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1、Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,上呼吸道外科手术中英,#,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,上呼吸道外科手术中英,#,Click to edit Master title style,Click
2、 to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,上呼吸道外科手术中英,#,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,上呼吸道外科手术中英,#,Click to edit Master title style,Click to edit Master text styles,Second lev
3、el,Third level,Fourth level,Fifth level,*,上呼吸道外科手术中英,#,上呼吸道外科手术中英,Introduction,前言,Anatomy&Physiology of the upper airways(nose,throat,trachea/bronchi),上呼吸道解剖,&,生理（鼻子、喉部、气管,/,细支气管）,Brachycephalic Obstructive Airway Syndrome,短头颅气道阻塞综合征,Temporary tracheostomy,临时气管切开术,2,上呼吸道外科手术中英,Anatomy&Physiology 1,解
4、剖学,&,生理学,1,Pharynx,咽部,Fibromuscular tube that serves as a conduit for both the respiratory and the digestive tract,纤维肌性的管道，同时作为呼吸道和消化道,Evans H.E.and Christensen G.C.Anatomy of the DOG,2,nd,edition,1993;The Respiratory Apparatus,fig 8-9,page 517,3,上呼吸道外科手术中英,Anatomy&Physiology 2,解剖学,&,生理学,2,Pharynx,咽
5、部,Nasopharynx,鼻咽,Oropharynx,口咽,Laryngopharynx,咽喉,Evans H.E.and Christensen G.C.Anatomy of the DOG,2,nd,edition,1993;The Respiratory Apparatus,fig 8-9,page 517,4,上呼吸道外科手术中英,Anatomy&Physiology 1,解剖学,&,生理学,Oropharynx,口咽部,Bounded laterally by the palatoglossal and palatopharyngeal arches,and caudally by
6、 the tip of the epiglottis,侧面以腭舌弓和腭咽弓为界，喉部为会厌尖部,5,上呼吸道外科手术中英,Anatomy&Physiology 6,解剖学,&,生理学,6,Tonsils,扁桃体,Thin lymph node located bilaterally in the lateral wall of the oropharynx,just caudal to the palatoglossal fold,薄淋巴结位于口咽部两边侧壁上，腭舌皱襞的后方,No afferent lymphatics,没有输入淋巴结,Efferent vessels drain in re
7、tropharyngeal Ln,出球小动脉流入咽后,Ln,6,上呼吸道外科手术中英,Anatomy&Physiology 7,解剖学,&,生理学,7,Tonsils,扁桃体,Located in tonsillar crypt or fossa and covered by tonsillar fold in dogs,犬：位于扁桃腺隐窝，由扁桃体褶覆盖,Cats:tonsil is very small and not covered by a mucosal fold,猫：扁桃体很小，没有被扁桃体褶覆盖,7,上呼吸道外科手术中英,Physiology,生理学,Pharynx,咽,Swal
8、lowing(deglutition),吞咽,Physiological phenomenon that occurs many times daily,生理现象，每天都会发生很多次,May be initiated voluntary,but most swallows occur subconsciously between meals,about once a minute in awake individuals,会主动发生，但大多数吞咽会潜意识地发生在餐间，清醒个体每分钟会吞咽一次,Driven by salivation,which stimulates the sensory r
9、eceptors in the mouth and pharynx,由唾液驱使，会刺激口腔和咽部的感觉受体,Salivation&swallowing cease during sleep,唾液以及吞咽在睡眠时会停止,8,上呼吸道外科手术中英,Physiology,生理学,Pharynx,咽部,Swallowing(deglutition),吞咽,Oral preparatory phase,口腔准备期,Oral phase,口期,Pharyngeal phase,咽喉期,Esophageal phase,食道期,9,上呼吸道外科手术中英,Anatomy&Physiology 8,解剖学,&,
