Ch. 5 Respiratory Function Flashcards
why is it common to develop a secondary bacterial infection with infectious rhinitis?
because the infectious organism invades the epithelial nasal mucosa. mild cellular inflammation leads to nasal discharge, mucus production, and the shedding of epithelial cells. this causes a break in the body’s first line of defense and so a secondary infection is more likely to occur
viral upper respiratory infection most often caused by the rhinovirus. also known as the common cold.
infectious rhinitis
why is the risk for secondary bacterial infections with infectious rhinitis further increased in people who smoke?
because there is chronic damage done by smoke to the mucosa and cilia
how is infectious rhinitis transmitted?
close physical contact with the virus transmits the infection through exchanges with other humans and surfaces. Transmission may occur through both inhalation and contact
does rainy and cold weather cause a person to get infectious rhinitis?
it doesn’t cause them to get the virus because of the weather, but when the weather is like this, there is increased congregation in confined spaces
why is the infectious rhinitis virus so contagious?
because it is shed in large numbers from the nasal mucosa, and the virus can survive for several hours outside of the body
how long is the incubation period for infectious rhinitis?
usually 2-3 days, but can be as long as 7
what are the clinical manifestations of infectious rhinitis?
sneezing, nasal congestion or stuffiness, clear nasal discharge, sore throat, lacrimation, nonproductive cough, malaise, myalgia, low-grade fever, hoarseness, headache, chills
an inflammation of the sinus cavities most often caused by a viral infection
sinusitis
what things can cause sinusitis?
most often caused by a viral infection, but may also be caused by a bacterial infection
what things can influence your risk of developing sinusitis?
environmental irritants, being immunocompromised, conditions that increase mucus production, and nasal structure abnormalities
how can sinusitis develop as a secondary infection to infectious rhinitis or allergic rhinitis?
drainage from the sinus cavity has become blocked and this drainage accumulation provides a supportive medium for bacterial growth
what two bacterias are commonly found in the upper respiratory tracts of healthy people?
Streptococcus pneumoniae and Haemophilus influenzae
what are the different types of sinusitis and what are their time frames?
acute - up to 4 weeks
subacute - 4-12 weeks
chronic - 12+ weeks and can continue for several months or even years
recurrent - several attacks occur within a year
why can facial bone pain accompany sinusitis?
as exudate accumulates, pressure builds in the sinus cavity which causes the pain and headache.
what can the location of the pain in sinusitis indicate?
which sinus is affected
what are the clinical manifestations of sinusitis?
facial bone pain, headache, nasal congestion, purulent nasal drainage, discharge, halitosis, mouth breathing, fever, sore throat, and malaise.
all but bone pain and headache may already be present when the infection develops
what are complications that may develop with sinusitis?
orbital cellulitis, meningitis, osteomyelitis, and abscesses
life-threatening condition of the epiglottis.
epiglottitis
what are causes for epiglottitis?
Haemophilus influenza type B (Hib), Group A beta-hemolytic Streptococcus, Streptococcus pneumonia, Staphylococcus aureus, throat trauma from events such as drinking hot liquids, swallowing a foreign object, a direct blow to the throat, or smoking crack or heroine.
what occurs during epiglottitis?
the inflammatory response is triggered, causing the epiglottis to quickly swell and block the air entering the trachea leading to respiratory failure. bacteria can also invade the blood stream leading to sepsis
who is epiglottitis seen in more often?
more often seen in children 2-6 years, but with increasing rates of vaccinations, the trend may change
what are the clinical manifestations of epiglottitis?
high fever, chills and shaking, sore throat and hoarseness, dysphagia, drooling with the mouth open, mild inspiratory stridor, respiratory distress, central cyanosis, anxiety irritability or restlessness, pallor, assuming a tripod position, often leaning slightly foreward
central cyanosis
blue discoloration of the mouth and lips
mild inspiratory stridor
a harsh, high-pitched sound made as a result of air turbulence
what is a priority if epiglottitis is suspected?
