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Respiratory Flashcards

1
Q

4 major functions of respiratory system

A
  1. Supply oxygen to the body for energy production
  2. Removing carbon dioxide as a waste product of energy reactions
  3. Maintaining homeostasis (acid-base balance) of arterial blood
  4. Maintaining heat exchange (less important in humans)
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2
Q

Control of respirations

A

involuntary control of respirations is mediated by the respiratory center in the brainstem (pons and medulla)

the major feedback loop is the change in carbon dioxide and oxygen levels in the blood

the normal stimulus to breath for most people is an increase in carbon dioxide in the blood (hypercapnia)

decrease of oxygen in the blood (hypoxemia) also increases respiration but is less effective than hypercapnia

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3
Q

Chronic obstructive pulmonary disease

A

too much supplemental oxygen can cause or worsen hypercapnia in COPD patients

reducing the drive to breath

people with healthy lungs rely on high co2 levels to stimulate brain to breathe. People with COPD and high CO2 levels may become “less sensitive” to a high CO2 level

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4
Q

COPD patients

A

rely more on low oxygen levels to stimulate their breathing

giving too much oxygen removes this stimulus to breathe, thus reduces the removal of CO2 from the lungs

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5
Q

Aging Adult

A

thorax is less mobile

respiratory muscle strength declines after age 50s and continues to decrease into 50s

older adults are at increased risk for pneumonia due to decreased ability to cough, loss of protective airway reflexes and increased amount of secretions

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6
Q

older lungs

A

less elastic and more rigid

have fewer functional capillaries

have decreased lung resiliency

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7
Q

Dyspnea

A

(difficulty breathing)

COPD: Cant breathe or can’t take a deep breathe

Anxiety: feel like I am suffocating

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8
Q

Onset

A

Gradual onset seen with lung changes such as emphsema

sudden onset seen with viral or bacterial infections, acute asthma exacerbation, acute MI, pulmonary embolism(blockage of one of the pulmonary arteries in the lungs)

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9
Q

Orthopnea

A

Dyspnea when lying supine=heart failure

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10
Q

Paroxysmal nocturnal dyspnea

A

(severe dyspnea that awakens a person from sleep)=heart failure

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11
Q

Sleep Apnea

A

Fatigue, snoring and gasping sounds

diminishes the quality of sleep leading to fatigue, depression, irritability, loss of memory, lack of energy and increased risk for MVA or work injuries

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12
Q

Sleep Apnea consequences if left untreated

A

left untreated it can have serious and life-shortening consequences: high blood pressure, heart disease, stroke, diabetes, depression

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13
Q

Coughs

A

continuous coughs are usually associated with acute infections

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14
Q

Early morning coughing

A

is associated with chronic bronchial inflammation or smoking

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15
Q

Late evening coughing

A

usually the result of exposure to irritants during the day

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16
Q

Coughing at night

A

related to postnasal drip or sinusitis

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17
Q

Nonproductive coughs

A

are usually associated with upper respiratory irritations or early congestive heart failure

