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PHTY205 > Wk 1 > Flashcards

Wk 1 Flashcards

1
Q

functions of the respiratory system

A
  1. gas exchange
  2. immunological
  3. biological
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2
Q

how does the immunological respiratory function protect the lungs from infection?

A

defense systems in both the airway and alveolus protect the lungs from infectionhy

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3
Q

hypoventilation definition

A

the state in which less air enters the alveoli, resulting in reduced O2 & increased CO2 levels in the blood

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4
Q

what can hypoventilation be due to?

A

breathing that is too shallow/ too slow, from a number of causes e.g. obesity, SC injury, NM diseases

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5
Q

is a shunt intrapulmonary or intracardiac?

A

both

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6
Q

what do both intrapulmonary / intracardiac forms of shunting reuslt in?

A

blood entering the left-sided circulation without an increase in O2 content

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7
Q

intra-cardiac shunting defintion

A

blood passing from right to left side of heart (e.g. via ventricular septal defect) without going through lungs to be oxygenated

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8
Q

what is a ‘dead space’

A

non gas-exchange areas

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9
Q

what areas are classified as ‘dead space’

A

conducting airways (trachea, bronchi, respiratory bronchioles)

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10
Q

V/Q mismatch when there is either:

A
  1. blood flow (Q) with reduced ventilation (V) –> low V/Q
  2. ventilation (V) with reduced blood flow (Q) –> high V/Q
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11
Q

shunt example

A

obstructed airway –> perfusion without ventilation

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12
Q

dead space example

A

obstructed blood vessel –> ventilation without perfusion (blood cant travel through but air can)

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13
Q

driving force for the exchange of gases between alveolar and capillary blood?

A

difference in partial pressure between the individual gases

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14
Q

2 main movements occurring in the respiratory system

A
  1. pump (NM-skeletal structures)
  2. lung (gas and secretion movement in the lungs)
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15
Q

Pump definition

A

to move air in and out of the lungwh

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16
Q

what does a ‘pump’ require?

A

neuro, musculo, and skeletal components to be intact e.g. SC, nerves, NMJ, muscles, bone, pleura

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17
Q

2 key functions within the lung:

A
  1. gas movement
  2. secretion movement
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18
Q

where does gas movement go

A

through the conducting airways to alveoli

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19
Q

where is the gas movement occurring?

A

between the alveolus and capillary

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20
Q

secretion movement occurs:

A

in the airways

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21
Q

Link between gas & secretion movement

A

if gas doesnt get into alveoli, clearance by gas flow will be ineffective

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22
Q

what happens if the airways are blocked / narrowed by secretions?

A

affects gas getting into alveoli (distribution of ventilation)

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23
Q

what can gas movement be divided into?

A

O2 and CO2 movement

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24
Q

what are the 2 components of secretion movement?

A
  1. MCC
  2. cough (back up clearance mechanism)
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25
Q

CO2 movement depends on…

A

the total volume of gas that moves in and out of the alveoli (Va) and is linked to the efficiency of the ‘pump’

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26
Q

what is O2 movement largely dependent on?

A
  1. alveolar surface area
  2. integrity of the interstitium
  3. pulmonary circulation
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27
Q

define respiratory load

A

what the muscles have to work against to:
1. move the chest wall (chest wall compliance)
2. move air through the airways (airway resistance)
3. expand the alveoli (lung compliance)

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28
Q

Is reduced O2 movement localised or generalised?

A

both

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29
Q

is reduced MCC mucus issues or cilia issues?

A

both

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30
Q

define symptom

A

new feeling, or a departure from normal feelings which is noticed by the patient

31
Q

are symptoms subjective or objective ?

A

subjective

32
Q

common symptoms of respiratory disease

A
  1. dyspnoea (breathlessness)
  2. wheeze/ chest tightness
  3. cough (+/- sputum, haemoptysis)
  4. pain
  5. constitutional symptoms
33
Q

what measurement tools are used for dyspnoea

A
  • self reporting scales e.g. VAS, BORG Dyspnoea scale
  • questionnaires
34
Q

what is the scale that validates cardiac disease?

A

New York Heart Association (NYHA)

35
Q

which scale describes how dyspnoea affects ADLs

A

the MRC Breathlessness Scale

36
Q

when does wheeze/ chest tightness occur?

A

when air moves through airways that are narrowed e.g. by mucus, spasm/ swelling

37
Q

questions to ask the patient to determine the pattern of symptoms and triggers

A
  1. nocturnal?
  2. exercise induced? / things in atmosphere
  3. post viral infection?
38
Q

what does a cough that is chronic, persistent, or distressing indicate?

