Respiratory System Pathologies Flashcards
What is hemothorax?
The presence of blood in the pleural cavity, which can cause the collapse of a lobe or an entire lung, leading to impaired ventilation and oxygenation.
What is pneumothorax?
The presence of air or gas in the pleural cavity, which can cause the collapse of a lobe or an entire lung, leading to impaired ventilation and oxygenation.
What is the pleural cavity?
The potential space between the parietal and visceral layers of the pleura.
What happens when the integrity of the pleural cavity is compromised?
Air or fluid enters, causing the loss of negative pressure that normally counters the lung’s elastic recoil. When the “seal” is broken, the lung recoils and collapses either partially or completely.
How quickly can a lung collapse in pneumothorax?
The collapse may be rapid or slow, depending on how air or fluid enters the pleural cavity.
What is a primary spontaneous pneumothorax (PSP)?
A pneumothorax that occurs without an apparent cause or underlying lung disease (idiopathic).
What are the risk factors for PSP?
• Smoking
• Family history of pneumothorax
• Higher prevalence in biological males
How long does PSP take to resolve?
Up to 12 weeks.
What is a secondary spontaneous pneumothorax?
A pneumothorax caused by an underlying lung disease that alters lung structure/function.
What are some examples of underlying lung diseases that can cause a secondary pneumothorax?
COPD, pneumonia, cancer.
How does secondary pneumothorax differ from PSP?
• Takes much longer to heal.
• Chest pain persists with more severe clinical symptoms.
• Higher recurrence rates (15-40%).
What are the different causes of pneumothorax?
- Traumatic: Blunt or penetrating trauma disrupting the pleura (e.g., gunshot, stabbing, rib fracture, surgery).
- Pathologic: Rupture of pleural layers or alveoli due to conditions like tumors, abscess, COPD, cystic fibrosis, tuberculosis.
- Iatrogenic: Secondary to a medical procedure.
- Idiopathic: No preceding trauma or lung disease, commonly seen in tall, thin, athletic adolescents and smokers.
How do symptoms of pneumothorax vary?
Symptoms range from asymptomatic to life-threatening respiratory distress, depending on the degree of lung collapse.
What are common symptoms of pneumothorax?
• Chest pain: Severe, stabbing, radiates to ipsilateral shoulder, worsens with inspiration (pleuritic-type pain).
• Dyspnea: Shortness of breath, respiratory distress, or respiratory arrest.
• Tachypnea and tachycardia: Rapid breathing and heart rate.
• Mediastinal shift: Can lead to hemodynamic instability.
What are the medical treatment options for pneumothorax?
• Watchful waiting (with or without supplemental oxygen).
• Simple aspiration.
• Tube drainage.
• Patient education.
What is pleuritis (pleurisy)?
Inflammation of the pleural membranes.
What are the characteristics of pleuritis?
• Extremely painful, often unilateral with abrupt onset.
• Pain may be referred to the shoulder.
• Pain worsens with deep breathing, coughing, or stretching of the inflamed pleura, leading to shallow and rapid breathing.
• Reflex splinting of chest muscles may occur.
What are the symptoms of pleuritis?
• Chest pain: Sharp, severe, knife-like on inspiration, worsens with movement/coughing.
• Tachypnea: Can lead to tachycardia.
• Dry cough.
• Weakness.
• Headache.
• Fever.
How is pleuritis treated?
• Treat the underlying cause and suppress inflammation.
• Pain medications.
• Lying on the affected side to reduce pleural stretching and pain during acute pleuritis.
How does musculoskeletal pain differ from pleuritis?
Musculoskeletal pain is often bilateral, located around the lower ribs, and irritated by coughing.
How does bronchial pain differ from pleuritis?
Bronchial pain is sub-sternal, dull, and tightening. It worsens with coughing but not deep breathing.
How does myocardial pain differ from pleuritis?
Myocardial pain is substernal discomfort that is not affected by respiratory movements.
What is hemothorax?
Hemothorax is the presence of blood in the pleural cavity, which can result in the collapse of a lobe or an entire lung, leading to impaired ventilation and oxygenation.
What is pneumothorax?
Pneumothorax is the presence of air or gas in the pleural cavity, which can result in the collapse of a lobe or an entire lung, leading to impaired ventilation and oxygenation.
What happens when the integrity of the pleural cavity is compromised?
When the pleural cavity is compromised and air or fluid enters, the negative pressure (which counteracts lung recoil) is lost. This causes the lung to collapse in whole or in part, either rapidly or slowly depending on the mechanism of entry.
What is Primary Spontaneous Pneumothorax (PSP)?