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18
Q

White Sputum

A

seen with colds, viral infections or bronchitis

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19
Q

Yellow or green Sputum

A

associated with bacterial infections

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20
Q

Brown or black sputum

A

associated with blood (hemoptysis) and seen in serious respiratory infections

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21
Q

Rust Sputum

A

colored is seen in TB or pneumoccal pneumonia

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22
Q

Pink Sputum

A

frothy sputum is seen in pulmonary edema

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23
Q

Wheezing

A

indicates narrowed airways due to spasm or obstruction

is associated with CHF, asthma or excessive secretions

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24
Q

Nasal flaring

A

seen with labored respirations especially in small children

indicative of hypoxia

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25
Pursed lip breathing
may be seen in asthma, emphysema or CHF as a physiologic response to slow down expiration and keep the alveoli open longer
26
Purple complexion
ruddy to purple complexion is seen in patients with COPD or CHF as a result of polycythemia cyanosis is seen in patients who are cold or hypoxic
27
Barrel Chest
AP ratio of 1:1 is called barrel chest and is a result of emphysema and the hyperinflation of the lungs
28
Kyphosis
is an increased curve of the thoracic spine seen in older adults caused by a loss of lung resiliency and loss of skeletal muscle
29
Kyphosis symptoms
can cause significant back pain and limited mobility severe deformities impair cardiovascular function example of compensation by hyperextension of head to maintain level of vision
30
Precuts Carinatum
Forward profusion of the sternum called pigeon chest more rare than Pectus Excavatum requires no treatment, but if severe surgery is an option
31
Pecuts Excavatum
Markedly sunken sternum more notable on inspiration usually congenital and not symptomatic severe sternal depression can be a source of embarrassment and distressing especially to adolescent boys surgery may be indicated
32
Scoliosis
is a lateral deviation of the spine deviation may cause individuals to have body image disturbances as shoulder and hip may be elevated in severe cases of spinal curvature, respiratory compromise can occur
33
Tripod Position
Patient will lean forward (enhances use of accessory muscles and use arms to support weight and lift chest to increase breathing capacity) often seen with COPD
34
Eupnea
Regular unlabored pattern with a rate of 12 to 20
35
Tachypnea
More than 24 breaths per minute seen with fever, anxiety, respiratory insufficiency, pain first sign of respiratory distress
36
Bradypnea
less than 10 breaths per minute and regular Normal in well conditioned athletes seen with narcotic use, diabetic coma and increased intracranial pressure
37
Apnea
Absence of breathing
38
Hypoventilation
decreased rate, decreased depth and irregular pattern usually associated with narcotics or anesthesia
39
Hyperventillation
increased rate and depth usually occurs with extreme exercise, fear, or anxiety is seen in disorders of the CNS, aspirin overdose, hypoxia, hypoglycemia, acidosis and infection
40
Kussmau
rapid, deep, labored hyperventilation associated with diabetic ketoacidosis
41
Biot Respiration
Irregular pattern characterized by varying depth and rate of respirations followed by periods of apnea seen with meningitis or severe brain damage head trauma
42
Cheyene-Stokes Respirations
Regular pattern characterized by alternating periods of deep, rapid breathing followed by periods of apnea may result from severe congestive heart failure, drug overdose, increased ICP or renal failure
43
Ataxic
Significant disorganization with irregular and varying depth of respiration indicates respiratory compromise breathing of a dying patient
44
Characteristics of respiratory distress
Anxious expression nasal flaring circumoral cyanosis sternocleidomastoid contractions substernal and intercostal retractions hyper expanded chest
45
Tenderness and sensation
muscle soreness from excessive work of breathing may be palpated as tenderness increased warmth can be a sign of infectoin
46
Crepitus
Crepitus, also called subcutaneous emphysema is a cracking sensation that occurs when air escapes into subcutaneous tissue
47
When does crepitus occur
after thoracic injury, around a chest tube, or tracheotomy it can also be palpated in areas of extreme congestion or consolidation as air passes through the exudate
48
Unequal chest expansion
can occur with severe atelectasis (collapse or incomplete expansion), pneumonia, chest trauma or pneumothorax (air in the pleural space) might guard to prevent pain cuz of the trauma
49
Decreased chest expansion
(excursion) at the base of the lungs is characteristics of COPD due to decreased function of the diaphragm
50
Resonance
the percussion tone elicited over normal lung tissue low pitched, hollow sounds heard over normal lung tissue (resonant sounds)
51
hyperresonance
is elicted in cases of trapped air such as emphysema or a pneumothorax indicate increased air in the lungs or pleural space the louder and lower pitched than resonant sounds
52
Flatness in percussion of lungs
is over bone
53
Dullness
