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158 Cards in this Set
- Front
- Back
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gastro
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stomach
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necro
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death
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ocul/opthal/opt
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eye
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ped/o or pod
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child/foot
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phleb
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vein
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py
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pus/fire
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rhabdo
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rodshaped/striated
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thrombo
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clot
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tox
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poison
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neo
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new
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pachy
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thick
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pro
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before
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retro
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behind
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pexy
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fixation or suspension
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poiesis
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formation of
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py
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pus/fire
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rhabdo
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rodshaped/striated
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thrombo
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clot
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tox
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poison
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neo
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new
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pachy
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thick
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pro
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before
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retro
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behind
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pexy
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fixation or suspension
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poiesis
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formation of
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When infection gets all the way down to respiratory unit. Can be deadly. (occurs frequently in those with lungs already compromised)
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pneumonia
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30% of pneumonia cases.
PTs intervene largely here. Affects whole lobe of lung. if untreated, will spread to others. |
bacterial pneumonia
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patient PW: fever, shaking, chills, productive cough, dyspnea, CP if pleuritic (could just be in airspaces-no nerve endings) asymmetrical breathing pattern
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bacterial pneumonia
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Signs include:
BS: crackled, decreased, maybe wheezes RR incr VE incr HR incr temp incr cyanosis (check nailbeds, mouth, eyes) WBC high ABGs: PaO2 decr, PaCo2 same (incr if too much of lung's involved) pH (decr if PaCo2 incr) CXR: can see where inf is-infiltrate |
bacterial pneumonia
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50 % of cases: patient PW:
fever non-productive cough dyspnea RAPID ONSET |
viral pneumonia
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patient has following signs;
BS: crackles, may be decreased RR incr HR incr WBCs same ABGs: PaO2 decr PaCo2 same CXR: can't determine if infiltrate's in alveoli or around |
viral pneumonia
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occurs in those who have trouble protecting their own airways. when object has surpassed branching of bronchiole tubes
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aspirated pneumonia
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patient PW:
BS: crackles, wheezes RR incr HR incr cyanosis likely WBC initially the same ABGs: paO2 decr paCo2: same, unless it's really bad pH: same " " CXR: shows location of object, extreme inflammation, eaten-up lung tissue (looks worse than symptoms) cough: not helpful in diagnosis patient profile indicative in Dx |
aspirated pneumonia
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disease affects healthy individuals, then goes away.
pt c/o headache (predominant symptom), dry cough |
mycoplasm (pneumonia)
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tends to be epidemic. environment is moist. -waterborne
pt c/o dry cough, severe headache, WBC slight incr |
legionella (pneumonia)
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fungus causes pathology-hosts are typically those w/weak immune systems: AIDS, premature babies (no immune system from mother)
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pneumocystic pneumonia (PCP)
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patient PW:
low grade fever progressive SOB dry cough (heavy, hard to eject from deep in lungs) weakness weight loss CXR: infiltrates present and visible WBC no change paCo2 usually incr paO2: decr |
pneumocystic pneumonia (PCP)
prevention is key for these people! |
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Prevention in those adults w/CD4 fell counts <200, clinical signs of opportunistic infection, and Hx of PCP:
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supportive measures: O2, ventilation, positioning,
pharmacological Tx: 21 days |
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severe acute respiratory syndrome
started in china |
SARS
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patient PW:
high temp dry cough lymphopenia leukopenia CXR: borderline |
SARS
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postprandial
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after a meal
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exophthalamus
