9/28 Class Notes- Respiratory

Question 1

When JVD is present, where will the problem be? 2 possibilities

Answer 1

Heart or lungs

Question 2

What breathing pattern would you expect to see in a heroin OD?

Answer 2

Hypopnea - shallow tidal volume

Question 3

What is apneustic breathing?

Answer 3

Prolonged inspiration followed by ineffective exhalation caused by lesions to lower pons and upper medulla. Death is imminent.

Question 4

What is a lateral deviation to the spine called?

Answer 4

Scoliosis

Question 5

What is a posterior deviation to the spine?

Answer 5

Kyphosis

Question 6

What is it called when there is a lateral and a posterior deviation to the spine?

Answer 6

Kyphoscoliosis

Question 7

What are absent breath sounds indicative of?

Answer 7

Pneumothorax, bleb, pleural effusion, massive atelectasis, complete airway obstruction

Question 8

What are diminished breath sounds indicative of?

Answer 8

Emphysema, atelectasis, and pulmonary fibrosis

Question 9

What is rhonchi?

Answer 9

Mucous or blood in the airway

Question 10

What are wheezes?

Answer 10

Bronchial irritation

Question 11

What are friction rubs?

Answer 11

Pluerosy

Question 12

What is stridor?

Answer 12

Above epiglottis

Question 13

What is tactile fremitus?

Answer 13

Refers to palpable vibrations felt through the chest wall when a patient speaks

Question 14

What is normal tactile fremitus?

Answer 14

Vibrations felt over the trachea, but barely over the periphery

Question 15

What is decreased tactile fremitus indicate?

Answer 15

There is interference of the transmission of the vibration due to pneumothorax, bronchial obstruction, or emphysema

Question 16

What does increased tactile fremitus indicate?

Answer 16

Increase in the transmission of vibrations due to pneumonia, lung cancer, and pulmonary fibrosis

Question 17

What are contraindications for use of an OPA?

Answer 17

Gag reflex, jaw fracture, reactive airway disease (asthma)

Question 18

What is the most effective way to ventilate?

Answer 18

Mouth to mask ventilation with supplemental O2

Question 19

What is ARDS?

Answer 19

Progressive lung changes that eventually causes the lungs to stiffen and lose their ability to exchange the gases of oxygen and carbon dioxide

Question 20

What can cause ARDS?

Answer 20

Severe pneumonia, shock, sepsis, aspiration, near drowning, PE, lung trauma, respiratory infection, multiple blood transfusions

Question 21

What are the three phases of ARDS?

Answer 21

1. ) exudative phase
2. ) proliferation phase
3. ) resolution phase

Question 22

What occurs in the exudative phase?

Answer 22

Starts at time of injury and gets worse over next 5 days. Capillary permeability is increased and fluid leaks into pulmonary interstitial space. Dysfunction of surfactant producing cells. Alveolar flooding occurs

Question 23

What occurs during the proliferation phase of ARDS?

Answer 23

Formation of hyaline cartilage membrane over insulted lung leading to loss of elasticity and worse hypoxia and hypercarbia. 5-7 days after insult, high risk of death. Fibrotic scar eventually replaces hyaline membrane and lung becomes nonfunctional and rigid. No opportunity for gas exchange

Question 24

What occurs during the resolution phase of ARDS?

Answer 24

Lung attempts to reorganize and recover. Function still impaired. Cough, fatigue, anxiety, depression. Takes 20 years off patients pulmonary life.