respiratory system Flashcards
common clinical manifestations of pulmonary diseases
- dyspnea
- cough
- sputum
- pain
- clubbing of nail beds
- cyanosis
cheyne stokes
- commonly seen at the end of life or neurological cancers
- increased breath and then stop
kussmal breathing
big breaths with no pause
respiratory system structure and function - infant and child
- obligatory nose breather (first 4wks)
- airway is shorter and narrower
- neck muscles and trachea is less developed
- increase o2 consumption
hypercapnia
- excess co2 in bloodstream
hypercapnia - cause
failure to remove CO2 adequately
hypercapnia - pH
low - acidosis
hypercapnia - clinical manifestations
- flushed skin
- hard time breathing
hypoxemia
low O2 in blood
hypoxemia - cause
failure to oxygenate adequately
hypoxemia - clinical manifestations
cyanic blue
shunt
blood but no air
dead space
air but no blood
respiratory failure
- hypoxemic respiratory failure
- hypercapnia respiratory failure
hypoxemic respiratory failure
failure to oxygenate adequately
hypercapnic respiratory failure
failure to remove carbon dioxide adequately
PaO2
equal or less than 50 mmHg
PCO2
> = 50 mmHg
pH
equal or less than 7.25
disorders of lung inflation
- pneumothorax
- atelectasis
- pulmonary edema
pneumothorax
- air enter the pleural space
- lung collapses inwards
- can be introduced by stab wound or blister on lung tissue
tension pneumothorax
- air enters pleural space but cannot exit
- compresses hear and other lung
- life threatening
atelectasis
- collapse of alveoli
- to keep open you encourage people to breath deeply
pulmonary edema
- accumulation of water in the alveoli
- heart failure
- inflammation
disorders due to infection
- influenza
- pneumonia
- bronchitis
- tuberculosis
influenza
- viral infection (A,B,C)
- annual epidemic
- initially upper airway infection
- lower respiratory tract
influenza - upper airway tract infection
kills mucous-secreting, ciliated cells
influenza - lower respiratory tract
shedding of bronchial and alveolar cells
pneumonia
- inflammation of alveoli/bronchioles
- categorized based on origin and type of presentation
- distribution in the lungs
inflammation of alveoli/bronchioles
infectious (bacteria, virus) or non-infectious (aspiration) causes
categorized based on origin
- community acquired
- hospital acquired
type of presentation
typical vs. atypical
distribution in the lung
- lobar
- bronchopneumonia
red hepatization
- red blood cells going into alveoli
- damage to capillary and alveoli
- shortness of breath
Gray hepatization
RBC breakdown and become break
pneumococcal pneumonia - risk factors
- age
- smoking
- immunosuppression
- altered level of consciousness
difficulty swallowing
pneumonia - clinical manifestations (7)
- fever
- increased WBC
- increased respiratory rate
- increase heart rate
- O2 down, CO2 up
- cough
- shortness of breath
pneumococcal pneumonia - primary level of prevention
- vaccinations
- good hand wash practices
pneumococcal pneumonia - secondary level of prevention
- early recognition of S & S
pneumococcal pneumonia - tertiary level of prevention
- antibiotics
- supportive treatment
acute bronchiolitis/ RSV
- actue infection or inflammation of lower airways
- common in infants and toddlers
- due to a viral illness caused by RSV
- reoccurs as infection does not confer immunity
bronchiolitis (RSV)
- mucous formation that blocks airways
bronchiolitis (RSV) - clinical manifestations
- wheezing, lung crackles, cyanosis, tachypnea, in drawing
in drwaing
sucking in at the ribs in young children because of small airways it is easy to become blocked
tuberculosis transmittion
through air
primary tuberculosis
- inhalation
- 95% if exposed TB will become dormant
- granuloma formed and infected tissue within dies
caseous necrosis
- cell death
- tissue “cheese-like”
secondary TB
- reinfection or reactivation of primary
- caseous granulomas rupture
- bacilli spread into lungs or other organs via blood or lymphatic vessels
