Respiratory

Question 1

What are two basic functions of respiratory
system? and what gases are exchanged

how much does an adult hold

Answer 1

1. Air distribution
2. Gas exchange

O2 and CO2

adult lungs can hold 5L one breath is 500ml

when deep breathing you can inhale 3L and 1L for an expiratory reserve an extra 1 L as residual volume to prevent the lungs from collapsing. Breathing controlled by sensory nerves that run to brain receptors to tell brain how much air, if theres tension in muscles etc. and motor nerves that run from diaphragm and intercostal or between the ribs

Question 2

organs of the upper and lower res tract

Answer 2

U-Nose, pharynx, larynx
L-Trachea, bronchi, lungs

Question 3

Upper Respiratory
Tract Infections (URI)

Answer 3

Upper Respiratory Infection
Sinusitis & Nasal Polyps
Adenoid Hypertrophy & Tonsillitis
Rhinitis
Pharyngitis
Laryngitis (croup)
Epiglottitis
Otitis Media
Choking

Occur several times a year
have a tendency to spread
upper resp mucosa is continous with mucous lining of sinuses, eustachian tube and middle ear, lower resp tract
-a common cold can become sinusitis or otitis media

Question 4

Sinusitis

Answer 4

upper resp infection
: Inflammation of nasal mucosa that lines sinuses
Symptoms: Headache, pressure, pain

Question 5

Nasal Polyps

Answer 5

painless, noncancerous tissue growths from nasal mucosa which can block nasal passage and affect breathing

what are polyps: - tissue growths linked to asthma- can run in families. if its small its not a problem but may need surgery if it blocks breathing

Question 6

Tonsils & Adenoids

Answer 6

upper resp infection
-lymphoid tissue in mucous membrane of pharynx
-lingual tonsils and palatine tonsils in oropharynx; pharyngeal tonsils in nasopharynx (called adenoids when swollen)

Immune function:
defends major entrance to body from
foreign invaders: germs we breathe and eat

Question 7

Adenoid Hypertrophy & its relation to Tonsillitis

Answer 7

upper resp infection
-lymph glands growing during acute infection to fight infectious agents: may lead to nasal obstruction and middle ear effusion

tonsillitis - when one or both tonsils are inflamed
Signs & symptoms: swollen tonsils, sore throat, difficulty swallowing and tender lymph nodes on sides of neck

• caused by infection with a common virus or bacteria
• Surgery to remove tonsils, once a common procedure to treat tonsillitis, is usually performed only when bacterial tonsillitis occurs frequently, doesn’t respond to other treatments or causes serious complications.

now the surgeries are delayed because tonsils are valued as lymphoid organs

Question 8

Rhinitis: Infectious & Allergic

Answer 8

upper resp infection
-comes from word rhino
-▪ inflammation and swelling of nasal mucosa
▪ Symptoms: red, itchy, “runny nose” and partially obstructed breathing - infectious rhinitis
-common cold - rhinovirus or flu
-solved in 7-10 days

Allergic rhinitis or “Hay Fever”: sensitivity-type reactions to nasal irritants and airborne allergens including animal dander and plant pollens
❖Symptoms similar to infectious rhinitis but may become chronic and result in formation of nasal polyps and secondary infections

Question 9

Pharyngitis

Answer 9

upper resp infection
-sore throat inflammation or infection of pharynx (throat)
Symptoms: Pain, redness, and difficulty in swallowing
➢caused by pathogens like streptococci pyogenes that cause “strep throat”

Question 10

Laryngitis

Answer 10

upper resp infection
-inflammation of mucosal lining of larynx, accompanied by edema of laryngeal structures
Symptoms: If swelling of vocal cords occurs, hoarseness or loss of voice results
➢ caused by bacteria, viruses, exposure to allergens, or by overuse of voice, smoking
➢In children, can obstruct air flow and result in asphyxiation

Question 11

Epiglottitis

Answer 11

upper resp infection
- life-threatening condition caused by Haemophilus influenzae type B (Hib) infection
-always an emergency because the epiglottis swells and blocks airway
-used to happen to young children but HIB vaccine stopped it

Question 12

Otitis Media

Answer 12

upper resp infection
inflammation of middle ear
It is very common in children

Question 13

Croup

Answer 13

upper resp infection
-a non–life-threatening type of laryngitis in kids age 3 and younger.
-caused by parainfluenza viruses resulting in bark like cough and labored breathing. Children get symptoms after they go to bed and wake up scared coughing but without a fever
-trachea swells but can extend lower
-can be viral and with cold like symptoms
➢LTB= laryngotracheobronchitis

Question 14

Choking

Answer 14

upper resp infection
-when something is stuck in the larynx
-five-and-five rescue method: Five blows to back (between scapulae) with heel of hand may be followed by five abdominal thrust maneuvers (Heimlich maneuver, or simply abdominal thrusts)

Question 15

Dyspnea, Apnea, & CSR

Answer 15

Breathing DISORDERS- look at slide for pics
Eupnea: normal respiratory rate
Dyspnea: labored - hypo ventilating
Orthopnea: reliving dyspnea by sitting upright
Apnea:-when breathing stops for a bit
Cheyne-Stokes respiration (CSR): cycles of alternating apnea and hyperventilation
Respiratory arrest- breathing does not restart afte apnea

Question 16

SIDS/SUDI

Answer 16

Breathing DISORDERS
SUDI: Sudden Unexpected Death in Infancy
-Sudden infant death syndrome - frequently in babies younger than 3
-cause unknown - might be the Pons and Medulla that control breathing

