Respiratory system part 1 Flashcards by Mohab sha

Which term refers to the delivery of blood to a capillary bed in tissue (every tissues, specifically lung tissues)?

Perfusion

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(Signs & symptoms of pulmonary disease) Which term refers to shortness of breath or trouble breathing?

What are the subjective & signs of said condition?

& what are other conditions associated with this state?

Dyspnea
-Subjective experiences: Breathlessness, air hunger, shortness of breath, laboured breathing, & preoccupation with breathing

Signs: Flaring of nostrils, use of accessory muscles, tracheal tug (Tracheal tugging is commonly seen in upper airway obstruction), & head bobbing in infants
Paroxysmal nocturnal dyspnea (PND): A sensation of shortness of breath that awakens the patient, often after 1 or 2 hours of sleep, & is usually relieved in the upright position; mostly due to heart failure
Orthopnea: Shortness of breath when lying flat (recumbent position); common in ppl with cardiac disease

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What are some other signs & symptoms of pulmonary disease?

Coughing, sputum (fluids expelled when coughing), hypo/hyper ventilation, cyanosis, clubbing, & pain

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Since coughing is a protective reflex, what does it mean for patients who are unable to cough?

What is classified as acute cough & how is it treated? Same with chronic cough

They are either too weak, or paralyzed; either way, it makes them susceptible to pneumonia

-Acute cough: lasts 2-3 weeks & is resolved with treatment
- Chronic cough: lasts longer than 3 weeks, & if its persistent in non-smokers than it means that their is a postnasal drainage, asthma, bronchitis, or taking ACE inhibitors. However, if its persistent in smokers, then it probably means bronchitis or potentially lung cancer

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What does it mean if the sputum is Clear/white, yellow/green, rusty, or pink frothy

Common cold
Bacterial infection
Pneumococcal bacteria (pneumonia)
Pulmonary edema

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Which conditions refers to coughing or spitting up of blood or bloody mucus from your respiratory tract (lungs and throat)?

& what are the potential causes?

Hemoptysis
- Due to damage to the lung, cancer, pulmonary infraction

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Which term refers to normal, good, healthy and unlabored breathing?

Eupnea

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(Abnormal breathing patterns) Which term refers to a deep and laboured breathing pattern often associated with severe metabolic acidosis, particularly diabetic ketoacidosis?

Kussmaul respirations or hyperpnea

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(Abnormal breathing patterns) Which term refers to alternating patterns of deep/shallow/apnea breathing where patients are usually close to death?

How does it occur during sleep & before death?

Cheyne-Stokes

During sleep = sleep apnea
Before death: Short cycles of breaths that deepen & then shallow & stop, due to brain stem injuries, encephalitis (inflammation of the brain), & increased intracranial pressure(ICP)

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(Abnormal breathing patterns) What are some risk factors for sleep apnea?

What does sleep apnea contribute to?

& how is sleep apnea treated?

Obesity, upper airway obstruction, large neck, & recessed chin
Heart disease (hypertension), atrial fibrillation, stroke, & diabetes
CPAP machine – continuous positive airway pressure & weight loss

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Which term refers to inadequate alveolar ventilation in relation to metabolic needs?

What type of acid-base imbalance does this condition cause?

& what does this condition cause?

Hypoventilation
- Respiratory acidosis, due to ↑ PCO2.
- Can cause hypoxemia (low oxygen in the blood), sleepiness, disorientation, & decreased blood saturation

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Which term refers to rapid or deep breathing, caused by severe anxiety, acute head trauma, pain, or a response to hypoxemia?

What type of acid-base imbalance does this condition cause?

& what does this condition cause?

Hyperventilation
- Respiratory alkalosis due to PCO2 <36 mm Hg
- Can cause hypocapnia

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Which term refers to a pathologic condition that is characterized by a bluish discolouration of the skin or mucous membrane, due to increasing amounts of desaturated or reduced hemoglobin?

What is it an indication of?

