respiratory disorder

Question 1

what is dyspnea?

Answer 1

subjective sensation of uncomfortable breathing

Question 2

what are the four different types of dyspnea and what do they mean?

Answer 2

• severe dyspnea = flaring of nostrils, use of accessory muscles and retraction of intercostal spaces
• dyspnea on exertion = shortness of breath with activity
• orthopnea = shortness of breath when lying down
  Paroxysmal nocturnal dyspnea = waking at night and gasping for air (must sit up/ stand)

Question 3

what does paroxysmal mean?

Answer 3

sudden increase or reoccurrence of symptoms

Question 4

Define a cough?

Answer 4

• a protective reflex that helps clear the airways by an explosive expiration

Question 5

distinguish the difference between an acute and a chronic cough

Answer 5

acute = resolves within 2-3 weeks
chronic = lasts longer than 3 weeks

Question 6

why is it important to recognise abnormal sputum and what do you look for?

Answer 6

• can tell you about the progression of a disease or the effectiveness of the therapy
• look for changes in consistency, colour, amount and odour

Question 7

define hemoptysis

Answer 7

coughing up blood or bloody secretions

Question 8

define eupnea

Answer 8

normal breathing pattern

Question 9

what are abnormal breathing patterns

Answer 9

adjustments made by the body to minimise the work of respiratory muscles

Question 10

what are Kussmaul respirations

Answer 10

• slightly increase ventilatory rate, very large tidal volume and no expiration pause
• can have a fruity acetone on breath

Question 11

define laboured breathing

Answer 11

increased work of breathing

Question 12

describe a cheyne-stokes breathing pattern

Answer 12

• rapid breathing then stop (ventilations increase in volume until peak is reached and then apnea lasts between 15 to 60 seconds, process repeats)
• near death breathing pattern

Question 13

define bradypnea

Answer 13

slow breath rate

Question 14

define biots

Answer 14

an irregular breathing pattern

Question 15

define restrictive breathing

Answer 15

disorders that stiffen the lungs or chest walls to decrease compliance

Question 16

what is cyanosis and why does it develop?

Answer 16

• blueish purple discolouration of skin and mucous membranes

- develops when you have 5 grams of desaturated haemoglobin regardless of concentration

Question 17

distinguish the difference between peripheral and central cyanosis ( where they are best seen and primary cause)

Answer 17

• peripheral = normally due to poor ciculation and best seen in the nail beds
• central = normally due to decreased arterial oxygenation ( low spo2) and best observed in buccal membranes and lips

Question 18

define clubbing and what causes it?

Answer 18

• enlargement in tips of fingers and change in angle of nail bed
• associated with many lung diseases due to decrease oxygen in blood

Question 19

in relation to the V/Q ration what does the v and q mean and what is the normal ratio?

Answer 19

• V = ventilation (the amount of air reaching the aveoli)
• Q = Perfusion (amount of blood reaching the aveoli)
• normal perminute ration is 0.8 - 0.9

Question 20

what happens if there is a ventialtion - perfusion ration mismatch

Answer 20

• results in hypoxemia ( low levels of oxygen in the blood)

Question 21

what does a low V/Q mean and what happens

Answer 21

• imparied gas exchange and results in low PaO2

Question 22

what does a high V/Q mean and what happens

Answer 22

• occurs in pulmonary embolism (blood clot in lungs) and results in a low PaO2

Question 23

what are the three things pulmonary function tests do

Answer 23

• assess lung function
• determines fitness
• detects impairment

Question 24

define hypercapnia and why it might happen

Answer 24

• increase in CO2 in arterial blood

- occurs from decreased drive to breath or inadequate ability to respond to ventilatory stimulation

Question 25

define hypoxemia

Answer 25

low levels of O2 in blood

Question 26

define hypoxia

Answer 26

low leveles of O2 in tissues

Question 27

what is the most common cause of both hypoxia and hypoxemia

Answer 27

ventilation - perfusion ration abnormalities

Question 28

how would yu test for hypercapnia, hypoxia, hypoxemia

Answer 28

blood gases

Question 29

what do ventilatory function test look at and what is the common tool used

Answer 29

• they measure lung volumes and pressures

- spirometre

Question 30

what doe FEV1 mean?

Answer 30

• forced expiratory volume in one second

Question 31

what does FVC mean ?

Answer 31

• forced vital capacity

Question 32

what is considered the normal FEV1/FVC and what factors contribute to this

Answer 32

• normal value = 80%

- normal ranges are dependant on age, sex, height and ethnicity

Question 33

what can impact the ventilatory function tests and what can the abnormal values generated tell us

Answer 33

• obstructive and restrictive respiratory defects will impact values
• the values can indicate if defect is restrictive or obstructive

Question 34

what is a restrictive defect and what will the values on the ventilatory tests show and provide an example

Answer 34

- defects that decrease the compliance of the lungs or chest wall
Ventilatory test outcomes : 
FEV1 = slighlty reduced
FVC = decreased proportionally to FEV1
FEV1/FVC= normal (80%)
- asbestosis

Question 35

what is an obstructive defect and what will the values on th ventilatory test show and what is an example

Answer 35

• defects that block the exchange of air to and from lungs
  ventilatory test outcomes:
  FEV1 = greatly reduced
  FVC= normal or slightly decreased
  FEV1/FVC = below 80% (normal)
• copd - emphysema and chronic bronchitis