PSP is a pneumothorax that occurs idiopathically, in the absence of known lung disease. It has a higher prevalence in smokers, individuals with a family history of pneumothorax, and biological males. It can take up to 12 weeks to resolve.
What is Secondary Spontaneous Pneumothorax?
Secondary Spontaneous Pneumothorax occurs due to an underlying lung pathology (e.g., COPD, pneumonia, cancer). It takes longer to heal than PSP, with persistent chest pain and more significant clinical symptoms. Recurrence rates are reported between 15-40%.
What are the causes of pneumothorax?
• Traumatic: Blunt or penetrating trauma (e.g., gunshot, stabbing, rib fracture, surgery).
• Pathologic: Rupture of pleural layers or alveoli due to tumors, abscesses, COPD, CF, TB.
• Iatrogenic: Secondary to medical intervention.
• Idiopathic: No trauma or underlying pathology, common in tall, thin, athletic adolescents and smokers.
What are the signs and symptoms of pneumothorax?
• Vary depending on lung collapse, ranging from asymptomatic to life-threatening respiratory distress.
• Chest pain: Severe, stabbing, radiating to the ipsilateral shoulder, worsens with inspiration (pleuritic-type pain).
• Dyspnea, respiratory distress, or respiratory arrest.
• Tachypnea and tachycardia: Mediastinal shift may affect hemodynamic stability.
What are the medical treatments for pneumothorax?
• Watchful waiting (with or without supplemental oxygen).
• Simple aspiration.
• Tube drainage.
• Patient education.
What is pleuritis (pleurisy)?
Pleuritis is an inflammation of the pleural membranes, often causing unilateral, abrupt, and severe pain that worsens with breathing, coughing, or movement.
What are the symptoms of pleuritis?
• Severe, sharp, knife-like pain on inspiration.
• Pain exacerbated by coughing or sneezing.
• Tachypnea, possibly leading to tachycardia.
• Dry cough, weakness, headache, fever.
What are the treatments for pleuritis?
• Treating the underlying cause and suppressing inflammation.
• Pain medications.
• Lying on the affected side to reduce pleural stretching and pain.
How can you differentiate pleuritis pain from other types of chest pain?
• Musculoskeletal: Bilateral, lower ribs, irritated by coughing.
• Bronchial: Substernal, dull, tightening, worsened by coughing but not deep breathing.
• Myocardial: Substernal discomfort, unaffected by respiratory movements.
What is atelectasis?
Atelectasis is incomplete expansion or collapse of a part or the entire lung, leading to reduced ventilation, poor oxygenation, and secretion clearance issues.
What are the complications of atelectasis?
• Acute pneumonia.
• Bronchiectasis.
• Respiratory failure.
• Sepsis.
• Pleural effusion.
• Empyema: Pus collection in a natural anatomical cavity, such as the pleural cavity.
What are the three sources of atelectasis?
- Obstruction (Resorption): Blocked airway leads to collapse as air is absorbed.
- Compression: Space-occupying lesion compresses lung, forcing air out (e.g., tumor).
- Collapse: Due to pleural effusion, pneumothorax, or hemothorax.
What is Atelectasis Neonatorum (Primary Atelectasis)?
• Occurs when the lung has never been inflated or has not inflated properly.
• Can be complete or partial.
• Most often seen in premature or high-risk births.
• May be fatal.
What is Acquired Atelectasis?
• Occurs when a lung that was previously inflated collapses.
• Commonly caused by obstruction or compression.
What are the clinical manifestations of atelectasis?
• Tachypnea (rapid breathing)
• Tachycardia (rapid heart rate)
• Dyspnea (difficulty breathing)
• Cyanosis (bluish discoloration of the skin due to low oxygen)
• Diminished chest expansion
What is the main focus of treatment for atelectasis?
• Treatment is focused on addressing the underlying cause by:
• Reducing obstruction or compression
• Re-inflation of the collapsed lung
• Encouraging deep breathing and using positions that promote lung expansion
• Oxygen therapy
What is asthma?
Asthma is a chronic inflammatory disorder of the airway that causes episodes of airway obstruction. It is characterized by recurring symptoms, respiratory hypersensitivity, inflammation, and acute intermittent obstruction.
How does chronic inflammation contribute to asthma?
Chronic inflammation increases airway hyperresponsiveness and results in decreased airflow, causing recurrent episodes of:
• Wheezing
• Breathlessness
• Chest tightness
• Coughing
• Airway constriction and swelling, leading to further obstruction
When are asthma episodes most common?
Asthma episodes commonly occur at night or in the early morning.
Is airflow obstruction in asthma reversible?
Yes, widespread airflow obstruction is often reversible, either spontaneously or with treatment.
