Respiratory ✅ Flashcards
how to diagnose a pleural effusion
chest xray
sample fluid through chest X-ray
what are the symptoms of pleural effusion
shortness of breath
felling of fullness
chest pain
reduction of breath sounds
what is a pleural effusion
collection of fluid outside the lung- can occur on one or both sides
what are the symptoms of pleurisy
sharp serve knifelike pain usually one sided pain increases pain when taking in deep breaths
explain the pathophysiology of pleurisy
infection/ injury to the pleura
cause inflammation of the pleura
irritation of sensory fibres of parietal pleura
this causing rubbing of layers during inspiration
this causes a lot of pain
what is the pleura
membrane that covers the lungs
contains 2 layers visceral and parietal
what is pleurisy
inflammation of both layer of the pleura
what are the signs and symptoms of atelectasis
fever
dyspnea
absence of breath sounds
what is the cause of atelectasis
excessive recreation of mucus
explain pathophysiology of atelectasis
airway obstruction causes loos of prexsiting air in alveoli causing the alveolar to collapse
what is atelectasis
loss of lung volume caused by inadequate expansion of the air space
this causes a shunt causing ventilation and perfusion miss match
what are the signs and symptoms of bronchiolitis
trachynoea
fever
increased levels of breathing- tracheal tug, intercostal resection
cyanosis and pale
explain the pathophysiology of bronchiolitis
rsv virus is spread through airborne droplets or through direct contact
this begins with replication of the virus in the nasal pharynx
infection in lower respiratory begins 1-3 days later
spread to the bronchioles
the infection promotes an inflammation response and immune cells rush to the area
this causes increase mucuse prodcution from the goblet cells
this leads to small airway production and air trapping which increases airway resistance
what are the cellular changes in bronchiolitis
narrowing of the airway due to mucus recreation
cell wall thickening and smooth muscle contract
this inflammation can cause air to be trapped in the alveoli making I difficult to breath
what is the cause of bronchiolitis
viral infection
RSV
what is bronchiolitis
inflammation of the bronchioles
what is a haemothorac
Haemothorax is when blood collects between the chest wall and the lungs. This area where blood can pool is known as the pleural cavity. The build-up of the volume of blood in this space can eventually cause the lung to collapse as the blood pushes on the outside of the lung.
what are the treatments to a haemothorax
chest drain
what are the complications for a haemothorax
Losing a lot of blood from this condition can cause the body to go into shock because of the lack of blood and oxygen being pumped throughout the body to your organs.
Shock caused by blood loss is called hypovolaemic shock. Going into hypovolaemic shock can cause long-term or permanent damage to organs, including the heart, lungs, and brain.
Blood getting into the chest cavity can infect fluid in the area around the lungs. This type of infection is known as empyema. An untreated empyema infection can lead to sepsis, which happens when inflammation occurs throughout the body.
how can you diagnose a haemothorax
- CT scans
- X-rays around broken bones near the chest or abdomen
- If it is suspected that an underlying condition — such as cancer, TB, or EDS — is causing a haemothorax, they may recommend further blood or imaging tests to properly diagnose and treat
what happens to the airways if resistnace is low
Airway resistance is low if the airway is clear and open
air can pass easily along the airways to ventilate the alveoli.
what happens to the airways if resistnace is high
Airway resistance is high if the airway is constricted or blocked
air cannot easily pass
ventilation and gas exchange is reduced
effort of breathing may increase.
what are the treatments to COPD
Oxygen supplement
Control of mucus secretions (physiotherapy)
Treatment of lung infection (antibiotics)
Control of airways obstruction (e.g. using bronchodilators, corticosteroids)
Treatment for pulmonary oedema (diuretics)
Reducing load on respiratory muscles
ways to prevent COPD
Stop smoking to prevent further damage
Smoking cessation is critical for all severities of COPD
Avoid exposures to
Second-hand smoke and
Other substances such as chemical vapors, fumes, mists, dusts, and diesel exhaust fumes that irritate lungs
ways to diagnose COPD
Spiromatary test
explain the pathophysiology of chronic bronchitis in terms of COPD
Damage to the cilia which become unable to move bacteria and foreign particles out of the lungs
Too much mucus production by goblet cells in airways
Bacteria become trapped in mucus and can cause respiratory infections.
