Syndromes of respiratory system № 1 Flashcards
explain the DF , Etology , degree of compaction , location , Inflammatory consolidation syndrome complmints , of Syndrome of lung consolidation
–Syndrome of lung consolidation : its Significant reduction or complete disappearance of airiness of lung tissue in a more or less common area (segment, lobe, several lobes)
–Eitology : there is 2 types :
1-Inflammatory infiltration:
- Pneumonia
- Infiltrative tuberculous
- Lung abscess (before communication with the bronchus)
2-Noninflammatory etiology:
- Pulmonary infarction with pulmonary embolism, thrombosis
- Lung tumor
- Obstructive atelectasis (segmental or lobar)
- Compression atelectasis (pulmonary collapse)
- Hypoventilation
- Congestive heart failure
–degree of compaction of focal :
1-Hypopneumatosis
2-Distelektasis - incomplete alveoli collapse
3-Atelectasis - complete alveoli collapse
–Location :
1-The tops of the lungs
2-The lower parts of the lungs
3-Middle lobe
4-Subpleural location
–Inflammatory consolidation syndrome complmints:
1-Cough
2-Dyspnea
3-(fever)
4-Pain in the side
5-Chills
6-Sputum
7-Weakness
explain the Inspection and Palpation of Syndrome of lung consolidation
–Inspection :
* Hyperemia of face (cheeks)
* Herpes (not always)
* The lag part of the chest during respiration
–Palpation:
* Pain in the intercostal space
* Increase of vocal (tactile) fremitus
explain the Percussion and auscultation of Syndrome of lung consolidation
–Percussion : Dull or flat percussion note
–auscultation : Breath:
1-Weakened vesicular breathing
2-Bronchial breathing
3-Additional respiratory sounds
* Fine cracles
* cracles (small, medium-bubbles)
* Pleural friction
4-Bronhofoniya increaced
explain the Chest X-ray of Syndrome of lung consolidation
An X-ray sign of inflammatory infiltration of the lung tissue is a
shadow of a heterogeneous structure with blurred boundaries (a clear
darkening edge is formed when the inflammation is delimited from one side of the interlobar pleura).
Compaction of the fiber of the root of the affected lung and slight effusion in the costophrenic sinus may be observed
explain the Laboratory diagnostics of Syndrome of lung consolidation
–Blood test :
1-Leukocytosis, left shift
2-ESR acceleration
–Sputum :
1-“Rusty”
2-mucous
3-purulent
4-culture tests: Cocci et al.
5-microscopy: white blood cells (WBC), red blood cells (RBC)
explain the DF, types , of Atelectasis
–DF : Atelectasis is is a complete or partial collapse of the entire lung or area (lobe) of the lung. It occurs when the tiny air sacs (alveoli) within the lung become deflated or possibly filled with alveolar fluid
–types : there are 3 types
1-
explain the DF, types , of Atelectasis
–DF : Atelectasis is is a complete or partial collapse of the entire lung or area (lobe) of the lung. It occurs when the tiny air sacs (alveoli) within the lung become deflated or possibly filled with alveolar fluid
–types : there are 3 types
1-Obstruction or reabsorption - compression, resulting in blockage of the bronchus > Pneumonia
2-Compression (extramore often intrapulmonary) -
compression of the lung from the outside > lung tumor or hydrothorax in the plura
3-Contraction (collapse) - compression, resulting of pneumothorax > fibrosis
explain the Compressive atelectasis , DF , Etiology , sings , X ray examnation
–DF : Compression (extramore often and
intrapulmonary) - compression of the lung from the outside
–Causes:
1-pneumothorax
2-pleural effusion syndrome
3- Lung tumor
–Sings:
1-Dyspnea.
2-Asymmetric chest motions in respiration.
3-Increased vocal fremitus in consolidation area.
* Dull-tympanic note (at the initial stage)
* Dull or flat percussion note
* - At the initial stage of atelectasis (hypoventilation stage) when a small amount of aired alveoli in the collapsed area is still kept, diminished vesicular breath sound may be defined. Then, after air resorption, breath sound becomes bronchial
–X ray examnation :
* Homogeneous darkening is determined, corresponding to the boundaries obtained with percussion, the presence of fluid in the external sinus can be detected. With the accumulation of a large amount of fluid, themediastinum shifts to the healthy side, and the diaphragm is pushed down
explain the Obstruction atelectasis , DF , Etiology ,Inspection and palpation of the chest ,Percussion and auscultation
–DF : Obstruction - compression, resulting in blockage of the bronchus which lead to collapse of part all lung
–Etiology :
* closure of airing bronchus
lumen by:
1-endobronchial tumour,
2-foreign body,
3-compression of the bronchus from the outside by enlarged lymph nodes or a cancerous tumor
–Inspection and palpation of the chest :
1-In the presence of severe atelectasis, a decrease in the volume of the affected half is observed (the affected part of the chest sinks due to a drop in intrapulmonary pressure), the intercostal space is narrowed.
