motor activity
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Define paresis
Weakness, partial loss of motor activity
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What are the suffixes - paresis and -plegia used to describe?
Paresis and paralysis, respectively
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Differentiate flaccid and spastic paresis or paralysis
- Flaccid: decreased or no tone in muscles
- Spastic: increased tone/ hypertonicity
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Define ataxia
Lack of coordinated movements with or without spasticity or paresis
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What can cause ataxia?
Lesions of the entire nervous system
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Define intention tremor and what it indicates
- A tremor that becomes worse with initiation of a movement and disappears at rest
- Indicates cerebellar disease
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Define nystagmus
Involuntary movement of eyes in rotatory, vertical, or horizontal directions
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How does nystagmus at rest appear and what does it indicate?
- Eyes move to the side of the lesion and snap back
- Indicates vestibular dysfunction
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Define dysmetria and what it indicates
- Improper measuring of distance in muscular activity
- Indicates cerebellar disease
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How do you screen for neurological problems?
- Observing:
- 1. conciousness, behavior, seizures
- 2. stance and head position
- 3. gait and strength
- 4. proprioceptive positioning
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Why is mental attitude/ conciousness, behavior, seizures observed in a neuroscreening test?
Screen for cerebrum and brain stem problems
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What does observation of stance and head position of a neuroscreening test check?
Cerebellar problem
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What abnormal stance and head position indicate neurological problems (cerebellum/vestibular system)?
Head tilt, wide based stance; head tremor/bobbing
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What does gait and strength observation evaluate?
Entire nervous system
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What is gait checked for during a neurological screening test?
Proprioceptive deficits, paresis, circling, ataxia, dysmetria, scuffing, knuckling, or atrophy
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What does abnormalities in gait indicate in neuro. screening?
Nervous system problem
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Do gait abnormalities localize a neurological lesion?
no, just a neurological problem
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How is strength tested during a neurological exam?
Push down on the standing animal
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What does weakness indicate during a neuro. screening?
Nervous problem but NOT the cerebellum or peripheral vestibular system
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What is the affect of UMNs damage on LMNs?
LMNs increase activity
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To where do LMN signs localize the lesion?
Peripheral nerves, spinal cord, or segment of brain stem the LMN arises from
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What does pointing your thumb down in LMN damage indicate?
Everything deceased or disappears
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List 4 LMN disease signs (thumbs down)
- 1. Decreased or absent tone (hypotonia to atonia)
- 2. Decreased to absent reflexes (hypo- to areflexia)
- 3. Flaccid paralysis
- 4. Rapid atrophy
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List 4 UMN disease signs (thumbs up)
- 1. Normal to increased muscle tone
- 2. Normal to inreased reflexes (hypereflexia)
- 3. Spastic paresis to paralysis
- 4. Slow atrophy
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List how the reflexes are checked for the limbs
Withdrawal reflex
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How is a withdrawal reflex performed?
Pinch the toe; normal response = withdrawal
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How is tone evaluated?
Palpate the muscles of the limbs
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What causes a coma?
Complete disconnection of the reticular activation system (RAS) from the cerebral cortex, usually due to severe brain stem lesion
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List 3 primary deficits that may be seen with lesions to the cerebrum
- 1. Seizures
- 2. Blind with normal pupillary responses
- 3. Behavior abnormalities
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Unilateral cerebral lesions will cause ___ signs
Contralateral
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How is brain stem disease characterized?
Abnormal gait + abnormal posture and cranial nerve deficits, decreased mental states, proprioception deficits and weakness
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What is the range of decreased levels of consciousness due to brainstem lesions?
Depression to coma
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What is the best evidence of brainstem lesions?
Multiple dysfunction of cranial nerves 3-12
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When should brain stem disease be suspected?
If cranial n. abnormalities + UMN paresis, or decreased conciousness
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How does a cerebellar lesion present?
Uncoordinated without paresis (no weakness), vestibular signs, and proprioceptive deficits
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What do vestibular system lesions affect?
The ability to control posture in relationship to gravity and eye movemets in relationship to head movements
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What are signs of vestibular disease?
Head tilt, nystagmus, asymmetric ataxia with possibly circling
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What is the primary diagnostic concern with vestibular disease?
Differentiating peripheral (no paresis or depression) and central (paresis and depression) vestibular disease
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What is the first deficit to show with a neurological deficit?
Proprioceptive positioning
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What does BAR stand for?
