quiz #1 respiratory pathologies Flashcards
what is sinusitis?
an acute / chronic inflammation of paranasal sinuses
nasal passages open into 4 sinuses…
-frontal
-ethmoid
-sphenoid
-maxillary
what are sinuses?
-air-filled continuations of nasal passages & are line with mucous membranes
-develop mostly after birth & continue to enlarge in adulthood
where do frontal sinuses drain?
into ducts that empty into top of nasal cavity
where do ethmoid sinuses drain?
empty into lateral portions of nasal cavity
where do sphenoid sinuses drain?
into posterior portions of nasal cavity
where do maxillary sinuses drain?
superiorly into nasal cavity
draining maxillary sinuses
-if head is upright, it is impossible for sinus to drain until it is full
-head must be HORIZONTAL to completely drain
sinusitis info
-inflammation & swelling in sinus mucosa
-sinus openings become blocked & mucopurulent discharge is produced which fills affected sinus
chronic sinusitis
occurs as result of persistent / recurrent infection
-mucosal linings thicken & may form into elongated masses = POLYPS
causes of sinusitis
-viral infection: cold virus
-bacterial infection: extraction of upper molars or abscess
-increase in pressure: airplane flight, underwater diving
predisposing factors of sinusitis
-deviation of nasal septum: obstructs sinus outlets
-dairy & wheat products: overproduction of mucus in people who have sensitivities
-upper molar abscess: may spread infection to maxillary sinus
medically treating sinusitis
treated with analgesics & decongestants
-prolonged use of meds can lead to worsening of symptoms (damage tissues & mucosa)
-chronic cases: surgery to add opening to drain sinus
symptom picture - ACUTE sinusitis
-pain, often severe
-tenderness over affected sinus
-feeling of fullness & pressure in affected sinus, difficulty breathing through nose
-can feel ill & have low-grade fever
-nasal discharge changes from clear & runny to yellow/ green & thick
-chronic = dull pain & discharge may stop due to blocked sinus
contraindications - sinusitis
-massage CI’d with fever
-local lymphatic drainage CI’d with acute infection
assessment - sinusitis
-palpation of frontal sinuses done by gently pressing superiorly at medial angle of superior orbital margin
-palpation of maxillary sinuses palpated under zygomatic arch
-tenderness & possible heat present
-lymph nodes in neck may be enlarged
massage duration - sinusitis
half hour duration to avoid exhausting client
focus of treatment - sinusitis
relaxation based including unforced diaphragmatic breathing
pre-treatment hydrotherapy - sinusitis
5 min facial steam to loosen mucus & aid in discharge
plenty of tissues & garbage bin present
massage positioning - sinusitis: PRONE
allows for draining of bilaterally affected maxillary sinuses
massage positioning - sinusitis: SIDE LYING
affected sinus UPPERMOST = best position for drainage of single infected maxillary sinus
massage positioning - sinusitis: SUPINE
may allow other sinuses to drain
what is chronic bronchitis?
condition that results in production of purulent sputum for at least 3 months in a row over two consecutive years
bronchial mucus - two sources
-bronchial glands
-epithelial goblet cells
line bronchial walls
chronic bronchitis - disease process
-airways become inflamed from ongoing irritation -> edema & thickening / hyperplasia of bronchial walls
-decrease in expiratory airflow rates & prolonged expiration due to airways being obstructed from increase in bronchial mucus
-wheezing, cough, dyspnea, respiratory infection
chronic bronchitis - disease process con’t
-blockage of airways: insufficient oxygenation in alveoli causes cyanosis = bluish tinge to skin
-chronic bronchitis: tend to gain weight
-cyanosis & edema = “blue bloater”
chronic obstructive pulmonary disease (COPD)
-combination of chronic bronchitis & emphysema
-most commonly occurs in people who smoke
causes of chronic bronchitis
-smoking: airway inflammation, changes in airway goblet cells & epithelium
-environmental factors: air pollution, occupational exposure to inhaled particles / fumes
respiratory tract & lungs - UPPER respiratory tract
-air flows through nasal cavity & pharynx where it is warmed & humidified
-air is filtered & particles removed by mucosa & cilia
respiratory tract & lungs - LOWER respiratory tract
-air transported to alveoli where gas exchange takes place
-ventilation is air exchange from atmosphere to alveoli
respiratory tract & lungs - trachea
-branches into left & right main bronchi at level of 2nd rib anteriorly & T5 posteriorly
-bronchi supply left & right lungs through further division into lobar & segmental bronchi
respiratory tract & lungs - bronchi (pathway)
-further divide into bronchioles -> terminal bronchioles -> respiratory bronchioles -> alveoli
-trachea & alveoli supplied by lots of mucus-producing cells & ciliated cells which line airways
respiratory tract & lungs - LEFT lung
-divided into TWO lobes
-divided obliquely by a fissure between left upper & lower lobes from 5th rib anteriorly to T3 posteriorly
respiratory tract & lungs - RIGHT lung
-divided into THREE lobes: upper, middle, lower
-fissure between upper & middle lobes runs obliquely from 3rd rib anteriorly to T3 posteriorly
-fissure between middle & lower lobe runs obliquely from 6th rib anteriorly & 5th rib at level of lateral border of scapula
muscles of respiration - RESTING INHALATION
-diaphragm contracts & flattens
-external intercostals contract, lifting ribs
-thorax volume increases & pressure in lungs decreases
-air moves into lungs
-scalenes elevate first 2 ribs, becoming active
-average adult breathes 10-12x per minute at rest
muscles of respiration - FORCED INHALATION
-diaphragm descends at least 3-4 intercostal spaces
-accessory mm of inhalation are recruited
-with activity, average adult breathes 50x per minute
muscles of respiration - RELAXED EXHALATION
-passive process
-diaphragm relaxes upward into domed shape
-external intercostals & scalenes relax, ribs drop
-thoracic volume decreases
-pressure in lungs increases, pushing air out of lungs
muscles of respiration - FORCED EXHALATION
-internal intercostals contract, pulling ribs down
-rectus abdominis, internal & external obliques, QL also recruited
