Body Systems: Respiratory System Flashcards
pulse oximetry
procedure used to measure the oxygen level in the blood
- normal rates are > 90%
- lower rates indicate decrease in lung function
material blood gases (ABGs)
used to evaluate levels fo O2 and CO2 and blood pH
sputum analysis
helpful in diagnosing some respiratory diseases
biopsy and imaging tests
- bronchoscopy: visual examination of air passages leading to lungs
- laryngoscopy: visual examination of the back of the throat
- chest x-rays
- CT and MRI scans to confirm
resonance
low-pitched sound heard over normal lungs
hyperresonance
loud, low-pitched sound than normal resonance heard over hyper inflated lungs
tympany
drum-like, loud, empty quality. abnormal chest sound indicating excessive air in chest
dull
typically heard over dense areas. dullness replaces resonance when fluid or solid tissue is considered instead of air-containing lung tissues
inspiration
diaphragm contracts down, causing air to be sucked into lungs
expiration
diaphragm relaxes, pushing upwards and forcing air out of the lungs
respiratory failure
- can be caused by inability to ventilate, resulting in build-up of CO2
- alveolar arterial gas exchange, resulting in a decrease of O2 in blood
- induced by infection, circulatory disorders, tumours, trauma, immune disease, congenital defect, central nervous system damage/disease, inflammatory disturbances, or environmental conditions
- main symptoms: chest pain, dyspnea, cough, heamopotysis, dyspnoea, chills, fever, wheezing fatigue
uppser respiratory diseases
acute inflammatory process tat affects mucous membrane that lines upper respiratory tract (common cold)
upper respiratory diseases ss
- nasal congestion and discharge
- sneezing
- watering eyes
- sore throat
- hoarseness
- coughing
- clear and thin nasal discharge early on that chances to yellow/green and thick
- headache
- slight fever
upper respiratory diseases etiology
can be caused by more than 200 viruses
- rhinoviruses being most common
upper respiratory disease diagnosis
based on physical exam and symptoms
upper respiratory disease treatment and prevention
treatment: no cure but pain relief, decongestant, and antihistamine medication can be helpful
prevention: proper hand-washing, avoid contact with sick people
allergic rhinitis
inflammation of the mucous membrane of the nose caused by allergic reactions to airborne substances
- risk factors: family history, having allergies, exposure to allergens
allergic rhinitis ss
- runny nose
- watery eyes
- congestion
- sneezing
allergic rhinitis etiology
immunoglobulin E binds to mast cells and induces them to release histamine and other chemicals responsible for allergic rhinitis
allergic rhinitis diagnosis
physical examination, medical history, allergy testing
sinusitis
inflammation of the mucous membrane lining of he sinuses
- sinuses: air-filled cavities behind facial bones
- risk factors: heaving an upper respiratory infection, allergies, obstruction of nose, weakened immune system
sinusitis ss
- facial pain and pressure
- nasal stuffiness
- nasal discharge
- loss of smell
- cough or congestion
sinusitis etiology
usually caused by viral infection, often common cold
sinusitis diagnosis
- medical history
- physical examination
- nasal endoscopy
- imaging tests
- nasal and sinus cultures
- allergy testing
sinusitis treatment
- symptomatic and may include using a saline nasal spray to rinse the nasal passages
- nasal corticosteroid to reduce inflammation
- decongestants
- pain relievers
pharyngitis
acute or chronic inflammation or infection of pharynx
pharyngitis ss
- inflammation os tonsils, uvula, palate
- sore throat with dryness, a burning sensation, or sensation of lump in throat
- chills
- fever
- dysphasia
- dysphonia
- cervical lymphadenopathy
pharyngitis etiology
- commonly viral
- tonsillitis an important cause
- often extension of bacterial streptococcal; infections form tonsils, adenoids, nose, or sinus in children
- persistent when infection spreads to pharynx and remains
- acute may be secondary to systemic viral infections
- can be caused by irritation/inflammation with no infection
- inhalation or swallowing of irritating substances can lead to trauma
- breathing in excessively heated air or chemical irritants
- seasonal allergies
pharyngitis prognosis
- uncomplicated: resolves in a few days
- bacteria: can bee cured with antibiotics
- chronic: may require illuminating underlying cause (smoking, allergens, etc.)
