Upper and Lower Respiratory Disorders Flashcards
What parts of the body qualify as the upper respiratory tract? (6)
Nose
Paranasal Sinuses
Pharynx
Larynx
Trachea
Bronchi
Fill in the blank:
Most upper airway disorders are _____.
minor
what can upper airway disorders cause?
discomfort
inconvenience
how are upper airway disorders treated?
self treated
What is the most common the of upper airway disorder?
the common cold
True or False?
URI’s are the most common reason for seeking health care?
True
It is also the most common cause of children missing school, and adults missing work
What type of pathogen most often causes URI’s?
Viruses
90% caused by viral infection
What are the four causes of upper airway obstruction and trauma?
- OSA
- Nasal obstruction
- Fractures of the nose
- Epistaxis
what is OSA?
Obstructive sleep apnea
causes recurrent apnea during sleep
loud snoring with periods of apnea
what is nasal obstruction? and what are 3 examples of a nasal obstruction?
blockage in the nose
may be caused by deviated septum, hypertrophy of turbinate and nasal polyps.
Why might a fracture in the nose cause obstruction?
location of the nose makes it susceptible to injury
may result in hematoma, infection, abscess, avascular or septic necrosis
what type of population is OSA most common in?
overweight men with large, thick necks
what is epistaxis?
nose bleed
what is the tx for OSA?
CPAP during sleep
what is a deviated septum characterized by?
sideways deviated septum, causing congestion, and noisy breathing
what might the treatment be for deviated septum?
nasal steroids; may resolve over time
what is a primary concern for nose fractures?
blood flow to the nose
treatment for nose fractures?
surgery if the bone is displaced.
when do we recommend people see an ENT for epistaxis?
if they have frequent nosebleeds
what can cause nose bleeds?
Hypertension
nose fractures
deviated septum
what is a laryngeal obstruction?
blockage of the upper airway, when the passage become narrow or blocked
what parts are effected?
trachea
larynx
pharynx
what is exercise induced laryngeal obstruction?
transient, reversable narrowing of the larynx, caused by intense exercise
what happens in exercise induced laryngeal obstruction?
airflow becomes impeded causing SOB, stridor, and some discomfort
who is exercise induced laryngeal obstruction most often seen in?
athletes
what may exercise induced laryngeal obstruction be misdiagnosed as?
exercise induced bronchoconstriction
Asthma
what is the larynx?
a stiff box that has a mucosal lining
what is most important to remember when treating disorders of the larynx?
it is stiff, and can be obstructed quickly
what is sinusitis?
inflammation of the paranasal sinuses
what does paranasal mean?
adjacent/surrounding to the nasal cavities
What pathogens could cause the sinusitis? (3)
bacteria
virus
fungus
what can sinusitis also be the result of? (2)
allergic reaction
autoimmune reaction
what is an autoimmune reaction?
when the immune system attacks the good parts of the body
what is sinusitis also known as?
rhinosinusitis
this is because inflammation of the nose almost always occurs with inflammation of the sinuses
true or false:
Sinusitis cannot be referred to as the cavity it affects
FALSE
sinusitis is referred to as the cavity it is affecting
what are the 4 different sinuses?
- maxillary
- frontal
- ethmoid
- sphenoid
what might maxillary sinusitis present with?
-pt feels pain/pressure in the cheek area
what might maxillary sinusitis be misdiagnosed as?
toothache/headache
what might frontal sinusitis present with?
pt feels pain behind or above the eyes
what may frontal sinusitis be misdiagnosed as?
headache
will enjoy cool/warm compresses
what may ethmoid sinusitis present with?
pain and pressure behind or between the eyes
what may ethmoid sinusitis be misdiagnosed as?
Headache
what may sphenoid sinusitis present with?
pain and pressure in the top part of the head
what is sinusitis linked to?
asthma
non-pharm tx for sinusitis?
salt water flushes
steam inhalation
fluids
pharm tx for sinusitis?
antibiotics
nasal corticosteriods
when may sinusitis need surgery?
if a patient has it chronically
what is acute tracheobronchitis?
acute inflammation of mucuous membranes of trachea and bronchial tree
what is tracheobronchitis often preceded by?
URI
what organisms can cause tracheobronchithis?
strep pneumonia
H.Flu
mycoplasma pneumonia
aspergillus
bordatella
pertussis
coronavirus
what non organism is a cause of tracheobronchitis?
inhalation of irritants
s/s of acute tracheobronchitis?
dry/convulsive cough on inspiration, mucoid sputum, SOA, stridor, wheeze, purulent sputum
what percent of cases of acute tracheobronchitis are viral?
more than 80%
tx of acute tracheobronchitis?
antibiotics
antiinflammatories
sputum culture
fluids to thin secretions
rest
what is pneumonia?
inflammation of the lung parenchyma
what is parenchyma?
any form of lung tissue including bronchioles, bronchi, blood vessels, interstitum, and alveoli
what can cause pneumonia?
bacteria
mycobacteria
fungi
viruses
who is most susceptible for pneumonia?
those with history of pneumonia
what is the most common cause of pneumonia in a child?
virus
what is the most common cause of pneumonia in an adult?
bacterial
T/F
Pneumonia is the leading infectious killer of children under 12
FALSE
it is the leading infectious killer of children under the age of 5
What is a non pathogenic cause of pneumonia?
aspiration pneumonia
what may cause a patient to obtain hospital acquired pneumonia?
a ventilator with improper oral care and suctioning
who is at highest risk for aspiration pneumonia?