& describe its peripheral & central manifestations

Cyanosis
- Hypoxemia
- Peripheral cyanosis: Seen in nail beds, caused by peripheral vasoconstriction
- Central cyanosis: Mucus membranes in lips, caused by pulmonary disease

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Which term refers to when the tips of the fingers enlarge & the nails curve around the fingertips?

What does this condition indicate?

Clubbing, usually painless

It indicates disruption of the normal pulmonary circulation with chronic hypoxemia (chronic low blood-oxygen levels)

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Pain arising from the pleurae (linings around thorax and lungs), airways or chest wall; is symptom of a pulmonary disease/disorder. However, what specifically causes this pain?

Infection or inflammation (producing a pleural rub)
Pulmonary infarct (PE), where pain is due to tissue death (necrosis)
Could be because of any injuries in our chest such as trauma
Infection and inflammation of trachea or bronchi
Excessive coughing or severe coughing

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Which term refers to an increase in partial pressure of carbon dioxide (PaCO2) above 45 mmHg, due to hypoventilation of the alveoli?

Hypercapnia

Which term refers to low O2 within blood circulation. Can be due to reduced oxygen delivery to alveoli, diffusion of oxygen from alveoli to blood _V/Q mismatch, or alteration in perfusion of pulmonary arteries? (Lower oxygen saturation than 95%)

Hypoxemia

(V/Q mismatch) Which term refers to when there is an obstruction in the alveoli, so it doesn’t get air, which can be due to pneumonia. There is a thick secretion trapped there. There is blood present (perfusion) but there is no air, so it doesn’t get oxygenated, no gas exchange occurs, creating hypoxemia?

Shunt

(V/Q mismatch) Which term refers to when the alveoli is full of air, and ventilation is happening properly, but we don’t have enough perfusion for that specific alveoli. This can happen due to low BP, or there is an embolism coming from another part of the body and is stuck in one of the lungs arteries and obstructs the flow of blood, not allowing perfusion. No gas exchange again?

Dead space

Which 2 states are major outcomes of pulmonary diseases?

Hypercapnia & hypoxemia

List some causes of Hypercapnia

Untreated COPD: Such as chronicbronchitis&emphysema
Depression of the respiratory center by medications: Such as an opioid overdose
Disease of medulla: Including infection & trauma
Nerve & muscular disorder: Such as Guillain-Barré syndrome& Myasthenia gravis, ALS, encephalitis, & trauma to spinal cord
Thoracic cage abnormalities or trauma
Sleep apnea

What are some manifestations or symptoms of hypercapnia?

Similar to respiratory acidosis, such as vasodilation of blood vessels & depression of CNS

List some causes of hypoxemia

Reduced oxygen delivery to alveoli: can be due to hypoventilation or high altitudes
Issue with diffusion of oxygen from alveoli to blood: Called a V/Q mismatch (shunt or dead space) & can also be due to alveolocapillary membrane impairment
Perfusion of pulmonary arteries: such as an atrial septal defect (ASD) or ventricular septal defect (VSD); When deoxygenated & oxygenated blood mix

What are some manifestations or symptoms of hypoxemia?

Anarerobic metabolism starts = increase in serum lactic acid = metabolic acidosis

Which term refers to a life threatening situation, where hypoxemia or hypercapnia is not addressed, & O2 sat is below 60, pressure of carbon dioxide is over 50, & pH is below 7.25 (due to acidosis)?

Acute respiratory failure

What are some causes of acute respiratory failure?

- Direct injures to airways, lungs or chest wall (multiple trauma) - Injuries involving brain, spinal cord, heart - Or due to pulmonary embolism, causing V/Q mismatch. - Can be due to atelectasis - Is also an important complication of any major surgeries especially those that involve abdomen, thorax (chest), or nervous system

Which term refers to when a blood clot gets stuck in an artery in the lung, blocking blood flow to part of the lung? Where blood clots most often start in the legs & travel up through the right side of the heart and into the lungs. This is called deep vein thrombosis (DVT). & what are some other causes & who is at risk?

