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Patho key terms 1-3 > Respiratory Exam > Flashcards

Respiratory Exam Flashcards

1
Q

Central Chemoreceptors

A

located in the medulla sense changes in the in CO2 and blood PH
-causes change in respiration and depth rate

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2
Q

What does PFT test for?

A

-maximal voluntary ventilation
-Forced vital capacity (FVC)
-Forced expiratory volume achieved in 1 second ( FEV )
-percentage of FVC

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3
Q

Maximal Voluntary ventilation (MVV)

A

Maximum amount of air that can be breathed in a given time

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4
Q

Forced vital capacity

A

maximum amount of air that can be rapidly and forcefully exhaled from the lungs after full inspiration. The expired volume is plotted against time.

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5
Q

Forced expiratory volume achieved in 1 second

A

volume of air expired in the first second FVC

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6
Q

Percentage of FVC

A

(fev/FVC%)
-Volume of air expired in the first second, expressed as a percentage

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7
Q

Ventilation

A

inspiration and expiration of air

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8
Q

perfusion

A

movement of blood

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9
Q

Ventricular-perfusion rate

A

defined as the ratio of the amount of air reaching the alveoli to the amount of blood reaching the alveoli

Measured with a ventilation and perfusion scan.

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10
Q

CM of respiratory issues

A

-Dyspnea
-SOB
-Irregular rhythm
- tachypnea, bradypnea, cheyene stokes
-orthopnea
-abdominal breathing
-pursed lip breathing
-crackles
-cyanosis
-use of accessory muscles
-clubbing

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11
Q

diagnostics

A

-pulse oximetry
-chest x-ray
sputum cultures
pulmonary fx
bronchoscopy
VQ span

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12
Q

Hypoxemia mild

A

feeling some shortness of breath
-Increas in SNS response (increase HR,BP,RR
-SLIGHT mental impairment

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13
Q

Hypoxemia severe

A

-confusion
-personality change
-uncoordinated muscle movement
-delirium
-stupor-coma

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14
Q

hypoxemia chronic

A

insidious attributed to other causes
-increased ventilation
-pulmonary vasoconstriction
-increase RBC production

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15
Q

Chronic hypercapnia

A

?????

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16
Q

atelectasis

A

-incomplete expansion of lungs or portion of the lungs–> reduced gas exchange (alveoli largely affected)
-ETI- mucus plug, tumor mass, exudate, post abdominal surgery, pain, imobility

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17
Q

Atelectasis CM

A

tachypnea, dyspnea, cyanosis, diminshed chest expansion
-Diagnostic: X-ray or CT scan

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18
Q

Aspiration

A

-particles or fluid from from oropharynx enters the lower respiratory tract

-ETI: trouble clearing lungs due to diminished gag or cough or decrease level of consciences

-Patho: failure to remove excess particles from the cilia so that it can be swallowed
- neurological decreased control
- decreased saliva productive.

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19
Q

Aspiration occurs most likely where

A

right lower lobe and right middle lobe

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20
Q

Upper respiratory diseases

A

rhinitis
pharyngitis
sinusitis
tonsilitis
common cold
influenza
covid

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21
Q

lower respiratory disease

A

acute
bronchitis
pneumonia
TB
COVID

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22
Q

obstructive respiratory disease

A

Asthma
COPD
Emphysema
chronic bronchitis
bronchiectasis
Obstructive sleep apnea

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23
Q

restrictive respiratory disease

A

pleural disease
pneumothorax
hemothorax
pleural effusion

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24
Q

Vascular respiratory disease

A

pulmonary edema
pulmonary
embolism
pulmonary htn
co pulmonale

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25
Q

Acute Rhinitis

A

Inflammation in the mucous membranes of the nose, generally viral, can be related to allergies

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26
Q

Acute pharyngitis

A

usually a virus but can be caused by bacterial such as streptococcus or group A strep.

-If caused by bacteria worry about rheumatic heart disease as a complication.

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27
Q

Acute sinusitis

A

inflammation of sinuses can be acute to chronic caused by virus bacteria.

Symptoms are HA, facial pain, pressure over sinuses, fever, bending forward increases HA

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28
Q

tonsilitis

A

infection either viral or bacterial, sore throat and difficulty swallowing.

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29
Q

COVID

A

can cause upper and lower inflammatory respiratory related issue.

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30
Q

Influenza ETI, EPI, CM

A

ETI: viruses either A,B , C transmission via droplet and aerosols generated by coughs and sneeze. hand to hand contact

EPI: outbreaks happen annually , young, old, and immunocompromised

CM: fever, HA, cough, sore throat, myalgias,

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31
Q

Influenza Patho

A

-starts as an upper travels to lower respiratory

-Virus will break down the hosts protective barriers in both and and lower respiratory tract.

