Week 11: Respiratory System Flashcards
Breath sounds
Refer to selams notes
Cardinal features of lung disorders (case history)
Questions you might ask the patient too
Cough
- acute cough lasts up to 3 wks productive or non productive
- subcutaneous cough- lasts between 3-8 weeks
- chronic cough- last 8+ weeks
- sputum (ie mixture of saliva and mucous coughed up)- volume/colour
- shortness of breath (dyspnoea)
- chest pain
- haemoptysis- coughing up blood
- wheeze/ stridor (inspiratory wheeze)
Questions:
- have you been coughing a lot lately? Saliva, mucous, volume, colour
- do you have shortness of breath, wheezing or chest pain
- have you coughed up any blood?
Respiratory disease
Chronic obstructive pulmonary disease (COPD)
incurable disease, limitation of airflow (in and out) because:
- bronchi and alveoli loss of elasticity
- alveolar walls destroyed
- bronchi lining-thick and inflamed
- excess mucous production ➡blockage
- chronic bronchitis➡ chronic inflammation of bronchi
- emphysema- degeneration of alveoli➡ enlarged alveoli decreasing surface area making gas exchange, breathing difficult
Respiratory disease
Cystic fibrosis
(inherited disease) genetic defect reducing the bodies ability to carry salt and water to and from cells. This causes buildup of thick mucus that clogs up the lungs and digestive organs. (affects ; lungs, pancreas, liver, intestines, sinuses, reproductive organs) patient can develop fatty liver, cholestasis and cirrhosis
Respiratory disease
Neoplasia
Abnormal mass of tissue as a result of abnormal growth or division of cells. Usually causes a lump or tumour, may be benign or malignant.
- mouth, nose, Larynx
- lung
Respiratory disease
Pneumothorax
-abnormal collection of air or gas on the pleural space that separates the lung from the chest wall
Respiratory disease
Pulmonary Embolism
Pulmonary artery blockage (or its branches) by a substance that has travelled through the bloodstream.
Respiratory disease Respiratory tract infections Name the upper ones and what they are Sinusitis Rhinitis Pharyngitis Tonsillitis Laryngitis
Upper
1. Colds/influenza
2. Sinusitis- infection of the paranasal sinuses bacterial/ occasionally fungal (can occur with asthma).
Symptoms- frontal headache, rhinorrhea, facial pain with tenderness and fever
3. Rhinitis- sneezing attacks, nasal discharge or blockage occurring for more than and hour on most days.
4. Pharyngitis- common sore throat, in which the orzo pharynx and soft palate are red and the tonsils are inflamed.
5. Tonsillitis- inflammation of the tonsils most commonly caused by viral or Bacterial infection. Symptoms: sore throat and fever
6. Laryngitis- inflammation (narrowing of upper airways) of the larynx, characterised by voice hoarseness, lowered vocal pitch, contestant need to clear the throat
Name the lower ones and what they are Bronchitis Pneumonia Bronchiectasis Tuberculosis
Bronchitis: permanent enlargement of the bronchi, destruction of the alveolar walls➡ reduced gas exchange thus difficult to breath
Pneumonia: bacterial inflammation of the substance of the lungs. Presents as an acute illness with cough, purulent sputum and fever.
Bronchiectasis: bronchial walls become enflammed, thickened, dilated and irreversibly damaged. The mucocullary transport mechanism is impaired and there is frequent bacterial infections.
Tuberculosis: airborne contagious disease that can be fatal if left untreated. Higher prevelance in developing countries. It’s inhaled, taken up by macrophages (normally kille pathogens) bit the TB bacteria can live within it. Symptoms:
- bad cough (blood tinged phlegm) that last 3 or more weeks
- chest pain, fatigue, loss of appetite, weight loss, fever, chills and night sweats.
Further research Dry cough (causes)
- recent virus, head cold, or influenza
- asthma
- gastro-oesophageal reflux
- heart failure
- medicine induced cough
- response to a dry atmosphere, air pollution or changes in temp
Further research
Presentation of lung cancer
- chronic cough-doesn’t go away
- shortness of breath with activity
- pain or aching in your shoulder, back, chest or arm
- repeated infection such as bronchitis and pneumonia
- any abnormal symptoms or decline in health- fatigue, decreased appetite, unexplained weight loss, depression
Further research Asthma is? History Physical exam? Diagnostic testing? Relievers? Preventer? Symptoms controllers?
Is a common chronic inflammatory condition of the lungs History: -wheeze -chest tightness -shortness of breath
Symptoms:
- recurrent or seasonal
- worse at night or early in the morning
- triggered by exercise, irritants, allergies or viral infections
- rapidly relived by a bronchodilator
Diagnostic testing:
Spirometry-
-assess change in airflow limitation
-measure degree of airflow limitation compared with predicted normal flow
Relievers:
-bronchodilator -acute relied of asthma symptoms
Preventer:
-have anti-inflammatory properties and are generally taken regularly to reduce symptoms and exacerbations
Symptom controllers:
- produce prolonged bronchi dilation for up to 12 hrs,
- protect the airways from bronchoconstriction secondary to exposure to allergens, exercise etx,
What is the different between chronic bronchitis and emphysema (symptoms)
Chronic bronchitis
- long term cough
- increased mucous produ film
- shortness of breath
- frequent respiratory infections
- wheezing
Emphysema:
- shortness of breath (dyspnoea)
- rapid breathing
- chronic cough
- wheezing
- reduced exercise tolerance
- loss of appetite leading to weight loss
- barrel chest in later stages; building of chest cavity caused by hyperinflation of the lungs leaving the ribs constantly expanded
Further research
Whooping cough (pertussis)
Symptoms
Etc
Initial symptoms low grade fever, runny nose, congestion, sneezing and cough
When improvement is expected child gets worse presenting:
-coughing fits, which Might end in ‘whoop’ sound
-vomiting after coughing spells
-cyanosis or blue spells after coughing
Terms to know Cirrhosis- Cholestasis Purulent Rhinorrhea
Cirrhosis- a chronic disease of the liver marked by degeneration of cells, inflammation, and fibrous thickening of tissue. It’s typically result of alcoholism or hepatitis
Cholestasis-bile can’t flow from live to duodenum
Purulent- consisting of, containing discharging pus
Rhinorrhea- very runny nose, excess amount of mucus fluid
