Unit 2 SG Flashcards
tachypnea
rapid breathing, >24 breath/ min
hypernea
tachypnea with very large breaths
bradynea
slow breathing, <12 breaths/ min
hyponea
shallow, slow breaths
orthopnea
shortness of breath when lying down
angina
chest pain caused by reduced blood flow to the heart
tactile fremitus
vibration of the chest wall that results from sound vibrations created by speech or other vocal sounds
cheyne-stokes breathing pattern
varying periods of increasing depth interspersed with apnea
adventitious breath sounds
sounds that are heard in addition to the expected breath sounds mentioned above
rhinovirus
infections causes common cold
adenovirus
common virus, causes range of illnesses, cold-like symptoms
Asthma
pulmonary disorder characterized by reversible airway obstruction that results from hyperactivity. Two components lead to obstruction inflammation and spasm.
Triggers- allergens, stress, anxiety, smoke, environmental pollutants, cold ambient temperatures, exercise
Signs and symptoms- shortness of breath, wheezing, chest tightness, dry cough. Respiratory rate and heart rate may be elevated. Breath sounds diminished.
How to diagnose and treatment- response to albuterol is often diagnostic. use of inhaled medications is the main treatment. Steroids can also be used. Avoid known triggers.
Prognosis, prevention return to play- athletes with mild asthma can participate. Refrain from activity when having problems
exercise-induced bronchospasm
reduction in lung function that occurs after a standardized test. Bronchospasm with decreased pulmonary function following exercise. More common in winter sports.
Triggers- strenuous exercise
Signs and symptoms- shortness of breath, dyspnea, cough, chest congestion, tightness with exertion
How to diagnose and treatment- bronchial provocation challenge is used to determine diagnosis. Use of B2-agonist from inhaler 15 to 30 minutes before exercise.
Prognosis, prevention return to play- no exclusion from play if EIB is controlled
acute and chronic bronchitis
inflammation of the bronchial passages. Acute is most common in self limited viral infections.
Signs and symptoms- acute would be productive cough. Can have clear sputum but can be yellow. Chest congestion and tightness mild shortness of breath. Can have fever, chills, night sweats. Must role out pneumonia.
How to diagnose and treatment- no diagnostic tests for bronchitis but should rule out other diseases first such as chest X-ray and CBC. Treatment is support, used of mucolytic, cough suppressants, and NSAIDs, fluids.
Prognosis, prevention return to play- can play as tolerated if no fever.
pneumonia
inflammation of lung parenchyma. Can be viral, bacterial, or fungal.
Signs and symptoms- shortness of breath, pleuritic chest pain, productive cough with dark colored sputum, abdominal pain, respiratory rate may be elevated, breathing labored, adventitious rales,
How to diagnose and treatment- antibiotics, refer to physician if febrile and labored breathing with chest pain or cough. Chest x ray can help diagnose. Hydration, mucolytic and cough suppressants.
Prognosis, prevention return to play- can return with no fever and normal vital signs. Should start antibiotics before return to play and can take up to 7-10 days for athlete to feel well enough to return.
pleurisy
inflammation of pleura that causes pain, can be caused by lung inflammation, rheumatic diseases, chest trauma, cancer, and asbestos related diseases. Fluid accumulation in site of pleural inflammation. Can compromise breathing.
Signs and symptoms- cheat pain at site of inflammation. Associated with breathing or any movement of chest wall. Can produce sound called a friction rub, can have rales or rhonchi.
How to diagnose and treatment- clinical examination. Refer to physician with non-traumatic chest pain. Lab tests can tell if viral or bacterial infection. Chest X-ray may reveal pneumonia or mass. Chest CT can show underlying lung disease. Ultrasound can detect fluid. Treating underlying conditions, NSAIDs, antibiotics if bacterial. Recovery depends on underlying illnesses but usually good with treatment.
Prognosis, prevention return to play- can return to play if no signs of other conditions or after other conditions have been addressed and athlete is without fever. Should gradually increase workload
influenza
viral infection, outbreaks in fall and winter. Transmitted person to person through droplets.
Signs and symptoms- rapid onset, high fever, headache, muscle aches, cough, chest pain, shortness of breath, fatigue, loss of appetite, nasal congestion, sore throat.
How to diagnose and treatment- refer individuals who have been in contact with someone with influenza. Usually clinical but can do an antigen test. Treatment is supportive and bed rest. Analgesics, increased fluid intake, avoid contact with others.