pharyngitis diagnosis
- physical examination
- locate primary source of infection for chronic
- sinus radiography
- blood count
pharyngitis treatment
- viral: home treatment using lozenges, mouthwashes, slat water, ice collar, anti-inflammatory medicine
- do not give aspirin to children’s (Reye’s syndrome)
- acute bacterial: antibiotics
- streptococcal pharyngitis: 7-10 day course of antibiotics
- surgical excision (chronic pharyngitis)
- bed rest and fluids
pharyngitis prevention
- maintain general good health
- avoid infection
- evade irritants
- control allergies
nasopharyngeal carcinoma
nasopharyngeal tumours that arise in area of pharynx which o[ens into nasal cavity anteriorly and oral pharynx inferiorly
nasopharyngeal carcinoma ss
- tumours in nasopharynx or neck mass
- often asymptomatic early
- nasal obstruction withe epistaxis
- serous otitis media
- headache
- hearing loss
- tinnitus
- pain
- impaired function of cranial nerves
nasopharyngeal carcinoma etiology
- rare in US +western europe
- common in southern china, mediterranean, Southeast Asia, arctic
- 2/3 times more common I males
- peak between 10-25, 50-60
- risk factors: consumption of salted fish as diet standard, food with hight levels of nitrates, Chinese herbs, infections with Epstein Barr virus, first degree relative with nasopharyngeal carcinoma, alcohol and tobacco
- strongly related to diet and virus
nasopharyngeal carcinoma prognosis
- often caught too later and have metastasis to bone, lung, or liver
- if tumour has extended to a cranial nerve or to a cervical lymph node, prognosis is worse
- presence of env dan can correlate with poor outcome
nasopharyngeal carcinoma diagnosis
- full clinical examination of head and neck
- endoscopic examination of nasopharynx
- biopsy of lesions
- staging according to tnm
- MRI, bone scan, CT, PET scan
nasopharyngeal carcinoma treatment
- surging usually not preformed due to anatomic constraints
- radiation therapy with/without chemotherapy
- chemoradiotherapy for more advanced
- follow up to asses for recurrence
nasopharyngeal carcinoma prevention
screen for EBV
laryngitis
inflammation of larynx, including vocal cors
laryngitis ss
- vary with severity f inflammation
- hoarseness causing aphonia
- fever and malaise
- painful throat
- dysphasia
laryngitis etiology
- viral or bacterial, chronic or acute
- can occur with bronchitis, pertussis, influenza, measles, tonsillitis, pharyngitis, sinusitis
- can be from irrational or infection
- acid reflux –> reflux laryngitis
- risk factors: inclement weather, tobacco, alcohol, irritating materials, excessive use of voice
- benign or malignant lesions
laryngitis prognosis
recovery usually within a week
laryngitis diagnosis
- largngoscopic examination for inflammation
- further tests if no inflammation
laryngitis treatment
- palliative measures: voice rest, bed rest, humidity, fluid intake, no tobacco or alcohol, lozenges
- improvement in 4-5 days
- antibiotics when bacterial infection
- corticosteroids
- chronic: eliminate causative factors
laryngitis prevention
- avoid known irritants
- difficult to prevent infection
deviated septum
crooked nasal septum (cartilage partition between nostrils)
deviated septum ss
- narrowing and obstruction of air passage making breathing difficult
- slightly increased tendency to develop sinusitis
- no significant symptoms
deviated septum etiology
- congenital anomaly for minor deviation
- trauma for substantial deviation (uncommon)
deviated septum prognosis
- good
- fairly common condition
deviated septum diagnosis
- nose can look normal with deviation visible during an examination with nasal speculum
deviated septum treatment
- not usually necessary unless compression fo air passage
- surgically straightened septum to repair obstruction or for cosmetic reasons
- straightening of deviated septum involves removing cartilage, reshaping and repositioning it in nose to maintain nasal structure
deviated septum prevention
- can’t avoid genetic anomalies
- avoid trauma to nose
nasal polyps
benign growth that form as a consequence of distended mucous membranes protruding into the nasal cavity
nasal polyps ss
- can become large enough to obstruct airway
- can affect or impair sense of smell
- can obstruct sinuses leading to sinusitis
- grey lumps along nasal passage
nasal polyps etiology
- caused by overproduction of fluid in the cells of the mucous membrane
