Reading Outline (beginning of "revised" section in Special Diagnostic Testing...) Flashcards
a cough can either be ____ or ____ based on length of time it has persisted
acute or chronic
an acute cough has persisted for…
less than 3 weeks
a chronic cough has persisted for…
over 8 weeks
two types of cough
- dry
2. productive
a dry cough often spirals into…
a self-perpetuated cough
is a dry cough generally valued?
nope
a dry cough may be seen in…
tumor, asthma
a productive cough clears…
airways
a productive cough might be present in…
infections
the release in a productive cough is termed
sputum
a bloody sputum might be present in
infection, tumor, infarction
a purulent (pussy) sputum might be indicative of
infection
a non-purulent sputum may indicate
airway irritation
what is dyspnea
shortness of breath
what does dyspnea indicate
poor ventilation/perfusion
causes of dyspnea (3)
- increased awareness of normal breathing (anxiety)
- increased work to breathe
- abnormal ventilatory function
what is orthopenea
dyspnea when laying down
chest pain can present in __#?___ different ways
3
chest wall pain can be described as (2)
- superficial
2. localized
visceral chest pain can indicate involvement of (3) things..
- pulmonary
- cardiac
- GI
where is pulmonary chest pain generally
directly over the involved lung field
can pulmonary chest pain be anterior, lateral, or posterior?
yee
is it possible for chest pain to mimic other neuromuscular/musculoskeetal causes of neck/shoulder pain?
yes
chest pain can radiatate: yay or nay
yay
what is cyanosis
bluish tint
for cyanosis, what is seen for PaO2 and Hgb
PaO2: low
Hgb: decreased
is gas exchange good or bad for cyanosis
poor
what parts are specifically blue for cyanosis
mucous membranes (tongue, lips)
in cyanosis, arterial saturation is often…
less than 75%
for cyanosis, how is peripheral oxygen extraction described
excessive
what is cyanosis often associated with
cold external temps, anxiety, heart failure, shock
Clubbing is a dumbed down word for
Hypertophic Pulmonary Osteoarthropathy
clubbing appears as
thick and wide terminal phalanges
what happens regarding the nail and neail bed
the angle between the nail and nail bed is lost
in clubbing, pulmonary problems often lead to…
hypoxia
clubbing is common in…(4)
cystic fibrosis, lung abscess, pulmonary fibrosis, congenital heart disease
what is the 2nd most common cause of disability in adults under 65
lung disease
two types of respiratory diseases
- obstructive
2. restrictive
three obstructive diseases
- COPD
- Asthma
- Chronic Bronchitis
two restrictive diseases
- Extrapulmonary Disorder
2. Parenchyma Disorders
what is an obstructive pulmonary disease
increased airway resistance
what is a restrictive pulmonary disease
lungs prevented from expanding fully
85-90% of all COPD deaths are caused by…
smoking
in COPD, what happens to the bronchial wall
inflamed and fibrosis
in COPD, what happens to the submucosal glands
hypertrophy and hyperscretion
in COPD, what happens elastic lung fibers and alveolar tissue
loss of elastic lung fibers and alveolar tissue
after inspiration in COPD, what happens to recoil of tissue
fail to get normal recoil of tissue after ispiration
in COPD, is there a decreased ability to get air out
yes
for COPD what are the goals (increase/decrease) for all of these?
- oxygenation
- activity tolerance
- CO2 retention
- airway edema/inflammation
- secretions
- anxiety/depression
- increase
- increase
- decrease
- decrease
- decrease
- decrease
is prognosis good or poor to COPD
poor
is there a cure for COPD
no
what can increase survival rate for COPD
O2
what is asthma
a reversible obstructive lung disease
what happens during asthma
chronic airway inflammation, narrowing
in asthma, do airways overreact or underreact
overreact
what is the most common chronic disease in adults and children
asthma
two main types of asthma
- extrinsic
2. intrinsic
extrinsic asthma is also called ___ asthma
allergic
intrinsic asthma is also called ___ asthma
non-allergic
what is intrinsic asthma triggered by
unknown trigger (secondary to respiratory infection)
asthma is most likely to occur before (age?)
5 y/o
asthma is more common in girls/boys?
boys (3x) (rates even out after puberty)
in asthma, what do airway spasms lead to
mucous plugs the airway –> distal air trapped
in asthma, distal air being trapped leads to…
VQ mismatch, hypoxemia, increased work to breathe
in asthma, is airway inflammation always present?
yes
in asthma, is chest tightness present?
yeah
in asthma, is wheezing common
yes
in asthma, is tachypnea common
yes
two medications for asthma
- bronchodilators
2. anti-inflammatory agents
is bronchial asthma a bad or good prognosis
good
what can asthma progress to
COPD (in small amount of individuals)
can severe asthma be life threatening?
yes
what is Status Astmaticus
acute asthma attack
Status Astmaticus is a severe…
bronchospasm
is Status Astmasticus a medical emergency
yes
during status astmasticus, what happens to breath sounds
diminished/absent
what can status astmaticus lead to
hypoxemia, acidosis
what can happen is status astmaticus is untreated
respiratory and cardiac arrest
what is chronic bronchitis
history of a productive cough of at least 3 months in duration for 2 consecutive years
in chronic bronchitis, what happens to the bronchial lining
inflammation and scarring
in chronic bronchitis, what happens as proximal airways collapse
air becomes trapped in distal airways
what is emphysema
enlarged airspaces and accumulated air in tissue
primary etiology of emphysema
smoking
what protein deficiency may be the cause of emphysema
genetic AAT
in emphysema, the increased release of _____ leads to destroyed elastin, loss of elasticity, and recoil
elastase
is there a problem with mucous production in emphysema
no
instead of mucous production problems, what happens in emphysema
airway narrowing/collapse
what happens to alveolar walls in emphysema
destroyed
does work of breathing increase for emphysema
yes
two main types of emphysema
- centriacinar
2. pantracinar
what populations is centriacinar seen in
- smokers
- men
- chronic bronchitis
two sub branches of centriacinar
- centrilobular
2. panlobular
what is the most common type of centracinar
centrilobular
what part of the lung is effected in centrilobular
upper lung
in centrilobular, _____ are destroyed, but _____ stays intact
bronchioles destroyed, alveolar sac stays intact
what develops around the airways in centrilobular
inflammation and edema
what part of the lung is most affected by panlobular
lower lung
what happens to the lobe in panlobular
entire lobe destroyed
what happens to the airspaces in panlobular
destroyed
panlobular usually begins in the ____ and expands ___
begins in alveoli and expands centrally
panlobular creates ____
bullae
Pantracinar is associated with…
AAT deficiency
is cough common with emphysema
no
what type of chest is seen with emphysema
barrel
in emphysema, ___ is seen at rest
dyspnea
in emphysema auscultation, what do breath sounds sound like
decreased in all lungs fields
what type of breathing is recommended for emphysema
pursed-lip
prognosis for emphysema
eventual death from cardiac complications
what is bronchiectasis
extreme bronchitis
pathophysiology of bronchiectasis
irreversible airway destruction and dilation of medium sized bronchi and bronchioles (chronic inflammation of the bronchial wall)
bronchiectasis is associated with…
chronic bacterial infections
pathophysiology of bronchiolitis
severe lower airway inflammation
who is generally affected by bronchiolotis
children under 2