Patients with an OG, Ventilated, poor gag reflex, or stroke pts
what is 3 ways to prevent pneumonia?
immunization
adequate nutrition
environmental factors
what does pneumonia create a mismatch in?
ventilation and perfusion
what does the ventilation and perfusion mismatch cause?
arterial hypoxia
how can pneumonia cause death?
it effects ventilation and perfusion; oxygen has trouble reaching the blood; causing the body to not work properly
the risk of infection increases and can easily spread throughout the body
what does the secretions and mucosal edema occlude?
ventilation
what can cause the block of diffusion of oxygen and C02?
exudate in the alveoli
what is indicative of arterial hypoxia?
An ABG, showing a Pa02 of <80mmHg
clinical manifestations of pneumonia?
-HA, fever, pleuritic pain, myalgia, pharyngitis, purulent sputum, orthopnea, confusion and lethargy
how to dx pneumonia?
chest Xray, history, exam, cultures
tx of pneumonia?
antibiotics
hydration
rest
NSAIDS
what is the most common antibiotic used for pneumonia?
zithromax
T/F
It is very important to take a cough suppressant when you have pneumonia
FALSE
if you suppress the cough, there is no way for all of the sputum to escape the lungs
what are the 3 keys to management of pneumonia?
- blood cultures
- antibiotics do not work for viral pneumonia
- monitor for shock and respiratory failure
What is pulmonary tuberculosis caused by?
acid fast aerobic rod
what does pulmonary tb affect?
lung parenchyma, meninges, kidneys, bones, and lymph nodes
how is TB spread?
airborne
how does TB settle in the lungs?
inhaled mycobacteria settle in the alveoli and can enter blood stream and spread to different areas
what test is used to dx TB?
PPD or Mantoux skin test
What is the difference between latent and active TB?
latent causes the germs to be dormant; they cannot spread TB to others
active TB causes germs to be reproducing and spreading through out the body
how is latent TB treated?
one medication for nine months
what are the s/s of active TB?
cough lasting more than 3 weeks
weight loss, night sweats and fever
what is the tx for active TB?
3-4 meds for at least 6 months
how to ID tb?
PPD test, CXR, sputum, interferon Gamma Release assay
what is COPD?
a group of lung conditions that make it hard to breathe well
What are the 2 most common COPD lung diseases?
chronic bronchitis
emphysema
why are chronic bronchitis and emphysema both classified together as COPD?
because those with COPD generally have symptoms of both disorders
What type of disease is COPD?
chronic and progressive; meaning it never goes away, and it never gets better, it slowly gets worse and worse over time
what are the primary causes of COPD?
breathing in irritants and toxins, pollution, exposure to dust and chemicals, cigarette smoke, secondhand smoke
what is the number one cause of COPD?
smoking cigarettes
how do pts with COPD present?
coughing, wheezing, barrel shaped chest, accessory breathing, tripod positioning
tx of COPD?
bronchodilators; they work to decrease hyperinflation, improve the emptying of the lungs and improve exercise performance
what are the goals for tx of COPD?
- slow the decline in lung fx
- relieve s/s
- improve daily function
- decrease exacerbations
- improve quality of life
what is a pulmonary embolism?
obstruction of the pulmonary artery or branch by thrombus/emboli
what is ventilation and perfusion mismatch?
ventilation is the air that reaches the alveoli and perfusion is the blood that reaches the alveoli
how is ventilation and perfusion measured?
with a V/Q scan
what does the V represent in a V/Q scan?
amount of air that reaches the alveoli
what does the Q represent in a V/Q scan?
amount of blood that reaches the alveoli
what does the V/Q scan determine?
o2 and C02 concentration
what does the PVR look like during a PE?
increased
What does the PAP look like during a PE?
increased
why might there be increased ventricular work during a PE?
to maintain pulmonary blood flow
what may increased ventricular work cause?
right ventricular failure which leads to decreased CO followed by decreased systemic BP and shock
s/s of PE?
dyspnea, tachypnea, pleuritic chest pain, anxiety, fear, tachycardia, hemoptysis, syncope
when can death occur with a PE?
within 1 hour of onset of symptoms
how to dx a PE?
CXR, EKG, usually sinus tach, PR interval depression and nonspecific T wave changes ABG VQ scan or CT D-dimer pulmonary angiogram
what is the most definitive method of dx a PE?
pulmonary angiogram