- anything that affects immune system can reactivate dormant TB
TB - clinical manifestations
- fatigue
- weight loss & anorexia
- fever
- night sweats
- suptum
- dyspnea
- hemoptysis
TB - can affect
more than the lungs
disorders due to obstruction
- asthma
- chronic bronchitis
- emphysema
chronic obstruction pulmonary disease
chronic bronchitis and emphysema
During obstruction breathing ___ is harder than normal
- out
- When we breath out the bronchitis contracts and the air ways get smaller and the air can’t get through
obstruction lung disease
- trouble breathing out
- air trapping
- hyperinflation of lungs
asthma
- hypertrophy of smooth muscles
- bronochospasms
- deem of bronchiole walls
- increased number of mucous producing cells
Asthma - involved cell type
- IgE and mast cells
- type I
asthma - prevalence
increasing in frequency globally
asthma - clinical manifestations
- dyspnea
- high bp
- cough/ wheezing
- increased respiratory rate
- hypercapnia
- hypoxemia
asthma treatment - long term
- minimized exposure to triggers
- peak flow monitors
- corticosteroids (inhaled or oral)
- mast cells stabilizers
- IgE inhibitors
asthma treatment - quick relief
- beta 2 agonists
- anticholinergic inhalers
status asthmaticus
- life threatening asthmatic attack and does not respond to normal treatment
- inability to speak, confusion, accessory muscle use, SOB, decreased wheezing
Chronic bronchitis
- chronic inflammation of bronchi (at least 3 months for 2 years)
- bronchial edema
- increased # of mucous glands (increase mucous production)
Chronic bronchitis - cause
exposure to cigarette smoke, air pollution and infections
emphysema
- permanent damage to terminal bronchioles and alveoli
- destruction of walls between alveoli and capillary beds
- floppy terminal bronchioles
- loss of elasticity of alveoli
- crease surface area for gas exchange
emphysema - aetiology
- smoking and chronic exposure to environment irritants
- genetic
chronic bronchitis and emphysema - clinical manifestations
- cough
- wheezing
- dyspnea
- hypoxemia
- hypercapnia
- barrel chest
Chronic Bronchitis and Emphysema - Complications
- pulmonary hypertension
- right-sided heart failure
disorders due to neoplasia
- can affect any part of the respiratory system
- focus: lung cancer
lung cancer
- bronchogenic carcinoma
- most common cause if cigarette smoking
- second hand smoking
- genetic
- environmental factors
lung cancer - tumour types
- non-small cell lung cancer (85%)
- small cell carcinoma (15%)
non-small cell lung cancer
- adenocarinoma: most common
- squamous cell carcinoma
- larger cell carcinoma
adenocarcinoma
glandular cancers
squamous cell carcinoma
central
larger cell carcinoma
anaplastics, grow rapidly
small cell carcinoma
- grow rapidly and aggressively
- metastasize early
- produce hormones
- worst prognosis
lung cancer - evaluation and treatment
- TNM classification (node, tumor, metastasis)
- surgery, chemo, radiation
Disorder due to genetics
cystic fibrosis
cystic fibrosis
- autosomal recessive
- most affects lungs but also sweat glans, pancreas and GI
CF: etiology
- the same mutation on a single gene on chromosome #7
- affects production and function of protein
- results in irregualar Na+, Cl- and HCO3-
CF clinical manifestations
- salt on skin surface
- dehydrated think mucus in lungs
- impaired exocrine pancreatic function
CF effect on lungs
- increase mucous, plugging of airways, decreased cilia mobility and chronic inflammation
CF effect on lungs - Recurrent lung infections and colonization with
Pseudomonas aeruginosa and Staphylococcus aureus
CF diagnosis
- cough, recurrent pneumonia, wheezing
- altered GI
- sweat test
- genotyping in new borns
GI treatment
- nutrition, enzyme replacement
- lung transplant
pulmonary vascular disorder
- most commonly occurs 2nd to a close in deep veins of legs
- also because of tissue fragments fats
pulmonary vascular disorder - risk factors
immobility, increased coagulation, injury to endothelium
