Respiratory Distress

Question 1

Gives some causes of instant dyspnoea

Answer 1

PE, pneumothorax

Question 2

Give some acute causes of dyspnoea

Answer 2

Asthma, PE, pneumothorax

Question 3

Give some gradual causes of dyspnoea

Answer 3

Lobar collapse, pleural effusion

Question 4

What are some chronic causes of dyspnoea

Answer 4

COPD, fibrosis, bronchiectasis

Question 5

Describe the cough reflex

Answer 5

Irritation of epithelia
Afferent - CN IX and X
Cough centre in medulla
Efferent - Vagus, phrenic, spinal motor

Question 6

What is a bovine cough

Answer 6

Where damage to the vagus nerve causes permanent abduction of the vocal cords so intrathroacic pressure can’t build up to cough normally

Question 7

What are the differences between cardiac pain and pericarditis pain

Answer 7

Cardiac - dull, poorly localised, radiates the jaw and left arm
Pericarditis - sharp, localised

Question 8

what is a wheeze

Answer 8

noisy musical sound produced by turbulent airflow

Question 9

when is a wheeze worse

Answer 9

on expiration as the intrapulmonary pressure is higher than atmospheric pressure so narrows the intrathoracic airways more

Question 10

when is a nocturnal wheeze heard

Answer 10

in asthma and COPD as the parasympathetics at night cause airway constriction

Question 11

what is a stridor

Answer 11

inspiratory wheeze

Question 12

what causes a stridor

Answer 12

obstruction in the extra thoracic airways e/g/ epiglottitis, croup or aspirated foreign bodies

Question 13

what is central cyanosis

Answer 13

blue lips/tongue due to 50g/L deoxygenated haemoglobin

Question 14

give an example of an inspiratory accessory muscle

Answer 14

SCM

Question 15

give an example of an expiatory accessory muscle

Answer 15

internal intercostal muscles

Question 16

what muscle can fix the shoulder girdle to help expiration

Answer 16

latissimus dorsi

Question 17

hw does pursed lip breathing help

Answer 17

helps to keep intra-alveolar pressure high to prevent them fully deflating making it easier to breath in

Question 18

what are bronchial breath sounds

Answer 18

sounds heard as air travels through large airways

Question 19

why can bronchial breath sounds be heard with consolidation

Answer 19

the consolidation conducts the sounds better than air in the lungs normally would

Question 20

what is a tension pneumothorax

Answer 20

when their is air in the pleural cavity, causing a high pressure as it cannot leave - this increases pressure on other structures in the chest

Question 21

why is a pleural effusion more likely to occur than ascites

Answer 21

there is a lower pressure in the pleural cavity which sucks the liquid in

Question 22

when do you get a transudate pleural effusion

Answer 22

increased hydrostatic pressure in the pulmonary vessel s

hypoproteinaemia

Question 23

when do you get an exudate pleural effusion

Answer 23

infection, cancer, infarct