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Cough Flashcards

1
Q

Cough

A

. Body response when something irritates throat
. Irritant simulates nerve that relays message to brain to have muscles in chest and abdomen push air out of lungs to force out irritant

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2
Q

Prolonged vigorous coughing can cause ___

A

Headaches, urinary incontinence and broken ribs

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3
Q

Acute cough

A

. <3 weeks
. Viral URI (most common)
. Acute bronchitis, pneumonia, left-sided HF, Asthma, Foreign body, smoking, ACE-inhibitor therapy

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4
Q

Sub-acute cough

A

. 3-8 weeks

. Post-infectious cough, pertussis, acid reflux (GER), Bacterial sinusitis, asthma

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5
Q

Chronic cough

A

. Over 8 weeks

. Post nasal drip (PND), asthma, gastroesophageal reflux (GER), chronic bronchitis, bronchiectasis

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6
Q

Bronchiectasis

A

. Bronchial wall inflammation causing inability to clear mucous
. Usually from infection

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7
Q

ROS important when evaluating cough

A 
. General
. Skin
. Musculo/osteopathic
. HEENT
. Neck
. Chest, heart, lungs 
. Abdomen/GI
. Extremities 
. Neurologic
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8
Q

Chest pain, shortness of breath, and cough

A

. Can be from heart, lungs, and other structures

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9
Q

Important information in relation to cough

A 
. Fever
. Weight loss/gain
. Type of cough (dry, purulent, blood, whitish-clear sputum)
. Post nasal drip
. wheeze
. Orthopnea
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10
Q

What spinal level is tracheal bifurcation

A

T4

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11
Q

What rib level is inf. Tip of scapula

A

Level at 7th rib

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12
Q

Thoracentesis landmark

A

Interspace T7-8

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13
Q

Right lung lobes

A

. Upper
. Middle
. Right
. Separated by horizontal and right oblique fissures

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14
Q

Left lobes

A

. Upper
. Lower
. Separated by left oblique fissure

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15
Q

Trachea

A

. Bifurcated at sternal angle ant. And T4 spinous process post.
. Bifurcated into 2 main bronchi at carina
. Right and left mainstem bronchus

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16
Q

Pleura

A

Membrane that covers lung

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17
Q

Parietal pleura

A

. Lines inner rib cage and upper surface of diaphragm

. Richly innervated by intercostal and phrenic nerves

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18
Q

Visceral pleura

A

. Covers outer surface of lung

. Lacks sensory nerves

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19
Q

Pleural space

A

. Space between parietal and visceral pleura
. Some fluid to lubricate surfaces (pleural fluid)
. May inc. size or fill w/ fluid (pleural effusion)

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20
Q

T/F auscultate directly on skin not through clothing

A

T

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21
Q

Rales

A 
. Fine Crackles (soft, high pitched)
. Coarse crackles (louder, low pitched) 
. Intermittent non-musical 
. Smaller airways
. Fluid in lungs (alveoli)
. Seen in CHF, pneumonia 
. Doesn’t clear w/ coughing
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22
Q

Rhonchi

A 
. Larger airways
. Obstruction/fluid accumulation in larger airways 
. Low pitched 
. May change w/ or w/o coughing 
. Seen in COPD, pneumonia
23
Q

Wheezing

A

. Effects bronchi
. Constriction
. Air trying to pass through bronchioles
. Seen in asthma and bronchitis
. Occurs during expiration
. Musical sounds, prolonged through narrow airways
. High pitched