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protrusion of eyeballs
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myxedema
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mucus edema caused by fluid retention
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glycohemoglobin
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molecule in hemoglobin that rises w/increased level of Blood sugar
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populations at risk for TB:
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elderly (weakened immune system)
alcohol dependent (immunity decr) infants prison inmates (no sunlight) health care workers |
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patient c/o:
slight, non-productive cough low grade fever usually mid/lower lung involvement lymph nodes |
primary TB
though often none; is mild; asymptomatic. positive skin test (manteaux) shows presence of antibodies, not active disease. drug ther. necessary to prevent post-primary |
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patient c/o:
fever weight loss cough night sweats CXR: often upper lobe involvement pneumocele w/scarring around it |
post-primary TB
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symptom of TB: focal, calcified spot on chest radiograph (suggests granulomatous disease)
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Ghon Lesion
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Pt considerations for TB:
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negative pressure isolation rm-2 weeks
cover mouth and nose when coughing mask when leaving room for tests |
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PT considerations for TB
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TB filtered masks
wash hands before and after gloves for potential blood/body fluids disinfect stethoscope b/w pts annual manteaux |
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Tumor stage:
-tumor with no regional/distal mets |
tumor stage I
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-tumor w/hilar/peribronchial node involvement
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tumor stage II
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-(outside of lungs)locally advanced tumors w/mediastinal or cervical
lymph node mets & ext to chest wall, mediastinum, diaphragm |
tumor stage III
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tumors and distant mets
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tumor stage IV
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malignancy of epithelium of respiratory tract; pre-invasive lesions, small cell lung cancer (type I), non small lung cancer (type II)
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bronchogenic carcinoma
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malignancy in hilar region, linked to smoking, very rapid growth, very early metastasis - hilar and lung
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small cell
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most common type of lung cancer; almost 80% of lung cancers
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non small cell
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of nonsmall cell types:
-in periphery, tend to find these by accident. NOT LINKED TO SMOKING |
adenocarcinomas
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of nonsmall cell types:
usually more centrally-located (more dangerous due to central structures), hilar, LINKED TO SMOKING.slow metastasis, but central. |
squamous
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of nonsmall cell types:
-cells relatively undifferentiated-cell hasn't yet decided what it wants to be; peripheral, LINKED TO SMOKING. early metastasy. |
large cell
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of non small cells:
-least common |
carcinoma
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pt presents w/following:
weight loss anorexia fatigue cough (doesn't go away for mos) dyspnea wheezing or decreased BS sputum or not (if pneumonia-obstructed, no secretions) hemoptysis (or not-coughing blood, only if tumor eats into capillary bed) |
cancer!
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pt pw:
airway compression/obstruction (wheezing and pneumonia w/partial obstruction, or pneumonia and volume loss w/full obstruction) cough hemoptysis dyspnea pain to chest, shoulder, back weakness fatigue hoarseness from compression atelectasis difficulty swallowing |
presence of central tumors
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patient pw:
cough sob fatigue, weight loss pleural pain if pleura involved pleural effusion |
peripheral tumors (are often undetected for some time)
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-extreme apex of lung
-invade wall of chest rather than lung itself (Lymphatics Lower roots of the brachial plexus Intercostal nerves Stellate ganglion (Sympathetic nervous system) Ribs Vertebrae) |
pancoast's tumor
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pt pw:
-neuritic pain -atrophy of arm and hand (reason for PT visit) -Horner's syndrome (sinking of eye socket, ptosis of eyelid, constriction of the pupil, flushing of the side of the face |
Pancoast's tumor
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PT considerations for cancer
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Bone metastasis-need to konw where they are, from whence they came, and what they can do.
Will have to deal with side effects of cancer tx (chemo, radiation, etc) |
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PT treatment for those w/cancer:
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-aerobic exercise-will improve fatigue and weakness (side effects of chemo and radiation tx)
-prevention of contractures, skin breakdown, weakness -pulmonary care to clear secretions as needed |
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platelet count is <50,000/uL
hemoglobin <10g/dL WBC <3000/uL absolute granulocytes <2500/uL ..can patient exercise? |
no. low WBC especially-you can't risk giving them anything
(if hemoglobin is low, SaO2 is useless, bc it tells you that carrying sites are full, but these people don't have any hgB to carry it!) |
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Pulmonary condition, 'dead space'
blocking of bl vessel. no blood getting by. alveolar cap membrane affected. no o2 coming in, no Co2 coming off. person will appear hypoxemic. usually occurs pretty quickly (hypoxia and pain) |
pulmonary emboli
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Pulmonary condition:
pleura stay intact but lung tissue loses air. no air in lobe, but takes rest of lung and expands it, to fill in space that should have been taken up by affected lobe. everything is stretched and shifted over. |
collapse!