What percentage of Canadians are affected by asthma?
Roughly 7-8% of Canadians are affected, with biological females being more likely to develop adult-onset asthma after menopause.
What are the two main types of asthma?
- Allergic (Atopic) Asthma
- Non-Allergic Asthma
What is the common factor in both types of asthma?
An exaggerated hyperresponsiveness to a variety of stimuli.
An exaggerated hyperresponsiveness to a variety of stimuli.
• Allergies
• Family history of asthma
• Exposure to tobacco smoke and environmental pollutants
• Hormonal changes (higher risk in biological females after menopause)
• Respiratory infections (especially viral)
• Premature birth and increased maternal age
• Maternal smoking and prenatal exposure to tobacco smoke
What is bronchiolar spasm in asthma?
Constriction and tightening of the smooth muscles surrounding the airways, leading to:
• Inflammation
• Swelling
• Irritation of the airways
What is airway inflammation in asthma?
Airway inflammation leads to:
• Widespread airflow obstruction
• Increased bronchial responsiveness to various stimuli
• Episodes of wheezing, dyspnea, chest tightness, and coughing
• Often reversible spontaneously or with treatment
What are the characteristics of intermittent airflow obstruction in asthma?
• Constriction of smooth muscles around the airways (may cause smooth muscle hyperplasia and airway remodeling)
• Edema of the mucosal lining
• Hypersecretion of thick, sticky mucus
What is bronchial hyperresponsiveness in asthma?
An exaggerated response to various stimuli, caused by:
• Airway edema
• Mucous secretion
• Degree of hyperresponsiveness correlates with asthma severity
What is status asthmaticus?
A severe asthma attack lasting several hours that is unresponsive to medical treatment.
Why is status asthmaticus a medical emergency?
• The patient will become fatigued and lethargic due to respiratory muscle exertion
• Cyanosis (lack of oxygen) will develop
• Can lead to respiratory failure and death
• Call 911 immediately
What is atopic (allergy-induced) asthma?
Asthma triggered by allergens, commonly seen in people under the age of 35 due to:
• Pollen, dust, cigarette smoke, etc.
In people over 35, it is often stress-related or due to chronic exposure to inhaled pollutants/chemicals (occupational or smog-related).
What are common allergens that trigger atopic asthma?
• Seasonal allergens: grass, tree, and weed pollens
• Perennial allergens: mold, dust mites, animal dander (especially cat and dog), cockroaches
What are the two subtypes of non-allergic asthma?
- Adult-onset non-allergic asthma
- Child-onset non-allergic asthma
What are common triggers of non-allergic asthma?
• Air pollutants
• Strong odors, perfumes, smoke (primary, secondary, tertiary)
• Cold, heat, or weather changes
• Exercise
• Stress and emotional upsets
• Certain medications (including Aspirin/NSAID hypersensitivity)
• Sinusitis with postnasal drip
• Obesity
• Viral respiratory tract infections
• Hormonal changes
What is asthma?
Asthma is a common, chronic inflammatory disorder of the airway that causes episodes of airway obstruction, characterized by recurring symptoms, including respiratory hypersensitivity, leading to inflammation and acute attacks of intermittent obstruction.
How does chronic inflammation contribute to asthma?
Chronic inflammation increases airway hyperresponsiveness and results in decreased airflow. It leads to recurrent episodes of wheezing, breathlessness, chest tightness, and coughing. Contraction of the airway and subsequent swelling further obstruct airflow.
When are asthma episodes most common?
Episodes are most common at night or in the early morning.
Is asthma-related airflow obstruction reversible?
Yes, widespread airflow obstruction is often reversible, either spontaneously or with treatment.
What percentage of Canadians are affected by asthma, and which sex is more commonly affected?
Roughly 7-8% of Canadians are affected, with more biological females affected than males.
What are the two main types of asthma, and what do they have in common?
The two main types are allergic (atopic) asthma and non-allergic asthma. The common factor in both is an exaggerated hyperresponsiveness to various stimuli.
List the risk factors for developing asthma.
• Allergies
• Family history of asthma
• Exposure to tobacco smoke and environmental pollutants
• Hormonal factors (biological females are more likely to develop adult-onset asthma after menopause)
• Respiratory infections, especially viral
• Premature birth and increased maternal age
•Maternal smoking and prenatal exposure to tobacco smoke
What is bronchiolar spasm in asthma?
Constriction and tightening of the smooth muscles surrounding the airways, leading to airway narrowing.
How does airway inflammation affect asthma?
Inflammation leads to widespread airflow obstruction, increased bronchial responsiveness, and episodes of wheezing, dyspnea, chest tightness, and coughing.
