Week 2 for Quiz 2 Flashcards
result of overinflation of the lungs, which increases the anteroposterior diameter of the thorax.
Barrel Chest
Barrel chest occurs in patients with?
aging, emphysema and COPD.
depression in the lower portion of the sternum. This may compress the heart and great vessels, resulting in murmurs
funnel chest (pectus excavatum)
funnel chest (pectus excavatum) occurs in patients with?
rickets or Marfan syndrome.
result of the anterior displacement of the sternum, which also increases the anteroposterior diameter.
rickets, Marf
PIGEON CHEST (pectus CARINATUM)
PIGEON CHEST (pectus CARINATUM) occurs in patients with?
rickets, Marfan syndrome, severe kyphoscoliosis
characterized by elevation of the scapula and a corresponding S-shaped spine. This deformity limits lung expansion within the thorax.
kyphoscoliosis
kyphoscoliosis occurs in patients with?
osteoporosis, thoracic skeletal
Increased responsiveness of lower airways to multiple stimuli. ;Episodic and with reversible obstruction.
asthma
ominous signs of asthma
Fatigue,
Pulsus paradoxus,
Diaphoresis,
Inaudible breath sounds with diminished wheezing,
Inability to maintain recumbency,
And cyanosis
FPDIIC
what do you call the perfusion pressure occurs in asthmatic patient?
Pulsus Paradoxus
medical management: of asthma
Albuterol (Ventolin) –
Adrenergic
Theophylline –
Hydration
what happens in a status asthmaticus
Severe bronchospasm and does not relieve within 30-60 mins.
Anticholinergics used in asthma
Ipratropium bromide (Atrovent, Combivent),
Characterized by airflow obstruction due to chronic bronchitis or emphysema.
chronic obstructive pulmonary disease (copd)
main cause of COPD
Smoking
According to the American Lung Association, smoking cigarettes causes ________ of all COPD cases
85-90%
Umbrella term that include: COPD
CRES
Chronic bronchitis
Refractory (irreversible) asthma
Emphysema
Severe bronchiectasis
Predisposing and Precipitating factors
of COPD
(1) Oxidative stress;
(2) Cytokine release due to inflammation;
(3) impaired activity of anti protease enzymes
Triad Symptoms of COPD
Cough
Sputum production
Dyspnea on exertion
method of assessing lung function by measuring the volume of air that the patient can expel from the lungs after a maximal inspiration.
Spirometry
Anticholinergic agents for COPD
Ipratropium bromide (Atrovent)
Oxitropium bromide (Oxivent)
Excessive mucus secretion within the airways and recurrent cough usually related to smoking, pollution, and infection.
chronic bronchitis “blue bloaters”
Destruction of alveoli, narrowing of small airways and trapping of air resulting in loss of lung elasticity.
emphysema “Pink puffers”
Alveoli of a patient with emphysema look like?
Cauliflower instead of grapes
To limit blood flow to hypoxic alveoli, low oxygen leads to pulmonary vasoconstriction, diverting blood to the better-ventilated alveoli
hypoxic pulmonary vasoconstriction
pathophysiology of cor pulmonale
Changes in vascular mediators:
high Endothelin-1
Low Endothelial nitric oxide synthase production: nitric oxide
Low Prostacyclin (vasodilator)
Main pathophysiology of Cor Pulmonale
hypoxic pulmonary vasoconstriction
pulmonary vascular remodeling
Irreversible dilatation of the cartilage containing airways.
bronchiectasis
Long-term condition where the airways of the lungs become widened, leading to a build-up of excess mucus that can make the lungs more vulnerable to infection.
bronchiectasis
Infectious Causes: of bronchiectasis
Adenovirus and Influenza virus
Staphylococcus aureus, Klebsiella, and Anaerobes
Bordetella pertussis
HIV infection
Tuberculosis
Main infectious cause of bronchiectasis
Adenovirus and Influenza virus
Texture of sputum of patient with bronchiectasis
Copious foul-smelling sputum that separates into three layers in a cup.
Parts of saliva of patient with bronchiectasis (3 layers)
Foam - Frothy partly saliva
Liquid- Thin sero-mucus liquid
Pus/sediment- pus, necrotic, cell debris
Treatment #1 for bronchiectasis
4 Goals:
Eliminate cause
Improve tracheo bronchial clearance
Control infection
Reverse airflow obstruction
Treatment #2 for bronchiectasis
Immunoglobulin
Antituberculous drugs
Corticosteroids (ABPA)
Remove aspirated material
Chest physical therapy
Mucolytics
Bronchodilators
Treatment #3 for bronchiectasis
Lung transplant
Initial empiric
Antibiotics
An acute inflammation on lung parenchyma.
pneumonia
pneumonia with onset in the community or the first 2 days of hospitalization.
Cap (community acquired pneumonia)
Common Causative Agents: for pneumonia
Streptococcus pneumonia (40%) MOST
Klebsiella (20%)
Haemophilus influenzae
Legionella, mycoplasma, Chlamydia
3rd most common cause of morbidity among nosocomial infections.
Hap (hospital acquired pneumonia) healthcare-acquired
A lung infection that develops in a person who is on a ventilator.
Vap (ventilator acquired pneumonia)
Vaccination for pneumonia
Haemophilus influenzae
Streptococcus pneumoniae
Pertussis, varicella, and measles
Sputum collection: for TB considerations
Best obtained on three consecutive mornings.
Clean and thoroughly rinse the mouth with water.
Breathe deeply 3 times.
After the third breath, cough hard and try to bring up sputum from deep in the lungs
