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73 Cards in this Set
- Front
- Back
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Asthma
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Chronic inflammatory disorder of the airways causing episodic dyspnea and wheezing
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Asthma
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7% of the US population has asthma
Incidence is increasing higher in kids - 10% |
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Asthma
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Associated with exposure to allergens, respiratory viruses, and cigarette smoke - also family history
Mast cells degranulate histamine release - IgE - leaking capillary beds |
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Asthma
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ANS - trigger
Bronchospasm occurs Can cause permanent scarring |
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Dyspnea
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Dyspnea is commonly referred to as shortness of breath. It can be defined as air hunger, or the sensation of having the urge to breathe, that is caused by lack of oxygen in the bloodstream. Dyspnea is the most common symptom of COPD.
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Asthma symptoms during remission
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individual is usually asymptomatic
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Asthma symptoms during attack
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dyspnea
increased respiratory effort decreased breath sound pronounced wheezing cough thick mucus developes can lead to irreversible damage to lung |
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Status sthmaticus
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Bronchospasm that is not releived by usual methods
MEDICAL EMERGENCY!! |
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Asthma treatment
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Bronchodialators
anti-inflammatory medications steroids |
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#1 cause of Chronic Bronchitis
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Smoking
1st and 2nd hand |
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What is Chronic Bronchitis?
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Hypersecretion of mucus and productive cough lasting 3 monts of the year for 2 years in a row
Diagnosis based on symptoms Aspiration of irritants cause inflammation of bronchial wall Leads to increased size and function of goblet cells and mucus glands impaired ciliary function leads to accumulation of mucus and increased risk of infection |
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Bronchospasm in Bronchitis leads to?
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Hypertrophy in bronchi
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Emphysema is....
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Abnormal permanent enlargement of gasexchange airways (acini) with desruction of alveolar walls
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Emphysema includes loss of....
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elastic recoil of lung tissue
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Major contributor to emphysema is?
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Cigarette smoking
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Emphysema forms.....?
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Bullae and Blebs
Does not include inflammatory processes or production of mucus. |
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Emphysema Symptoms.....
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Dyspnea
Barrel Shaped Chest Prolonged expiration Over development of accessory muscles - hypertrophy of neck and chest muscles intercostal retraction |
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Primary Emphysema
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Genetic defect
Begun in area (lungs) No enzyme control auto digest elastic proteins in the lungs Get by or before 40 Pancinar developes in alpha Trypsin deficency |
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Late emphysema disease process symptoms
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hypoventilization
polycythemia cor pulmonale |
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Polycythemia
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Increase in the proportion of blood volume that is occupied by red blood cells, which is measured as hematocrit level
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Cor Pulmonale
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pulmonary heart disease is damage to the right ventricle of the heart as a response to resistance or high blood pressure in the lungs.
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Cor Pulmonale Symptoms
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Shortness of breath which occurs on exertion but when severe can occur at rest
Wheezing Chronic wet cough Swelling of the abdomen with fluid (ascites) Swelling of the ankles and feet (pedal edema) Enlargement or prominent neck and facial veins Enlargement of the liver Bluish discoloration of face Presence of abnormal heart sounds |
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Respiratory Tract Infections
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Upper vs Lower
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Upper Respiratory Tract Infections
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Are the illnesses caused by an acute infection which involves the upper respiratory tract: nose, sinuses, pharynx or larynx.
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Lower Respiratory Tract Infections
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Infection including lung abscess, acute bronchitis, pneumonia and emphysema.
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Pneumonia
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Acute infection of the lower respiratory tract
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Types of Pneumonia
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Bacteria
Viral Fungal Protozoal Parasitic |
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Risks for Pneumonia
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Advanced age
immune compromise lung disease smoking alcohol abuse altered consciousness ET tubes immobilization poor nutrition |
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Clinical Manefestations?symptoms of Pnrumonia
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Usually proceeded by an upper resp. infection
Fever Chills productive or dry cough Malaise Pleural pain (very common) - pain with inspiration and coughing, hemoptysis and dyspnea Elevated WBC count, inflitrates in a single lobe of the lung |
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Two areas of development of pneumonia....