A

bronchial irritation by excess secretions, chronic infection/ inflammation or airflow restriction

39
Q

questions to determine cough characteristics

A
  1. frequency & pattern (aggs ? AM/PM)
  2. is it moist or dry
  3. is it productive / non-productive of sputum, blood
40
Q

sign definition

A

something that can be demonstrated physically
- objective
- noticed by other people/ the therapist

41
Q

what is pectus excavatum?

A

funnel chest

42
Q

what is pectus carinatum?

A

pidgeon chest

43
Q

how many dimensions do you observe the chest wall movement?

A

3

44
Q

what are the dimensions of chest wall movement?

A
  • AP
  • Basolaterally
  • inferior/ superior
45
Q

breathing pattern
- observe muscle action

A
  • diaphragmatic movement pattern
  • are there accessory muscles being used in quiet breathing?
46
Q

what do you observe with muscle recruitment with abnormalities of breathing pattern?

A

Muscle recruitment
- excessive / early recruitment of accessory muscles
- can be an appropriate strategy to deal with increased CVS demands of strenuous activity, or may be a sign of respiratory distress

47
Q

what is paradoxical breathing patterns?

A
  • abdominal, lower ribs or intercostal in-drawing
  • sign of respiratory distress / chest wall abnormality
48
Q

observable abnormalities of breathing pattern

A
  1. pursed lip breathing
  2. nasal flaring
  3. barrel chest
  4. accessory muscle use
  5. fatigue
  6. SOB
  7. lateral basal expansion
  8. paradoxical breathing
49
Q

how does pursed lip breathing assist breathing?

A
  • creates back pressure
  • splints airways
  • helps with gas exchange
50
Q

what is the NORMAL ADULT RR?

A

12-16 breaths/min with insp:exp ratio approx 1:1.5/ 1:2

51
Q

tachypnoea

A

too fast RR (>20 breaths/min)

52
Q

bradypnoea

A

too slow RR (<10 breaths/ min)

53
Q

apnoea / hypopnoea

A

period of absent respiration

54
Q

where are normal breath sounds loudest?

A

over the trachea

55
Q

where do normal breath sounds become softer and softer?

A

more peripherally

56
Q

what can wheeze be?

A

polyphonic or monophonic

57
Q

what must you define with wheeze?

A

in which phase of the respiratory cycle they occur (i.e. inspiratory / expiratory)

58
Q

what are crackles characterised as?

A

coarse / fine

59
Q

UPPER AIRWAY SOUNDS
characteristics of stridor

A

harsh, loud, louder in inspiration

60
Q

what does stridor indicate?

A

acute upper airway narrowing (extra-thoracic)

61
Q

what is the cause of pleural/ pericardial rub sounds?

A

inflamed pleural/ pericardial tissues may transmit a sound through the airways

62
Q

haemoptysis define

A

presence of blood in the sputum from a bleeding source in the airway

63
Q

what can haemoptysis range from?

A

very mild (streaking) to life threatening

64
Q

when should you documented and reported?

A

always (haemoptysis of any volume)

65
Q

what can bilateral ankle oedema indicate?

A
  • cor pulmonale, right sided heart failure
  • congestive heart failure
66
Q

what is digital clubbing associated with?

A

some conditions where there is chronic hypoxia, such as lung cancer, CF

67
Q

what are some validated QoL tools to use with patients with respiratory disease?

A
  • St George’s Respiratory Questionnaire
  • Chronic Respiratory Questionnaire
  • Short Form 36
  • COPD Assessment Test
  • Cystic Fibrosis Quality of Life
68
Q

what can the results of the QoL tools be used to do?

A
  • assess disease progression
  • set treatment goals
  • outcome measure
69
Q

red flags to Rx

A
  • chest pain
  • calf pain
  • are they in respiratory distress?
  • do they have stridor?
  • paradoxical breathing?
  • have they had any haemoptysis ?
  • has there been any acute deterioration / change in their condition
70
Q

what is a ‘relevant finding’?

A

some that you need to consider, which:
- may influence hypothesis generation and / or treatment choice/ implementation
- is often found in the patient’s history
- may or may not have a cause

71
Q

examples of a relevant finding

A
  • main diagnosis of the patient
  • multimorbidities
  • older age
  • smoking history
  • medications
  • past intervention strategies (and their effect)
72
Q

example of how signs and symptoms = relevant findings

A

new shortness of breath (symptom) –> reduced Oxygen saturations ( signs)
+
fatigue and increased SOB walking to bathroom (symptoms) –> opaque changes on CXR in Right middle lobe (signs)
= MEDICAL DIAGNOSIS OF PNEUMONIA (RF)

73
Q
A

PHTY205 (5 decks)

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