10、生理学,8,Hedlund C.S.Atlas of Small Animal Ear-,Nose-,and Throat-Diseases,2002,10,上呼吸道外科手术中英,Physiology,生理学,Larynx,喉部,Regulation of air flow,调节气流,Coughing,咳嗽,A reflex evoked by stimulation of,“,cough receptors,”,working as a clearing mechanism to protect the lower airway,由“咳嗽受体”的刺激诱发的反射，是一种保护下呼吸道的清洁机制,
11、Vocalization,发音,11,上呼吸道外科手术中英,Cough receptors,咳嗽受体,Sensory receptors responding to:,感觉受体，对如下刺激有反射：,Airway pressure,气道压,Vocal fold motion,生襞运动,Tactile stimuli,触觉刺激,Chemical stimuli,化学刺激,Variable threshold,可变化的阈值,Mucosa of the,黏膜,Larynx,喉部,Trachea,气管,Carina,支气管,Bronchi,细支气管,12,上呼吸道外科手术中英,Diagnosis,诊断,
12、History,病史,Patient,患病动物,Clinical signs,临床症状,Dyspnea,stridor,dysphonia,dysphagia and salivation!,呼吸困难、喘鸣、发声困难、咽下困难、分泌唾液,13,上呼吸道外科手术中英,Physical examination,身体检查,General examination,一般检查,Examination of respiratory system,呼吸系统检查,Upper respiratory tract,上呼吸道,Lower respiratory tract,下呼吸道,Examination of ca
13、rdiovascular system,心血管系统检查,14,上呼吸道外科手术中英,Diagnosis,诊断,Pharyngo-Laryngoscopy!,咽喉镜检查,Throat inspection with laryngoscope,检喉镜进行喉部探查,Nasopharyngoscopy,鼻咽镜检查,Diagnostic Imaging,诊断图像,Electromyography,肌电图学,15,上呼吸道外科手术中英,Diagnosis,诊断,Laryngoscopy!,喉镜检查,16,上呼吸道外科手术中英,Intubation,插管,Laryngoscopy!,喉镜检查,17,上呼吸道
14、外科手术中英,Intubation,插管,Laryngoscopy!,喉镜检查,18,上呼吸道外科手术中英,Diagnosis,诊断,Diagnostic Imaging,诊断影像,Videofluoroscopy,电视透镜检查,Radiography,放射线照相,Ultrasonography,超声波检查,CT-scan/MRI,CT,扫描,/MRI,19,上呼吸道外科手术中英,Diagnosis,诊断,Laryngoscopy!,喉镜检查！,Diagnostic Imaging,诊断图像,Radiography,放射线照相术,20,上呼吸道外科手术中英,Diagnosis,诊断,Laryn
15、goscopy!,喉镜检查！,Diagnostic Imaging,诊断图像,Radiography,放射线照相,Ultrasonography,超声波,CT-scan/MRI,CT,扫描,/MRI,Electromyography,肌电图,21,上呼吸道外科手术中英,Introduction,简介,Brachycephalic Obstructive(Airway)Syndrome,短头颈气道阻塞综合征,History/Signalment,病史,/,特征描述,Etiopathogenesis&Symptoms,发病机理和症状,Diagnostic Procedures,诊断程序,Curre
16、nt treatment options,当前治疗方法,Management&Breeding program,管理,&,品种计划,22,上呼吸道外科手术中英,BOS History/SignalmentBOS,历史,/,特征,Brachycephalic breeds,短头颅品种,Upper airway obstruction,上呼吸道阻塞,Bones of the skull grow to a normal width but reduced length,头骨宽度正常但是长度较短,Soft tissues not proportionally reduced,are even redundant,软组织没有适当减少，甚至非常多,23,上呼吸道外科手术中英,BOS EtiopathogenesisBOS,发病机理,Stenotic nares,狭窄的鼻孔,Elongated soft palate,狭长的软腭,Eversion of laryngeal saccule(laryngeal collaps),喉囊翻转（喉头塌陷）,Tracheal hypoplasia(E Bul
