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LINDSAY - PATHO 1 > TEST 3 - RESPIRATORY PART 1 > Flashcards

TEST 3 - RESPIRATORY PART 1 Flashcards

1
Q

WHAT SYSTEM? Air distributor & gas exchanger.

A

RESPIRATORY

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2
Q

DEFINITION: air moving in and out of the lungs

A

VENTILATION

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3
Q

DEFINITION: the amount the lungs can inflate

A

DISTENSIBILITY

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4
Q

DEFINITION: the amount of force that the lungs have to work against

A

RESISTANCE

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5
Q

DEFINITION: how well the lungs can recoil

A

ELASTICITY

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6
Q

DEFINITION: The delivery of blood flow to a specific organ or an area of the body.

A

PERFUSION

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7
Q

Ventilation/perfusion (VQ) ratio:

A

4L air : 5 L of blood per minute

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8
Q

VQ scan is used to determine what?

A

whether there’s a blood clot

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9
Q

Clinical Manifestations of Respiratory Dysfunction

indicates irritation in upper respiratory tract

A

sneezing

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10
Q

Clinical Manifestations of Respiratory Dysfunction

difficulty swallowing

A

dysphagia

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11
Q

Clinical Manifestations of Respiratory Dysfunction

hoarse voice eg. laryngitis

A

Dysphonia

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12
Q

Clinical Manifestations of Respiratory Dysfunction

protective mechanism; occasional normal, productive is abnormal

A

cough

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13
Q

Clinical Manifestations of Respiratory Dysfunction

coughing blood

A

Hemoptysis

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14
Q

Clinical Manifestations of Respiratory Dysfunction

shortness of breath

A

dyspnea

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15
Q

Clinical Manifestations of Respiratory Dysfunction

positional shortness of breath, person needs to sit up to breathe

A

orthopnea

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16
Q

Clinical Manifestations of Respiratory Dysfunction

wake up at night with shortness of breath, eg. Pulmonary edema or CHF

A

Paroxysmal nocturnal dyspnea (PND)

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17
Q

Abnormal respiratory patterns - increase in the depth of breathing

A

KUSSMAUL

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18
Q

Abnormal respiratory patterns - progressive increase in rate of breathing, followed by a period of apnea

A

Cheyne Stoke

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19
Q

Use of accessory muscles - more common in children

A

NASAL FLARING

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20
Q

Use of accessory muscles - above the stermum

A

SUPRASTERNAL

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21
Q

Use of accessory muscles - above the clavicle

A

SUPRACLAVICULAR

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22
Q

Use of accessory muscles - below the stermum

A

SUBSTERNAL

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23
Q

Use of accessory muscles - below the ribcage

A

SUBCOSTAL

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24
Q

Use of accessory muscles - more common in children

A

intercostal indrawing

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25
Q

Abnormal respiratory sounds - snoring

A

SONOROUS BREATHING

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26
Q

Abnormal respiratory sounds - upper respiratory blockage, high pitched sound eg. croup

A

STRIDOR

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27
Q

Abnormal respiratory sounds - discontinuous popping sound

A

CRACKLES

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28
Q

Abnormal respiratory sounds - continuous musical quality

A

WHEEZE

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29
Q

Abnormal respiratory sounds - sound of pleura rubbing together

A

FRICTION RUB

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30
Q

PAIN FROM BREATHING

A

PLEURITIC

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31
Q

WHAT IS THIS?

  • fibrotic changes in nail beds
  • eg. Cystic Fibrosis, COPD due to chronic hypoxemia
A

CLUBBING OF DIGITS

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32
Q

an early sign of hypoxemia

A

ANXIETY/RESTLESSNESS

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33
Q

Conditions caused by Pulmonary Disease or Injury

elevated carbon dioxide levels in the blood

A

HYPERCAPNIA

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34
Q

Conditions caused by Pulmonary Disease or Injury

decreased O2 concentration in the blood

A

HYPOXEMIA

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35
Q

Conditions caused by Pulmonary Disease or Injury

Inadequate oxygen supply to the cells

A

HYPOXIA

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36
Q

end result of pulmonary disease

A

RESPIRATORY FAILURE

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37
Q

RESPIRATORY FAILURE - ARTERIAL BLOOD GAS OXYGEN LEVEL

A

< 60 mmhg

38
Q

RESPIRATORY FAILURE - ARTERIAL BLOOD GAS CARBON DIOXIDE LEVEL

A

> 45 mmhg/pH < 7.25

39
Q

6 Tests to Evaluate Respiratory Function

A
  1. Chest Xray (CXR): easiest & least expensive way
  2. Computed tomography (CT scan)
  3. Arterial blood gas analysis (ABG’s)
  4. Pulmonary function tests (PFT)/spirometry
  5. Sputum analysis (C&S, cytology, AFB: acid fast bacilli - test for TB)
  6. VQ scan (ventilation/perfusion scan)
40
Q

