S1 L2.1: Physical Diagnosis of the Respiratory System Flashcards
Complaints as reported by the patient (Subjective)
Symptom
Findings by the medical professional (Objective)
Sign
Choices:
a Tidal Volume
b. Inspiratory Reserve Volume
c. Expiratory Reserve Volume
d. Vital Capacity
e. Residual Volume
f. Total Lung Capacity
Amount of air a person exhale some more maximally at the end of a normal expiration
c. Expiratory Reserve Volume
Choices:
a Tidal Volume
b. Inspiratory Reserve Volume
c. Expiratory Reserve Volume
d. Vital Capacity
e. Residual Volume
f. Total Lung Capacity
Air that always stays in the lungs at the end of the expiratory reserve volume (residual)
e. Residual Volume
Choices:
a Tidal Volume
b. Inspiratory Reserve Volume
c. Expiratory Reserve Volume
d. Vital Capacity
e. Residual Volume
f. Total Lung Capacity
Amount of air a person is able to inhale and exhale at rest
a Tidal Volume
Choices:
a Tidal Volume
b. Inspiratory Reserve Volume
c. Expiratory Reserve Volume
d. Vital Capacity
e. Residual Volume
f. Total Lung Capacity
Amount of air a person can maximally inspire at the end of a normal inspiration
b. Inspiratory Reserve Volume
Choices:
a Tidal Volume
b. Inspiratory Reserve Volume
c. Expiratory Reserve Volume
d. Vital Capacity
e. Residual Volume
f. Total Lung Capacity
VC + RV
f. Total Lung Capacity
Choices:
a Tidal Volume
b. Inspiratory Reserve Volume
c. Expiratory Reserve Volume
d. Vital Capacity
e. Residual Volume
f. Total Lung Capacity
IRV+TV+ERV
Amount of air that can come in and could get out of a person’s lungs
d. Vital Capacity
Breathing Patterns
a. Eupnea
b. Tachypnea
c. Bradypnea
d. Hyperpnea
e. Sighing
f. Air Tapping
g. Cheynes-Stokes
h. Kussmaul
i. Biot
j. Ataxic
> 20 cpm
Causes: exercise, infections, acidosis, hypoxemia, heart failure
b. Tachypnea
Breathing Patterns
a. Eupnea
b. Tachypnea
c. Bradypnea
d. Hyperpnea
e. Sighing
f. Air Tapping
g. Cheynes-Stokes
h. Kussmaul
i. Biot
j. Ataxic
Normal, regular and comfortable at a rate of 12-20 cpm (age-dependent)
a. Eupnea
Breathing Patterns
a. Eupnea
b. Tachypnea
c. Bradypnea
d. Hyperpnea
e. Sighing
f. Air Tapping
g. Cheynes-Stokes
h. Kussmaul
i. Biot
j. Ataxic
- Rapid (tachypnic), deep, labored
- Can also present with intercostal retractions (from video of pt c diabetic ketoacidosis)
h. Kussmaul
Breathing Patterns
a. Eupnea
b. Tachypnea
c. Bradypnea
d. Hyperpnea
e. Sighing
f. Air Tapping
g. Cheynes-Stokes
h. Kussmaul
i. Biot
j. Ataxic
- <12 cpm, slow
- Causes: hypothyroidism, electrolyte imbalances (sodium,
potassium), drugs, obesity
c. Bradypnea
Breathing Patterns
a. Eupnea
b. Tachypnea
c. Bradypnea
d. Hyperpnea
e. Sighing
f. Air Tapping
g. Cheynes-Stokes
h. Kussmaul
i. Biot
j. Ataxic
Increasing difficulty in getting breath out
Causes: asthma, chronic obstructive pulmonary disease
(COPD)
f. Air Tapping
Breathing Patterns
a. Eupnea
b. Tachypnea
c. Bradypnea
d. Hyperpnea
e. Sighing
f. Air Tapping
g. Cheynes-Stokes
h. Kussmaul
i. Biot
j. Ataxic
● Frequently interspersed
● Deeper breath
● Can happen in between normal breaths
e. Sighing
Breathing Patterns
a. Eupnea
b. Tachypnea
c. Bradypnea
d. Hyperpnea
e. Sighing
f. Air Tapping
g. Cheynes-Stokes
h. Kussmaul
i. Biot
j. Ataxic
● Significant disorganization w/ irregular & varying depths of respiration
● Indicates poor prognosis
● Occasionally interchanged w/ biot; difference is there is
more irregularity & depth is varying, and has no apnea
j. Ataxic
Breathing Patterns
a. Eupnea
b. Tachypnea
c. Bradypnea
d. Hyperpnea
e. Sighing
f. Air Tapping
g. Cheynes-Stokes
h. Kussmaul
i. Biot
j. Ataxic
● Hyperventilation, deep breathing
● Form of tachypnea
● >20 cpm
d. Hyperpnea
Breathing Patterns
a. Eupnea
b. Tachypnea
c. Bradypnea
d. Hyperpnea
e. Sighing
f. Air Tapping
g. Cheynes-Stokes
h. Kussmaul
i. Biot
j. Ataxic
Varying periods of increasing depth interspersed w/ apnea (not breathing)
Apnea in between of increasing depths of breathing
“Parang naghihingalo”
g. Cheynes-Stokes
T/F: Babies will be breathing faster than an adult
True
Up to 44/min in infants
How does infection increase the respiratory rate?