Prognosis, prevention return to play- resolves in 7-10 days. Can return to play after a week or two if the afebrile and no respiratory compromise at rest. To prevent stay way with others who have influenza and be immunized, handwashing and not sharing drinks
upper respiratory infection
viral infection in upper respiratory tract. Can be caused by rhinovirus, adenovirus, and parainfluenza virus. Highly transmissible through contact with infected droplets.
Signs and symptoms- mild, fever, cough, nasal congestion, sore throat, runny nose.
Red flags- fever greater than 100 degrees F, chills, night sweats
How to diagnose and treatment- refer if symptoms last longer than 7-10 days. Treatment mainly supportive such as cough suppressants, decongestants, antihistamines, and expectorants.
Prognosis, prevention return to play- prevention includes not sharing drinks and proper hand washing. May play as long a afebrile and able to stay hydrated
tuberculosis
highly contagious bacterial infection caused by Mycobacterium tuberculosis. Involved lungs, development of granulomas in infected tissues. Usually, asymptomatic.
Signs and symptoms- asymptomatic with latent TB. With active pulmonary TB symptoms are mild and insidious, fatigue, fever, weight loss, and cough. Can have chest pain, shortness of breath, and wheezing.
How to diagnose and treatment- can do a skin test for latent TB. Active TB is diagnosed with positive PPD test and consistent symptoms of pulmonary TB and radiographic evidence of infection. Latent TB is treated with chemoprophylaxis for several months under supervision of physician. Active TB involves several antibiotics.
Prognosis, prevention return to play- anyone with TB or suspected may not play. Normal activity can be resumed after contagious period
lung cancer
affects smokers, those exposed to secondhand smoke,
Signs and symptoms- develop slowly overtime, can have fever, fatigue, weight loss, and loss of appetite. Cough with bloody sputum, chest pain and shortness of breath, pneumonia can develop. Pleural effusion may be detected.
How to diagnose and treatment- chest x Ray to detect malignancies. Bronchoscopy or biopsy of malignant. Treatment can include radiation therapy, chemotherapy, or surgical excision, most cases use palliative therapy if only option.
Prognosis, prevention return to play- has a cure rate from 25-5%
ARDS
accumulation of pulmonary edema that is caused by fluid accumulation in the interstitial space. sepsis, aspiration, pneumonia, pulmonary injury, oxygen toxicity, high altitude
Signs and symptoms- hypoxia, hypotension, cardiac arrest, dyspnea, confusion, agitation, unusual breathing sounds
How to diagnose and treatment- call 911, provide supplemental oxygen, monitor vital signs, corticosteriods
Prognosis, prevention return to play- high mortality, multiple organ failure
COPD
nonreversible airway obstruction, 2 categories: emphysema is characterized by destruction of alveoli and pulmonary capillary bed, decreases ability to oxygenate blood. Chronic bronchitis is excessive mucus production with upper airway obstruction.
Triggers- long term smoking
Signs and symptoms- emphysema high respiratory rates and ruddy skin tone due to muscle wasting. Rounded chest, diffuse wheezing, and decreased breath sounds. Chronic bronchitis will have smoker’s cough, edema, and cyanosis, coarse rhonchi, and wheezing.
How to diagnose and treatment- chest X-ray and CT scans. Pulmonary function testing and absence of reversibility. Treatment looks at addressing spasm and inflammation. Can include oxygen therapy. Medicine to control bronchospasms. Quitting smoking.
Prognosis, prevention return to play- those with mild disease can participate when tolerated
emphysema
destruction of alveoli and pulmonary capillary bed, decreases ability to oxygenate blood.
Triggers- long term smoking
Signs and symptoms- high respiratory rates and ruddy skin tone due to muscle wasting. Rounded chest, diffuse wheezing, and decreased breath sounds.
How to diagnose and treatment- chest Xray and CT scans. Pulmonary function testing and absence of reversibility. Treatment looks at addressing spasm and inflammation. Can include oxygen therapy. Medicine to control bronchospasms. Quitting smoking.
Prognosis, prevention return to play- quitting smoking, mild disease can participate
pulmonary embolism
obstruction of pulmonary artery, emboli of air, thrombus, fat, amniotic fluid, foreign body
Signs and symptoms- heart failure, JVD and hypertension, warm swollen extremities.
How to diagnose and treatment- maintain airway, support breathing, monitor vital signs call 911
toxic exposure (carbon monoxide)
carbon dioxide binds to hemoglobin which means oxygen cannot bind to hemoglobin.
