Respiratory 3 Upper Resp Conditions Flashcards
Problems of the nose and paranasal sinuses
Deviated septum Nasal fracture Rhinoplasty Epistaxis Allergic rhinitis Acute viral rhinitis Influenza Sinusitis
Deviated septum u
Displacement of the cartilage that normally divides the nose symmetrically
Nasal fracture
Common facial fracture, by blunt trauma
Rhinoplasty
Surgical reconstruction of a nasal deformity. Can be performed for cosmetic reasons or to improve airway function caused by nasal obstruction
Epistaxis
Rupture of a blood vessel in the nasal mucosa
Caused by low humidity, allergies, URTI, sinusitis, trauma, ht, foreign body, chemical irrigabnts, tumour, nasal surgery, anatomical malformation and overuse of nasal decongestant
Allergic rhinitis
Inflammatory reaction of the nasal mucosa in response to the presence of an allergen
Acute viral rhinitis
The common cold. Inflammatory response to an infection of the urt which can be caused by 200 different viruses
Influenza
Contagious respiratory illness
Sinusitis
Affects approx 12.5 of people when inflammation ir hypertrophy of the mucosa blocking the opening in the sinuses it
Epistaxis management
Reassure and calm patient
Place in upright position
Apply direct pressure by pinching the entire lower portion of the nose fo 10-15 minutes
Application of ice may encourage vasoconstriction
Allergic rhinitis
Patho physiology
Inflammation reaction of the nasal mucusa in response to allergens presence
Classified as seasonal, perennial or frequency( episodic, intermitted, persistent)
Allergic rhinitis symptoms
Sneezing, watert eyes and itchy eyes a d nose
Altered sense of smell
Nasal discharge
Allergic rhinitis management
Identify and ackid triggers
Desensitasion ( immunotherapy) can ve effective but requires careful patient selection and administration
Drug therapies that ain to reduce inflammation, nasal symptoms and maximises quality if life
Causes of allergic rhinitis time
House dust Dust mites Pet allergens Pollens Mold spores Smoke
Drugs
Corticosteroids Mass cell stabilizer Anticholinergics Antihistamines (1 and 2) Decongestants
Corticosteroids
Types
Action
Effects
Beclomethasone
Budesonide
Fluticasone
Inhibits inflammatory response
Mild transient nasal burning and stinging, musical drying . In rare occasions, localised fungi infected eith candida albucans
Mast cell stabiliser
Sodium cromoglicate spray
Blocks nasal cholinergic receptors, reducing nasal secretions in common cold and non-allergic rhinitis
Nasal dryness and irritation may occur
Antihistamines(1st generation)
Brompheniramine
Chlorpheniramine
Bind h1 receptors on target cells, blocking histamine binding. Relieve acute symptoms of allergic response
Cross blood-brain barrier, frequently causing sedation and somnolence Can cause paradoxical stimulation ( restlessness, insomnia) Anticholinergics effects( palpitations, dry mouth, constipation)
Antihistamine ( 2nd generation drugs)
Loratadine
Cetirizine
Fexofenadine
Bind with h1 receptors on target cells, blocking histamjne binding. Relieve acute signs of allergic response
Limited affinity for brain h1 receptors. Cause minimal sedation, few effects in psyhcomotor activities or bladder function
Decongestant
Pseudoephidrine
Stimulated adrenergic receptors in blood vessels, promote vasoconstriction and reduce nasal congestion
Cns stimulation, causing insomnia, excitation, headache, irritability, increased bp, and ocular pressure, dysuria, palpitation, tachycardia
Obstructrion of the nose and sinuses
Nasal polyps
Foreign bodies
Nasal polyps
Soft, painless, benign growth that form slowly in response to repeated inflammation of the sinus or nasal mucosa. They can be removed with endoscopic surgery but reoccurrence is common
Foreign bodies
Inorganic and organic objects can cause pain, difficulty breathing and nasal bleeding. Sneezing or blowing the nise wjth the opposite nostril closed is often effective in removal of foreign bodies
Problems with pharynx
Acute pharyngitis
Peritonsillar abscess
Acute pharyngitis
Acute inflammation of the pharyngeal walls. Can be caused by viral, bacterial or fungal causes. Viral more common
Peritonsillar abscess
Complication of acute pharyngitis most often caused by b-haemolytic strepcocci. Causes pain swelling and possibly obstruction of the throat, threatening the airway
Intravenous antibiotics are needed along eith needle aspiration