Infection causes faster metabolism → need to burn more/ need energy in the face of infection → so pulmonary system also compensates because body needs more oxygen → thus ↑ respiratory rate
High levels of acid present in the blood
Acidosis
How does acidosis affect the respiratory system?
Acidosis → produces a lot of carbonic acid (one major form of acid) and if not removed will cause injury to the body
Low levels of O2 in the blood
Hypoxemia
How does heart failure affect the respiratory system (inc difficulty in breathing?
Left side of the heart fails to pump → damming of blood in left ventricle → damming in left atrium → blood and fluid will go back upstream to pulmonary bed causing it to be flooded → low oxygenation → compromised O2 and CO2 exchange (in the capillary beds) → hypoxemia → difficulty breathing → ↑ respiratory rate
Low levels of thyroid hormones = ?
slow metabolism which can also affect breathing pattern
T/F: Drug such as anesthetic drugs/ pain reliever speeds up the heart
False
Anesthetic drugs/ pain reliever slow down the heart
T/F: Hyperpnea is deeper than tachypnea
True
T/F: Occasional sighing is not normal
False
Asthma has a problem in air entry. It also has a problem in expiration of air
a. TF
b. FT
c. TT
d. FF
b. FT
T/F: Asthmatic patients have bigger lungs than normal people
True
T/F: When Cheynes-Stokes is seen in a patient, it is considered a medical emergency.
True
Process of Ketoacidosis
D/t too much rigor in the body → poor sourcing of fuel leads to the body sourcing from ketones, with acid becoming a byproduct
T/F: Kussmaul is the breathing patten that is an effort to blow off a lot of acids (CO2) in the body
True
Influences on the inc of rate and depth of breathing
- Acidosis
- CNS Lesions
- Anxiety
- ASA (Aspirin) Poisoning
- Hypoxemia
- Pain
Influences on the dec of rate and depth of breathing
- Alkalosis
- CNS Lesions (Cerebrum-volitional breathing)
- MG (muscle weakness)
- Narcotic Overdose
- Obesity
Type of Dyspnea that begins or increases when the pt lies down; gets the feeling of being drowned
Orthopnea
Orthopnea
In upright position, there is less venous return to the heart as compared to a lying position because?
Gravity is eliminated thus more blood return to the heart.
The blood that cannot be pumped by the system will go where to cause orthopnea?
It will just upstream to the pulmonary bed
T/F: Orthopnea is a common indicator of congestive heart failure (CHF), mechanical impairment of the diaphragm associated with obesity, or asthma triggered by esophageal reflux.
True
Paroxysmal Noctural Dyspnea is a sudden onset of shortness of breath after a period of __?
Recumbancy
T/F: PND happens immediately after assuming
the supine position.
False
Happens 3-4 hrs (sometimes 5 hrs) after assuming the recumbent position.
SOB that begins or increases when the pt is upright
Platypnea
What defect occurs whent eh foramen ovale does not close ?
Atrial Septal Defect
Shunt direction that would cause the SOB in the upright position
Right-to-Left
SOB that is pronounced on side lying d/t to a unilateral diseased lung
Trepopnea
Which side does the patient lie when they have a L collapsed lung
Sidelying on the L
10 Ps of Dyspnea of Rapid Onset
Infection in the lung parenchyma
Pneumonia
10 Ps of Dyspnea of Rapid Onset
Excessive fluid in the pericardial sac
Pericardial Tamponade
10 Ps of Dyspnea of Rapid Onset
Hole in air sac; Air stays in the pleural cavity compressing on the lung parenchyma resulting to dyspnea, can lead to death in an instant
Pneumothorax
10 Ps of Dyspnea of Rapid Onset
Blood / fluid will get dammed up in the pulmonary bed
Pump Failure
10 Ps of Dyspnea of Rapid Onset
Bronchial Constriction
Pulmonary Constriction
10 Ps of Dyspnea of Rapid Onset
Difficulty in breathing bc body is not accustomed to high altitudes
Peak Seekers
10 Ps of Dyspnea of Rapid Onset
Foreign body lodged/stuck in the airway
Peanut
10 Ps of Dyspnea of Rapid Onset
Emotional
Psychogenic
10 Ps of Dyspnea of Rapid Onset
When clot dislodges and obstructs the pulmonary artery or lung parenchyma
Pulmonary Embolus
10 Ps of Dyspnea of Rapid Onset
Certain poisons can cause dyspnea
Poisons
Performs an essential protective function for human airways and lungs
Cough
What occurs when one has no effective cough reflex?
