Respiratory Flashcards
What is FIV and how does it relate to airway constriction?
Forced Inhalation Volume - a constricted airway will take longer to reach FIV.
Allergies relate to which white blood cell?
Mast cell sensitisation by IgE.
Which 3 anatomical features mark asthmatic airways?
- Smooth muscle hypertrophy
- Fibrosis
- Goblet cell hyperplasia
What does 100% FVC indicate?
100% Forced Vital Capacity indicates that the patient could get all the air out of their lungs, so any issue must be obstructive not restrictive.
What features are unique to cervical vertebrae?
Butterly spinous processes and extra holes in transverse process for vertebral arteries.
What is the most common neural tube defect?
Spina Bifida
Name an intrinsic muscle of back
Erector Spinae
Which thoracic muscle can move anterior to posterior and posterior to anterior?
Transverse abdominis
How would you define asthma?
Reversible airway obstruction
Which 3 physiological features are present in asthma?
- bronchoconstriction
- mucus increase
- inflammation leading to cough
What is emphysema?
Loss of alveolar membrane - they start to join - decrease surface area
How does smoking impact the lungs? x5
- kills cilia
- mucus hypersecretion
- kills macrophages, chronic inflam
- neutrophils make proteases and break down bronchiole elastin –> gas trapping
- fibrosis
If you have chronic raised CO2, which reflex will kick in to control breathing?
- O2 detection (carotids)
- Stretch receptors in lungs
THIS IS HYPOXIC BREATHING
How to tell if someone’s respiratory rate is running of hypoxia?
- RR will be chronically low
Hypoxia sends what message to the kidneys?
To release EPO - to make more red blood cells.
Which people are most at risk of sleep apnea?
Obese or super skinny - both due to floppy soft palate.
A wheeze suggests what type of issue?
obstructive
Barrel chest gives what finding on CXR?
Retrosternal shadow
What is FEV1/FVC?
Amount of air that can be forcibly pushed out in 1 second / amount of air that can be pushed out total. COPD is less than 70.
What oxygen % will cause sleep apnea to wake someone up?
60%
Describe a pneumothorax and the examination findings of a pneumothorax
Air leaking into the pleural space, pushes on lungs.
Trachea will be pushed away from site of injury.
Expansion will be less on affected side.
Percussion of area will be hyper resonant due to being air.
Auscultation will show reduced/absent breathing sounds as it’s not liquid or solid.
Vocal resonance will be muffled.
Describe pneumonia and the examination findings
Infection of the lung, typically lobar.
Trachea will be midline.
Expansion will typically be unaffected.
Percussion will be more dull at site.
Auscultation will show crackles and louder breath sounds maybe.
Vocal resonance will be hyper resonant - clearer.
Describe a collapsed lung and the examination findings
Internal collapse of lung structures due to things like cancer.
Trachea will move towards collapse as it is being pulled in.
Expansion reduced on affected side.
Percussion will be dull.
Auscultation will be absent cos no air getting in.
Vocal resonance will be really clear.
Describe a pleural effusion and the examination findings
Liquid build up at bottoms of pleural space.
Trachea normal in midline.
Expansion normal.
Percussion will be duller. STONEY Dullness.
Auscultation will be absent due to weird physics mechanism.
Vocal resonance will be absent due to weird physics.
Stoney Dullness is a giveaway for what condition?
Pleural effusion
What factors prevent damage/irritant of the trachea?
IgA, cilia, irritant receptors, mucus, antimicrobials, alveolar macrophages riding the wave.
Rust coloured sputum is a giveaway for what organism and disease? How would you treat it?
Strep pneumoniae caused pneumonia.
Amoxicillin.
What is the most common ECG finding for a PE?
Sinus tachycardia
What are Type 1 and Type 2 Hypoxia and what typically causes type 2?
Type 1 - just oxygen hypoxia
Type 2 - oxygen and CO2 issues.
Type 2 tends to be due to hypoventilation.
Which WBC are most important in asthma vs COPD
Asthma is eosinophilic, COPD is neutrophilic.
What is atypical pneumonia and how does it look on CXR?
‘walking pneumonia’, less intense symptoms, tend to be hospital acquired, diffuse grey on CXR.
Mnemonic for all the important squamous cell carcinoma stuff:
Having a milkshake on Sydney Harbour Bridge, its a pearler of a day.
Calcium up due to paraneoplasia, keratin pearls on histo, people are squashed together (squamous).
Describe the lobes of the lungs.
The right lung has 3 lobes, the left has 2.
In right lung - middle love is smallest, all of the lobes touch each other.