What is intermittent airflow obstruction?
• Constriction of smooth muscles around the airways (which may lead to smooth muscle hyperplasia and airway remodeling)
• Edema of the mucosal lining of the airways
• Hypersecretion of thick, sticky mucus
What is bronchial hyperresponsiveness?
An exaggerated airway response to numerous stimuli, often worsened by airway edema and mucus secretion. The degree of hyperresponsiveness correlates with the severity of asthma.
What is status asthmaticus, and why is it dangerous?
It is a medical emergency involving an asthma attack lasting several hours that is unresponsive to treatment. It can lead to respiratory failure and death.
What are signs of status asthmaticus?
• Fatigue and lethargy due to respiratory muscle exertion
• Cyanosis from lack of oxygen
• Possible respiratory failure and death
What should be done in case of status asthmaticus?
Call 911 immediately!
What is atopic asthma (allergy-induced asthma)?
What is atopic asthma (allergy-induced asthma)?
What can trigger atopic asthma in individuals over 35?
Stress, chronic exposure to inhaled pollutants, or occupational chemicals.
What are common allergens that can trigger atopic asthma?
• Seasonal: Grass, tree, and weed pollens
• Perennial: Mold, dust mites, animal dander (especially cats and dogs), and cockroaches
What are the two subtypes of non-allergic asthma?
Adult-onset and child-onset asthma.
List common triggers of non-allergic asthma.
• Air pollutants
• Strong odors, perfumes, smoke (primary, secondary, tertiary)
• Cold, heat, weather changes
• Exercise
• Stress, emotional upsets
• Some medications (including aspirin/NSAIDs)
• Sinusitis with post-nasal drip
• Obesity
• Viral respiratory infections
• Hormonal changes
What medications are commonly used to manage asthma?
• Bronchodilators (e.g., adrenaline, muscle relaxants)
• Antihistamines
• Corticosteroids
What are the medications for quick relief of asthma symptoms?
Reliever medications, used for acute exacerbations or exercise-induced asthma:
• Short-acting beta-agonists (bronchodilators)
• Anticholinergics (for severe exacerbations)
• Systemic corticosteroids (to speed recovery)
What are the long-term control medications for asthma?
Controller medications, used chronically to manage asthma:
• Inhaled corticosteroids (primary drug of choice)
• Long-acting beta-agonists (e.g., puffers like Ventolin, Atrovent)
What other treatments may help manage asthma?
• Supplemental oxygen
• Education on trigger avoidance
• Breathing and relaxation techniques
How does asthma affect the respiratory system?
• Loss of lung elasticity and alveolar damage increase susceptibility to congestion and infection
• Labored breathing and chronic dyspnea
How does asthma affect the musculoskeletal system?
Over-recruitment of accessory respiratory muscles, leading to:
• Thoracic Outlet Syndrome (TOS)
• Head-forward carriage
• Trigger points
• Weakened cough
• Headaches
• Thoracic hyperkyphosis with compensatory lumbar and cervical hyperlordosis
• Thoracic hypomobility
• Barrel chest (from chronic lung hyperinflation)
• Fixation of ribs in the inspiratory position (rib springing may be contraindicated)
How does asthma affect the cardiovascular system?
• Increased risk of hypertension and heart failure (due to increased lung and pulmonary vessel resistance, potentially leading to CCHF)
•Tachycardia during an attack to maintain oxygen delivery
What emotional considerations should be kept in mind for asthma patients?
• Dyspnea may cause fear
• Deep breathing may be associated with triggering an attack
• Patients may avoid exercise, lying supine, or certain environments (humid, windy, or cold)
• Risk of social isolation
What health history questions should be asked when treating an asthma patient?
• Medications and location of inhaler
• Asthma attack plan
• Known triggers
• Formal diagnosis and type
• History of medical emergencies or • hospitalizations
• History of lung damage or disease
• Cardiovascular disease
• Emotional health and anxiety related to asthma
What are the treatment goals for asthma patients?
• Address respiratory muscles for tone, length, and strength
• Maintain thoracic ROM and joint health
• Normalize respiratory function
• Use diaphragmatic or pursed-lip breathing exercises (when appropriate)
• Promote relaxation
• Tapotement over T1-T4 may stimulate the SNS for airway dilation
• Educate patients on trigger avoidance and environmental modifications
What modifications should be considered when treating asthma patients?
• Monitor cardiovascular health and hypertension
• Be cautious with allergens (essential oils, detergents, disinfectants)
• Be aware that face cradles may cause claustrophobia
• Pillowing and prone positioning may inhibit diaphragm function
