Clinical Presentation Of Respiratory Diseases Flashcards

1
Q

Three major categories of respiratory diseases

A

Obstructive

Restrictive

Vasculature abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Common concerning symptoms

A

Chest pain

Dyspnea

Wheezing

Cough

Hemoptysis

Daytime sleepiness and/or disordered sleep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Top 3 causes for chronic coughing

A

Asthma
- usually associated with wheezing

GERD
- symptoms worse at night

Allergies
- shows allergy symptoms in conjunction

  • note chronic coughing is almost always non-infectious
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

3 types of restrictive pulmonary diseases and examples

A

Parenchyma disease

  • idiopathic pulmonary fibrosis
  • asbestosis
  • sarcoidosis

Neuromuscular weakness

  • ALS
  • guillian-Barre syndrome
  • myasthenia gravid

Pleural diseases

  • scoliosis
  • ankylosis spondylitis
  • pleural effusions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

4 main types of chests

A

1) normal
- ratio of AP diameter to lateral is 0.7-0.9
- increases with aging
- normal shaped

2) pectus excavatum (funnel chest)
- sternum is posteriorly displaced dramatically
- can appear with murmurs

3) barrel chest
- AP diameter is increased
- accompanies with obstructive disorders

4) pectus carinatum
- sternum is anteriorly displaced dramatically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Flail chest

A

Multiple rib fractures in multiple places

  • produces an inward movement of ribs when inhaling and moves outward with expiration
  • moves separately from the rest
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Special landmarks for respiratory

A

2nd intercostal space near sternum
- area for needle insertion for tension pneumothorax

4th intercoastal space mid way better run sternum and anterior axillary line
- area for chest tube insertion

T7-8 intercostal space posteriorly
- area for thoracentesis just superior to the 8th rib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Normal respiratory rates in children and adults

A

Adults= 14-20

Children = 14-44

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Bradypnea

A

Slow breathing with or without increased tidal volume to maintain alveolar ventilation

Without increased tidal volume = uremia, respiratory depression, increased intracranial pressures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Sighing respiration

A

Breathing rates that are normal except for frequent punctuated sighs
- suggests hyperventilation syndrome and is a common cause of dyspnea/dizziness

can be normal to prevent atelectasis as long as it is not frequent (<1 min)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Tachypnea

A

Rapid shallow breathing

Numerous causes but is commonly seen in restrictive lung diseases or fractured ribs/sternum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Cheye-stokes breathing

A

Periods of deep breathing alternating w/ periods of apnea (no breathing)

Normal in children and older adults

Not normal in young adults
- signals brain injury, heart failure, uremia and/or respiratory depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Obstructive breathing

A

Always found in obstructive lung diseases
- asthma and COPD are most common

Inspiration is normal, but expiration is prolonged since the narrowed airways increase resistance to air flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Hyperpnea

A

Rapid deep breathing that occurs in a metabolic demand increased
- examples are: sepsis, high altitude, anemia

Is often seen in diabetic ketoacidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Ataxic breathing

A

“Blot breathing”

Breathing is irregular w/ periods of apnea alternating w/ regular deep breaths

Causes include

  • meningitis
  • respiratory depression
  • brain injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Types of breathing sounds

A

Tracheal
- loud harsh sounds heard over the trachea in the neck

Bronchial

  • loud harsh and high pitchers sounds in the lungs
  • produce short silence between inspiration and expiration as well

Bronchovesicular
- sounds in inspiration and expiration are equal in length but sometimes present w/ silent intervals

Vesicular

  • soft/low pitched breathing
  • heard well in inspiration, but fade away in the middle of expiration
17
Q

Key things to do with auscultation

A

Ask patient to cough once or twice to clear mild non-pathological sounds

Always place the stethoscope directly on skin and not clothing

18
Q

Stridor

A

Musical high-pitched sound heard best over trachea or upper airways

Almost always indicates upper-airway obstruction W/ lesions
- needs ER to treat.

19
Q

Rhonchus

A

Musical low-pitched sounds similar to snoring
- lower pitched than wheezing and can be heard on either inspiration ro expiration

Associated with rupture of fluid films, abnormal airway collapsibility
- bronchospasms, edema

20
Q

Pleural friction rubs

A

Non musical explosive biphasic sounds usually heard in basal regions of lungs
- often indicates pleural effusions

21
Q

What is the sound characterizes for abnormal percussion

A

1) Dullness sounds
- Usually indicates any of the following
- pneumonia
- pleural effusions of any kind
- fibrous tissue/tumors

2) generalized hyper resonance
- indicates COPD/asthma due to increased air present in lungs

3) unilateral hyper resonance
- indicates large pneumothorax
- 100% pneumothorax if tracheal shift is present on imaging

22
Q

Abnormalities in palpation

A

1) unilateral decreases of delays in chest expansion
- chronic fibrosis
- pneumoniae
- pleural effusions
- diaphragm paralysis

2) frenitus (vibratory tremors, ask patient to say 99 or blue balloons)
- COPD
- Pleural effusion
- pneumonothorax

Crepitus (crackling/rales)

  • respiratory distress
  • emphysema
23
Q

Accessory muscle use

A

SCM
Scalenes
Intercostals
Abdominal obliques

*monitor all of these muscles and if they are being used, can signify respiratory distress

24
Q

What is the value for total lung capacity that indicates restrictive pulmonary diseases?

A

<80% (0.8)

25
Q

What is the cardinal value for obstructive lung diseases?

A

FEV1% = <70% (0.7)