Respiratory diseases Flashcards
Dyspnoea
difficult or laboured breathing DIB or SIB
Orthopnoea
difficulty breathing when laid flat
Apnoea
cessation / lack of breathing
Tachypnoea
RAPID respiration
Hypoxemia
Low O2 in the blood
Hypoxia
LOW O2 in the tissue
cyanosis
bluish discolouration LOW O2
Hypercapnia
High CO2 in the tissue
What does COPD stand for
Chronic obstructive pulmonary diseases
What is COPD
progressive, irreversible lung damage that reduces air flow and ability to breath.
UMBRELLA term - for two main respiratory chronic disease
-chronic bronchitis
-emphysema
What causes COPD
by chronic smoking but sometimes industrial activity (eg: work in a hazardous environment without proper PPE or heavy pollution
Name symptoms of COPD
Constantly low oxygen saturations (SpO2 less than 95%)
Constant dyspnoea and/or wheezing.
Persistent mucus build-up in the lungs and a continuous productive cough
More frequent chest infections due to tissue damage.
COPD Pathophysiology
Alveoli lose elasticity and shape - making it harder to EXHALE
Air trapped in the lungs
Bronchial tubes become inflamed and narrowed
Thick mucus builds causing a chronic cough
Explain what happens in the bronchioles for COPD
Bronchitis is inflammation of the airway. Specifically, of the lining of the bronchial tree
Define Chronic Bronichitis
Chronic bronchitis → thickening and scarring of the bronchial lining → airway becomes narrower and stiffer.
Also → Hypertrophy and hyperplasia of mucus-producing structures (seromucous glands and goblet cells)
This fills the airways with mucus.
What defines the term chronic bronchitis
diagnosis confirmed if the patient has a daily cough that produces purulent sputum for 3 months or more in at least 2 consecutive years.
Emphysema
damage to the alveoli wall.
Disintegration of the alveolar walls → alveolar sacks contain fewer individual alveoli → abnormally low surface area available for gas exchange.
Loss of elasticity of the alveoli walls → reduces their ability to “elastically recoil” during exhalation → exhalation more difficult.
Emphysema therefore makes breathing more difficult, and reduces how much O2 is obtained and how much CO2 is released from each breath.
COPD Pathophysiology
airways that are narrower, constantly inflamed, in-elastic and full of mucus.
Alveolar sacs that are distended, with fewer individual alveoli: greatly reduced surface area for gas exchange.
…result in the symptoms of COPD, as well as poor ventilation (low values in FEV1 and PEFR tests) and therefore hypoxia, resulting in low SpO2.
Treatment / management for COPD
keep SpO2 in known COPD patients between 88% and 92% to avoid hypercapnia
to support and open airways Salbutamol may be used
Bronchiectasis
An uncommon disease, usually secondary to an infection.
abnormal, permanent dilation of one or more proximal and medium bronchi
what does bronchiectasis cause within the bronchi
weakening of bronchial walls via destruction of their muscular and elastic components.
Bronchial wall inflammation, ulceration and/or scarring.
Oedema
this makes the lungs more likely to get infected
Asthma
Chronic inflammatory condition.
bronchial spasm, inflammation and increased mucus production → wheezing & difficult breathing (lower FEV1 and PEFR).
acute periods called asthma attacks.
Explain what happens to the bronchioles during an asthma attack
the bronchioles are lined with smooth muscle.
This spasms and constricts as well as increasing mucus this results in wheezing difficulty breathing or no ability to breath.
inflammation intensifies, obstructing the airway significantly/almost totally
acute bronchoconstriction
airway oedema
mucous plug formation
airway remodelling – increasing stiffness
These obstructions increase resistance to airflow → decrease ability to expel air → hyperinflation of the lungs → breathing difficulty → less O2.
how can asthma be managed
nebulizers (inhalers) containing a bronchodilator (eg: adrenaline receptor agonists, salbutamol)
Cystic Fibrosis CF
A genetic condition in which the body excessively produces large amounts of mucus, particularly in the respiratory tract and intestines.
Symptoms of or following CF Cystic Fibrosis
recurring chest infection.
wheezing/ SOB/ coughing/ damage to airway e.g bronchiectasis
difficulty putting on weight/growing
Jaundice skin and eyes
diarrhoea/constipation/bowel obstruction
patients with CF can also develop related conditions e.g liver problems/infertility/diabetes/thin/weaking of bones
Pneumonia
caused by infection of the lungs.
