Respiratory Flashcards
What breath sounds would you hear upon auscultation if airways are narrowed?
Wheezing
What conditions is narrowing of the airways associated with?
Asthma
COPD
Bronchitis
Smoking
Heart failure
Inhaling a foreign object into lungs
Allergic reaction
Would wheezing occur during inhalation or exhalation
Both - can sound rhythmical
Classic high pitched wheeze during exhalation
**Ronchi - Can be low pitched snoring, gurgling, rattle like sound;
**Often heard in chronic bronchitis or cystic fibrosis (usually clear after coughing)
What does a stridor breath sound like?
What causes a stridor?
High pitched musical sound heard on inspiration (resembles wheezing).
When listening with a stethoscope, if the sound is louder over the throat, it is stridor, not wheezing.
Air is moving roughly over a partially obstructed upper airway. Stridor is caused by something blocking the larynx, such as a person choking on an object.
**Stridor can also be heard in a person with an infection, swelling in the throat, or laryngospasm. You may frequently hear stridor in children, as they are more likely to choke and more likely to get childhood infections like croup. Stridor can indicate a medical emergency if not enough oxygen is able to get through the airways.
Osteoarthritis pathophysiology
Progressive loss of articular cartilage and remodelling of the underlying bone due to an active response to chondrocytes in articular cartilage and inflammatory cells in surrounding tissues. The exposure of theunderlying subchondral boneresults insclerosis, followed by reactive remodelling changes that lead to the formation ofosteophytesand subchondralbone cysts. Thejoint space is progressively lostover time.
erodes and may erode to joint level affecting the joints surface.
damage to the cartilage can cause damage to the matrix resulting in chondrocytes multiplying and forming clusters. This causes bony lumps to form calledbone spurs.
Damage to the matrix can also cause thickening of the bone underneath the cartilage and may sometimes cause fluid-filled areas in the bone calledbone cysts
inflammation of the joint’s synovium.
Synovial fluid thickens and limits movement
OA risk factors
obesity,advancing age,female gender, andmanual labouroccupations
OA Clinical features
pain and stiffnessin joints,worsened with activity* and relieved by rest. Pain tends to worsen throughout the day, whereas stiffness tends to improve. Prolonged OA results indeformityand areduced range of movement.
Atelectasis pathophysiology
collapse oflungtissue (parenchyma) (alvioli) with loss of volume.
Alveolar can’t inflate properly, which means blood, tissues and organs may not get oxygen (reduced gaseous exchange)
Pneumonia patho
infection of the lung parenchyma.
Bacterial
Viral
Fungal
Complications if untreated
Resp failure
Sepsis
Metastatic infection
Lung absess
Community-Acquired Pneumonia(CAP)
Hospital-Acquired Pneumonia(HAP) - acquired 48hr after admittance
VentilatorAssociated Pneumonia(VAP) - 48hrs after endotracheal intubation
Bronchiectasis Patho
Widening of bronchi due to recurrent inflammation of the bronchial walls and repeated infections.
Stimulates formation of excess mucus which pools in enlarged airways. Thick mucus crushes cilia causing more damage.
Warm moist environment = inflammation and ore obstruction and breeding ground for infection.
Immune system response releases toxic inflammatory chemicals (neutrophils)
Can lead to fibrosis (thickening/scarring of tissue - alveoli become stiff and scarred)
Can lead to bronchospasm.
Types of bronchiectasis and most common type?
Cylindrical (common)
varicose
cystic
Subdural hematoma patho
Cerebral vessel torn forming accumilation of blood between the dura matter and arachnoid matter which causes pressure on the brain
Bleeding in a SDH occurs from tearing of the bridging veins that cross from the cortex to the Dural venous sinuses, which are vulnerable to deceleration injury. This can lead to herniation and brainstem death if left untreated as can occlude major arteries.
Significant haematoma Can result in displacement/distortion of other brain tissue (midline shift??) Damage can occur as the brain is pressed against the skull or into adjacent intracranial compartments to accommodate the buildup of fluids or swelling. Results in compression of the brain but also occlusion of major arteries can occur
What is a craniotomy
surgical removal of part of the bone from the skull to expose the brain.
Can be done to remove brain tumor, blood clots from the brain, relieve brain from pressure after injury or stroke.
What happens in a CABG
Arteries to the heart are replaced due to arherosclerosis (plaques in the arteries narrowing the arteries)
Arteries used in CABG
internal Mammary artery
radial artery
saphenous vein (Least longevity as narrows over time unlike arteries)
Most commonly the mammary artery is used when replacing the LAD (LEFT ANTERIOR DESCENDING ARTERY) Considered the gold standard as it doesn’t narrow overt time like veins and arteries from arms and legs
Why would you need a CABG
Treat blockage or abnormal narrowing of the coronary arteries
Restore blood supply / oxygen to the heart muscle
To avoid myocardial infarction (stop/reduction in blood supply to the heart due to blockage)
What is Atherosclerosis?
Thickening / narrowing of the arteries due to a build up of plaque in the inner lining of the artery.
Atherosclerosis risk factors
High cholesterol & triglyceride levels
High blood pressure
Smoking
diabetes
obesity
Signs of myocardial infarction
Feeling of Impending doom
Chest pain
Shortness of breath
pain in jaw, neck, back, arm, shoulder, nausea, light headed, unusually tired.
Arteries of the heart
Left coronary artery (blood to left atrium and ventricle)
Circumflex (blood to outer side and back of heart)
Left marginal artery
Left anterior descending artery (LAD) (front and left & Septum of heart)
Right coronary artery (right atrium & ventricle & sinoatrial (SA)/atrioventricula (AV) nodes - Regulates heart rhythm)
RIGHT POSTERIOR DESCENDIG ARTERY (RPD)
ALSO SMALLER BRANCHES -
Obtuse Marginal, septal perforator (SP), Diagonals
right marginal artery
Gall bladder function
a small, pear-shaped organ located under your liver that stores and releases bile. Bile is the fluid your liver produces that helps digest fats in the food you eat.
Stored bile squeezed out through billary tract upon eating (signal sent from brain) travels to the bile duct into the duodenum (first part of small intestine) where it mixes with food waiting to be digested. After you eat gall bladder is empty and awaits to be refilled.
Gall bladder location
right upper right of abdomen sits just under the liver
Why have cholecystectomy
Gallstones
Cholycystitis - inflammation of GB - oftern due to gallstone blocking bile from exiting GB
Gall stone pancreatitis - inflammation of pancreas due to gallstone travelling down bile duct and blocking the pancreatic duct just before draining in to duodenum
Gallbladder cancer
What is cellulitis
bacterial skin infection (deeper layers of the skin) that causes redness, swelling, and pain in the infected area of the skin.
If not treated can cause sepsis (blood poisoning), kidney damage, leg ulcers)
Cellulitis symptoms
Red, hot, tender/painful swelling of the skin
May be a break in the skin and blood / pus filled blisters.
typical on arms and lower legs , feet, hands (can be on face)