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hospital vs community
(nosocomial infection) |
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Nosocomial
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Nosocomial infections are infections which are a result of treatment in a hospital or a healthcare service unit, but not secondary to the patient's original condition. Infections are considered nosocomial if they first appear 48 hours or more after hospital admission or within 30 days after discharge.
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Tuberculosis
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Infection of Mycobacterium tuberculosis
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Tuberculosis transmission
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Airborn transmission from infected persons
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Tuberculosis causes....
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formation of granuloma around colonies of bacilli called tubercle.
Many individuals are asymptomatic, in an immune compromised system, this can occur within weeks |
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Clinical Manifestations/Symptoms of Ative Tuberculosis Infection
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Active cases -
Fatigue Weight loss Anorexia Low grade fever Night sweats Blood in sputum Positive reaction to TB skin test Positive sputum culture for Acid Fast Bacilli (AFB) Positive chest x-ray |
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Treatment of TB
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Poly antibiotic therapy
Public Heath Supervision of medications if person is noncompliant with treatment |
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Pulmonary Embolism
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Occlusion of a portion of the pulmonary vasculature by an embolism
is a blockage of the main artery of the lung or one of its branches by a substance that has travelled from elsewhere in the body through the bloodstream (embolism) |
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Risk factors for Pulmonary Embolism
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Conditions that promote venous statsis such as immobility
Prolonged immobility - Blood clots are more likely to form in your legs during periods of inactivity Age - Older people are at higher risk of developing clots. Family history Surgery Life style - smoking, being overweight, estrogen supplementation |
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Pulmonary Embolisms occur....
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most commonly without infarction - symptoms are vague
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Pulmonary Embolism with infarction
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has pronounced symptoms
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Infarction
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The formation of an infarct, an area of tissue death due to a local lack of oxygen.
For example, in a myocardial infarction there is death of myocardial (heart muscle) tissue due to sudden (acute) deprivation of circulating blood. This is usually caused by arteriosclerosis with narrowing of the coronary arteries, the culminating event being a thrombosis (clot). |
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Pulmonary Embolism
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Pulmonary embolism is usually caused by a blood clot, although other substances can also form emboli and block an artery.
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PE symptoms
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Symptoms vary but usually include shortness of breath
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PE Diagnosis
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Doctors often diagnose pulmonary embolism by looking for blockage of the pulmonary artery using a lung scan or CT angiogram.
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PE Treament
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Blood thinners (anticoagulants) can be given to people at high risk to prevent pulmonary embolism.
Anticoagulant drugs are used to keep emboli from enlarging while the body dissolves the clots; other measures (such as drugs to break up blood clots or surgery) may be needed for people who appear to be at risk of dying. |
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Embolism
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occurs when an object migrates from one part of the body (through circulation) and causes a blockage (occlusion) of a blood vessel in another part of the body.
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Thrombus
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A thrombus, or blood clot, is the final product of the blood coagulation step in hemostasis. It is achieved via the aggregation of platelets that form a platelet plug, and the activation of the humoral coagulation system (i.e. clotting factors). A thrombus is normal in cases of injury, but pathologic in instances of thrombosis.
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Pulmonary Hypertension
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High blood pressure in the pulmonary arteries
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Primary Form of Pulmonary Hypertension
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is rare but occurs in women 20 - 40
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Secondary Hypertension is caused by
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CHF
Congenitial Heart Defect Destruction of pulmonary vascular beds Constriction of pulmonary vascular beds due to hypoxemia |
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Hypoxemia
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is generally defined as decreased partial pressure of oxygen in blood,sometimes specifically as less than 60 mmHg or causing hemoglobin oxygen saturation of less than 90%
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Symptoms of Pulmonary Hypertension
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Enlargement of right ventricle and atria (can see on EKG)
Fatigue Chest pain Tachypnea Dyspnea |
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Tachypnea
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is characterized by rapid breathing.
