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MS: NCM 112 > P1.2: RESPIRATORY: INTRO-COPD > Flashcards

P1.2: RESPIRATORY: INTRO-COPD Flashcards

1
Q

Normal Breath Sounds

A
  • Tracheal Breath Sounds
  • Vesicular Breath Sounds
  • Bronchovesicular Breath Sounds
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2
Q

Normal Breath Sounds

  • Heard over the trachea and are harsh and discontinuous
  • E > I
A

Tracheal Breath Sounds

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3
Q

Normal Breath Sounds

  • Soft, low-pitched sounds that are heard over the majority of the lung fields; sounds produced
  • Produced by air moving through the bronchioles and filling the alveoli
  • E < I
A

Vesicular Breath Sounds

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4
Q

Normal Breath Sounds

  • Medium-pitched and continuous with muted characteristics of both bronchial and vesicular breath sounds
  • Produced by air moving through large airways and are heard over the first and second intercostals spaces along the sterna border and between the scapula
A

Bronchovesicular Breath Sounds

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5
Q

Abnormal (Adventitious) Sounds

A

A. Crackles (crepitations, rales)
* Fine Crackles
* Coarse Crackles

B. Wheezes

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6
Q

Abnormal (Adventitious) Sounds

  • Referred to as discontinuous sounds; they are intermittent, non-musical and brief
  • May heard either upon inspiration or expiration
  • The popping sounds produced are created when air is
    forced through respiratory passages that are narrowed by
    fluid, mucus, or pus
    Often associated with inflammation or infection
A

Crackles (crepitations, rales)

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6
Q

Abnormal (Adventitious) Sounds

  • A continuous, coarse, whistling sound produced in the respiratory airways during breathing
  • Caused by air moving through narrowed airways
  • Do not clear with coughing
A

Wheezes

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7
Q

Radiologic Tests

  • Obtained to diagnose disorders of the lung
  • Normal lung tissue is radiolucent and that foreign bodies, infiltrates, tumors and fluids appear as white areas or densities
  • Performed in the radiology department or at the bedside with a portable unit; they are completed in a few minutes and are painless
A

Chest Roentgenograms

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7
Q

Abnormal (Adventitious) Sounds

  • Soft, high-pitched, and very brief
  • Sounds like a lock of hair rolled in between fingers
A

Fine Crackles

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7
Q

Radiologic Tests

  • Performed to assess the perfusion of the lungs
  • A radioactive contrast dye is injected into a vein or an artery and a series of X-rays of the chest are taken to detect blood flow abnormalities (these films provide a picture of the vasculature that can detect pulmonary embolism or infarction
A

Pulmonary Angiography (Pulmonary Arteriography)

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7
Q

Laboratory Tests

A
  1. Complete Blood Count (CBC)
  2. Arterial Blood Gases
  3. Sputum Analysis
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7
Q

Radiologic Tests

A
  1. Chest Roentgenograms
  2. Pulmonary Angiography (Pulmonary Arteriography)
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7
Q

Abnormal (Adventitious) Sounds

Are somewhat louder, lower in pitch, and last longer than
fine crackles
Sounds like opening a Velcro lock

A

Coarse Crackles

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8
Q

Special Tests

A
  1. Pulmonary Function Test
  2. Thoracentesis (Pleural Fluid Analysis)
  3. Lung Biopsy
  4. Breath Analyzer
  5. Fagerstrom Test
  6. Oxygen Saturation
  7. Skin Test (Mantoux Test
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8
Q

Laboratory Tests

Provides information about RBC, hemoglobin, hematocrit and WBC

A

Complete Blood Count (CBC)

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8
Q

Laboratory Tests

  • Can be helpful in evaluating patients suspected of having tuberculosis, pneumonia or lung cancer
  • It is vital for the care provider to emphasize to the patient the difference between saliva and sputum
A

Sputum Analysis

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9
Q

Laboratory Tests

  • Provides information about patient’s oxygenation and ventilation hence deemed valuable in assessing the efficiency of pulmonary gas exchange.
  • In this test, the examiner obtains a blood sample (2mL) by direct puncture of a radial, brachial or femoral artery
A

Arterial Blood Gases

Looking for the gastreous content of the blood

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10
Q

Special Tests

  • Refers to a non-invasive method of assessing the functional capacity of the lungs
  • Measures air flow rates and calculate lung volumes and lung capacities
A

Pulmonary Function Test

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11
Q

The volume of air inspired or expired can be measured during breathing with a recording device called WHAT

A

Kymograph

12
Q

Terms to describe Lung Capacities

A
  • Tidal Volume (TV)
  • Inspiratory Reserve Volume (IRV)
  • Expiratory Reserve Volume (ERV)
  • Residual Volume (RV)
13
Q

Lung Capacities (determined by combining two or more lung volumes)

Refers to the amount of air remaining in the lungs at the end of normal exhalation (approximately 1,200mL)

A

Functional Residual Capacity (FRC)

13
Q

Term to describe Lung Capacities

Refers to the amount of air inspired or exhaled during normal, quiet breathing

A

Tidal Volume (TV)

  • Amount is approximately 500mL in a 70kg person
  • Volume capacities are 20-25% lower in women
  • A decrease in TV without a decrease in respiratory rate (RR) indicates a restrictive disorder such as pulmonary fibrosis
  • A decrease in TV with a decrease in RR indicates a neurological
  • problem
14
Q