maintaining the airway and stabilizing respiratory status
an inflammation of the larynx that is usually a result of an infection, increased upper respiratory exudate, irritants, or over use
laryngitis
what is the most common cause of laryngitis?
viral infections
what occurs during laryngitis?
the vocal cords become irritated and edematous because of the inflammatory process. this inflammation distorts sounds, leading to hoarseness and in some cases making the voice undetectable. occasionally the airways can become blocked
what two diseases can laryngitis be associated with?
croup and epiglottitis
what are the clinical manifestations of layrngitis?
hoarseness, weak voice or voice loss, tickling sensation and raw feeling in the throat, sore dry throat, dry cough, swollen nodes of the neck, leukocytosis (if bacterial), difficulty breathing in children
how long do the manifestations of laryngitis usually last?
less than a week
common viral infection in which outbreaks and epidemics occur in autumn to early winter, but cases can occur sporadically year round
laryngotracheobronchitis or croup
who does croup most often affect?
children 3 months - 3 years of age
what are common causes of croup?
parainfluenza viruses, adenoviruses, and respiratory syncytial virus. can also be caused by bacterial infections, allergens, and irritants
what occurs with croup?
usually begins as an upper respiratory infection with nasal congestion and cough. The larynx and surrounding area swell, leading to airway narrowing and obstruction. this can also lead to respiratory failure. clinical manifestations worsen at night and can eventually lead to respiratory failure
clinical manifestations of croup
low-grade fever, nasal congestion, seal-like barking cough, hoarsenss, inspiratory stridor, mild expiratory wheezing, dyspnea, anxiety, cyanosis
inflammation of the tracheobronchial tree or large bronchi
acute bronchitis
what is acute bronchitis most commonly caused by?
a wide range of viruses, bacterial invasion, irritant inhalation, allergic reactions
who have the highest risk for developing acute bronchitis?
young children, the elderly, smokers
what occurs during acute bronchitis?
the airways become irritated and narrowed due to the results of the inflammatory process
what are the clinical manifestations of acute bronchitis?
productive or nonproductive cough, dyspnea, wheezing, abnormal lung sounds, low-grade fever, pharyngitis, malaise, myalgia, chest discomfort
how long do the clinical manifestations of acute bronchitis usually last?
usually last 7-10 days and are mild, but coughing may linger for several weeks after the infection is resolved
what is epiglottitis often misdiagnosed as? what is the distinct difference between the two?
it is often misdiagnosed as croup, but a distinct difference in manifestations can help you distinguish between the two. with epiglottitis the patients look worse than the sound and with croup they sound worse than they look due to the seal-like barking cough. additionally cough is not usually seen with epiglottits
viral infection that may infect the upper and lower respiratory tract
influenza
most common type of influenza virus which is usually responsible for the most serious epidemics and global pandemics. found in humans and many animals
type a influenza
type of flu in which outbreaks can also cause regional epidemics, but the disease is generally milder. found in humans primarily
type b
type of influenza that causes sporadic cases and minor, local outbreaks. has never been connected with a large epidemic. found in humans, pigs, and dogs
type c
when is the flu season in the US? how is the flu spread? who are most likely to be infected with the flu?
November-March. transmitted through the inhalation or contact with respiratory droplets. children are two to three times more likely to contract the virus than adults and they frequently spread the virus to others
who are persons at greater risk for negative outcomes with the flu?
children, elderly, immunocompromised, pregnant women, and individuals with preexisting chronic diseases
what are deaths associated with the flu often the result of?
secondary bacterial pnuemonia
what is the incubation period of the flu? peak transmission risk? what about for children and immunocompromised patients?
incubation period is 1-4 days
peak transmission risk starts at approximately 1 day before the onset of the symptoms and lasts 4-7days afterward in adults
children can spread the virus for more than 10 days and be infectious for 6 days before the onset of symptoms
severely immunocompromised patients can spread the virus for weeks or months
how does the flu differ from the common cold?
the flu usually has sudden onset of symptoms
what are the clinical manifestations of the flu
fever, headache, chills, dry cough, body aches, nasal congestion, sore throat, sweating, malaise, vomiting and diarrhea
typically fever and body aches last 3-5 days while cough and fatigue may last for 2+ weeks
common viral infection of the bronchioles which is most frequently caused by the respiratory syncytial virus (RSV). most often occurs in children less than 1 year of age and incidence increases in the fall and winter months
bronchiolitis
what are some lower respiratory tract infections?
bronchiolitis, pneumonia, tuberculosis,
what are some causes for bronchiolitis?