Overgrowth of the smooth muscle cells in the bronchi restricts airflow
what are the causes of pleural effusion
Transudative- due to increased hydrostatic pressure or decreased oncotic pressure in blood vessels.
Fluid is then leaked into the pleural space.
Exudative- inflammation of pulmonary capillaries causing leakage into the pleural cavity.
what are the risk factors of atelectasis
Older age
Any condition that makes it difficult to swallow
Confinement to bed with infrequent changes of position
Lung disease, such as asthma, COPD, bronchiectasis or cystic fibrosis
Recent abdominal or chest surgery
Recent general anaesthesia
Weak breathing (respiratory) muscles due to muscular dystrophy, spinal cord injury or another neuromuscular condition
Medications that may cause shallow breathing such as opiates.
Pain or injury that may make it painful to cough or cause shallow breathing, including stomach pain or rib fracture
Smoking
what is atelectasis
Also known asCollapsed lung
Atelectasis is a condition in which the airways and air sacs in the lung collapse or do not expand properly.
Atelectasiscan happen when there is an airway blockage, when pressure outside the lung keeps it from expanding, or when there is not enoughsurfactantfor the lung to expand normally. When your lungs do not fully expand and fill with air, they may not be able to deliver enough oxygen to your blood.
what are the signs and symptoms of emphysema
Dyspnea
- Minimal cough
- Increase minute ventilation to expel more CO2 from the lungs
- Pink skin and pursed lip to extend the airway
- Accessory muscle use
- Cachexia (extreme weight loss and muscle wasting due to extra work in breathing)
- Hyperinflation, barrel chest
- Decreased breath sounds
- Tachypnoea
what are the risk factors to emphysema
Smoking: Smoking of any kind encourages inflammation to the airway.
what causes emphysema and how
Smoking causes inflammation and injury to the lung. As a result this stimulates the movement of inflammatory cells into the lung and these neutrophils release protease in attempt to reduced inflammation
what is emphysema
Emphysema is a condition under the umbrella term COPD which is inflammation of the bronchial wall, this is a breakdwon of elestic firbes
All this adds up to a mismatch of ventilation and perfusion.
treatments for asbestosis
The main treatment is avoiding the dust or fumes causing the condition. There are no specific drug treatments. Oxygen therapy and pulmonary rehabilitation may help with your symptoms.
signs and symptoms of asbestosis
- shortness of breath
- persistent cough
- tiredness
- difficulty breathing
- chest pain
- coughing up black phlegm (coal worker’s pneumoconiosis only)
explain what happens in cystic fibrosis
cells cannot secreate chlorine irons as they are trapped inside the cell
therefor they don’t attack water to help thin out the mucus
this makes mucus abnormally thick and then it builds obstructing the organs
this leads damage overtime
what is the role of mucus
protects the winning of organs and tissues
what is the cystic fibrosis transmembrane conductance regulator
transports negatively charged chlorine irons
in gland that secretes mucus the chlorine ions which help to attract water- help to make mucus less viscous
what is cystic fibrosis
a condition that causes sticky mucus ti build up in the lungs and digestive system
what is the causes of cystic fibrosis
a defect to chromosome 7 and a mutation to the cystic fibrosis transmembrane conductance regulator
what are the signs and symptoms of cystic fibrosis
respiratory signs and symptoms • A persistent cough that produces thick mucus (sputum) • Wheezing • Breathlessness • Exercise intolerance • Repeated lung infections • Inflamed nasal passages or a stuffy nose Digestive signs and symptoms –
- Foul-smelling, greasy stools
- Poor weight gain and growth
- Intestinal blockage, particularly
what is extrinsic asthma
Extrinsic asthma develops in response to allergens, such as dust mites, pollen, and mold. It is the most common form of asthma.
