Respiratory System

Question 1

Key parts of resp system

Answer 1

Upper Resp Tract (Bronchus up)
- Dual Function

Lower Resp Tract

Question 2

Flu is what type of illness

Answer 2

Systemic, paired with Resp illness

Question 3

Age related changes that affect respiratory funciton

Answer 3

• Degenerative structural changes in the nose
• Diminished blood flow to nose
• Thicker mucus in nasopharynx
• Stiffening of trachea due to calcification of cartilage
  Blunted cough and laryngeal reflexes
• Atrophy of laryngeal nerve endings

Question 4

Chest wall and musculoskeletal age related changes oto resp function

Answer 4

Ribs and vertebrae become osteoporotic
- Intercostal cartilage calcifies and resp muscles weaken
Kyphosis
Chest wall expansion is compromised adn older adults need to expend more energy to achieve resp efficiency

Question 5

Age related changes to lungs

Answer 5

Become Smaller + more fatty
Alveoli enlage and walls thin = gradual increase in anatomic dead space
Pulmonary artery gets wider, thicker, and less elastic
# of caps decrease
Cap blood volume decrease
Mucosal bed, site of diffusion, thickens

Question 6

Gas exchange changes

Answer 6

Older adults shallow breathe more

Question 7

Hyper capnia

Answer 7

High CO2

Question 8

What stimulates breathing

Answer 8

Response to Hypercapnia and hypoxia

Question 9

What cell is changed that causes an increase in prevalence of lung disease in older adults

Answer 9

T cells change

Question 10

Summary of age related changes to resp

Answer 10

Increased stiffness of chest wall
Enlarged alveoli
Weaker respiratory muscles
Decreased response to hypercapnia or hypoxia

Question 11

Risk factors affecting older adults

Answer 11

Tobacco smoking
Environmental pollutants
Occupational exposure to resp toxins
Obesity or chronic illness that interferes with the ability to obtain adequate physical
Kyphosis
Medications

Question 12

Functional consequences to Older adults

Answer 12

Increased susceptibility to lower resp infections
- Pneumonia and influenza

Fraility and dysphagia

Poor Oral care

Aspiration Pneumonia

Question 13

TB

Answer 13

Eats away at the tissue in the lungs

Lung tissue bleeds up through resp tract

Opportunistic illness

Question 14

TB rates are highest

Answer 14

in Indigenous
persons, foreign-born, and certain ethnic
minorities
◦ Higher incidence of TB in Long Term Care
(LTC) residences related to virulence and
altered/ more subtle disease
manifestation in older adults

Question 15

COPD

Answer 15

Chronic
Obstructive
Pulmonary
Disease

Including both chronic bronchitis
(affecting bronchi) and emphysema (chronic progressive
lung disease

Question 16

COPD Characterized by

Answer 16

chronic airflow obstruction that
interferes with normal breathing

(inflammation of bronchus)

Question 17

Risk factors for developing COPD

Answer 17

Smoking (primary cause)
◦ Exposure to secondhand smoke and other air pollutants
◦ Increased age
◦ Genetic predisposition
◦ Low Socioeconomic status
◦ History of significant childhood respiratory disease (chronic advanced asthma)

Question 18

COPD symptoms

Answer 18

Chronic productive cough worsening dyspnea,
especially with exertion
◦ Wheezing and chronic sputum production
◦ Barrel-chest over time due to trapped air in the
lungs
◦ Chest tightness
◦ Fatigue
◦ Cyanosis of the fingernail beds and lips

Question 19

Progression of COPD

Answer 19

Progressive and cumulative

Question 20

Men or women have higher COPD mortality rates

Answer 20

Men

Question 21

Treatment of COPD

Answer 21

Bronchodilators (nebulized, metered dosed
inhalers or MDI’s)
Inhaled steroids (nebulized or MDI)
Combination inhalers
Oral steroids (in exacerbations of COPD
only)
Continuous or Intermittent O2 therapy (in
later stages)

Question 22

Pneumonia

Answer 22

An infection in one or both lungs causing alveoli to fill with fluid or pus making breathing difficult

Question 23

Risk factors for pneumonia

Answer 23

Age
◦ Recent upper respiratory illness
◦ Asthma/ COPD/ CHF/ other chronic diseases
◦ Smoking
◦ Weakened or suppressed immune system

Question 24

Symptoms of pneumonia in normal adults

Answer 24

Cough, fever, purulent sputum, SOB, fatigue, chest tightness/pain

Question 25

Older adults symptoms of pneumonia

Answer 25

Present atypically in older adults
acute delirium/ confusion
◦ dizziness
◦lower than normal body temperature
(cold vs warm sepsis, with T < 36 C)

Question 26

Treatment for pneumonia

Answer 26

Antipyretics for fever (ie. Acetaminophen)
Antibiotics (if bacterial vs viral)
Bronchodilators if wheezes present
Oxygen therapy if needed
Deep breathing and coughing (ex. incentive
spirometer)

Question 27

Do antibiotics treat viral pneumonia

Answer 27

No

Most virus flus are 14 days

Antibiotics are just a placebo, killing gut flora

Question 28

How can bacterial pneumonia be identified

Answer 28

Throat swab

Question 29

TB

Answer 29

A bacterial infection (caused by the
Mycobacterium Tuberculosis) that most commonly
affects the lungs

Droplet spread

Question 30

Endemic vs pandemic

Answer 30

Endemic does not have an end

Question 31

Risk factors for TB

Answer 31

Persons who have been recently exposed to
someone with active TB
Persons with weakened immune systems related
to chronic disease or high risk behavior

Question 32

Symptoms of TB

Answer 32

Persistent coughing that lasts three or more weeks
Coughing up blood
Chest pain, or pain with breathing or coughing
Unintentional weight loss
Fatigue
Fever
Night sweats
Chills