-which puts the host at risk for pneumonia or other bacterial infection

32
Q

Acute Bronchitis

A

Patho: inflammation and mucus in the bronchi and bronchioles due to an infection w/out evidence of pneumonia and or COPD

ETI: viral most common
common pathogens: influenza A and B, parainfluenza

33
Q

Acute bronchitis CM

A

CM: Start similar to upper respiratory infection
(common cold) but then with persistent cough (10-20 days), and potential
wheezing, mild shortness of breath, musculoskeletal pain

SPUTUM is NOT indicative of bacterial vs viral infection

34
Q

What classifications are there of Pneumonia (PNA)

A

2 types: hospital or community acquired. Another classification is typical vs a typical.

35
Q

What does PNA typical mean

A

infection of bacteria in alveoli
epi: older adults
CM: cough fever leukocytes

36
Q

what does PNA atypical mean

A

viral and mycoplasma infection involve alveolar septum and interstitium lung

patho: patchy lung environment

CM: Minimal, fever, HA, dry hacking , no leukocytosis

EPI: common in children and younger adults

37
Q

What is Pneumonia?

A

Eti: infection by bacteria or virus

CM: TYPICAL (the type) has cough, fever, lekocytosis. ATYPICAL (THE TYPE) less striking sx, and physical findings no leukocytosis, no purulent sputum lack of labor consolidation on chest X-RAY.

patho: inflammation of lung tissue in the alveolar space which fills with purulent drainage

38
Q

flow of PNA

A

Inhale droplets, droplets enter upper airway and go to lung tissue, gets to lower respiratory alveoli, mucus and exudate and edema hinder gas exchange.

PNA either in part of 1 lobe or unilateral

39
Q

What is community- acquired pneumonia (CAP)

A

Etiology: bacteria or viral. most
common is Streptococcus
Pneumoniae, Haemophilus influenzae

Epi: children and older adults more susceptible under normal conditions

Prognosis: use of vaccine every 5-10 years

40
Q

What is hospital acquired pneumonia

A

Eti: Infection 48hours after admission or while in the hospital

Epi: Immuncompromised, chronic lung disease, intubation, predisposing condition

prognosis: 20%-50%

41
Q

Tuberculosis (TB)

A

Eti: bacteria. airborne transmission vs droplet

Patho: a person can develop latent TB or inactive TB so they cannot spread it because the body has contained it. Active TB where they have clinical presentation

Diagnosis: tuberculin skin test to measure a delayed hypersensitivity. Positive TB test means you have been exposed.

42
Q

What type of TB can be spread?

A

Active TB

CM: Weight loss and night sweats and coughing

43
Q

What are some obstructive respiratory disease?

A

asthma, COPD, emphysema, chronic bronchitis, bronchiectasis, obstructive sleep apnea, cystic fibrosis.

44
Q

What does obstructive respiratory disease mean?

A

This is when air has trouble flowing out of the lugs due to airway resistance. this causes a decreased air flow

45
Q

what are some restrictive respiratory diseases?

A

pneumothorax
hemothorax
pleural effusion

46
Q

what is asthma

A

chronic disorder of airway obstruction, bronchial hyper-responsivness, air way inflammation, and in some airway

Eti: cigarette smoke, pollutants, dust, upper respiratory issues can make asthma worse.

Epi: genetic predisposition to developing IgE mediated
response to common allergies

47
Q

Asthma CM

A

wheezing, cough, dyspnea, chest tightness can be worst at night, SOB, CAN GET mucus plugs, use of accessory muscles, distant breath sounds.

48
Q

What two diseases is COPD usually defined as?

A

Chronic Bronchitis
Emphysema
Highly heterogenous

49
Q

Chronic Bronchitish

A

Cough for 3 consecutive months out of the year for 2 consecutive years .

CM: hypersecretion of mucus, hypoxia, and cyanosis. Excess mucus creates obstruction

50
Q

Emphysema

A

OVER DISTENTION of alveoli with trapped air, creating an obstruction to expiratory airflow, loss of elastic recoil of alveoli high residual volume of CO2 in lung

51
Q

COPD

A

Epi: results from gene(G)_environment (e) interactions occuring over a lifetime(t) of the individual that can damage the lungs and/or alter their normal development/age process

Smoking remains the greatest risk factor but toxic air pollutants from household and outside playa role as well.

