Disease of the Respiratory System Flashcards
List common tests used to determine the presence of a respiratory disorder
- Pulse Oximeter
- Peak expiratory flow
- Peak expiratory flow rate
- Visual examination (cyanosis)
- Spirometry
- Arterial blood gases
- X ray
Describe normal breathing sounds
Bronchial - loud and high pitched
Bronchovesicular - medium pitched
Vesicular - soft, low pitched, gentle, rustling sounds
Describe what abnormal breathing may sound like.
Wheezing, crackling, sounds wet (PO), absent, noisy (air passing past sputum = [pneumonia)
Define the term COPD
Progressive diseases that affect the ability to breathe
COPD can cause coughing that produces large amounts of a slimy substance called mucus, wheezing, shortness of breath, chest tightness
Compare and contrast the clinical manifestations observed in a
patient with bronchitis and with a patient with emphysea
Often coexist
Polycythemia exists in both for compensation
Bronchitis (type of COPD) is the inflammation of the larger airways in your lungs (bronchial tubes) - ongoing coughing, blue bloater, Right sided heart failure, acidosis
Emphysema is the collection of pus in the pleural cavity - coughing, wheezing, shortness of breath, chest tightness, increased production of mucous
Describe the complications associated with chronic bronchitis
- Chronic coughing
- Barrel chest
- Right sided heart failure (pulmonary constriction of blood vessels - backflow) due to pulmonary hypertension
- Increased bronchial wall thickness
- Peripheral Edema due to right sided heart failure
- Scarring of the lining of the respiratory tract
- acidosis due to CO2 retention
State two pathophysiological changes that occur in emphysema
- Abnormal dilation of the alveoli - lost elastic recoil due to proteases destroying elastic fibres
- Toxins - immune response IL-1 and IL-2 - macrophages - Release proteases
- Loss of lung elasticity
Compare and contrast the risk factors and symptoms of
emphysema with chronic bronchitis.
Often co-exist and both cause difficulty breathing
- Polycythemia (abnormally increased concentration of Hb) exists in both due to compensation
Chronic Bronchitis
- Sputum producing cough
- Blue bloater: poorly oxygenated lung causing cyanosis
- RHF due to pulmonary HTN
- Peripheral oedema due to RHF
- Acidosis resulting in CO2 retention
Emphysema
- Pink puffer: oxygenated by strains to breath due to collapse of the airways during expiration
- Not cyanotic
- Barrel chest
- Pursed lip breathing with rapid RR
Describe the therapies used and the rationale behind their use in
the treatment of COPD
Chest radiography, arterial blood gases analysis, Doppler echocardiography, electrocardiography, pulmonary lungs function tests (Functional residual capacity, total lung capacity)
Quiting smoking, bronchodilators (relax the airways, relieve obstruction and reduce resistance), supplemental oxygen for patients
Compare how restrictive lung disease differs from obstructive lung
disease.
TIP: O - can’t get the air out
R - can’t get the air in, all things ending with osis, intrinsic and extrinsic
Obstructive - asthma, emphysema, bronchitis
Define the term hypercapnia and describe 3 common causes of this
condition
Hypercapnia - excess CO2 in the blood
- Air trapped troubling expirating
- Hyperventilation
- CNS depressants such as morphine and heroin
- Infections or trauma to medulla oblangata
- Abnormalities in the spinal conducting pathways
- Airway obstruction, chest injuries
Define the term ARDS and describe its pathophysiology
Acute respiratory distress syndrome (ARDS) is a type of respiratory failure characterized by rapid onset of widespread inflammation in the lungs, dangerous as it prevents gas exchange, symptoms include shortness of breath, rapid breathing, cyanosis, low blood pressure and other organ failure.
Outline how patients with ARDS are evaluated and treated
- Sputum Test (will whether its viral)
- Blood tests
- ABG
- bronchoscopy and chest x ray
- ECG needed to rule out congestive heart failure
- ICU
- Positive end expiratory pressure (PEEP) improves the efficiency of supplemental oxygen
Define the term pulmonary oedema and discuss how it develops?
Excess fluid in the lungs (collects in the alveoli in the lungs leading to impaired gas exchange)
Compare and contrast the pathology of non-small cell carcinomas
and small cell carcinomas
SCLC are found in smokers, aggressive, spreads quickly, survival rate is low
Non- SCLC consists of 3 types of tumours
- Squamous cell carcinoma - localised
- Adenocarcinoma - invades lymph nodes. pleura
- Large-cell carcinoma - grow rapidly
