Respiratory Disorders Flashcards
Obstructive disorders
COPD Emphysema Asthma Bronchiectasis Cystic Fibrosis
COPD
Used to descrive chronic lung diseases that are characterized by progressive obstruction of airflow into and out of the lungs & increases SOB
Combination of what two diseases for COPD are most notably known as?
Chronic bronchities & emphysema
Chronic bronchities
Airway narrowing, exciessive mucus secreation and productive cough for 3 months or more at a time over 2 consecutive years.
Tendency to become Blue Bloaters?
- Primary cause is Chronic Bronchities, capillary beds are undamaged, but increased mucus production causes obstruction of airways/ body responds with decreased ventilation and increased cardiac output due to poor ventilation.
- hypoxemia results with increased carbon dioxide retention the obstruction causes increased residual lung volume ( “Bloating” part) hypoxemia manifests as bluish lips and faces ( “Blue” part ) who abandon the fight for normal blood gases; are less breathless; but experience inadequate gas exchange, edema, and mortality Rate 2X as high as the pink puffers.
Pink Puffers
Primary cause is emphysema
- Causes destruction of airways distal to terminal bronchiole and capillary beds, thus decreasing ability to oxygenate blood; the body compensates by hyperventilation ( “puffer” part) due to low cardiac output muscles wasting and weight loss occurs
- They have less hypoxemia than blue bloaters and appear to have a pink complexion
Chronic bronchities is thought to be related to?
-Long term irritation of tracheobronchial tree; most commonly smoking; others: air pollution, occupational exposure infection
Signs and Symptoms of Chronic bronchitis
Patient is stocky; color is dusky; breathes with moderate to marked use of accessory mm; may wheeze; may have intercostal retractions ( mm b/w ribs pull inward ); dependent edema ( edema in lower or dependent part of the body); neck vein dissension; high BP that swells vein walls
Emphysema
Primarily a disease of the alveoli which become hyper inflated
- Tendency to become pink puffers who maintain near normal blood gasses at the expense of breathlessness and wt. loss
- pt is dyspneic (difficulty breathing) thin has increased A/P chest diameter, uses accessory mm, leans forward with forearms on keens (target sign: discoloration above knees); uses pursed lips in expiration; some hereditary factor possible; commonly with chronic bronchitis
- Rare among non- smokers
- males > females
Asthma
INcreased reactivity of the tracheobronchial tree in the presence of various stimuli manifested in episodic attacks of wheezing and dyspnea.
Extrinsic Stimuli with asthma
Pollen, animals, feathers, molds, household dust, food: contact with substance to which sensitized
Intrinsic Stimuli with asthma
Inhaled irritants, weather ( high humidity, cold air ); respiratory infections, drugs, emotions, exercise- usually first attack after age 35 and has evidence of chronic airway obstruction with episodes of acute bronchospasm ( abnormal contraction of smooth mm causing acute obstruction of airway )
Lumen ( Asthma )
INside space of tubular structure of airways is narrowed or occluded by bronchial spasm, inflammation, vicious tenacious mucous.
Tachypnea ( Asthma)
Rapid breathing
Uses accessory mm, prolonged expiratory phase, audible wheezing and ronchi ( coarse rattling sounds like snoring); frequent unproductive cough, c/o chest tightness, x-ray may show hyperinflation
Clinical picture of asthma
- prolonged forced expirations.
- Intermittent episodes of wheezing.
- X-ray reveal hyperinflated lungs, flattened diaphragm, enlarged R ventricle due to increased pulmonary artery pressure.
- Important for pt to breathe at slow rate.