RSV, parainfluenza, influenza, adenoviruses, and metapneumoviruses
is bronchiolitis common in children?
yes, nearly all children will have an RSV infection by the time they are 2 years old
what happens during bronchiolitis?
when the virus infects the bronchioles, these small airways become inflamed and swollen. As a result of the inflammatory process, mucus collects in these airways. The combination of edema and mucus prevents air flow into the alveoli
how is RSV transmitted?
through contact with or inhalation of infected respiratory droplets
what are factors that contribute to the development of bronchiolitis?
neonatal prematurity, asthma, family history, and cigarette smoke exposure
what are the clinical manifestations of bronchiolitis?
nasal drainage, nasal congestion, cough, wheezing, abnormal lung sounds (ronchi or rales), rapid shallow respirations, labored breathing, dyspnea or tachypnea, fever, tachycardia, malaise
inflammatory process caused by numerous infectious agents and injurious agents or events
pneumonia
what is the most common cause of pneumonia? how common is it?
streptococcus pneumoniae is responsible for 75% of all cases of pneumonia
what are the most common viral causes of pneumonia?
influenza, parainfluenza, and RSV
which type of pneumonia is more mild, viral or bacterial?
viral pneumonia is more mild, but without intervention it can lead to bacterial pneumonia
what are some irritating agents or events that can lead to pneumonia?
aspiration of gastric contents, endotracheal intubation, respiratory suctioning, and inhalation of smoke or chemicals
when does aspiration pneumonia frequently occur?
when the gag reflex is impaired because of a brain injury or anesthesia
how can aspiration lead to pneumonia?
gastric contents and tube feeding formulas irritate lung tissue and trigger the inflammatory response which increases mucus production, which can in turn lead to atelectasis and penumonia. tube-feeding formulas also contain sugar and protein in which bacteria grow.
why does the stasis of pulmonary secretions lead to pneumonia?
when the cilia cannot remove the bacteria laden mucus, the bacteria flourish in the lungs and cause pneumonia
what activities can keep mucus in the lungs moving?
activities such as movement, talking, and coughing keep secretions moving and adequate hydrations keep secretions thin, decreasing the chance of getting pneumonia
what is pneumonia classified based on?
the causative agents, location in the lung, or where it was acquired
pneumonia that is confined to a single lobe and is described based on the affected lobe
lobar pneumonia
what are the types of pneumonias classified based upon the causative agent?
viral pneumonia, bacterial pneumonia, aspiration pneumonia, pneumonia caused by stationary pulmonary secretions
what are the types of pneumonia that are classified based on location in the lung?
lobar pneumonia, bronchopneumonia, interstitial pneumonia
the most frequent type of pneumonia and is patchy pneumonia spread through several lobes
broncopneumonia
atypical pneumonia. occur in the areas between the alveoli and is routinely caused by viruses or uncommon bacteria
interstitial pneumonia
what is the difference between viral and bacterial pneumonia with regards to the cough?
viral cough is nonproductive while bacterial is productive
what is the difference between viral and bacterial pneumonia’s fever?
viral pneumonia is a low grade fever while bacterial has a higher fever
what is the difference between viral and bacterial pneumonia’s white blood cell count?
viral is normal/low while bacterial is elevated
what is the difference between viral and bacterial pneumonia’s x-ray scan?
viral pneumonia shows minimal change while bacterial shows infiltrates
what is the difference between viral and bacterial pneumonia in severity?
viral is less severe while bacterial is more severe