what are the two types of asthma
extrinsic
intrinsic
what is intrinsic asthma
non allergic asthma
Has various types of stimuli target hyper-responsive tissues in the airways o Adulthood onset o Cigarette smoke o Exercise o Exposure to cold and dry air o Heat and humidity o Chemicals and fumes o Certain drugs (aspirin and NSAIDs) o Respiratory tract infections o Hormonal changes o Anxiety o Fragrances
what symptoms does asthma display due to inflammation
this inflammation causes recurrent episodes of wheezing, breathlessness, chest tightness, and coughing, particularly at night or in the early morning.
what is asthma
Asthma is a chronic inflammatory disorder of the airways
where are the t-helper cells found and what do they do
t-helper 1 is normally found in the lung
t-helper 2 not normally found in the lungs but are regulated in asthma
they prmote inflamation by increasing the mediated immunity
explain the pathophysiology of extrinsic asthma
individual inhales an allergen
iGe cells (that are involved in inflammation and allergic response)
these IgE cells bind to a mast cell including a T-helper 2 cell
this realises white blood cells that contains histamine
this stimulates smooth muscles in the air way to cause bronchconstriction and vasodilation & increased primality of blood vessels
what are the cellular affects of asthma
increased mucus production
increased goblet cells
what are the two types of respiratory failure
- Type 1: low levels of oxygen in the blood, this is known as Hypoxaemic Respiratory Failure unrelieved by O2 therapy
- Type 2: low levels of oxygen in the blood plus an increase in the level of carbon dioxide, this is known as Hypercapnic Respiratory Failure
what is the start of respiratory failure
when ventilation and oxygenation upsets homeostasis
where do airway and breathing problems originate from
inability of the lungs to either ventilate or oxygenate
What is respiratory failure
Is a condition in which respiratory system fail in one or both of its gas exchange function due to dysfunction of one or more essential components of the respiratory system
How long does it take for chronic respiratory failure take to develop
Several dates or longer
What are the essential components of the respiratory system
Chest wall Airways Alveolar and capillary units Pulmonary circulation Cns ( brain stems) and nerves
What are the two types of respiratory failure
Hypoxamic failure
Hypercapnic failure
What is type one respiratory failure
Hypoxameic
What is type two respiratory failure
Hypercapnic
What is hypoxemic respiratory failure
Failure to oxygen exchange
Low oxygen levels and normal carbon dioxide levels
What is hypercapnic failure
High levels of carbon dioxide , low levels of oxygen
What are the common causes of hypoxemic
Cardiogenic pulmonary oedema
Pneumonia
Pulmonary embolism
What is the common causes of hypercapnic
Severe asthma Copd Drug overdose Neuromuscular disease Chest wall abnormalities
What is management of respiratory failure
Oxygen supplement Control of mucus secretion (physiotherapist) Treating lung infections (antioboitics) Control of airway obstructions Treating pulmonary oedema
What type of respiratory failure does not respond to oxygen therapy
Type one- hypoxemic
What is the definition of ventilation
Volume of air which moves in and out of the mouth
Give a definition of perfusion
Flow of blood through tissues
What is a shunt
Under ventilation areas of the lungs can cause a shunt where venous blood returns to the heart without collecting its normal oxygen Gupta
What can respiratory diseases be classed as
Shunt producing
What is the common cause of pneumonia
Infection by bacteria or viruses
What is the venous system
Blood that flows through the body and returns blood to the right side of the heart
What is tuberculosis
Chronic inflammatory disease cause by the pathogenic bacterium
Where is tuberculosis most common
Built up low income areas
Prisms
Where does tuberculosis affect
Mainly affects the lungs
How does transmission of tuberculosis occur
Through coughing infectious droplets and close contact with infectious cases
What are the two types of tuberculosis
Latent tb - bacteria infect the body but doesn’t cause symptoms
Active tb- infection causes symptoms
Explain the pathophysiology of tuberculosis
