9/28 Class Notes- Respiratory Flashcards
When JVD is present, where will the problem be? 2 possibilities
Heart or lungs
What breathing pattern would you expect to see in a heroin OD?
Hypopnea - shallow tidal volume
What is apneustic breathing?
Prolonged inspiration followed by ineffective exhalation caused by lesions to lower pons and upper medulla. Death is imminent.
What is a lateral deviation to the spine called?
Scoliosis
What is a posterior deviation to the spine?
Kyphosis
What is it called when there is a lateral and a posterior deviation to the spine?
Kyphoscoliosis
What are absent breath sounds indicative of?
Pneumothorax, bleb, pleural effusion, massive atelectasis, complete airway obstruction
What are diminished breath sounds indicative of?
Emphysema, atelectasis, and pulmonary fibrosis
What is rhonchi?
Mucous or blood in the airway
What are wheezes?
Bronchial irritation
What are friction rubs?
Pluerosy
What is stridor?
Above epiglottis
What is tactile fremitus?
Refers to palpable vibrations felt through the chest wall when a patient speaks
What is normal tactile fremitus?
Vibrations felt over the trachea, but barely over the periphery
What is decreased tactile fremitus indicate?
There is interference of the transmission of the vibration due to pneumothorax, bronchial obstruction, or emphysema
What does increased tactile fremitus indicate?
Increase in the transmission of vibrations due to pneumonia, lung cancer, and pulmonary fibrosis
What are contraindications for use of an OPA?
Gag reflex, jaw fracture, reactive airway disease (asthma)
What is the most effective way to ventilate?
Mouth to mask ventilation with supplemental O2
What is ARDS?
Progressive lung changes that eventually causes the lungs to stiffen and lose their ability to exchange the gases of oxygen and carbon dioxide
What can cause ARDS?
Severe pneumonia, shock, sepsis, aspiration, near drowning, PE, lung trauma, respiratory infection, multiple blood transfusions
What are the three phases of ARDS?
- ) exudative phase
- ) proliferation phase
- ) resolution phase
What occurs in the exudative phase?
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
What occurs during the proliferation phase of ARDS?
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
What occurs during the resolution phase of ARDS?
Lung attempts to reorganize and recover. Function still impaired. Cough, fatigue, anxiety, depression. Takes 20 years off patients pulmonary life.