Bright, alert, and responsive
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What does multiple dysfunction of cranial nerves indicate?
Brain stem lesion
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What would cause a dropped jaw?
Paralysis of trigeminal nerve
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Why is paralysis of the orbicularis oculi and loss of lacrimation the most vital results of facial nerve paralysis?
Drying of eye; animals are not vain
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How is the auriculopalpebral nerve manipulated clinically? In what species?
Blocked to paralyze eyelids for eye procedures; large animals
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How is the facial nerve commonly injured in the horse?
Lying on a halter buckle during sx
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What cranial nerve is assoc. with: blindness
Optic n.
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What cranial nerve is assoc. with: Anisocoria (unequal sized pupils)
Sympathetic, parasympathetic (3) (oculomotor)
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What cranial nerve is assoc. with: Strabismus (uncontrolled deviation of the eye)
Oculomotor, trochlear, abducens
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What cranial nerve is assoc. with: dropped jaw and head atrophy
Trigeminal
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What cranial nerve is assoc. with: Increased of decreased facial sensation
Trigeminal
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What cranial nerve is assoc. with: Facial paralysis
Facial n
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What cranial nerve is assoc. with: Deafness and/or loss of balance
Vestibulocochlear n
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What cranial nerve is assoc. with: Dysphagia (difficult swallowing)
Glossopharyngeal, vagus
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What cranial nerve is assoc. with: Megaesophagus
Vagus
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What cranial nerve is assoc. with: Laryngeal paralysis
Vagus, recurrent laryngeal n.
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What cranial nerve is assoc. with: Paralysis of the tongue
Hypoglossal
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Paralysis of which nerve results in a weak tongue?
Hypoglossal nerve
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How is the facial/trigeminal reflex arc checked?
- Prick the face, pulling away = intact trigeminal n.
- Twitch of face muscles = intact facial nerve
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What cranial nerve problem can be seen with middle ear infections?
Paralysis of the facial n. and resulting dry eye
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What procedure can be used to facilitate the exam of the eye? How?
Auriculopalpebrae n. block, eliminates blinking and closing of eye
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What are signs of damage to the recurrent laryngeal n?
- Laryngeal paralysis / hemiplegia : failure of glottic cleft to open
- High pitched, whistling on inspiration, exercise intolerance
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Discuss the clinical significance of the accessory n.
Little clinical sig
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Describe the pupillary light reflex and what structures it involves?
Shinning a light in the eye, noting if pupil constricts; checks cranial nerves Optic and Oculomotor
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Describe signs of facial nerve damage
- Paralysis of muscles of facial expression resulting in a distorted face
- Paralysis of orbicularis oris m. and ANS fibers to lacrimal gland, resulting in a dry eye
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What is dysfunction of the sympathetic fibers to the eye?
Horner's syndrome
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List the cardinal signs of Horner's syndrome
- Miosis (small pupil)
- Enopthalmos (small eyes)
- Ptosis (drooping eyelid)
- Protrusion of 3rd eyelid
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What results in swelling or draining (pus) below the carnivore's eye?
Carnassial tooth abscess (upper P4)
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How is aging of dog by their teeth used practically in dogs?
- Baby teeth in by 6 weeks: vx time
- Adult in by 6 mo: spay/neuter time
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Which dog teeth have three roots?
Last 3 on top
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Which cat permanent teeth has 3 roots?
Upper PM4 (carnassial)
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How is a nasogastric tube placed?
Thru the nostril and the ventral nasal meatus
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A laryngotomy to open the larynx goes thru which paired muscles to expose the larynx?
Sternohyoid mm, middle "strap muscle"
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The esophagus is accessible to sx in the ___ half of the neck region on the ___ side
Caudal; left
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What surgical landmark indicates the ventral midline of the larynx?
Cricothyroideus or bow tie muscle
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Paralysis of what muscle results in "roarers" in horses?
cricoarytenoideus dorsalis m.
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How is a tranquilized dog intubated?
Gently pull the tongue rostrally, push the soft palate up, hold the epiglottis down, direct the tube b/t the vocal folds into the trachea
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What causes laryngeal paralysis?
Damage to recurrent laryngeal n. --> paralysis of crico. dor. m --> no opening to glottic cleft --> roaring sound when breathing
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What is a roarer?
Dog or horse with laryngeal paralysis due to damage of recurrent laryngeal n --> paralysis of crico. dor. m.
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