Signs and symptoms- hypoxia, carboxyhemoglobin
How to diagnose and treatment- remove from exposure to fresh air, support breathing, 911 if severe
hyperventilation syndrome.
fast breathing in an individual, can be caused by acidosis, pain, pneumonia, hypoxia, high altitude.
Signs and symptoms- rapid breathing, chest pain, numbness, tachypnea, tachycardia, fatigue, dizziness, dyspnea, spams in feet or hands
How to diagnose and treatment- maintain airways, support breathing, call 911 if cannot be slowed down or not caused by panic attack
Turbinates
small structures inside the nose that cleanse and humidify air that passes through the nostrils into the lungs
Pharynx
passageway that extends from the base of the skull to the level of the 6th cervical vertebra. Both respiratory and digestive systems
Nasopharynx
the upper part of the pharynx, connecting with the nasal cavity above the soft palate
oropharynx
part of the pharynx that lies between the soft palate and the hyoid bone
laryngopharynx
behind larynx
larynx
the hollow muscular organ forming an air passage to the lungs and holding the vocal cords in humans and other mammals; the voice box
trachea
airway that leads from larynx to bronchi
bronchi
large airway that leads to the trachea to a lung
right main bronchus
wider, shorter, and vertical in direction
left main bronchus
smaller in diameter and longer
bronchiole
any of the minute branches into which a bronchus divide
alveolar sac
sacs of many alveoli
alveoli
cells that exchange oxygen and carbon dioxide
right lung lobes
3 lobes that upper, middle, and lower
left lung lobes
has 2 lobes upper and lower.
internal intercostal muscles
group of skeletal muscles located between ribs
external intercostal muslces
outer layer of muscles between ribs
diaphragm
dome shaped muscular partition separating the thorax from the abdomen in mammals. Plays role in breathing
explain the physiological process of ventilation
Chemoreceptors in medulla oblongata sense changes in pH and carbon dioxide levels. Decrease in pH and increase in carbon dioxide result in increase in ventilation. Neural control of breathing comes from phrenic nerve which innervates diaphragm. Diaphragm and intercostal muscles contract, and thoracic cavity expands. This generates negative pressure, which causes air to go into the lungs during inspiration. When alveolar pressure equalizes with atmospheric pressure, intercostal receptors fire and inspiration ceases. Elastic recoil of the thoracic cage results in passive process of expiration.
Describe the four common chest shapes and any common pathology that may be associated with each
Normal chest- thorax is elliptical and is narrower anterior to posterior than it is across the transverse axis
Barrel chest- rounded shape that is the same diameter from anterior to posterior as it is transversely. Chronic emphysema and asthma
Pectus excavatum- congenital shape, not symptomatic, presents with a depression at the junction of the xiphoid with the sternum.
Pectus carinatum- forward protrusion of the sternum
Describe the three methods in which the body maintains its acid-base balance
Respiratory Buffer works by increasing or decreasing CO2 by ventilation until its at the proper level. Can compensate in one to three minutes. The Renal Buffer works by retaining or excreting HCO3-. Can take hours or days to compensate. The buffer system helps to compensate and keep the body’s pH in the normal range.
What is the body’s normal pH?
7.34-7.45
respiratory acidosis
pH less than 7.35 and PaCO2 is greater than 45 mm Hg. Caused by accumulation of CO2 which produces carbonic acid which lowers the pH of the blood. Can occur form central nervous system depression from head injury, medications, sedatives, anesthesia. Impaired respiratory function from injury and disease, pulmonary disorders such as atelectasis, pneumonia, massive pulmonary embolus, and hypoventilation.
respiratory alkalosis
pH is greater than 7.45 and PaCO2 is less than 35 mm Hg. Caused by hyperventilation which could be anxiety, fear, pain, increased metabolic demands, medications, central nervous system lesions.
metabolic acidosis
Bicarbonate level less than 22 mEq/L with pH less than 7.35. Caused by deficit of base in bloodstream or excess of acids. Diarrhea and intestinal fistulas may decrease base. Renal failure, diabetic ketoacidosis, anaerobic metabolism, starvation, and salicylate intoxication may increase acids.
metabolic alkalosis
Bicarbonate level greater than 26 mEq/L and pH greater than 7.45. Either excess base or acid in the body. Excess base is from antacids, excess use of bicarbonate, use of lactate in dialysis. Loss of acids can occur secondary to vomiting, gastric suction, hypochloremia, excess diuretics, high levels of aldosterone.
pH> 7.45
alkalosis
pH < 7.35
acidosis
pCO2>45
acidossis
pCO2<35
alkalosis
