CAD Respiratory system Flashcards
What makes the lungs smooth and slide across each other.
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
What are some abnormalities that you can see in the lungs
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.
What are the most common respiratory conditions
What are some primary survey considerations for respiratory conditions
Airway: can they talk, sounding muffled or hoarse (dysphonia)
Breathing: WOB RR WPB
Circulation: Cyanosis, Mottled, Pallor
What are some signs that we can look out for that can trigger respiatory distress
Smokes
GTN
Ventolin inhaler
Home oxygen
What is the difference with CPAP and BIPAP
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
Respiratory terms
What is the difference between abnormal respiratory distress and respiratory failure
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
What does the medical assessment for respiratory look like.
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
What does Peak flow expiratory rate (PFER) measure
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
What are vitals that we want immediately for a resp complaint
RR, SPO2, BP
What are some factors that can influence the SPO2 reading
Shock
Hypothermia
False fingernails
Severe anemia
Carbon monoxide poisoning
excessive movement
(Don’t be tricked on the reading this gives)
That does the pleth reading for a SPO2 show
This should be wide and uniform and following the HR if it is irregular and narrow the reading could be false.
What is Asthma
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)
What is COPD/CORD
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
What is Pneumonia
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)
What is the difference between Pleural effusion and pleurisy
What is a PE
This is where there is ischemia usually from a thrombus in the pulmonary circulation.
Most commonly caused by DVT or AF
What is a Pneumothorax
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
Why is a tention pneumothorax so deadly
As each inflation the lungs becomes more and more compressed eventually causing medial stinal shift and ultimately causing obstructive shock
Why does the tripod position work for SOB
This position drops the diaphragm and opens up the chest cavity allowing more air entry
What is the treament plan for severe asthma
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)
What are some signs of immediately life threatening asthma.
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
For a patient with mild/moderate COPD what is the treatment plan
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
For servere COPD what is the treatment plan
Call for CCP
Transport without delay
Administer prednisone and nebulized bronchodilators
NOT ADRENALINE
What are the treatment plans for CPO
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
Is Stridor a clinical diagnosis
No this is only a clinical sign it is not a full diagnosis.
What is the treatment for stridor
Follow the procedure of the underlying condition e.g. anaphylaxis follow that procedure.
Otherwise, administer 5mg nebulized adrenaline and repeat as required
What is croup
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
What is the managment and treatment for croup
administer nebulized adrenaline if there is moderate or severe resp distress (5mg repeated as required)
Administer prednisolone
What are some signs of a PE
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)
