Symptoms of respiratory system Flashcards
Acute Dyspnea
- Bronchial Obstruction
- Larynx Obstruction
- Asthma
- Spontaneous pneumothorax
- Acute pulmonary embolism ( ventilation / perfusion mismatch )
Chronic Dyspnea
- COPD
- Pure emphysema
- Extensive pulmonary fibrosis
- Agonic status
Physchogenic Dyspnea
Deep respiratory effort at variable intervals
no objective diagnosis features
Changes in respiratory cycle
- Chake stones respiration
- Sleep apnea syndrome
- Kussmaul respiration
- Biot respiration
Cheyne - Stokes respiration
altering periods of acceleration and deceleration with apnea periods of variable duration ( 15-60 sec)
tachypnea = anxious
apnea = somnolent
when apnea is longer = seizures
Cheyne - Stokes respiration is due to
depression of the exitability in respiratory centers
- sign of CNS depression in :
> left ventricular failure with low output
> brain hemorrhages , brain tumors
>morphin use
> normal subjects at high altitude
Sleep apnea syndrome ( SAS )
- caused by soft tissue collapse in pharynx
- Normal ventilation altering with periods of apnea , during sleep
- Associated with COPD ,obesity , hypertension
- patient feels -> sleepy + dizzy
- snorring
Kussmaul respiration
cycles of high amplitude respiratory movements , separated by short pauses
- Appear in METABOLIC ACIDOSIS
Biot respiration
periods of apnea + normal respiration or hyperpnea
- brain tumors
- meningitis
- agonic status
Cough and sputum ( what is it ?)
its a reflex that either blocks foreign body penetration into the airways / expels mucus / pus accumulation in the bronchial tree
Cough and sputum - excitation
comes from special receptors who’s stimulation provokes deep inspiration - > glotic shut down -> sudden + strong expiration
Dry cough
- no expectoration
- acute inflammatory airway conditions , airway compression
wet cough
- expectoration
- acute / chronic conditions
Aphonic cough
- laryngeal conditions
- laryngeal cancer
Barking cough
- tracheobronchial compression
Bitonal cough
- left vocal cord paralysis , due to left recurrent laryngeal nerve
- lymph nodes in mediastinum , aneurysm , tumor
Cavernous cough
- metallic sound , in caverns - 6 cm with free drainage bronchi
Convulsive cough
- in paroxysmal crisis
- starts with a deep breath -> short and rapid cough -> air is evacuated from lungs
- at the end of crisis inspiration is deep and associated with wheezing due to glotic spasm
- patient becomes cyanotic and vomits
cough with emesis
- appear in tuberculosis
- appear in esophageal - bronchial fistulae
Irritation cough
appear in acute + chronic lung diseases
chronic bronchitis in smokers
Morning cough
due to secretion evacuation in chronic bronchitis + bronchiectasis
Evening cough
- concomitant
- with fever increase in the evening in tuberculosis
Effort cough
appear in pulmonary and cardiac diseases
Continuous cough
pulmonary tuberculosis - laryngitis, tracheobroncial compression
Position cough
determined by position changes in pleural effusions , lung abcesses ,bronchiestasis
Cough in massive pleural effusion drainage
can appear when the visceral pleura makes contact with the needle -> cardioinhibitory reflex
Mucous sputum
transparent
Serous sputum
white colour
Purulent sputum
creamy , yellow - green colour
Blood sputum
hemoptysis
combination sputum
seromucous sputum , mucopurulent sputum , mucous - bloody sputum
Rusty sputum
Mucofibrinous , aerated , viscous - pneumococcus pneumonia
Pearled sputum
at the end of asthma crisis
Pseudomembranous sputum
high amount of mucus and fibrin , appearaance of bronchial tree cast
Vomica
= sudden elimination after cough effort of a clloection which has penetrated the airways - can be : > pus > serous , liquid > blood
Vomica appear from
- pulmonary parenchyma : abcess , hidatidosis
- pleural cavity
- Mediastinum : mediastinitis
- Abdominal : underdiphragmatic abcess
The evacuation can be associated with intense , tearing chest pain , dyspnea , anxiety
Vomica quantiny + differential diagnosis
large : 1-2 lt Medium : 250 -300 ml Differential Dg : - vomiting - pseudovomica > smaller quantity
Hemoptysis definition
evacuation of fresh , bright - red , aereated blood after cough , from tracheobronchial tree / pulmonary tissue
Hemoptysis : what does the patient feel ?
- Retrosternal heatsensation appears before the onset of hemoptysis
- Sometimes the patient has a special metallic taste,
- he is anxious, pale and dyspneic
Hemoptysis
Small hemoptysis = <100ml
· Medium hemoptysis = 100-500ml
· Large hemoptysis = >500ml
· Fractioned = hour or days, small amounts of blood
- In sudden, massive hemoptysis —> death by asphyxiation; patient shouldn’t be moved
- At the end of bleeding, the expectoration becomes black in colour
Hemoptysis Differential Diagnosis
blood from the oral cavity, pharynx, epistaxis
Hemoptysis - causes : 1,2,3,4
- Pulmonary Tuberculosis
- from the onset of the disease - 1st sign
or in evolution it can be massive - Chronic bronchitis + bronchiectasis : small hemoptysis
- Acute bronchitis : very rare , due to bronchial mucosa hiperemia - viral etiology / irritant gases
- Bronchiopulmonary cancer
Hemoptysis - causes : 5,6,7,8
- Cardiac causes : mitral stenosis , LV failure ( rare ) , pulmonary embolism with infarction , ruptured aortic aneurysm ( very rare )
- Thoracic trauma
- Hematologic bleeding disorders
- Endometriosis = diesease in which tissue that normally grows inside the uterus grows outside it
Chest pain cause : 1-7
- Pulmonary disease
- Cardiac disease
- Vascular disease
- GI disease ( esophagus )
- Spine disease
- Irradiation pain from abdominal aria ( acute cholecystitis )
- Chest wall
Chest pain in pulmonary disorders : Stitch
- similar to point knfe hit
- acute , high intensity
- accentuated with respiration , cough
- due to irritation of nerve endings in the parietal pleura
- appears in various respiratory conditions
Lobar pneumonia
= under the nipple, pathognomonic if its accompanied by shivering & temperature raise
Pneumothorax
At the nipple or subscapular
Pulmonary embolism with pulmonary infarction
= blood streaked sputum
Purulent pleural effusions
= skin hyperestesia
