i wouldn't suggest primal surge.  it's not going to be super useful as a spell.  you might get one or two permanents, but not much more than that for primal surge.  i find if you cut all your sorcerys and instants except for something like life from the loam or unburial rights or living death, then i can see this, but with the amount of non-permanents, i just don't see it

I might consider putting that into Mayael, since I designed that deck to Warp World with 90% permanent retention.

I'm considering running ghostway for two reasons: 1. It'll let me dodge a wrath attempt. 2. This deck has a fair amount of etb triggers that I would get upon casting that.

As for Vish Kal and the Altar, those are because free sac outlets are wonderful because they make your creatures difficult to tuck, among other things. I figure there are going to be times where I would rather have a creature in my Graveyard just so I can cast/dredge it, as well. The altar gets bonus points for working well as a controlled self-mill card. Both of these synergize well with Lord of Extinction, with Vish Kal giving pseudo-haste, and Altar doubling its size (and making Karrador cost BGW for the rest of the game).

Tooth and Nail is too good of a card to not run with this variety of creatures available.