52
Q

How do we test for COPD

A

FEV1/FVC if below 0.07 after give bronchodilator then confirms COPD

FEV1: IS THE AMOUNT OF AIR EXPELLED OUT IN ONE SECOND
FVC: is total

53
Q

COPD CM

A

Insidious onset
exercise intolerance
cough
SOB
barrled CHEST
crackles tripod position
emphysema

54
Q

obstructive sleep apnea

A

also called hypoventilation syndrome. intermitten cessation of airflow from the nose and mouth during sleep is characterized by recurrent episodes of sleep apnea for
seconds to minutes and occurring frequently during the night

ETI: nasal blockage, presence and distribution of body fat

CM: loud snoring, choking or gasping during sleep during sleep. Alcohol and sedative meds make it worse. Can lead to pulmonary HTN, can cause right sided heart failure, polycythemia

55
Q

Cystic fibrosis

A

eti: genetic disorder autosome recessive

Patho: due to impaired chloride transport of the CFTR gene mutation. Which increases reabsorption of sodium and water from airway to blood causing mucociliary tract to become viscid and sticky.

Occurs too pancreatic and biliary ducts as well.

56
Q

lUNGs layers

A

Pleura
outer parietal. layer
inner visceral
pleural space

57
Q

pleura

A

thin layered serous membrane that encases the lung

58
Q

outer parietal layer

A

lines the thoracic wall and superior aspect of the diaphragm

59
Q

inner visceral

A

layer covers the lung

60
Q

pleural space

A

is a cavity between
two layers contains serous fluid that
lubricates the plural surfaces

61
Q

Disorders of the pleura

A

Pleura effusion
-hemothorax
-empyema

pneumothorax

62
Q

Pleura effusion

A

abnormal collection of fluid in the pleural cavity.
The fluid may be an exudate or transudate, purulent, lymph, or sanguineous.

ETI. HF severe pulmonary infection

CM: dyspnea tachypnea,
sharp pleuritic chest pain, dullness to percussion, and diminished breath sounds on the affected side.

63
Q

what is emyema

A

infection of the pleural cavity results from exudate with glucose, protein, leukocytes.

Caused by adjacent bacterial pna, infection, trauma, ruptured lung abscess

64
Q

hemothorax

A

blood in the pleura; cavity

caused by chest injury after chest surgery
sx can be sudden and distressing for pt.

65
Q

pneumothorax

A

Patho: Known as a collapsed lung
presence of air in pleural cavity that causes a large section or whole lobe of lung

Air can enter the pleural cavity because of chest trauma or rupture of alveoli

66
Q

Pneumothorax

A

CM: asymmetry of the chest, intercostal muscle retractions, percussion may result of hyper-resonance, auscultation absent breath sounds, dyspnea chest pain

67
Q

Spontaneous pneumothorax

A

Air is present in the intrapleural
space without preceding
trauma and without
underlying clinical or
radiological evidence of lung
disease.

commonly seen in tall young men.

ruptured alveoli is theorized for cause

68
Q

traumatic pneumothorax

A

penetrating or non-penetrating wound injury.
-the punctured thoracic cage and pleural membrane create an opening between the pleural cavity and outside environment.
- the open wound allows the pleural cavity to act as a vacuum and pull air into the pleural space. collapsing a lung

69
Q

traumatic pneumothorax

A

Life-threatening
condition when
injury to chest
permits air to enter
but not leave the
pleural space

70
Q

pulmonary edema

A

excess fluid in lungs, high hydrostatic pressure within the pulmonary capillaries causes fluid from the blood to diffuse into interstitial spaces.

most common cause is left sided heart failure
other causes: high altitude

CM: severe respiratory distress, pinky frothy sputum , SOB, confusion stupor, coarse loud crackles, cyanotic

71
Q

pulmonary embolism

A

a clot that had traveled to the arterial pulmonary circulation and caused obstruction of arterial blood flow through the lungs.

-originated in the legs as a deep vein thrombus or in the right sided heart.
-thrombi often form around central venous catheters.

CM: dypnea, pleuritic chest pain, tachycardia, signs of chest pain

72
Q

pulmonary htn

A

Pulmonary pressure is elevated (mean pulmonary artery pressure ≥20 mmHg at rest with a
pulmonary vascular resistance ≥3 Wood units).

73
Q

cor pulmonae

A

Eti: pulmonary htn, COPD, *not all pts with COPD will develop cor pulmonae

patho: right sided HF due to narrowed or blocked pulmonary arteries, right sided hypertrophy of heart.
CM: venous congestion, peripheral edema, sob, jvd edema in legs, cyanosis

74
Q
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Patho key terms 1-3 (8 decks)

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