At risk for retained airway secretions and aspirated material predisposing to infection, atelectasis, and respiratory compromise
A cough is a __ or __ response to an irritant
Voluntary or reflexive
T/F: Cough can signal right-sided heart failure
False (Left side)
Type of cough cause is viral upper respiratory infections
Acute Cough
Type of cough that is seen in postnasal drip, asthma, gastroesophageal reflux, chronic bronchitis, and bronchiectasis
Chronic Cough
Sequence of Events that occur when coughing
- Deep inspiration closure of glottis
- Contraction of chect and pelvic muscle sudden spasmodic expiration
- Closed glottis is forced to open
- Coughs out all of the things that have been irritating the airway
- Air and secretion are exhaled
Substance generally associated w/ cough
Sputum
T/F: You can expel sputum without coughing
False
Some Causes of Sputum/Hemoptysis
a. Bacterial Infection
b. Viral Infection
c. Chronic Infectious Disease
d. Carcinoma
e. Infarction
f. Tuberculosus Cavity
Slight, persistent blood streaking
d. Carcinoma
Some Causes of Sputum/Hemoptysis
a. Bacterial Infection
b. Viral Infection
c. Chronic Infectious Disease
d. Carcinoma
e. Infarction
f. Tuberculosus Cavity
Possible that airways are wounded d/t continuous coughing); no too much hue
b. Viral Infection
Some Causes of Sputum/Hemoptysis
a. Bacterial Infection
b. Viral Infection
c. Chronic Infectious Disease
d. Carcinoma
e. Infarction
f. Tuberculosus Cavity
Blood clotted;
When large amounts of blood, pt should be brought to the ER already
e. Infarction
Some Causes of Sputum/Hemoptysis
a. Bacterial Infection
b. Viral Infection
c. Chronic Infectious Disease
d. Carcinoma
e. Infarction
f. Tuberculosus Cavity
Large amounts (copious) of blood
f. Tuberculosus Cavity
Some Causes of Sputum/Hemoptysis
a. Bacterial Infection
b. Viral Infection
c. Chronic Infectious Disease
d. Carcinoma
e. Infarction
f. Tuberculosus Cavity
Yellow, green, rust (blood mixed w/ yellow sputum), clear, or transparent; purulent (pus); blood streaked; mucoid (thick), viscid (thicker)
a. Bacterial Infection
Breath: Clues Behind the Smell
a. Sweet and Fruity
b. Fishy and Stale
c. Ammonia-like
d. Musty Fish & Clover
e. Foul & Feculant
f. Foul & Putrid
g. Halitosis
h. Cinnamon
Intestinal obstruction, diverticulum (feces reroutes towards mouth)
e. Foul & Feculant
Breath: Clues Behind the Smell
a. Sweet and Fruity
b. Fishy and Stale
c. Ammonia-like
d. Musty Fish & Clover
e. Foul & Feculant
f. Foul & Putrid
g. Halitosis
h. Cinnamon
Uremia (acute/chronic renal failure, too much toxic in blood, urea nitrogen, creatinine in the blood)
b. Fishy and Stale
Breath: Clues Behind the Smell
a. Sweet and Fruity
b. Fishy and Stale
c. Ammonia-like
d. Musty Fish & Clover
e. Foul & Feculant
f. Foul & Putrid
g. Halitosis
h. Cinnamon
PTB (pulmonary tuberculosis)
h. Cinnamon
Breath: Clues Behind the Smell
a. Sweet and Fruity
b. Fishy and Stale
c. Ammonia-like
d. Musty Fish & Clover
e. Foul & Feculant
f. Foul & Putrid
g. Halitosis
h. Cinnamon
Fetor hepaticus: hepatic failure, portal vein thrombosis, portocaval shunts
d. Musty Fish & Clover
Breath: Clues Behind the Smell
a. Sweet and Fruity
b. Fishy and Stale
c. Ammonia-like
d. Musty Fish & Clover
e. Foul & Feculant
f. Foul & Putrid
g. Halitosis
h. Cinnamon
Tonsillitis, gingivitis, respiratory infections, vincent angina, gastroesophageal reflux, PUD (peptic ulcer disease, H. Pylori
g. Halitosis
Breath: Clues Behind the Smell
a. Sweet and Fruity
b. Fishy and Stale
c. Ammonia-like
d. Musty Fish & Clover
e. Foul & Feculant
f. Foul & Putrid
g. Halitosis
h. Cinnamon
Diabetic ketoacidosis (c loss of sensorium; loss of consciousness/ consciousness is waning); starvation ketosis
a. Sweet and Fruity
Breath: Clues Behind the Smell
a. Sweet and Fruity
b. Fishy and Stale
c. Ammonia-like
d. Musty Fish & Clover
e. Foul & Feculant
f. Foul & Putrid
g. Halitosis
h. Cinnamon
Nasal/sinus pathology: infection, foreign body (common in pedia), cancer; respiratory infections: emphysema, lung abscess, bronchiectasis
f. Foul & Putrid
Breath: Clues Behind the Smell
a. Sweet and Fruity
b. Fishy and Stale
c. Ammonia-like
d. Musty Fish & Clover
e. Foul & Feculant
f. Foul & Putrid
g. Halitosis
h. Cinnamon
Uremia
c. Ammonia-like
Most blood-tinged sputum and small-volume hemoptysis are due to?
Viral Bronchitis