M103 T4 L16 Flashcards
What is the difference between a sign and a symptom?
sign - is observed by a health worker
symptom - is experienced by the patient
What is the mechanism behind a ptussive reflex?
irritation in the upper airway
stimulates the medulla - co-ordinates inspiration
the glottis closes and contracts
cough - expulsion
Why do patients with a chronic cough get a hoarse voice?
bc it causes a recurrent build of applied pressure behind the closed glottis
causes oedema of the vocal folds
Which two conditions are common in older patients that could cause extra effects from a chronic cough?
osteopenia
osteoperosis
How could an older patient with osteopenia or osteoperosis be affected by a recurrent cough?
fractured ribs
very painful and difficult to manage
What are the three categories of cough?
acute
sub acute
chronic
What are the types of identifiable coughs?
smokers cough, productive cough, fruity or dry cough
whooping cough, barking cough
nocturnal cough
How does smoking cause a cough?
the body’s reaction to cigarette smoke is a build-up of mucus in the lungs
leads to a recurrent cough in the morning
Why are barking / whooping coughs seen much more commonly in children?
bc younger children have smaller airways
What causes a croup?
a virus that causes respiratory tract infections
What generates the sound associated with Croup?
the greater effort made trying to maintain normal respiratory rate respiration due to the smaller opening in the airway in a smaller child
How can a croup sound be identified?
makes a different sound
can be associated with respiratory distress
How is an oedema in the airway of a child treated?
dexamethasone (high dose)
prednisolone (in the community)
What are things to look out for in productive coughs?
coloured sputum (green / yellow)
viscosity
blood
What might a bovine cough be a warning side of?
a tumour in the upper bronchial tree that could be compressing on the recurrent laryngeal nerve
What are the causes of an acute cough?
Irritation
Infection
What are the causes of a chronic cough? (COrMAR)
Cancer, Oesophageal reflux
Medications, Asthma, Rhinitis
Which medications could be responsible for a chronic cough?
ACE inhibitors
blood pressure tablets
How is gastro-oesophageal reflux disease treated?
proton pump inhibitor
What might cause nocturnal coughing?
when the patient lies down at night, the physical levelling out of the body means that more acid is going to be sloshing around up at the top of their oesophagus and airway
causes irritation and so coughing
What four aspects of sputum is assessed?
Quantity
Colour
Smell
Blood
What are the three different colours of blood in haemoptysis?
Frothy & pink
Bright red
Dark (altered)
Why might blood from a haemoptysis be bright red or dark?
bc the blood would be from the upper respiratory tract or the oropharynx where it’s not had a chance to oxidise or become altered
Why might blood from a haemoptysis be frothy and pink?
associated with heart failure
What might dyspnoea be caused by?
an acute obstruction to the airway
a restriction to the expansion of the lungs
What might acute dyspnoea be caused by? (3Ps + OTI)
Obstruction, Trauma, Infection
PE, Panic, Pneumothorax
What might chronic dyspnoea be caused by? (CCAHM-AF) -calm af
Cancer, COPD, Anaemia, HF, Metabolism
asthma, fibrosis
What is the physiological lifespan of a panic attack?
20 - 40 mins
What does ABCD stand for?
airways
breathing
circulation of the cardiac shadow
diaphragm
How can coughing be avoided? (ABCDs, QASAI)
ABCDs Quarantine Avoidance Syrups & linctus Antibiotics Inhalers
Why can’t children below the age of approx 7 be diagnosed for asthma?
they’re not really able to do things like spirometry or peak flow in a way that is going to give you a reliable enough result to test or diagnose asthma
Which two coughs are common in children?
whooping and barking
g What muscles are innervated by the recurrent laryngeal nerve?
the posterior cricoarytenoid muscles
g What are the only muscles that can open the vocal folds?
the posterior cricoarytenoid muscles
g What are the lateral cricoarytenoid muscles responsible for?
adducting the vocal folds so that the rima glottidis is narrowed
AAR tone and volume of speech is modulated
g What are the origins of the lateral cricoarytenoid muscles?
the arch of the cricoid cartilage
g What is the purpose of the lower oesophageal sphincter closing?
to prevent the backward movement of acid and stomach contents
g What are the symptoms of gastro-oesophageal reflux disease?
heartburn, an unpleasant taste in the back of the mouth