It is not identical with hyperventilation - tachypnea may be necessary for a sufficient gas-exchange of the body, for example after exercise, in which case it is not hyperventilation. |
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Cor Pulmonale
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Right ventricular enlargement due to pulmonary hypertension
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Cor Pulmonale symptoms
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Decreased cardiac output with exercise
Chest Pain Murmur Systemic edema from increase pressure in systemic venous system |
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Cor Pulmonale Treatment
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Similar to pulmonary hypertension
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Cancer of the Lungs
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Arises from the endothelium of the respiratory tract
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Most common cause of lung cancer.....
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Cigarette smoking
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Lung Cancer Classifications
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Small Cell Cencer
Non Small Cell Cancer Squamous Cell Carcinoma Adenocarcinoma Undifferentiated Large Cell Carcinoma |
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Small Cell Cencer
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Small cell lung carcinoma is less common. Also called oat cell cancer, it tends to arise in the larger airways (primary and secondary bronchi) and grows rapidly, becoming quite large. The small cells contain dense neurosecretory granules (vesicles containing neuroendocrine hormones), which give this an endocrine/paraneoplastic syndrome association. While initially more sensitive to chemotherapy, it ultimately carries a worse prognosis and is often metastatic at presentation. Small cell lung cancers are divided into limited stage and extensive stage disease. This type of lung cancer is strongly associated with smoking.
25% of lung cancer Strongest correlation to smoking |
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Non Small Cell Cancer
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The non-small cell lung carcinomas are grouped together because their prognosis and management are similar. There are three main sub-types: squamous cell lung carcinoma, adenocarcinoma, and large cell lung carcinoma.
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Squamous Cell Carcinoma
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Squamous cell carcinoma of the lung is more common in men than in women. It is closely correlated with a history of tobacco smoking, more so than other types of lung carcinoma. It usually arises centrally in larger bronchi and eventually spreads to hilar lymph nodes.
30% of lung cancers |
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Adenocarcinoma
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Adenocarcinoma of the lung is currently the most common type of lung cancer in lifelong non-smokers is the adenocarcinoma. Adenocarcinomas account for approximately 10% of lung cancers. This cancer usually is seen peripherally in the lungs, as opposed to small cell lung cancer and squamous cell lung
cancer, which both tend to be more centrally located. More common in women 40% (according to notes) |
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Undifferentiated Large Cell Carcinoma
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Large-cell undifferentiated carcinoma is a type of lung cancer in which the cells are large and look abnormal when viewed under a microscope. It can be found in any part of the lung and tends to grow and spread rapidly.
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Hilus
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a small notch, recess, or opening, as where vessels and nerves enter an organ
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Respiratory Disorders in Children
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Croup
Ocstructive Sleep Apnea Asthma Cyctic Fibrosis |
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Croup
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is breathing difficulty accompanied by a "barking" cough. Croup, which is swelling around the vocal cords, is common in infants and children and can have a variety of causes.
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Laryngotracheobronchitis (Croup)
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Croup is a contagious viral infection causing inflammation and swelling of the larynx and surrounding tissues. It presents with difficulty in breathing especially breathing in and a typical barking cough.
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Croup Symptoms
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Stridor- a harsh, raspy vibrating sound heard when the child breathes in. This is usually present when the child is agitated but in severe cases may be present even at rest. Stridor occurs when the opening between the vocal cords becomes narrower.
Difficulty in breathing may awaken the child from sleep. Fever The child's condition may improve in the morning but worsen at night. Usually lasts 3 to4 days. |
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Croup Risk Factors
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Allergies
Repeated upper respiratory infections Previous croup. |
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Obstructive sleep apnea
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Obstructive sleep apnea is a condition in which a person has episodes of blocked breathing during sleep.
Snoring and Labored breathing during sleep |
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Asthma
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Incidence has increased in last 20 yrs. (10% of all children)
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Cyctic Fibrosis
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Autosomal recessive, production of abnormally thick, viscous and copius mucus i the resp. tract and GI tract. Can also affect the reproductory tract.
Increased resp. infections and poor absorption of nutrients. |
