Respiratory disorders

Question 1

• Passage of fluid or food, vomitus, drugs, other foreign material into trachea and lungs
• Which lung is more common?
• Cough usually will remove material if in upper tract
• Vocal cords and epiglottis normally prevent entry into lower tract

Answer 1

Aspiration

Question 2

Effect on respiratory function depends on characteristic of the item aspirated
Solid objects, acidic secretions, etoh, lipids
Obstruction is common: either directly (object) or indirectly (inflammation)
Inflammation can inhibit gas exchange: increases risk of pneumonia

Answer 2

pathophysiology of aspiration

Question 3

carrot or coin: may obstruct airflow and cause inflammation and swelling
Piece of steak (large object): occlude trachea, block airflow, can lose consciousness quickly
Hot dog: lodge in bronchus: collapse of area distal
Can have ball-valve effect: air in on inspiration, closes on expiration, air builds up
Pea or bean: may swell
Fatty or irritating solids: cause inflammation to area, may develop granuloma or fibrous tissue

Answer 3

Effects of aspirated solid

Question 4

Acidic, etoh or oils: disperse into several bronchi and cause inflammation
Narrow airways and increase secretions
Can cause impairment of gas diffusion
Other complications
Respiratory distress syndrome
Pulmonary abscess
Solvents can be absorbed

Answer 4

Aspirated liquid

Question 5

Young children
Put objects in mouth
Smooth round objects most dangerous
Hot dogs, candy, carrots, coins, balloons, toxic fluids
Depressed swallowing or gag reflex
Post anesthesia, stroke
Adults 
Eating and talking
Alcohol intake

Answer 5

Etiology of aspiration

Question 6

Cough, choke with marked dyspnea
Stridor or hoarseness
Wheezing
Tachycardia, tachypnea
Nasals flaring, chest retraction
May reach for chest or neck

Answer 6

Signs and symptoms of aspiration

Question 7

Prevent
Cough it up
Can use finger probe
Heimlich maneuver
Back blows
Instrumentation may be needed
Oxygen, supportive therapy, prophylactic antibiotics

Answer 7

Treatment for aspiration

Question 8

Usually secondary
Usually occurs with CF or COPD
Childhood infections: aspiration

Answer 8

Bronchiectasis

Question 9

Irreversible abnormal dilation or widening of of the medium-sized bronchi
Usually from recurrent inflammation and infections
Obstruction in airways or weakening of muscle and elastic fibers
Can be localized in one lobe or more diffuse
Fluid can collect and gets infected
Obstructionloss of ciliadifficult to remove fluid

Answer 9

Pathophysiology of Bronchiectasis

Question 10

Chronic cough
Copious amounts of purulent sputum
Paroxysmal cough in morning
Rhales and rhonchi can be heard
Foul breath, dyspnea, hemoptysis
Weight loss, anemia, fatigue

Answer 10

Signs and symptoms of Bronchiectasis

Question 11

Antibioitics
Bronchodilators
Chest PT
Treat the primary condition

Answer 11

treatment of Bronchiectasis

Question 12

Lung expansion is impaired
Reduced lung capacity
Some diseases demonstrated obstructive and restrictive signs

Answer 12

Restrictive lung disorders

Question 13

Abnormality of chest wall

Answer 13

Restrictive Lung Disorders

Question 14

Chronic long term exposure to irritating substances
Coal dust, silica, asbestos, fungal spores
Overload of small particles, difficult for cilia, mucus and nasal hairs to handle
Exposure over long time period, large number of particles, particles are very small
Aggravated by smoking

Answer 14

Pneumonconioses

Question 15

Inflammation occurs
Develop fibrous tissue
Destroy connective tissue
May have immune response (silica)
Lose functional areas of lung
Inspiration is difficult
Tissue changes are irriversible

Answer 15

Pathophysiology of Pneumonconioses

Question 16

Can cause pleural fibrosis

Increases risk of lung cancer (cigarette smokers)

Answer 16

Asbestos

Question 17

Insidious onset
Develop dyspnea
Difficulty with inspiration
Cough is common…productive?

Answer 17

Signs and symptoms of Asbestos

Question 18

Stop the exposure

Treat infections

Answer 18

Treatment of Asbestos

Question 19

Pulmonary edema
Fluid collects in alveoli and intersitial area
Fluid decreases amount of oxygen diffusing into blood
Difficulty with lung expansion
Occurs when:
Inflammation is present
Plama protein levels are low (decrease plasma osmotic pressure)
Pulmonary hypertension

Answer 19

Vascular disorders

Question 20

Left sided congestive heart failure
Hypoprotienemia (liver, kidney disease)
Inflammation in lungs (tumors, toxic gasses)
Blocked lymphatic drainage (tumors, fibrosis)

Answer 20

Etiology of vascular disorders

Question 21

Mild pulmonary edema

More severe edema

Answer 21

Signs and symptoms of vascular disorder

Question 22

Cough
Orthopnea
Rales

Answer 22

Mild pulmonary edema

Question 23

Hemoptysis
Frothy sputum
Labored breathing
Feels as if drowning
Hypoxemia
cyanosis

Answer 23

More severe edema

Question 24

Treat the cause
Supportive care
Positive pressure mechanical ventilation
More at risk for pneumonia

Answer 24

Treatment for edema

Question 25

Blood clot or mass that obstruct pulmonary artery or branch of it
Blocks flow of blood through the lung tissue
Usually caused by blood clots in leg veins
Lodges in lung as gets to smaller arteries
Leading cause of death in hospitals
600,000 people a year have PE, 60,000 die

Answer 25

Pulmonary Embolus