Question 17

Infant Respiratory Distress Syndrome

Answer 17

Breathing DISORDERS
-affects premature infants less 37 weeks
-lack of surfactant in alveolar air sacs

-Surfactant reduces surface tension of water fluid on surface of alveolar walls and allowing easy movement of air in and out of lungs
* allows alveolar sacs to stay open
* If there is a lack of surfactant alveoli collapse easily and are difficult to re-open
* body is only able to make this shortly before birth (normally about 40 weeks after conception)

Question 18

Adult Respiratory
Distress Syndrome

Answer 18

Breathing DISORDERS
-impairment or removal of surfactant in alveoli by smoking, chemical inhalation
-edema of lungs can impair surfactant and the lungs ability to stretch

Question 19

Endotracheal Intubation
& Tracheostomy

Answer 19

• Intubation - a tube put in mouth through pharynx, larynx and into the trachea to ensure open airway

Tracheostomy -cutting an opening into trachea to improve ventilation of lungs

Question 20

Pleurisy

Answer 20

Lower respiratory tract disorders
-: inflammation of parietal pleura, difficulty breathing and stabbing pain
-breathing restriction is caused by the visceral and parietal pleurae rubbing up on each other during breathing
-can be caused by tumors and infections -pneumonia and tuberculosis

Question 21

Atelectasis, Bronchiectasis
& Pneumoconiosis

Answer 21

Atelectasis-when the lung doesnt completely expand or collapse - breathing is hard

Bronchiectasis - permanent enlargement of airways in lungs causing mucus, shortness of breath, coughing up blood. You get lots of lung infections -pneumonia and tuberculosis

Pneumoconiosis- occupational lung disease -restrictive lung disease - inhalation of dust like from working in mines

Question 22

Pneumothorax

Answer 22

Pneumothorax: Air in pleural space that can happen in two ways - lung collapse

1-rupturing of visceral pleura and the air from lungs comes rushing out
2-when outside air rushes into chest through an open wound

If blood accumulates in pleural space,
condition is called hemothorax

Question 23

Acute Bronchitis

Answer 23

-inflammation of bronchi when the trachea is involved its called tracheo-bronchitis. Starts with upper resp infection like a cough that moves downwards into a cough with sputum -mucus and pus

Question 24

Pneumonia and the types o

Answer 24

acute inflammation of lungs: alveoli and bronchi become plugged with thick fluid (exudate)

Streptococcus pneumoniae - most likely thing to cause
-high fever, chills cough, chest pain

Lobar pneumonia: affects an entire lobe of lung
Bronchopneumonia: patches of infection in portions of bronchial tree
Aspiration pneumonia: lung infections caused by inhalation of vomit or other infective material e.g. acute alcohol intoxication and as a result of anesthesia

Question 25

Tuberculosis with diagnosis

Answer 25

-chronic bacillus infection caused by Mycobacterium tuberculosis
-pleurisy, weight loss, and fever, lung hemorrhage and dyspnea
-also called Consumptive disease or “consumption”: due to weight loss
-high contagious droplets, inhalation of bacillus

-use acid fast staining - the mycolic acid in M Tuber resists decolorization
-culture
-histo examination would show tissues with cheese like appearance
-mantoux test PPD test injected in your arm and looked at 48 hours later

Question 26

Cystic Fibrosis

Answer 26

-inherited
-severe lung and digestive damage
-thick secretion build up with mucus, sweat and digestive juices. They block tubes, ducts in lungs and pancreas
-no cure
-difficulty digesting fat and protein

do a sweat chloride test to measure sodium and chloride levels - gold standard
-test on forearm and collect sweat usually CF pt will have 2-5 times more
-part of newborn screening

Question 27

Restrictive Pulmonary
Disorders

Answer 27

-restriction (reduced stretch) of alveoli - reserve volume and vital capacity decreased

fibrosis (scarring) of lung tissue due to asbestos, coal or silicon dust inhalation
-can also be caused with pleurisy

Question 28

Obstructive Lung
Disorder

Answer 28

-shortness of breath because exhaling all air from lungs is difficult
- airways are narrowed or lungs are damaged so the exhaled air comes out slower and even after exhaling a large amount of air is still left in the lungs

-caused by smoking, second hand smoke, pollution

Question 29

Chronic Obstructive
Pulmonary Disease (COPD)

Answer 29

-a broad term used to describe conditions of progressive irreversible obstruction of expiratory air flow

-diffculty breathing, emptying lungs and have inflated chests
-found in people with chronic bronchitis and emphysema. These people will often have swelling in legs, no energy, cyanosis - blue lip/nails

Question 30

Chronic
Bronchitis

Answer 30

chronic inflammation of bronchi and bronchioles
-caused by edema and mucus that blocks airways
-trouble exhaling and they cough alot to try to get rid of mucus
-cigarette smoking, second hand smoke, pollution

Question 31

Emphysema

Answer 31

-when chronic bronchitis progresses and air gets trapped in alveoli causing them to get larger and rupture. This rupturing reduced lung surface area making it hard to breath and people develop hypoxia or O2 deficiency

Question 32

Asthma

Answer 32

-recurring spasms of smooth muscle in walls of bronchial air passages
-muscle contraction narrow airways
-triggered by stress, exercise, allergens

Question 33

Lung Cancer

Answer 33

malignancy of pulmonary tissue that destroys ability for gas exchange when it gets to other parts of the body is it called metastsis
-common cause is cigarette smoking , 2nd hand , pollution, radon gas, chromium, asbestos, pollution

Pneumonectomy is surgical removal of an entire lung
a lobectomy, only affected lobe of a lung is removed