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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
Q

What is idiopathic pulmonary fibrosis?

A

Scarring of lung tissue

Chronic irreversible and ultimately fatal

26
Q

What are the primary inspiratory muscles?

A

External intercostal muscles

Diaphragm

27
Q

What are the accessory inspiratory muscles?

A

SCM

Scalene muscles

Pect minor

Serratus anterior

28
Q

When are accessory inspiratory muscles used?

A

When adequate pulmonary ventilation cannot be achieved by normal inspiratory efforts when there is gross overdistention of the lungs

29
Q

When are accessory expiratory muscles used?

A

When the elastic recoil of the lungs is insufficient to empty the alveoli or if there is expiratory airway obstruction

30
Q

Why does purse lip breathing help?

A

Laplace’s law

Stoping the alveoli from getting too small = next breath is easier

31
Q

Why does a pt have a barrel chest in emphysema?

A

Loss of elastin in lungs allows chest wall to expand

32
Q

In what situations does the trachea deviate away from the affected side? (PUSH)

A

Tension pneumothorax

Large pleural effusion

33
Q

In what situations does the trachea deviate towards the affected side? (PULL)

A

Lung or lobar collapse

Pulmonary fibrosis

34
Q

How does lung/lobar collapse occur?

A

Obstruction of bronchus

Gas resorbed from lung parenchyma distal to obstruction = collapse of lung

35
Q

What are the normal percussion notes on the anterior chest wall?

A

Flatness over muscles and bone

Cardiac dullness

Stomach tympany

Liver dullness

Resonance over ribs

36
Q

What are the normal percussion notes on the posterior chest wall?

A

Flatness over scapulae

Dullness over viscera

Dullness over liver

37
Q

Define lung consolidation

A

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
Q

Define bronchial breath sounds

A

Tubular, hollow sound over large airways

39
Q

Define vesicular breath sounds

A

Lower-pitched, rustling sounds, higher intensity during inspiration

40
Q

When are fine lung crackles heard?

A

Idiopathic pulmonary fibrosis

Consolidation

LVF

41
Q

When are coarse lung crackles heard?

A

COPD

Bronchiectasis

42
Q

Discuss the findings in a pleural effusion

A

X-ray = meniscus sign, mediastinum pushed away

Stoney dull percussion

No breath sounds – as no airways

43
Q

Discuss the findings in a pneumothorax

A

X-ray = recoiled lung, if tension mediastinum pushed away

Hiper resonant percussion sound

Absent breath sounds

44
Q

Discuss the findings in consolidation

A

X-ray = cloudy

If the entire lung involved = reduced chest movement

Dull percussion

Bronchial breathing over the lung fields

45
Q

Discuss the findings in lobar collapse

A

Little mediastinal shift towards collapse

Chest wall movement reduced

Dull percussion over collapse

Breath sounds reduced

(Lung cancer, mucus plug)

46
Q

What are the common causes of pleural effusion (transudate)?

A

Increased pleural capillary hydrostatic pressure (congestive heart failure)

Decreased capillary oncotic pressure (cirrhosis, nephrotic syndrome)

47
Q

What are the common causes of pleural effusion (exudate)?

A

Bronchial carcinoma

Pneumonia

TB

2.3.4. Respiratory System (19 decks)

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