2-Restriction of mobility on the affected side of the chest.
3-Decrease of vocal (tactile) fremitus
–Percussion and auscultation :
1- Percussion : Dull or flat percussion note
2- Ausculation :
Breath: Weakened vesicular breathing or complete lack of breathing over the affected side
Bronhofoniya - decrease.
explain the X ray examnation of Obstruction atelectasis
X-ray examination: homogeneous intensive darkening of the lung tissue of a triangular shape (the apex is facing the root of the lungs, and the base is adjacent to the wall of the chest cavity) with a retracted border.
The intercostal space on the roentgenogram is narrowed, the mediastinal organs are displaced to the diseased side, there is a higher standing of the diaphragm in relation to the healthy lung
explain the Lung cavity syndrome ( lung abscess) DF, Etiology ,Symptomatology, Stages , cilincal sings
–DF:Lung abscess is a type of liquefactive necrosis of the lung tissue and formation of cavities
–Etiology :
1-Abscessed pneumonia
2-Tuberculous cavity
3-Abscessed pulmonary infarction
4-Wegener’s granuloma
5-Gangrene
6-Disintegrating tumor
–Symptomatology in every concrete case depends
on many conditions:
1-Cavity size
2-Depth of its location
3-Cavity contents: air only (empty cavity), air with some amount of fluid (e.g. air and exudates).
4-respiratory tract ( via drainage bronchus) or isolated cavity
–Stages :
1-inflammatory inflitarion of lung tissue
2- 2nd stage formation of cavity filled with pus
3- 3rd stage occurence of obilatraion of the cavity with the formation of the area of pneumosclarosis
– clinical sings
-1- first Stage - before communication with the bronchus (isolated cavity)
1-Hectic fever
2-Cough - dry or with a small amount of sputum
3-General weakness
4-Forced position on the affecten side
5-Decrease of vocal (tactile) fremitus
6-Dullness of percussion sound
7-Weakened vesicular breathing
-2- second Stage - after communication
with the bronchus
1-Reducing signs of intoxication
2-Productive cough with a big amount of purulent sputum
3-Increased vocal fremitus
4-Tympanic sound
5-Bronchial or amphoric sound
6-Coarse crackles (major “bubble” crackles or medium “bubble” crackles)
explain the Conditions under which it is possible to identify
cavity syndrome: - / X ray examnation , Laboratory diagnostics
—Conditions under which it is possible to identify
cavity syndrome: -
1-the cavity in the lungs should be at least 4-5 cm in diameter;
2-the cavity should be located near the chest wall;
3-the lung tissue surrounding the cavity should be compacted;
4-the walls of the cavity should be thin;
5-the cavity must communicate with the bronchus and contain air.
—- X ray examnation of the lung abscess :
-characterized by : the presence of limited round-shaped darkening, as a rule, against the background of pneumonic infiltration with a horizontal fluid level or without it
— Laboratory diagnostics :
1-Blood
- Leukocytosis
- Shift left of leykoformula
- ESR acceleration
- Toxic granularity of neutrophils
2-Sputum
- Pus mixed with blood
- Number - up to 2 liters per day
- Smell - putrescent
- two, three-layer sputum
- Microscopically:
1) cork Dietrich
2) Pieces of necrotic lung
3) The crystals of cholesterol, fatty acids
explain the Emphysema pulmonary syndrome , DF , Etiology , Anatomical substrate
–DF : is characterized by a pathological expansion of air spaces
located distal to the terminal bronchi, and is caused by
a decrease in the elastic properties of the alveolar
septa
–Etiology :
1-Obstructive bronchitis (CORD)
2-Bronchial asthma
3-Emphysema
4-Cancer lymphangitis
–Anatomical substrate :
-decrease in elastic traction of the lungs; - expiratory collapse
of terminal bronchioles; - expansion of the air spaces of the
lungs with the destruction of the alveoli
–
explain the classfication of Emphysema of lungs , Causes,
- Interstitial
- Alveolar:
2-1 nonobstructive
2-2 obstructive
2-3 diffuse
2-4 acute
2-5 chronic
3-Primary emphysema : is a genetically determined deficiency of 1-antitrypsin
4-Secondary emphysema: develops against the background of
chronic lung diseases.
–Causes:
1-frequent cough (chronic bronchitis);
2-chronic obstructive pulmonary disease (COPD);
3- genetically determined deficiency of 1-antitrypsin;
4- mechanical stretching of the alveoli during forced expiration
(for glass blowers, singers), musicians playing wind instruments);
5-smoking;
6-elderly age .
explain the Pathogenesis of secondary (obstructive)
alveolar emphysema
–The valve mechanism is:
Chronic obstructive bronchitis
1- bronchial distortion
2- bronchospasm
3-mucus accumulation
4-accumulation of air in the alveoli
5-compression of the alveoli causes a deterioration in
power of their walls, dystrophy and deterioration of the
mechanical properties
6-the destruction of the alveoli
