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Anatomy and Physiology > Respiratory Conditions > Flashcards

Respiratory Conditions Flashcards

1
Q

How can respiratory conditions cause hypoxia?

A

Airway obstruction

Impaired perfusion of the alveoli

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2
Q

What are obstructive airway conditions?

A

It is where pulmonary tissues causes obstruction to the free flow of air in the lungs

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3
Q

What are two examples of obstructive airway conditions?

A

COPD

Asthma

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4
Q

What does COPD stand for?

A

Chronic Obstructive Pulmonary Disease

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5
Q

What are the two main COPD conditions?

A

Emphysema and chronic bronchitis

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6
Q

What percentage of people over 40 have COPD?

A

4.5%

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7
Q

How many people are living with COPD in the U.K.?

A

1.2 million

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8
Q

How much does COPD cost the NHS?

A

£9.9 billion annually

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9
Q

How many beds are taken up by COPD patients every year?

A

1 million

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10
Q

What is acute bronchitis?

A

It is short lived and is due to infection not COPD

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11
Q

What is chronic bronchitis?

A

Where the bronchus becomes inflamed and bronchial goblet cells secrete excess mucus which can block the airway

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12
Q

What is considered chronic bronchitis?

A

Persistent symptoms for at least 3 months of the year for 2 consecutive years to be considered chronic.

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13
Q

What are some risk factors of bronchitis?

A

Aged over 35

Are or have been a smoker

Had chest problems as a child

Been exposed to dust, fumes and chemicals as part of their job

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14
Q

What are some signs and symptoms of bronchitis?

A

Productive cough

Tachypnoea - rapid breathing

Dyspnoea - difficulty breathing

Use of accessory muscles

Decreased SPO2 - sats

Tachycardia - over 100 bpm

If hypoxia is severe, level of consciousness may be reduced

Slow capillary refill

Cyanosis (late sign)

Auscultations (stethoscope) may reveal rhonchi (low pitched rattling) and wheezes

Use of domiciliary O2

Heart failure

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15
Q

How would you manage bronchitis? (6)

A

Ensure an open airway - suction if required

Maintain patient in most comfortable position (as close to upright as possible)

Administer O2 according to JRCALC guidelines

Consider administration of salbutamol and ipratropium

Be prepared to ventilate

Collect sputum

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16
Q

What is emphysema? (3)

A

It is a distension (swelling) of the alveoli and destructive changes in the membranes

Lung tissue loses its elasticity and muscular integrity and collapses

Hypoxia is the main respiratory stimulus but patients are not usually cyanotic

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17
Q

What are some risk factors associated with emphysema? (5)

A

Aged over 35

Are or have been a smoker

Had chest problems as a child

Be exposed to dust, fumes and chemicals as part of their job

May have genetic condition called alpha-1-anti trypsin deficiency. This is rare but may cause COPD at a young age.

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18
Q

What are some signs and symptoms of emphysema?

A

Thin

Barrel chest

Tachypnoea - rapid breathing

Dyspnoea - difficult breathing

Use of accessory muscles

Pursed lips on expiration

Tachycardia

Confusion and anxiety may be present due to hypoxia

May be decreased lungs sounds

Wheezing and crackles on inspiration during auscultation (stethoscope)

Cardiac dysrhythmia (heart rhythm problems)

May be evidence of oedema (swelling caused by build up on fluid in body tissues, particularly in the ankles, wrists and legs)

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19
Q

How would you manage emphysema?

A

Ensure an open airway

Maintain patient in the most comfortable position (as close to upright as possible)

Administer O2 as per JRCALC guidelines

Consider administration of salbutamol and ipratropium

Be prepared to ventilate

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20
Q

What is asthma?

A

The narrowing of medium to small airways (particularly bronchi and bronchioles) due to muscle spasm, oedema and blockage by inflammatory cells

Can be caused by infections, cold air or inhaled irritants

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21
Q

What are the severities of asthma? (4)

A

Near fatal asthma

Life threatening asthma

Acute severe asthma

Mild/moderate exacerbated asthma

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22
Q

How do you treat mild/moderate asthma? (3)

A

Take patient to calm, quiet environment

Encourage use of own inhaler

If unresponsive to own inhalers, administer high doses of O2 and administer nebuliser salbutamol

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23
Q

How do you treat acute severe asthma? (5)

A

Administer high levels of supplement O2

Administer nebuliser salbutamol

If no improvement, administer ipratropium (must only be administered once after 1 dose of salbutamol and salbutamol must then continue unless no longer needed)

Administer steroids

Further salbutamol nebulisation may be necessary

24
Q

How do you treat life threatening asthma? (6)

A

Administer high levels of supplement O2

Administer nebuliser salbutamol

If no improvement, administer ipratropium bromide

Administer steroids

Administer adrenaline 1:1000

Further salbutamol nebulisation may be necessary

25
Q

How do you take a Peak Exploratory Flow? (9)

A

Ensure scale and meter are consistent with patients usual measurement

Measure peak flow before and after use of bronchodilators

Assemble device and ensure it is set to zero (or lowest point)

Place the patient in position of comfort, preferrebly standing

Ask patient to take deep breath, place device in their mouth and exhale as forcibly as possible, ensuring that the patient does not breath through their nose

Ensure that the patient does not obstruct the mechanism

Perform the test three times and take the best of three readings

Allow rest periods between measurements

Document results

26
Q

What are some conditions caused by impaired perfusion of the alveoli?

A 
Pneumonia
Pleurisy
Pulmonary embolism
TB
Industrial lung disease
27
Q

What is pneumonia?