Individual inhaled mycrobacterium
Travels down the airways to the alveoli
Bacterium starts to multiply
Body goes into defence mode- starts inflammatory
Bacteria become engolfed
The immune system also attacks healthy cells ( this leads to a build up of fluid)
The live and dead bacteria accumulated and transform into fibrous mass
Eventually calcify and form scars
The build up will irritate the lungs
What are the signs and symptoms of tuberculosis
Persistant cough Increase shortness of breath Lack of appetite/ weight loss Night sweats Extreme fatique
What’s a pulmonary embolism
An occlusion within the pulmonary arteries that obstructs blood flow to the lung tissues
What is the usual Cause of a pulmonary embolism
Usually as a result of a blood clot that’s formed in part of the body
They travel through the Venus system and become stuck in the pulmonary artery
Explain the pathophysiology of a pulmonary embolism
A blood clot travels and becomes stuck in the pulmonary artery
This causes the blood supply to become compromised caused infection and death of lung tissues (cells become starved of oxygen and nutrients)
The instruction causes a ventilation/ perfusion miss match (due to a segments of the lung receiving adequate ventilation but perfusion is absent)
The blood then starts to back up and arteries begin to engorge and rupture
This overal leads to pulmonary odema due to in not being able to emerge the vascular demands
What are the cause of a pulmonary embolism
Throbis formed in the deep beings
Tumours where cells have broken of and embolised
Sickle cell disease
What are the risk factors to a pulmonary embolism
Abnormal clotting Pregnancy Smoking Sickle cell disease Surgery Truma IV drug uses Infection Immobile Heart failure
What are the signs and symptoms of a pulmonary embolism
Sudden onset Increase resp rate Difficulty in breathing Tachycardia Coughing up blood Pin point pain
What is inhalation
Diaphragm and intercostal muscles contract in a downwards and outwards motion expanding the thoracic cavity
What is the pulmonary plura
Two layers of Cyris membrane surrounding the lung and attaching to the thoracic cavity
What is exhalation
Passive process (no muscle contraction involved) the diaphragm and intercostal muscles relax which increases intrathoracic pressure
What is Industrial lung disease
Term for a group of lung diseases caused by breathing in specific dusts in your work place which gets lodged inside your lungs and causes scarring
Explain the pathophysiology of asbestosis
Tiny absorbed fibres penetrate deep into the lungs (small airways and alveoli)
Macrophages attempt to digest asbestos fibres
Inflammatory factors are released
Fibrous tissues develop around the macrophages
Leads to long term inflation and scaring of the lungs
What happens during a pneumothorax
Air can Enter and exit through the plural cavity during inhalation and exhalation
Due to damage of the visceral or parietal cavity
Two different types of pneumothorax
Spontaneous: caused by a defect in the alveoli wall or visceral pleura due to airfield pockets just below the visceral pleura
Traumatic: traumatic injury to the thoracic cavity such as rib fractures or stab wounds
What is an open pneumothorax
It is a penetrating thoracic injury
Open to the outside world
What is a closed pneumothorax
An accumulation of air within the pleural space originating from respiratory tract
(Closed to the outside world)
Pneumothorax
During inhalation, the opening will allow air to escape the lung and enter the pleural space
What happens during pneumonia
Infection in the lung tissues —> this beings water into the lungs making it difficult to breath—> air sacks are filled with fluid—> breathe in air and microbes(cause infection)—> if successful it takes over the bronchioles and aveoli—>this multiplies and enters the lung tissues—>creates and inflammatory response and sends white blood cells,protein and fluids and red blood cells
Symptoms of pneumonia
Shortness of breath
Chest pain
Fatigue
Fever
What is COPD
Progressive chronic lung disease—>associated with inflammation of the lungs
Chronic bronchitis
Chronic inflammation of bronchi, excessive mucus production, cough and this leads to emphysema
Causes of COPD
Smoking Long term exposure to harmful Gases Genetics Age History childhood respiratory condition