Pulmonary embolism - Causes: Fat from the marrow of a broken long bone, part of a tumour, air bubbles, or amniotic fluid - People at risk for PE are those who: Have been inactive or immobile for long periods of time (bed rest), have inherent blood clotting disorder, are having surgery, or a broken bone

What do the effects of a pulmonary embolism depend on?

- The extend of pulmonary blood obstruction, the size of the affected vessels, & the nature of the embolus

What are the 2 possible scenarios when a patient comes into contact with a pulmonary embolism?

- Scenario 1: Embolus does not cause infarction, clot is absorbed circulation returns to normal, only creating temporary hypoxia. - Scenario 2: Embolus causes infarction, shrinking & scarring occur in affected part of the lung, & we lose some part of the pulmonary system (its irreversible)

List the signs & symptoms of a pulmonary embolism

- Sudden onset sharp chest pain (due to low perfusion, creating acid = pain), dyspnea (due to hypoxemia), tachypnea(compensatory mechanism), tachycardia (compensatory mechanism), unexplained anxiety (Due to the feeling of dying, becoming restless)

How is a pulmonary embolism diagnosed?

A ventilation–perfusion (VQ)scan: Which is a nuclear medicine scan that uses radioactive material (radiopharmaceutical) to examine airflow (ventilation) & blood flow (perfusion) in the lungs. Basically looking for any blood clots

Which term refers to a life-threatening medical condition that occurs when a segment of the rib cage breaks due to trauma and becomes detached from the rest of the chest wall? What are the symptoms of said state? & what are the 3 ways in which it negatively affects respiration?

Flail chest - Chest pain & shortness of breath - 1. Ineffective ventilation (due to pain), 2. pulmonary contusion (damaged lung tissue), & 3. hypoventilation with atelectasis

What are some other examples of chest wall abnormalities?

- Obesity: Dyspneic (out of breath) on exertion or when lying down – risk of respiratory failure or infections - Deformities: Such as kyphosis, which is an exaggerated curve in the thoracic spinal cord. & Thoracic scoliosis - Impaired muscle function: Such as muscular dystrophy (progressive weakness and loss of muscle mass), myasthenia gravis (causes weakness in the skeletal muscles), & Guillain-Barre syndrome (immune system attacks your nerves, eventually causing paralysis of muscles)

Which term refers to when air leaks into the space between your lung and chest wall? This air pushes on the outside of your lung and makes it collapse, it can be complete or partial chest collapse What are the 2 forms of said state?

Pneumothorax - Primary Pneumothorax: Which is unexpected or spontaneous, can happen any time, & could be genetic as well - Secondary Pneumothorax: Which is due to direct trauma where the pleura is torn

Describe the close, open, & tension classifications of pneumothorax

Closed: Pleural cavity pressure is less than the atmospheric pressure, when there is a hole, some air gets in by force, and then the hole is closed Open: Pleural cavity pressure is equal to the atmospheric pressure, when the air would get in due to breathing, but air goes out as well Tension: Pleural cavity pressure is more than atmospheric pressure, when site of rupture is a one-way valve – air gets in during inspiration – closed during expiration (the hole gets closed & the air gets trapped in) *its life threatnening*

List some of the manifestations or symptoms of pneumothorax

Pleural pain, increased respiratory rate, increased heart rate, decreased breathing sounds, & tracheal deviations

(Plueral abnormalities) Which term is sometimes referred to as “water on the lungs,” is the build-up of excess fluid between the layers of the pleura outside the lungs?

Pleural effusion

(Plueral abnormalities) Which term refers to water accumulation (clear fluid) – fluid leaking from capillaries, due to cardiovascular disease ? Which term refers to WBCs & plasma proteins accumulation, due to lung cancer, breast cancer, lymphoma - infection, inflammation Which term refers to pus accumulation, due to pneumonia, lung abscesses, or localized infection Which term refers to blood accumulation, due to trauma, surgery, rupture Which term refers to milky fluid accumulation, due to lymph & fat, rare complication of surgeries in the neck & mediastinum (usually caused by breast cancer)

- Transudative (hydrothorax) - Exudative - Empyema - Hemothorax - Chylothorax