The alveoli fill with fluid
pneumonia main symptom
VERY productive cough
Risk factors of Pneumonia
Streptococcus
secondary infection
after influenza or parainfluenza
Hospitalised “ill” patients
Cigarette smoking
Excess Alcohol
Bronchiectasis
Bronchial obstruction eg: carcinoma ‘cancer’
Immunosuppression
IV Drug users
Inhalation from oesophageal obstruction
All signs and symptoms of pneumonia
Hyper/hypothermia
rapid breathing
USE of accessory muscles
Tachycardia
central cyanosis
altered mental state
ODD breath sounds crackling/rhonchi/wheeze
decrease intensity breath sounds
dull percussion
lymphadenopathy
pleural friction rub (may be able to hear this)
Viral Pneumonia
Viruses infect the respiratory tract causing inflammation and damage to the endothelial lining (making bacterial infection more likely)
This is called SARS
severe acute respiratory syndrome
example - disease caused by SARS - COVID 19
what is SARS
Severe Acute Respiratory Syndrome
name another VIRAL lung infection
common cold - cause by caused by Rhinovirus infection.
Influenza or “flu” caused by Influenza virus infection
Common cold symptoms
nasal discharge and congestion, sneezing and pharyngeal irritation) are caused by local inflammatory response to viral infection in the respiratory tract.
Influenza symptoms
nasal discharge and congestion, sneezing and pharyngeal irritation) are caused by local inflammatory response to viral infection in the respiratory tract.
acts by infecting the respiratory tract, but can lead to systemic infection and symptoms
What is TB
caused by infection of Mycobacterium Tuberculosis, an Intracellular bacteria that can infect the lungs or spread to other tissues, or stay hidden and dormant for decades.
What are the signs and symptoms of TB
Cough
Weight loss/anorexia
Fever
Night sweats
Hemoptysis
Chest pain (can also result from tuberculousacute pericarditis)
Fatigue
What is Pleuritic chest pain ?
Pain associated with the pleurae. e.g. the sack that supports and protects the lungs.
The presence of pain receptors in the parietal pleurae means this inflammation generates pleuritic chest pain: a sharpchest paincaused by forceful or deep breathing, coughing and sneezing.
How do patients react when showing symptoms of Pleuritic chest pain ?
perceived dyspnoea due to consciously or subconsciously suppressing breathing to avoid pain.
sharp chest pain - by forceful/deep breathing/coughing or sneezing
Pneumothorax
abnormal build up of AIR within the pleural space. the pressure build creates difficulty breathing.
what section of the body does pneumothorax affect
Pleura - membranous sac surround the lungs. with small space in-between for pleural fluid
consists of two layers
- visceral pleura
-parietal pleura
What causes a pneumothorax
mainly trauma - blunt/ penetrating
underlying lung disease ‘COPD/CF/cancer/infection.
OR without cause:
SPONTANOUEOUS pneumothorax
Describe what tension pneumothorax is
Damage to the pleural tissue acting as a one way valve.
pressure builds within the pleural sac through inhalation but CANNOT escape on expiration.
Exceeding atmospheric pressure causes the affected lung to collapses resulting in respiratory failure/obstructive shock .
how is a tension pneumothorax treated
‘popping the chest ‘needle thoracocentesis
supporting the patients airway through ALS management
symptoms of tension pneumothorax
tachypnoea/ uneven breath sounds/chest pain/shock symptoms
pulmonary hypertension
Manifests as oedema in the lungs and pleura effusion
High BP in the pulmonary vessels, caused as a side effect of various other pathologies including Chronic lung disease or Pulmonary Embolism.
pulmonary venous hypertension is often due to Left-sided heart failure, a disease with the bicuspid/mitral valve or ventricular hypertrophy.
IF Chronic Pulmonary hypertension : what do patients develop
develop thickening of the alveoli walls (fibrosis) which hinders gas exchange and therefore breathing.
Define respiratory failure.
insufficient O2 from the air passing through the respiratory membrane in the lungs into the blood
What are the TWO types of respiratory failure
Type 1 RF: resp. system does not provide adequate O2 to the body > hypoxemia.
Type 2 RF: resp. system doesn’t remove CO2 from the body sufficiently > hypercapnia.
What is the purpose of the Medulla
Assists in supporting the respiratory system sending signals (neurons from the brain) for the system to function on a subconscious level and support humans in living