TRUE OR FALSE?

before bed is the best time to get a sputum sample

A

early morning bc of pooling of secretions overnight

41
Q

Categories of Respiratory Disorders

diseases where air has trouble getting in and out of the lungs; resistance to airflow

A

Obstructive

42
Q

Categories of Respiratory Disorders

disease that result in a decrease in lung expansion; lungs don’t expand

A

restrictive

43
Q

Categories of Respiratory Disorders

diseases caused by virus or bacteria, eg. pneumonia

A

infectious

44
Q

Categories of Respiratory Disorders

problem is in the bloodflow to the lungs, eg. pulmonary embolism

A

Disorders of Vascular Origin

45
Q

Categories of Respiratory Disorders

lung cancer

A

malignancies

46
Q

Obstructive Disorders

  • most commonly occurs in 6 months to 5 yr age group.
  • characterized by inflammation extending from vocal cords to bronchial lumina
A

CROUP

47
Q

Obstructive Disorders

Cause:

  • parainfluenza virus
  • influenza A
  • respiratory syncytial virus (RSV)
A

CROUP

48
Q

Obstructive Disorders

Clinical manifestations:

  • catarrhal symptoms
  • rhinorrhea
  • low-grade fever
  • barking cough
  • stridor
  • nasal flaring
A

CROUP

49
Q

Obstructive Disorders

TREATMENT & EVALUATION

  • based on symptoms
  • X-ray to rule out epiglottitis
  • Current treatment: glucocorticoid, epinephrine (<1% require intubation
A

CROUP

50
Q

Obstructive Disorders

Complication: bacterial tracheitis

A

CROUP

51
Q

Obstructive Disorders

Most common in 2 – 6 year age group, but may also affect adults

A

Epiglottitis

52
Q

Obstructive Disorders

Cause:

  • Haemophilus influenzae type B
  • Streptococcus pneumoniae
A

Epiglottitis

53
Q

Obstructive Disorders

Clinical manifestations:

  • sudden onset
  • sore throat, dysphagia, drooling, fever
  • “sniffing position”, muffled voice, anxious
  • stridor, respiratory distress
A

Epiglottitis

54
Q

Obstructive Disorders

Evaluation:

  • based on symptoms
  • X-ray of soft tissues of neck.
  • Characteristic “thumbprint”

*

A

Epiglottitis

55
Q

Obstructive Disorders

  • Do not attempt to examine pt’s throat because it can put person into laryngospasm and can occlude airway
A

Epiglottitis

56
Q

Obstructive Disorders

Prognosis:

  • fatal
  • death may occur in a few hours
A

Epiglottitis

57
Q

Obstructive Disorders

Treatment: IV antibiotics; may required rapid intubation.

A

Epiglottitis

58
Q

Obstructive Disorders

Highly contagious

A

Bronchiolitis

59
Q

Obstructive Disorders

Etiology:

  • respiratory syncytial virus (RSV)
  • virus can stay on stethoscope for 18 hours
A

Bronchiolitis

60
Q

Obstructive Disorders

Prevalence:

  • 2 – 24 month age group
  • November to February
A

Bronchiolitis

61
Q

Obstructive Disorders

Pathogenesis

  • Edema of submucosa, increase in mucus secretion
  • Necrosis of bronchial epithelium
A

Bronchiolitis

62
Q

Obstructive Disorders

Clinical manifestations

  • Nasal congestion, mild conjunctivitis,
  • Inspiratory crackles, expiratory wheezes
  • Use of accessory muscles, (such as intercostal indrawing), nasal flaring, increased work of breathing
A

Bronchiolitis

63
Q

Obstructive Disorders

Clinical manifestations

  • Tachypnea (with resp rate 50 – 60 per min)
  • Tachycardia, poor feeding
  • Pallor, cyanosis, hypoxemia
  • Episodes of apnea
A

Bronchiolitis

64
Q

Obstructive Disorders

Evaluation & Treatment

  • CXR, RSV screening
  • Humidity, fluids, rest
  • Infection control precautions
A

Bronchiolitis

65
Q

Obstructive Disorders

Inflammation of the trachea and bronchi

A

BRONCHITIS

66
Q

Obstructive Disorders

Etiology:
* influenza virus A or B, parainfluenza virus, respiratory syncytial virus (RSV); smoke or inhalation of chemical irritants

A

BRONCHITIS

67
Q

Obstructive Disorders

Pathogenesis:

  • Edema of mucous membranes
  • Increased mucous production
  • Loss of ciliary function
A

BRONCHITIS

68
Q

Obstructive Disorders

Clinical manifestations

  • Expiratory wheezing, dyspnea, malaise
  • Cough (productive or nonproductive)
  • Chest pain related to persistent coughing
A

