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2.3.4. Respiratory System > Symptoms and Signs of Respiratory Disease > Flashcards

Symptoms and Signs of Respiratory Disease Flashcards

1
Q

What are the 6 cardinal symptoms of respiratory disease?

A

Breathlessness

Cough

Chest pain

Wheeze/stridor

Sputum

Haemoptysis

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2
Q

When taking a pt history what factors are relevant to the respiratory system?

A

Childhood illnesses (whooping cough, asthma)

Occupation

Pets

Travel

Smoking

Medication

Allergic disorders

Nasal symptoms

Psychosocial history

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3
Q

How do heart failure pts describe their breathing?

A

Air hunger

Suffocation

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4
Q

How do COPD pts describe their breathing?

A

I cannot take a full breath

Increasing effort

Unsatisfying breathing

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5
Q

How do pts with bronchoconstriction describe their breathing?

A

Chest tightness

Increased effort of breathing

Air hunger

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6
Q

What are the common causes of dyspnoea?

A

Asthma

COPD

Idiopathic pulmonary fibrosis

Myocardial dysfunction

Anaemia

Obesity

Deconditioning

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7
Q

If breathlessness is instantaneous what is this indicative of?

A

PE

Pneumothorax

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8
Q

If breathlessness if acute (mins-hours) what is this indicative of?

A

Asthma

PE

Pneumonia

LVF?MI

Hyperventilation syndrome

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9
Q

If breathlessness is gradual (days) what is this indicative of?

A

Lobar collapse (lung cancer)

Pleural effusion

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10
Q

If breathless of chronic what is this indicative of?

A

COPD

Idiopathic pulmonary fibrosis

Bronchietasis

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11
Q

How does dilation of the bronchioles occur in bronchiectasis?

A

Persistent chronic inflam leads to loss of elastin = dilate

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12
Q

Where are the mechano/chemoreceptors involved in the cough reflex found?

A

Resp ep

Oesophagus

Diaphragm

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13
Q

Outline the causes of chest pain

A

Cardiac

Pericarditis (relieved by sitting forward)

Oesophageal pain

Chest wall = costocondritis, rib fracture, spinal osteoarthritis, herpes zoster

Pleuritic = pleurisy, PE, infarction, pneumothorax

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14
Q

What is a wheeze?

A

Noisy musical sound produced by turbulent flow through narrow small airways.

It is mostly expiratory.

Seen in: asthma, COPD, bronchiolitis

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15
Q

What is the alveolar pressure on inspiration and expiration?

A

I = -1

E = +1

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16
Q

When is intrathoracic airway narrowing exacerbated?

A

Expiration

As +ve intrapulmonary pressure pressing on narrowing

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17
Q

What is stridor?

A

Coarse inspiratory wheeze

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18
Q

What are the causes of stridor?

A

Epiglottitis

Croup

Diptheria

Aspirated foreign bodies

Extrinsic compression e.g. large goitre

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19
Q

When is extrathoracic airway narrowing exacerbated?

A

Inspiration

-ve pressure in trachea coupled with narrowing

= stridor (inspiratory noise)

20
Q

Name some causes of increased sputum

A

Smoking/smoke pollution

COPD

Acute viral or bacterial bronchitis

Pneumonia

Bronchiectasis (may be foul smelling sputum)

Lung abscess

Acute asthma

Lung cancer

LVF (pink-tinged frothy sputum)

21
Q

What causes haemoptysis?

A

Infection = pneumonia, TB, bronchiectasis, bronchitis

Lung cancer

PE

Anticoagulation

LVF

22
Q

Outline the causes of central cyanosis

A

R to L shunt

COPD

Severe pneumonia

Severe bronchospasm

23
Q

What is the normal nail bed angle vs clubbing?

A

Normal = 160 degrees

Clubbing = 180 degrees

24
Q

What are the respiratory causes of clubbing?

A

Lung cancer, mesothelioma

Bronchiectasis

Empyema

Idiopathic pulmonary fibrosis

25
What is idiopathic pulmonary fibrosis?
Scarring of lung tissue Chronic irreversible and ultimately fatal
26
What are the primary inspiratory muscles?
External intercostal muscles Diaphragm
27
What are the accessory inspiratory muscles?
SCM Scalene muscles Pect minor Serratus anterior
28
When are accessory inspiratory muscles used?
When adequate pulmonary ventilation cannot be achieved by normal inspiratory efforts when there is gross overdistention of the lungs
29
When are accessory expiratory muscles used?
When the elastic recoil of the lungs is insufficient to empty the alveoli or if there is expiratory airway obstruction
30
Why does purse lip breathing help?
Laplace’s law Stoping the alveoli from getting too small = next breath is easier
31
Why does a pt have a barrel chest in emphysema?
Loss of elastin in lungs allows chest wall to expand
32
In what situations does the trachea deviate away from the affected side? (PUSH)
Tension pneumothorax Large pleural effusion
33
In what situations does the trachea deviate towards the affected side? (PULL)
Lung or lobar collapse Pulmonary fibrosis
34
How does lung/lobar collapse occur?
Obstruction of bronchus Gas resorbed from lung parenchyma distal to obstruction = collapse of lung
35
What are the normal percussion notes on the anterior chest wall?
Flatness over muscles and bone Cardiac dullness Stomach tympany Liver dullness Resonance over ribs
36
What are the normal percussion notes on the posterior chest wall?
Flatness over scapulae Dullness over viscera Dullness over liver
37
Define lung consolidation
Solidification of lung tissue due to the filling of the lungs with liquid and solid Most common cause = pneumonia Bronchial breath sounds where vesicular breath sounds should be heard
38
Define bronchial breath sounds
Tubular, hollow sound over large airways
39
Define vesicular breath sounds
Lower-pitched, rustling sounds, higher intensity during inspiration
40
When are fine lung crackles heard?
Idiopathic pulmonary fibrosis Consolidation LVF
41
When are coarse lung crackles heard?
COPD Bronchiectasis
42
Discuss the findings in a pleural effusion
X-ray = meniscus sign, mediastinum pushed away Stoney dull percussion No breath sounds – as no airways
43
Discuss the findings in a pneumothorax
X-ray = recoiled lung, if tension mediastinum pushed away Hiper resonant percussion sound Absent breath sounds
44
Discuss the findings in consolidation
X-ray = cloudy If the entire lung involved = reduced chest movement Dull percussion Bronchial breathing over the lung fields
45
Discuss the findings in lobar collapse
Little mediastinal shift towards collapse Chest wall movement reduced Dull percussion over collapse Breath sounds reduced (Lung cancer, mucus plug)
46
What are the common causes of pleural effusion (transudate)?
Increased pleural capillary hydrostatic pressure (congestive heart failure) Decreased capillary oncotic pressure (cirrhosis, nephrotic syndrome)
47
What are the common causes of pleural effusion (exudate)?
Bronchial carcinoma Pneumonia TB

2.3.4. Respiratory System (19 decks)

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