Modules 2.1 & 2.2 Flashcards
What are the different respiratory rhythms?
Kussmaul: deep, laboured breathing
Cheyne-Stokes: alternating deep and shallow breathing with periods of apnoea
Ataxic: irregular breathing pattern
Apneustic: prolonged insp. phase followed by short exp. phase
What is Paroxysmal nocturnal dyspnoea?
Due to left-sided congestive heart failure.
- body fluid is redistributed during sleep, but left ventricle cannot keep up with output of right ventricle, leading to increased venous return and pulmonary oedema
- individual wakes up gasping for air and coughing
What is the pathway of dyspnoea?
Motor output: efferent signals from primary motor cortex/brainstem to muscles, feedback to senseory cortex
Chemoceptor stimulation: aortic arch and carotid bodies sensing O2 & CO2 levels, medulla sensing CO2 & H+ in CSF
Causes: HF, anemia, PE, Pluerisy, P cancer and fibrosis, pneumonia, COPD, asthma
What is a cough?
- innate response to irration of resp. tract
- defense mechanism to manually clearn airway of debris or pathogens
What are the different types of breath sounds?
Crackles= serous secretions
Course crackles= thicker mucous
Absence of breath= lung collapse
Wheezing/whistling= narrowing of small airway
Stridor= upper airway obstruction
What defines a acute, sub-acute and chronic cough?
Acute: <3 weeks
- infectious (viral, bronchitis), non infectious (exacerbations)
Sub-acute: 3-8 weeks
- post infection due to epi cell inflammation
Chronic: >8 weeks
- asthma, GORD, UACS, NAEB
What are the differences in sputum?
Dark-coloured: pneumococcal pneumonia
Purulent/odoured: bronchiectasis
Thick mucous: asthma/CF
Blood tinged: tumour or TB
Haemoptysis: PE
What is cyanosis and the differences between central and peripheral?
- bluish discoloration of the skin and mucous membranes due to inc in deoxyhaemoglobin
Central: locating around lips and tongue, o2 <85%, due to insufficient O2, dec pulmonary bf, mixing of arterial and venous blood, or polycythaemia.
Peripheral: located in fingers and toes, blood contains greater than 5g of deoxyhaemoglobin.
What is the difference between hypoxia and hypoxemia?
Hypoxia: dec. o2 in tissues
Hypoxemia: dec. o2 in arterial blood
What is digital clubbing?
- growth of digits due connective tissue
proliferation and increased blood flow beneath the nail matrix.
What are the stages of clubbing?
- Softening of nail bed
- Increased angle of nail plate
- Inc. convexity of nail
- Enlargement of distal finger
- Glossy and striated nail
What is the pathophys. of digital clubbing?
- Megakaryocytes fail to fragment in the pulmonary vasculature.
- Unfragmented megakaryocytes enter systemic circulation.
- They accumulate in distal capillary beds
- Release growth factors: Platelet-derived growth factor (PDGF) and vascular
endothelial growth factor (VEGF). - Growth factors stimulate: Vascular and connective tissue proliferation, leading to
the characteristic bulbous appearance.
What’s the difference between obstructive and restrictive diseases?
Obstructive: airflow limitation during exhalation, inc. lung volumes
Restrictive: lung expansion prevention during inhalation, dec. lung volumes
What are the normal arterial blood gas (ABG) values?
pH: 7.35-7.45, determines acidity levels
PaCO2: 35-45mmHg, indicates resp. component
HCO3: 22-36mmol/L, inidcates metabolic component
How are O2 and CO2 transported throughout the body?
O2: Mainly attached to haemoglobins
CO2: 7% dissolved into plasma, 23% attached to haemoglobins, 70% converted into HCO3 to enter an erythrocyte to be exchanged for Cl, converted back to CO2 to then be exhaled
What is the difference between hyper/hypocapnia?
Hyper: hypoventilation, hence inc. CO2 in body >60mmHg severe
Hypo: hyper ventilation, hence dec. CO2 in body <25mmHh severe
- alters acidity of blood in body
What are the differences between Type I and Type II Resp failure?
Type I: inadequate oxygenation of blood, hypoxemia
- due to low O2 environment, impaired alveolar diffusion or ventilation perfusion mismatch
Type II: inadequate oxygenation of blood and CO2 removal capabilities
- due to ventilation failure, obstructive or musculoskeletal problems