BRONCHITIS

69
Q

Obstructive Disorders

Evaluation & Treatment:

  • based on clinical presentation, CXR
  • Increase fluids, smoking cessation expectorants/antitussives, antibiotics not routinely prescribed
  • People are at risk of reoccurring pulmonary infections
A

BRONCHITIS

70
Q 
Obstructive Disorders
Risk factors:
   * Family history
   * Allergen exposure
   * Exposure to air pollution and cigarette smoke
   * Urban residence
A

Asthma

71
Q

Obstructive Disorders

Pathogenesis

  • Hypersensitivity
  • Release of inflammatory mediators
  • Mucosal edema
  • Increased mucus production
  • Bronchospasm
A

Asthma

72
Q

Obstructive Disorders

Clinical Manifestations

  • Dyspnea, with increased respiratory effort
  • Wheezing (inspiratory and expiratory)
  • Prolonged expiration
  • Cough – nonproductive during acute attack; productive with thick mucous as attack resolves
  • Use of accessory muscles, respiratory distress with severe attacks
  • May lead to respiratory failure
A

Asthma

73
Q

Obstructive Disorders

Acute attacks: inhaled bronchodilators, oral corticosteroids, oxygen prn

A

Asthma

74
Q

Obstructive Disorders

Chronic management: avoidance of allergens and triggers, patient education, anti-inflammatories (ie. inhaled corticosteroids), antileukotrienes. Airway inflammation may be still be present in some individuals, even though they are asymptomatic

A

Asthma

75
Q

Obstructive Disorders

FOR ASTHMA PATIENTS

  • give ____________ first, short acting bronchodialator
  • give ____________ second, long acting cholinergic
A

ventolin

atrovent

76
Q

bronchospasm not reversed by usual measures.

A

Status asthmatics:

77
Q

Narrowing of the bronchi and bronchioles because of abnormal contraction of the smooth muscles of the bronchial walls

A

Bronchospasm:

78
Q

Obstructive Disorders

  • Permanent damage
  • Cannot be cured
  • Person must live with symptoms
A

COPD

79
Q

Obstructive Disorders

  • Hypersecretion of mucus and chronic productive cough for 3 months a year for 2 consecutive years
  • Increase in the size and number of mucous glands and goblet cells
  • Airway obstruction caused by chronic infection and injury
A

Chronic Bronchitis

80
Q

Obstructive Disorders

Risk factors

  • cigarette smoking (90% of cases),
  • 12 repeated airway infections,
  • genetic predisposition
  • inhalation of physical or chemical irritants
A

Chronic Bronchitis

81
Q

Obstructive Disorders

Clinical Manifestations

  • shortness of breath on exertion,
  • excessive amounts of sputum
  • chronic cough
  • evidence of excess body fluids (edema, hypervolemia)
A

Chronic Bronchitis

82
Q

Obstructive Disorders

Clinical Manifestations

  • history of smoking.
  • chills,
  • malaise,
  • muscle aches,
  • fatigue
  • “blue bloaters”
A

Chronic Bronchitis

83
Q

Obstructive Disorders

Pharmacologic treatment

  * use of inhaled short-acting β2 agonists and inhaled anticholinergic bronchodilators, cough suppressants, and antimicrobial agents for infections. 
  * Inhaled or oral corticosteroids may also be used in the treatment of some patients for acute exacerbations
A

Chronic Bronchitis

84
Q

Obstructive Disorders

Treatment

  • Low-dose oxygen therapy
  • Mechanical ventilation may become necessary
  • smoking cessation is essential
A

Chronic Bronchitis

85
Q

Obstructive Disorders

  • Loss of elastic recoil occurs from destruction of alveolar walls resulting in permanent enlargement of gas-exchange airways
    • big and boggy alveoli
    • air becomes trapped in alveoli
A

emphysema

86
Q

Obstructive Disorders

deficiency of alpha1-antitripsin which protects against proteolytic enzymes that want to destroy lung tissue

A

primary emphysema

87
Q

Obstructive Disorders

injury to lungs from inhaled toxins

A

secondary emphysema

88
Q

Obstructive Disorders

Clinical manifestations

  • barrel chested
  • “pink puffers”
  • tripod position
  • thin and emaciated appearance
  • high risk of pneumonia
A

emphysema

89
Q

Obstructive Disorders

Treatment

  • ventolin (bronchodilator)
  • flovent (corticosteroid inhaler)
A

emphysema

90
Q

Obstructive Disorders

  • Dilation of the bronchi
    • risk of rupture
    • threat of infection as a result of rupture
  • Saccular, cylindrical, fusiform
  • Weakening of muscle and elastic fibers of bronchial wall
  • Congenital or acquired
A

Bronchietasis

LINDSAY - PATHO 1 (4 decks)

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