CAD Respiratory system Flashcards

1
Q

What makes the lungs smooth and slide across each other.

A

The pleurae
Parietal pleura: this is the OUTER layer lining the ribcage and the upper diaphragm

Visceral pleura: this is the INNER layer covering the joining structures of the lungs

The pleura space is between these layers and is lubricated with serous fluid allowing them to glide over each other with ease

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2
Q

What are some abnormalities that you can see in the lungs

A

Barrel chest: This is where the chest bulges out like a barrel and is usually associated with COPD or emphysema, usually occurring from gas trapping and hyperinflation.

Pectus Excavatum: This is a funnel shape (center of chest caved in) in the chest and is a birth defect

Pectus carinatum: This is the opposite where the chest of pointing outwards instead of having inwards.

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3
Q

What are the most common respiratory conditions

A
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4
Q

What are some primary survey considerations for respiratory conditions

A

Airway: can they talk, sounding muffled or hoarse (dysphonia)

Breathing: WOB RR WPB

Circulation: Cyanosis, Mottled, Pallor

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5
Q

What are some signs that we can look out for that can trigger respiatory distress

A

Smokes
GTN
Ventolin inhaler
Home oxygen

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6
Q

What is the difference with CPAP and BIPAP

A

CPAP - Continuous positive airway pressure, this is commonly used for sleep apnea and provides a constant air flow

BIPAP - this is variable pressure between inspiration and expiration (lower pressure on expiration and more on inspiration) This is more commonly used so that people don’t find it hard to breath out

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7
Q

Respiratory terms

A
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8
Q

What is the difference between abnormal respiratory distress and respiratory failure

A

Respiratory distress:
A state of abnormal respiratory rate or effort this can range from mild to severe (severe can be a indication of respiratory failure).

Respiratory failure (this can be type 1 or type 2):
The clinical state of inadequate oxygenation, ventilation, or both. The respiratory system can not meet the bodies demands

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9
Q

What does the medical assessment for respiratory look like.

A

Look:
WOB, Normal sounds, Accessory muscle use, Nasal flaring?
Any odema on limbs or in sputum
Any structural changes diagnosed with chronic conditions?
Think head-to-toe

Listen:
listen to all the lobes of the lungs

Feel:
Any peripheral odema or unilateral chest rise, flail lung

Tap:
Percuss all the lobes of the lungs

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10
Q

What does Peak flow expiratory rate (PFER) measure

A

This device records the forced expiratory volume. If it is LESS than 70% of patients normal this = obstructive ventilatory defect.

This is the best indicator for Asthma or COPD severity

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11
Q

What are vitals that we want immediately for a resp complaint

A

RR, SPO2, BP

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12
Q

What are some factors that can influence the SPO2 reading

A

Shock
Hypothermia
False fingernails
Severe anemia
Carbon monoxide poisoning
excessive movement

(Don’t be tricked on the reading this gives)

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13
Q

That does the pleth reading for a SPO2 show

A

This should be wide and uniform and following the HR if it is irregular and narrow the reading could be false.

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14
Q

What is Asthma

A

This is characterized as REVERSIBLE bronchospasm with SOB and wheezing. Often associated with mucus plugging of out small airway. Usually leading to hyperventilation (trouble getting air out)

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15
Q

What is COPD/CORD

A

This is a term that covers chronic inflammatory or destructive diseases of the lungs. The bronchoconstriction associated with these conditions are NOT completely reversible.

Some risk factors are
Age over 50
Smokers
Factory works (Exposure to irritants)
Vaping

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16
Q

What is Pneumonia

A

This is a inflamation of gas exchange structures of the lung. Can have infectious (Viral, Bacterial, Fungal). Chemical pneumonia (inhalation of toxic chemicals). Aspirational pneumonia (Toxic secretions of stomach or enzymes going into the lungs)

17
Q

What is the difference between Pleural effusion and pleurisy

A
18
Q
A
19
Q

What is a PE

A

This is where there is ischemia usually from a thrombus in the pulmonary circulation.

Most commonly caused by DVT or AF

20
Q

What is a Pneumothorax

A

This is where air gets caught in the pleural cavity.
There is spontaneous, tension and you can have a hemothorax. Usually caused by blunt trauma and penetrating trauma

21
Q

Why is a tention pneumothorax so deadly

A

As each inflation the lungs becomes more and more compressed eventually causing medial stinal shift and ultimately causing obstructive shock

22
Q

Why does the tripod position work for SOB

A

This position drops the diaphragm and opens up the chest cavity allowing more air entry

23
Q

What is the treament plan for severe asthma

A

Call for CCP backup
Measure flow rate if the patient usually does
Administer nebulized salbutamol (5mg) and Neb ipratropium (0.5mg), and repeat neb salbutamol if required.

If deteriorating administer 0.5mg IM adrenaline (repeated every 10 mins if required)

24
Q

What are some signs of immediately life threatening asthma.

A

if there is a quiet chest that means there is little to no air movement.

Accessory muscle use may not be present because of the exhausted state of the patient

25
Q

For a patient with mild/moderate COPD what is the treatment plan

A

Follow the action plan if one is in place.
Administer bronchodilators
When nebulizing use MEDICAL AIR NOT O2
SPo2 range should be kept 88-92%
administer prednisone

26
Q

For servere COPD what is the treatment plan

A

Call for CCP
Transport without delay
Administer prednisone and nebulized bronchodilators
NOT ADRENALINE

27
Q

What are the treatment plans for CPO

A

Sit the patient up
Acquire 12 lead
Administer GTN (0.8mg) repeated every 3-5 mins if not improving.
Use CPAP or PEEP set at 10 increase to 15

28
Q

Is Stridor a clinical diagnosis

A

No this is only a clinical sign it is not a full diagnosis.

29
Q

What is the treatment for stridor

A

Follow the procedure of the underlying condition e.g. anaphylaxis follow that procedure.

Otherwise, administer 5mg nebulized adrenaline and repeat as required

30
Q

What is croup

A

This is a VIRAL infection of the upper airway usually common in 6 month - 2 years

Onset can be over a few days.

May present with low grade fever

31
Q

What is the managment and treatment for croup

A

administer nebulized adrenaline if there is moderate or severe resp distress (5mg repeated as required)

Administer prednisolone

32
Q

What are some signs of a PE

A

SOB
Chest pain (localised and pin point)
Potential for a cough (may contain blood)
Cyanotic in the neck/face/head
Sudden onset

Hall mark sign is recent long haul flight (potential to develop a DVT)