24
Q

Stridor

A

. Upper airway
. Over trachea
. Foreign airway obstruction

25
Adventitious lung sounds
. Abnormal sounds heard when auscultations a patient’s lungs and/or airways
26
Pleural friction rub
. Squeaking/grating sounds of pleural linings rubbing together . Directly assoc. w/ inspiration and expiration (can’t be auscultated if patient holds breath . Result of inflamed pleural layers which are inflamed and lost lubrication
27
GREAT BAD TOM CAT
``` . GERD . Rhinitis . Embolism . Asthma/COPD . TB . Bronchitis . Aspiration . Drugs . Thoughts . Other (hiatal hernia) . Malignancy . CF/cardiogenic . Achalasia: failure esophageal smooth muscle to relax . Thyroid enlargement ```
28
Vesicular sounds
``` . Inpiratory sounds . Last longer than exploratory sounds . Soft . Low pitch . Found over most of both lungs ```
29
Bronchovesicular sounds
. Inspiratory and expiratory sounds equal . Intermediate sound intensity . Intermediate pitch . Found in 1st and 2nd interspaces ant. And btw scapulae
30
Bronchial sounds
. Expiratory sounds last longer than inspiratory ones . Loud sound . High pitch . Found overmanubrium (larger prox. Airways)
31
Tracheal sounds
Inspiratory and expiratory sounds equal . Very loud high pitch . Found over trachea in neck
32
Chronic obstructive pulmonary disease (COPD)
. Chronic disease of lungs where alveoli become damaged | . Inc. mucous production and overly distended alveoli/general hyperaeration
33
Hyperaeration
. Limitation of expiratory air flow
34
COPD signs and symptoms
``` . Progressive dyspnea . +/- wheezing . Dec. exercise tolerance . Cough/sputum production . Inc. chest in AP diameter . Nicotine stained fingers . Central cyanosis . Nail clubbing . Pursed lip breathing ```
35
COPD etiology
. Smoking/secondhand smoke . Occupational dust/chemicals . Indoor air pollution from cooking stoves
36
Emphysema
. Pathological diagnosis | . Permanent enlargement/destruction of airspaces distal to terminal bronchiole
37
Emphysema signs/symptoms
. Older and thin . Severe dyspnea . Quiet chest . Hyperinflation w/ flatter diaphragms on x-ray
38
GERD
Condition where gastric fluid flows backward into esophagus
39
GERD signs and symptoms
``` . Cough . Bloating . Burping . Nausea . Weight loss . Wheezing . Heartburn/chest pain . Red vocal cords . Hoarseness . Dysphagia . Melena . Hematochezia ```
40
GERD etiology
``` . Overeating . Weak/dysfunctional lower esophageal sphincter . Prolonged transit time . Inc. stomach acidity . Foreign body . Anatomic abnormality ```
41
Conditions that inc. risk of GERD
``` . Obesity . Smoking . Meds . Pregnancy . CT disorders . Fatty food diet ```
42
Bronchitis
. Inflammation of mucous membrane in bronchial tubes . Infectious etiology . Causes bronchospasm and coughing, nausea, fever, weakness, dyspnea, chest pain, weight loss, inspiratory stridor
43
Pneumonia
. Inflammation of lungs . Etiology (bacterial, viral, fungal, atypical) that causes air sacs to full w/ pus and become solid . Inflammation may affect both lungs, one, or only certain lobes
44
Asthma
. Reversible respiratory condition . Bronchial hyperresponsiveness involving release of inflammatory mediators, inc. airway secretions, and bronchoconstrition
45
Asthma signs and symptoms
``` . Cough . Wheezing . Chest tightness . Dyspnea . Dec. breath sounds ```
46
Asthma etiology
. Exposure to various irritants and substances that trigger allergies . Can trigger signs and symptoms of asthma
47
Fine crackle
. Predominantly inspiration . Dry, high pitched crackling, popping . Short duration . Seen in COPD, CHF, pneumonia, pulmonary fibrosis, atelectasis
48
Coarse crackle
. Inspiration . Moist, low pitched crackling, long duration, gurgling . pneumonia, Pulmonary edema, bronchitis, atelectasis
49
Sonorous wheeze
. Low pitched snoring . Expiration . Asthma, bronchitis, airway edema, tumor, bronchiolar spasm, obstruction
50
Sibilant wheeze
. Expiration . High pitched, musical . Asthma, chronic bronchitis, emphysema, tumor, obstruction
51
Chronic bronchitis
``` . Daily productive cough for 3+ months in at least 2 consecutive years . Overweight . Cyanotic . Elevated Hb . Peripheral edema . Rhonchi and wheezing ```
52
Melena
Dark black poop assoc. w/ upper GI bleeding
53
Hematochezia
Fresh blood through anus in or w/ poop | . Bright red

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