A

An acute inflammation of the lungs caused by bacteria and less commonly a virus

If often follows a cold, particularly in the elderly or those suffering from chronic bronchitis

28
Q

What are some risk factors for pneumonia?

A

Babies and young children

People over 65

People with long term heart, lung and kidney disease, or diabetes

People with cancer, especially those having chemo

People on drugs that suppress the immune system, and those with HIV

People who smoke or drink alcohol to excess

29
Q

What are some signs and symptoms of pneumonia?

A

Tachypnoea

Coughs up sputum which may be blood stained

Deep breaths and coughing may cause distressing chest pain

Tachycardia

Pyrexia

30
Q

How would you manage pneumonia?

A

Ensure open airway

Administer O2 as per JRCALC

Monitor vital signs

31
Q

What is pleurisy?

A

Inflammation of the pleura, often occurs with pneumonia

Has a characteristic rubbing sound when listening to chest using stethoscope (auscultation)

Treated in same way pneumonia

32
Q

What is pulmonary embolism (PE)?

A

A blood clot blocking part of a pulmonary artery, which deprives part of a lung of its blood supply

May cause pulmonary infarction (lung death)

33
Q

What are some causes of pulmonary embolism?

A

Deep vein thrombosis (DVT)

Elderly

Bed ridden

Recent operation

Long distance travel

Childbirth

Contraceptive pill

34
Q

What are some signs and symptoms of pulmonary embolism?

A

Tachypnoea

Dyspnoea

Pleuritic pain

Cough

Haemoptysis (coughing blood)

Tachycardia

Apprehension (anxiety)

May have experienced leg pain (clinical DVT)

35
Q

How would you manage pulmonary embolism?

A

Ensure open airway

Administer O2 as per JRCALC

Consider Entonox

Be prepared to perform CPR

36
Q

What is tuberculosis (TB)?

A

Chronic lung infection that may persist for several years

Patient may not have any particular symptoms

37
Q

What are some signs and symptoms TB?

A

Fever

Weight loss

Cough - often with haemoptysis

Often related to travel to TB infected countries

Is prevalent amongst patients with HIV or those who are homeless

38
Q

What is hyperventilation syndrome?

A

A rate of breathing that exceeds metabolic demand

It’s is higher than what is required to maintain normal CO2 levels

39
Q

What are some causes of hyperventilation syndrome?

A

Pulmonary embolism

Diabetic Ketoacidosis

Asthma

Hypovolemia

Emotional stress and anxiety

40
Q

What does hyperventilation syndrome do that is problematic to the body in relation to gases?

A

CO2 levels decrease which in turn reduces the uptake of oxygen

Patients can begin to become hypoxic

41
Q

What are some symptoms of hyperventilation?

A

Acute anxiety

Tetany (muscle spasms)

Carpopedal spasm (flexion of wrists/fingers, dorsiflexion of ankles and plantarflexion of toes.

Numbness and tingling of mouth and lips

Aching of chest

Feeling lightheaded

42
Q

What is tetany?

A

Muscle spasm

43
Q

What causes tetany?

A

Caused by malfunction of the parathyroid glands and a consequent deficiency of calcium

44
Q

How do you manage hyperventilation?

A

Ensure open airway

If cyanosed or decreased SPO2 then administer O2

Maintain calm approach

Coach respiration’s and encourage talking

DO NOT USE PAPER BAG technique

45
Q

What is industrial lung disease? (5)

A

Pneumoconiosis (inhalation and retention of dust)

Coal-workers pneumoconiosis (inhalation and retention of coal dust)

Silicosis (inhalation and retention of respirable crystalline silica)

Asbestosis (inhalation and retention of asbestos fibres)

Byssinosis (inhalation and retention of textile fibre dust - less common in the U.K.)

46
Q

Was is spontaneous pneumothorax?

A

More common in young men

Caused by a leakage of air from a small spontaneous rupture in the lung surface creating a build up of air in the pleural cavity

47
Q

What is open pneumothorax AKA sucking wound?

A

Air is sucked into a lung and pleural cavity through an open chest wound during inspiration

Some of the air may bubble out of the wound when the patient exhales

48
Q

What are the general signs and symptoms of pneumothorax?

A

Dyspnoea

Panic

Cyanosis

Haemoptysis

Pain at site

Tachycardia

Tachypnoea

Possible asymmetry of chest wall

49
Q

What is tension pneumothorax?

A

Air enters the pleural cavity through an open chest wound but cannot escape due to a flap of tissue acting as a one way valve

Every time the patient exhales, the intrathoracic pressure increases

This is very serious and can be fatal

50
Q

What are some signs and symptoms of tension pneumothorax?

A

Extreme respiratory distress

Severe pain

Increasing cyanosis

Asymmetry of the chest wall

Diminished breath sounds (on affected side)

Hyperresonance (on affected side)

Possible evidence of subcutaneous emphysema (gas or air under layer of skin)

Tracheal deviation (late sign) - unequal intrathoracic pressure within chest cavity

51
Q

What is surgical emphysema?

A

Air is subcutaneous tissues

Swelling of affected area

Crepitus over site (grating sound)

Most commonly affects neck and thorax

52
Q

What is haemothorax?

A

Damage to the lungs and surrounding tissues causes bleeding into pleural cavity

53
Q

What is haemothorax?

A

Accumulation of blood within the pleural cavity

54
Q

How do you manage chest injuries?

A

Ensure open airway

100% O2

Consider assisting ventilations

Seal any wounds with a occlusive, three sided dressing (open at the lowest edge to allow for drainage)

55
Q

What are some signs and symptoms of haemothorax?

A

Chest pain

Difficulty breathing

Reduced breath sounds on affected side

Rapid heart rate

Anatomy and Physiology (26 decks)

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