Term to describe Lung Capacities

This refers to the amount of air can be inhaled after a normal or tidal inspiration (normal is approximately 3,300mL)

A

Inspiratory Reserve Volume (IRV)

15
Q

Term to describe Lung Capacities

Refers to the mount of air that can be forcibly exhaled after normal or tidal expiration

A

Expiratory Reserve Volume (ERV)

15
Q

Terms to describe Lung Capacities (determined by combining two or more lung volumes)

A
  • Vital Capacities (VC)
  • Inspiratory Capacity (IC)
  • Functional Residual Capacity (FRC)
  • Total Lung Capacity (TLC)
  • Forced Vital Capacity (FVC)
16
Q

Lung Capacities (determined by combining two or more lung volumes)

Refers to the amount of air that can be inhaled with maximal effort after normal exhalation (approximately 3,000mL)

A

Inspiratory Capacity (IC)

16
Q

Term to describe Lung Capacities

Refers to the amount of air remaining in the in the lungs after forced, maximal expiration (approximately 1,000mL)

A

Residual Volume (RV)

17
Q

Lung Capacities (determined by combining two or more lung volumes)

  • Refers to the maximal amount of air that can be exhaled after maximal inspiration (approximately 5,000mL)
  • Refers to the total of the TV, IRV and ERV
A

Vital Capacities (VC)

18
Q

Lung Capacities (determined by combining two or more lung volumes)

Refers to the amount of air in the lungs with maximal inspiration (approximately 6,000mL)
Total of the four lung volumes: TV + IRV + ERV + RV

A

Total Lung Capacity (TLC)

19
Q

Special Tests

Performed to obtain fluid samples from the pleural space, relieve pressure from accumulated fluid and obtain tissue for biopsy

A

Thoracentesis (Pleural Fluid Analysis)

19
Q

COPD embraces several diseases which includes:

A
  • Chronic Bronchitis
  • Emphysema
20
Q

Lung Capacities (determined by combining two or more lung volumes)

Refers to the amount of air expelled with maximally forced exhalation

A

Forced Vital Capacity (FVC)

20
Q

Used to describe a group of conditions that is characterized by permanent changes in the airways leading to the impairment of air flow

A

CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)

20
Q
  • Literally means “looking inside”
  • Refers to a procedure which allows the examiner to visualize internal structures through the use of an instrument known as endoscope
A

Endoscopy

20
Q

Special Tests

  • A test to determine the presence of tuberculosis
  • A small amount of purified protein derivative (0.1mL) is injected intradermally in the forearm and then the area is examined 48-72 hours later to note any swelling and erythema
A

Skin Test (Mantoux Test)

20
Q

Special Tests

  • Used to determine whether or not a patient has been smoking
  • A simple, non-invasive way to measure carbon monoxide poisoning in a patient
A

Breath Analyzer (Carbon Monoxide Breath Test)

20
Q

Special Tests

A simple questionnaire used to determine nicotine dependence

A

Fagerstrom Test

20
Q

Special Tests

  • Performed to obtain tissue samples for microscopic examination
  • May be performed through either open or closed technique
A

Lung Biopsy

  • Open Technique- performed in the operating room and require general anesthesia
  • Closed Techniques- involves the use of local anesthesia and may be accomplished through needle biopsy
20
Q

Special Tests

  • Measures the amount of oxygen dissolved in the arterial blood
  • Measure through pulse oximetry which makes use of spectrophotometer to determine the amount of light absorbed by the hemoglobin in arterial blood
A

Oxygen Saturation

Normal saturation levels: 96% - 100%

21
Q

A recurrent inflammation of the bronchial walls with hypertrophy of the mucous goblet cells, characterized by hypersecretion of mucus accompanied by a chronic/recurrent productive cough for a minimum of 3 months a year for two successive years

A

CHRONIC BRONCHITIS

With excessive mucus and decreased effectiveness of mucocillary blanket, there is mucus stasis, which initiates inflammation and infection

22
Q

Risk Factors for CHRONIC BRONCHITIS

A
  • Cigarette smoking
  • Immunological factors
  • Familial predisposition
  • Respiratory infection
23
Q

Cycle of airway obstruction and destruction with:
* Hypertrophy of the goblet cells
* a decreae in ciliated epithelial cells
* a decrease in mucociliary clearance

A

CHRONIC BRONCHITIS

Patients with this disorder were described as BLUE BLOATERS because the increased secretions and airway obstruction causes hypoxemia (hence cyanosis [blue]) and peripheral edema from right sided heart failure (hence bloater).

24
Q

Refers to an abnormal irreversible enlargement of air spaces distal to terminal bronchioles caused by a complex obstruction and destruction of alveolar walls, resulting in decreased elastic recoil properties of lungs.

A

EMPHYSEMA

24
Q

A condition characterized by loss of lung elasticity, narrowed bronchioles and abnormal dilation of terminal airspaces caused by the destruction of the alveolar walls

A

EMPHYSEMA

25
Q

Risk Factors of EMPHYSEMA:

A
  • Cigarette smoking
  • Deficiency of alpha 1 – anti-trypsin (AAT)
  • Infectious agent
  • Environment/Industrial pollution
  • Hereditary
  • Aging
26
Q

EMPHYSEMA

Administration of medications:

A
  • Bronchodilators (ipratropium and albuterol, salmetrol)
  • Corticosteroids if bronchodilators are not sufficient

MS: NCM 112 (17 decks)

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