Respiratory review Flashcards
Age of developent of all four sinuses
Maxillary and Ethmoid: at birth
Sphenoid: within first two years
Frontal: around 6-8 years
Automatic signals that increase respiration
stretch/irritant receptors (dec)
Muscle/joint receptors
Increased CO2/H+ to carotid/aortic or central chemoreceptors
Decreased O2 to carotid/aortic chemoreceptors
How does exercise change breathing?
increases minute ventilation by increasing both tidal volume and respiratory rates
Change in lung volumes in COPD
TLC: inc FRC: inc RV: greatly increased FVC: dec FEV1: dec
Change in compliance and elastric recoil in obstructive lung disease
Compliance: inc (floppy lung)
Elastic: dec (lose elastic fibers)
Change in compliance and elastic recoil in restrictive disease
Compliance: dec (can’t inhale)
Elastic recoil: increased (stiff lungs exhale quickly)
Physiologic factor that stimulate binding to hemoglobin?
cold, high ph, low pCO2
In what population do you see high 2,3 BPG levels (and there fore greater oxygen binding)
people living at high altitudes
What do bronchial breath sounds tell us
fluid or solid in airspace
What does eegophany tell us?
solid: tumor, atelectasis, consolidation pneumonia
Inspiratory wheeze in toddlers
Croup (laryngotracheitis)
Caused by parainfluenza virus
Acute onset of fever or pain
Middle ear effusion
Inflammation
OM
Newborn
heart sounds on right
unilateral lung sounds
Cyanosis after eating
Diaphragmatic hernia
Upper airway obstrucion and noisy breathing
Cyanosis with feeds which improves with crying
Choanal atresia
tachypnea retractions cyanosis in premie newborn Pneumothorax and air leaks
Neonatal respiratory stress syndrome
Causes of recurrent sinopulmonary infections
CF Kartagener's SCID (T and Bs) CVID X-inked agammaglobulinemia
Three bugs that most commonly cause CF infections
Staph aureus
Pseudomonas aeruginosa
Burkholderia cepacia
Kartagener’s syndrome
primary ciliary dyskinesia
situs inversis
Dyspnea on exertion progressing to rest
chronic cough
prolonged expiratory phase
COPD
Hyponatremia
Fatigueable limb weakness (Lambert Eaton)
Facial edema, dyspnea, distended neck veins (SVC syndrome)
Small cell lung carcinoma
Hypercalcemia
Horner syndrome and shoulder pain (Pancoast syndrome)
Pancoast syndrome
Causes of transudative pleural effusion
heart failue constrictive pericarditis hypoalbuminemia nephrotic syndrome cirrhosis malnutrition
Causes of exudative pleural effusion
infection neoplasm collagen vascular disease pulmonary infarction hemothorax
Erythematous nodular rash on shins
bilateral hilar adenopathy
arthritis in ankle
Sarcoidosis
Difference in cause between hypoxemic respiratory failure and hypoxemic + hypercarbic respiratory fialure
Hypoxemic: VQ mismatch or diffusion defect
Hypercarbic + hypoxemic: neuromuscular
Causes of acute respiratory acidosis
CNS depression:
sedatives, ischemia, trauma, infection, brain tumor
Causes of chronic respiratory acidosis
Neuromuscular: myasthenia gravis, MS, ALS
Respiratory :COPD, interstitial lung disease, pulmonary edema
Causes of acute respiratory Alkalosis
Anxiety, pain
stroke
Drugs (salicyclates, progesterone, cathecholamines)
Causes of chronic respiratory alkalosis
hyperthyroidism
hypoxia
pregnancy
cirrhosis
Most common cause of ARDS
sepsis
Bilateral pulmonary infiltrates without left atrial hypertension
ARDS
Multiple household members with: headache/lightheadedness N/V chest pain cherry red appearance to skin
Carbon monoxide poisionig
Causes of Bronchiolitis obliterans organizing penumonia
post-infectious
drugs (bleomycin, amiodarone, methotrexate)
Connective tissue disorder