- often as a result of allergic rhinitis
- some aspirin sensitive poole have triad of nasal polyps, asthma, urticaria
nasal polyps prognosis
- good
- tends to recur
nasal polyps diagnosis
- examine inside of nose using nasal speculum
nasal polyps treatment
- surgery with local anesthetic when minor, general anesthetic when lining of sinus must be removed
- steroid
nasal polyps prevention
- none known
- management beneficial
anosmia
impairment or loss of smell
anosmia ss
- loss of smell without obvious cause
- lost or impaired ability to taste
anosmia etiology
- commonly caused by chronic conditions
- temporary: intra nasal swelling accompanying upper respiratory condition
- phobia for particular smell as a psychological basis
- damage to olfactory nerves (head injury, brain tumour)
anosmia prognosis
- temporary when related to upper respiratory infection
anosmia diagnosis
- physical examination
- neurological diagnostic tests
anosmia treatment
- aimed at cause of condition
- nerve damage may not be corrected
- injecting of allergen to desensitize patient for allergic rhinitis
anosmia prevention
- none known
- avoid head trauma
epistaxis (nose bleed)
hemorrhage from nose
epistaxis ss
- usually from one nostril
- systemic symptoms withs significant blood loss (vertigo, tachycardia, pallor, shortness of breath, hypertension)
epistaxis etiology
- no apparent explanation or bleeding
- most are not concerning
- unlikely to be symptom for other disorders
- more common in children than adults
epistaxis prognosis
generally good
epistaxis diagnosis
- based on patient history, injury, or systemic diseases
- also u can see it???
epistaxis treatment
- mild hemorrhage: constant direct pressure on nose bridge for 5-10 min
- persistent: local application of epinephrine followed by cauterization
–> if bleeding continues posterior nasal packing left for 1-3 days - mild sclerosis agent can be injected into bleeding vessel
- surgical ligation of leading artery
epistaxis prevention
- treatment of underlying disease
- education about avoiding recurrences
laryngeal tumours
growths on the larynx
laryngeal tumours ss
- dysphonia is usually only symptom
- common in children because of their small airways
- benign: intermittent hoarseness
- cancer: continuous hoarseness that gradually gets worse
laryngeal tumours etiology
- benign or malignant
- not very common, malignant more common in men
- benign: papillomas(multiple), polyps(single)
- benign caused by miss or overuse of vocal cords
- smoking and reflex contribute
- malignant more often in tobacco use
laryngeal tumours prognosis
- depends on type of tumours
- can almost always be cured if diagnosed early
laryngeal tumours diagnosis
- physical examination of larynx and vocal cords
- biopsy to determine cancer
laryngeal tumours treatment
benign: correction of vocal strain, reflux management, smoking cessation, excision with oral anesthetic
- malignant: radiation therapy
- metastasis: laryngectomy followed by speech therapy
laryngeal tumours prevention
- avoid smoking
- avoid chronic irritation of larynx
laryngeal cancer
neoplasm of larynx
laryngeal cancer ss
- if involves vocal cord, persistent hoarseness early on
- dysphasia
- haemoptysis
- chronic cough
- referred pain to ear
- strider
- potential airway obstruction
laryngeal cancer etiology
- most common site for head and neck tumours
- most are squamous cell carcinomas
- main risk factors: smoking + alcohol use, multiplicative
- other factors: hp infection, occupational exposure to agents, asbestos, relative with laryngeal cancer
- peak in 60-70 yrs old
laryngeal cancer prognosis
- often diagnosed at stage where cure is possible
- five year survival rate 30-90%
- more likely to develop 2nd primary cancers
- development of another primary tumour worsens prognosis
laryngeal cancer diagnosis
- diagnosed early because hoarseness
- flexible fiber oppik endoscopy
- biopsy via fine needle aspiration
- staging via TNM
- CT, PET, MRI to look for metastasis
- panendoscopy
laryngeal cancer treatment
- radiation to preserve voice
- surgery: partial/total laryngectomy, scopic laser resection
- choice depend son tumour stage
- resectable tumours: surgery followed by radiation
- chemoradiotherapy in patients choosing to save organ
- follow up + speech and swallowing therapy
laryngeal cancer prevention
- cessation of smoking and alcohol
- periodic panendoscopy