is present over fluid or solid tissue this can be an organ when dullness is heard in a pleural space it backs be a sign of lobar pneumonia, pleural effusion or tumor heard over airless tissue and can be replicated by percussing the thigh or bony structure
54
Auscultate for Breath sounds
Do. not attempt to listen through clothing ask patient to breath deeply through their mouth for each are of auscultation listen to inspiration and expiration at each point
55
Bronchial Normal breath sounds
``` Location: trachea and thorax Pitch: High Quality: Harsh or Hollow Amplitude: Loud Duration: Short on inspiration, long on expiration ```
56
Vesicular Normal breath sounds
``` Location: Peripheral lung fields Pitch: low Quality:Breezy Amplitude: soft Duration: long in inspiration and short in expiration ```
57
Bronchovesicular Normal breath sounds
Location:over major bronchi posterior: Between the scapulae anterior: around the sternum in the 1st and 2nd ICS pitch: moderate quality: mixed amplitude: moderate duration: same during inspiration and expiration
58
Adventitious sounds
these are sounds added or superimposed over normal breath sounds fine crackles, coarse crackles, pleural friction rub, wheezes, stridor, and atelectatic crackles
59
Fine crackles
High pitched short popping sounds heard during inspiration not cleared with coughing associated with restrictive diseases and obstructive disorders
60
Coarse crackles
low pitched, bubbling, moist sounds that persist from inspiration through expiration sounds like velcro conditions where inhaled air comes into contact with secretions like pneumonia, pulmonary edema, pulmonary fibrosis
61
Pleural Friction Rub
Low pitched, dry, grating sound occurs during both inspiration and expiration results of rubbing two inflamed pleural surfaces seen in pleuritis
62
Wheezes Siblant
(sibilant) high pitched musical sounds heart primarily during expiration air is passing through constricted passages (constriction of the airways) heard in acute asthma or chronic emphysema may signal asthma
63
Wheeze Sonorous Ronchi
Low pitched snoring or moaning heard primarily during expiration but may be heard throughout the respiratory cycle these wheezes may clear with coughing heard in cases of bronchitis or single obstructions, snoring before an episode of sleep
64
Stridor
A high pitched, whistling sound most often heard while taking in a breath airflow is disrupted by a blockage in the larynx (voice box) or trachea (windpipe) seen with severe Broncholaryngospasm- croup
65
Atelectatic Crackles
(morning rales) not pathologic short, popping, crackling sounds that last only a few breaths when sections of alveoli are not fully inflated, they deflate slightly and accumulate secretions will usually disappear if patient coughs or take several deep breaths may result from pulmonary congestion
66
Bronchophony
Ask the patient to repeat 99 while listening voice should sound soft, muffled, and indistinct if the words are easily understood and louder in areas of increased density this could indicate consolidation(liquid) conditions:pneumonia, atelectasis or tumor
67
Egophony
ask a patient to repeat the letter "E" while you listen voice should be soft, muffled and "E" indistinguishable over areas of consolidation(liquid) or compression it sounds like "A"
68
Whispered Pectoriloquy
Ask the patient to whisper a phrase like 1-2-3 while you listen transmission of sound should be faint and muffled over areas of consolidation(liquid) or compression, the sound is clearly transmitted and distinct -sounds like the patient is whispering into the stethoscope
69
Pneumothorax
X ray of collapsed lung. Alveoli are deflated and no air exchange occurs in the lung so breath sounds in the lung are absent. unequal chest expanision hyperressonance on percussion decreased fermitus or absent breath/voice sounds decreased or absent trachea would be pushed away from the pneumothorax to the unaffected side
70
Atelectasis
"white out" a section of alveoli collapses due to obstruction, like thick mucous, or a foreign body. can also collapse in a newborn due to lack of surfactant expansion of the affected side will lag Decreased tactile fremitus or absent over affected area dullness on percussion over the area breath and voice sounds will be decreased or absent trachea would be pulled toward the atelectasis (affected side)
71
Pneumonia
on the chest x ray there is an ill defined area of increased density in the right upper lobe alveoli are now filled with bacteria, cellular debris, fluid and blood. If enough of the alveoli fill, the patient will have less surface area of the lung for oxygenation=hypoxemia asymmetrical chest expansion decrease on affected side increased tactile fremitus dulness on percussion over affected lobes breath sounds will be louder with crackles voice sounds: bronco phony, ego phony, whispered pectoriloquy will all be heard clearly
72
Emphysema
(COPD) caused by destruction of pulmonary connective tissue results in "air trapping"-hyperinflated lungs barrel chest-use of accessory muscles-tripod decreased tactile fremitus and chest expansion decreased breath sounds hyper resonant on percussion
73
Use of accessory muscles
The use of accessory muscles for respiration indicates the client is having difficulty breathing
74
Diaphragmatic and pursed-lip breathing
two controlled breathing techniques that help the client conserve energy
75
Fremitus
the feeling of vibrations while the patient says 99. Percent
76
Smoking
obstructive airway disease

Health Assessment (9 decks)

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