Respiratory

Question 1

causes of troubled breathing

Answer 1

croup: swelling in the baby’s upper airway
respiratory distress syndrome
bronchiolitis: swelling in the smallest airways of the lungs
buildup of infected pus in the back of the throat

Question 2

causes of chest retractions

Answer 2

** can happen at any age if something is blocking your windpipe **
- asthma
- pneumonia
- bad allergic reaction
- epiglottitis: tissues that cover windpipe swell up

Question 3

subcostal retractions

Answer 3

• belly pulls in beneath your rib cage
• belly breathing

Question 4

substernal retractions

Answer 4

• belly pulls beneath your breastbone

Question 5

suprasternal retractions

Answer 5

• skin in the middle of your neck sucks in (also called a tracheal tug)

Question 6

superclavical retractions

Answer 6

• happen on the part of your neck above your collarbone

Question 7

intercostal retractions

Answer 7

• happen between each rib indrawing of the skin inbetween each rib

Question 8

abnormal bronchial breath sounds

Answer 8

• consolidation
• collapse of patent bronchus
• sounds almost like one continuous movement

Question 9

absent breath sounds

Answer 9

• pleaural effusion
• pneumothorax
• collapse with blocked bronchus

Question 10

wheeze (low pitched rhonchi)

Answer 10

• mainly inspiratory, can be expiratory
• COPD, bronchiectasis
• almost sounds like a horse to me

Question 11

wheeze (high pitched)

Answer 11

• asthma
• bronchiolitis
• typically expiration but can happen on inspiration

Question 12

crackles (fine)

Answer 12

• pulmonary edema
• interstitial fibrosis
• almost sounds like a skateboard going on bumpy concrete

Question 13

crackles (coarse)

Answer 13

• resolving pneumonia
• bronchiectasis
• chronic bronchitis

Question 14

pleural rub

Answer 14

• friction rub

Question 15

stridor

Answer 15

• medical emergency
• causing blocking large airway

Question 16

wheezes

Answer 16

high pitched musical flute
narrowed airways from bronchoconstriction inflamed lung tissue
- asthma and COPD exacerbation

AIM
Albuterol
ipratropium (can’t pee with a troPIUM… since it dries out secretions)
Methylprednisolone (solumedrol) - slow acting steroid to tx swelling

Question 17

crackles think CRAZY fluid

Answer 17

• liquidy bubbling or crackling
• fine = high pitched… rubbing hair between fingers
• coarse = low pitched… velcro pulled apart
  location: lower lobes
  patho: alveoli “pop” open - inflammation and congestion
  disease: pulmonary edema “fluid in the lungs” with CHF or pneumonia (infection)
  TX: diuretics (furosemide) infection (Antibiotics)

Question 18

stridor

Answer 18

SERIOUS SQUEAK
MED EMERGENCY: AIRWAY OBSTRUCTION
- high pitched harsh, INSPIRATORY, whistle
location: throat region
patho: blockage of larynx or trachea
disease: choking obstruction, epiglottitis, croup (child)
AFTER THYROID SURGERY
TX: endotracheal intubation, surgery

Question 19

rhonchi “rumble”

Answer 19

• low pitched rattling or rumbling , like snoring
  location: bronchi (not alveoli)
  disease: bronchitis, COPD, pneumonia (infection), CF
  tx: chest percussion (vibration vest), fluids to loosen and thin mucus

Question 20

pleural friction rub “pebbles friction”

Answer 20

• low pitched, dry rubbing like two rocks grinding together
• front side of lung… during inhalation and exhalation
  patho: infection caused by inflammation of pleura layer of the lungs rubbing together
  disease: worsening pneumonia
  tx: TCDB, incentive spirometer, antibiotics