Respiratory Flashcards
• The bronchioles continue to subdivide into..
– Terminal Bronchioles
– Respiratory Bronchioles
– Alveolar Ducts
– Alveoli
Alveoli
- Tiny, thin walled air sac at the end of bronchiole branches where gas exchange occurs.
- Millions of alveoli in each lung
The lungs
- Two lungs lying each side of the midline in the thoracic cavity
- The area between is the mediastinum occupied by the heart, great vessels, trachea, and right and left bronchi
The Pleura
• Closed sac of serous membrane that covers each lung and separates them from other organs
• Consists of two layers
– Visceral Pleura (adhered to lung)
– Parietal Pleura (adhered to chest wall and diaphragm)
– Two layers separated by thin film of serous fluid secreted by the membrane to prevent friction when breathing
Function - Respiratory system
Purpose – gas exchange • Deoxygenated blood to oxygenated blood Moving air – through the ducting system Function - Warms - Humidifies - Filters
Lung volumes
Male = 6L Female = 4.2L Tidal volume = 400mL … single breath volume Dead space = 150mL … no perfusion Respiration rate = 12-20/min adults
Cough - Common causes
- Asthma – wheeze, often nocturnal, worse in mornings
- COPD – (‘smokers’) usually produces sputum in mornings
- Chronic heart failure
- Interstitial lung disease
- Drugs
Cough - Ask about
- Time of cough – when is it worse?
- Duration – acute <3 weeks, sub-acute 3-8 weeks, chronic > 8 weeks
- Relief with inhaler
- Worse on lying down
- Wakening
- Sputum
- Haemoptysis
Sputum and haemoptysis - Types
- serous: clear waters (acture pulmonary oedema), frothy pink (alveolar cell cancer)
- mucold: clear, grey (chronic bronchitis/chronic obstructive pulmonary disease), white, viscid (asthma)
- purulent: yellow (acute bronchopulmonary infection, asthma eosinophils), green (longer standing infection - pneumonia, bronchiectasis, cystic fribrosis, lung abscess)
- rusty: rusty red, phneumococcal pneumonia
Sputum and haemoptysis - ask about
• Colour • Amount • Taste or smell • Solid material • Haemoptysis – Amount, fresh, in sputum? – Coughed up vs. • vomited/regurgitated • from nasopharynx
Breathlessness, shortness of breath,
dyspnoea
- Dyspnoea – the sensation that unable to breath properly (subjective)
- Shortness of breath, breathlessness – includes objective measures of difficulty in breathing
- Orthopnoea – SoB on lying, usually associated with LVF
- Paroxysmal nocturnal dyspnoea – wakes patient from sleep – usually LVF (in asthma – wheeziness often causes waking in early morning)
- Exercise induced bronchoconstriction
- Assessment of severity – MRC breathlessness scale
Dysphonia define
hoarseness caused by damage to larynx or the nerve to larynx
wheeze define
– high pitch whistling noise – air passing through narrowed airways
stridor define
– high pitched, harsh noise caused by obstruction of
large airway – always needs investigation (unless viral croup!)
Physical Assessment
IPPE Introduction Permission Position Exposure
IPPA Inspection Palpation Percussion Auscultation
