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Year 2 Cardio > week 2 > Flashcards

week 2 Flashcards

1
Q

name 6 possible mechanical causes of increased work of breathing

A

increased airway resistance
increased elastic load
decreased energy supply
decreased power
increased drive to breathe
increased alveolar surface tension

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2
Q

Name some pathologies that cause increased airway load/resistance

A

COPD
asthma
chest infection
lung tumour

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3
Q

what are some of the causes of increased airway resistance

A

increased secretions
inflammation in the airways
bronchospasm
obstruction in the airway

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4
Q

name some pathologies that can cause increased elastic load

A

pulmonary fibrosis
surfactant depletion
hyperinflation
pregnancy
distended abdomen
obesity
abdominal surgery
kyphoscoliosis
ankylosing spondylitis

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5
Q

explain how increased elastic load increase WOB

A

reduction in lung compliance increases the inspiratory muscle work required to overcome the elastic recoil of the lungs
increases inspiratory muscle work
increased alveolar surface tension
reduction in chest wall compliance

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6
Q

name some pathologies that can cause decreased energy supply

A

eating difficulties
hypovolemic shock

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7
Q

explain how decreased energy supply is a problem

A

malnutrition
lack of perfusion tot he respiratory muscles

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8
Q

name some pathologies that can cause respiratory muscle dysfunction

A

MND
MS
GBS
COPD
kyphoscoliosis
malnourished
phrenic nerve damage

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9
Q

name some pathologies that increase the drive to breathe

A

pneumonia
fibrosis
acidosis
anaemia

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10
Q

how does respiratory muscle dysfunction affect WOB

A

there is reduced power or endurance

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11
Q

name some pathologies that increase alveolar surface tension

A

pulmonary oedema
acute respiratory distress syndrome (ARDS)
surfactant depletion

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12
Q

what are the preliminary checks for interpreting an X ray

A

name and date
projection (AP/PA)
exposure
position (supine, erect, rotated)
inspiration

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13
Q

What system do you use to interpret an X-ray

A

A-G
A=alignment
B=bones
C=cardiac
D=diaphragm
E=expansion
F=field

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14
Q

what are some common abnormalities for chest x-rays

A

consolidation
atelectasis/collapse
pleural effusion
pneumothorax
pulmonary oedema
fracture

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15
Q

what is consolidation

A

A condition in which the lung tissue becomes firm and solid rather than elastic and air-filled because it has accumulated fluids and tissue debris

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16
Q

what would you see on a chest x ray for someone with consolidation

A

white/grey shadow
no loss of volume

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17
Q

what would you hear on auscultation for someone with consolidation

A

increased breath sounds/bronchial breathing or decreased breath, with or without crackles or wheezes (dependent on stage of consolidation)

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18
Q

what are the main causes of consolidation

A

pneumonia
chest infection
lung contusion following trauma

19
Q

what is atelectasis/ collapse

A

an airless state of the lung tissue which may involve all or part of the lung

20
Q

what would you see on a chest x ray for someone with atelectasis/collapse

A

white/grey shadow, with loss of volume and shifting of structures
a total collapse may displace (pull the mediastinum towards the affected side

20
Q

what would you hear when auscultating a patient with atelectasis/collapse

A

quiet breath sounds if occluded bronchus or bronchial breath sounds if patent bronchus
fine end-inspiratory crackles with smaller atelectasis

21
Q

what are the main causes of atelectasis/collapse

A

shallow breathing
bronchial obstruction
absorption of trapped gas
surfactant depletion
compression from external pressure such as pleural disorder
abdominal or cardiothoracic surgery

22
Q

what is pleural effusion

A

excess fluid in the pleural cavity

23
Q

what is seen on the chest x ray of a patient with pleural effusion

A

A small amount of fluid will result in loss of the costo-phrenic angle
as the amount increases a fluid line may be visible
large amounts of fluid will displace (push) the mediastinum towards the non-affected side

24
Q

what will you hear when auscultating a patient with pleural effusion

A

quiet breath sounds over the pleural effusion with bronchial breathing just above the top of the fluid level

25
Q

what are the main causes of pleural effusion

A

disturbed osmotic or hydrostatic pressure in the plasma
changes in membrane permeability
malignancy
heart, kidney or liver failure
abdominal or cardiothoracic surgery
pneumonia
TB

26
Q

what is pneumothorax

A

air in pleural space secondary to a rupture in either pleural layer
lung squashed towards the hilum in proportion to the amount of pleural air

27
Q

what would you see on the chest x ray of a patient with pneumothorax

A

air in pleural space is very black

28
Q

what would you hear when auscultating a patient with pneumothorax

A

quiet over the area of pneumothorax

29
Q

what are the main causes of pneumothorax

A

fast growth, particularly in men
blebs particularly smokers
trauma such as #ribs, surgery, insertion of a line
barotrauma with high pressure positive pressure devices
bullae in emphysema

30
Q

what is pulmonary oedema

A

extravascular water in the lungs - interstitial and alveoli

31
Q

what would you see on the chest x ray of someone with pulmonary oedema

A

bilateral fleecy opacities spreading from the hila known as bats-wings or butterfly-wing shadows
depending on the cause there may also be an enlarged heart

32
Q

what would you hear when auscultating someone with pulmonary oedema

A

Crackles that are more evident in dependent regions, sometimes fine, sometimes bubbly noise

33
Q

what are the main causes of pulmonary oedema

A

fluid overload
back pressure from a failing left heart
osmotic or hydrostatic pressure changes
increased capillary permeability

34
Q

what do barrel chested patients have

A

hyperinflation

35
Q

what conditions do you commonly see hyperinflation in

A

COPD
asthma
CF
bronchiectasis

36
Q

what is interstitial lung disease

A

a group of conditions that is characterised by fibrosing or scarring of the lung tissue

37
Q

what would you see on a chest x ray of a patient with pulmonary fibrosis

A

reticular shadowing of the lung peripheries, which is more prevalent in the bases
the heart appears less distinct
often appears as ground glass

38
Q

what are the differences between CT and MRI

A

CT is quicker
CT is cheaper
Ct is better at providing general images of tissues, organs and skeletal system.
MRI is thought to be more superior in regards to detail of image

39
Q

what factors affect strength within the respiratory system

A

diminished CNS drive
muscle weakness
impaired peripheral nerve innervation

40
Q

what factors affect the load within the respiratory system

A

chest wall abnormalities
crushed chest
fractured ribs
airway and lung abnormalities

41
Q

name some conditions in which the efficiency of the respiratory muscles can be reduced

A

respiratory disease/thoracic deformities
severe obesity
ascites
pregnancy
cardiac disease
cerebral lesions
sepsis

42
Q
A

Year 2 Cardio (10 decks)

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