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pt PW:
BS: absent over site tracheal shift toward site |
collapse
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pt pw:
temperature decr saO2 pain in thorax-therefore not much air entry in area --reinflating lungs will make normalize body temp |
atelectasis
(collapse on a small scale) |
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pleural effusion
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fluid collecting in CostoPhrenic angle (lowest portion of lung, where thorax meets gravity; most gravity-dependent part of lung..if fluid is present in pleura it will drop to this space).
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Infected material residing in pleural space creating
BS fever increased WBC SOB |
empyema
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pt PW:
BS fever increased WBC SOB TRACHEAL SHIFT away site |
hemothorax/pneumothorax
(blood or air in pleural space) |
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With a tumor that is obstructing the left lower lobe bronchus, what will happen to the structures within the thorax?
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to the left
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With a right lower lobe pneumonia, what will happen to the structures within the thorax
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Air will be replaced by an exudate. No change to the size or structure. SO, there will be no movement within the thorax.
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With a right hemothorax, what will happen to the structures within the thorax?
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Blood in the pleural space. This will shove the lung tissue away, shifting everything away from it..to the left.
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-eucapnia
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condition of normal Co2
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scopy
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to look into/view
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surgical incision - cutting down center of sternum, easily accessible; heals well
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midsternotomy
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surgical incision: from T4-following fissure line around thru interspace; comes around to just before costochondral junction. ribs spread apart. (lung transplant incision; not ideal for heart surg)
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posterior lateral thoracotomy
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surgical incision-ribs spread apart. (pt will complain of aching at fulcrum points)
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anterior lateral thoracotomy
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surgical incision: cut underneath ribcage and "peeling it up"
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clamshell incision for double lung transplant.
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surgical procedure: (problem w/bronchi, common w/cancer): taking out piece of one, end to end anastamose.
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bronchoplasty sleeve resection
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surgical procedure: looking into lungs; only goes to segmental bronchus, after which you'll need a CT scan
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bronchoscopy
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surgical procedure: taking out lobe, leaving rest intact. (airway must come out with lung tissue) initially there'll be fluid where lobe was; shift away. when fluid reabsorbs it'll shift back
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lobectomy
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surgical procedure: a look into the mediastinum
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mediastinoscopy
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surgical procedure: binding together of pleura (when visceral and parietal pleura won't stay together).
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pleurodesis
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surg procedure: removal of whole lung. initially fills w/fluid; once this reabsorbs the other lung will have more space
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pneumonectomy
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surg procedure: removal of some air in lungs when there's too much that it's distended, impeding the healthy tissue from normal function. (volume reduction surgery)
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pneumectomy
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surg procedure: taking out segment of lung
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segmental resection
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surg procedure: removal of fluid from pleural space
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thoracocentesis
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surg procedure: noninvasive; going in with a stick to look at thorax
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thorascopy/VATS
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surgical procedure: hole in trachea, usually with hole for airway (now person can eat, move head, talk sometimes improve functionality)
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tracheostomy
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surgical procedure: removing lung segments without having to abide by anatomical boundaries
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wedge resection
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tests and measures following surgery:
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vital signs
lab values BS cough ability |
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PT assessment for post operative care:
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excursion
ROM of UE strength balance functional ability |
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DNI/DNR
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do not intubate; do not rescussitate
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MVC
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motor vehicle crash
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IVDU
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intravenous drug use
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LVEF
..normal is? |
left ventricle ejection fraction?
55% |
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TKA
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total knee arthroplasty
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NAD
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no acute distress
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PE
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pulmonary embolis, pleural effusion, physical exam
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childs larynx and vocal cords as compared to adult's
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much higher
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infant's
-tongue -larynx -epiglottis |
large tongue,
high high |
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angulation of infant's epiglottis
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long, angled away from trachea
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shape of infant's larynx
shape of adult's |
funnel-shaped, narrowest at level of cricoid ring
cylindrical, straight down, narrowest at level of vocal cords |
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infant's airway vs adult's
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less cartilaginous support in infant's; more easily compressed & occluded. small airways, less laminar flow, increased work of breathing
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lungs of infant vs adult
compliance? |
infants' lungs are less compliant, still dense, haven't completely inflated
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thorax of infant as compared to adult
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entirely cartilage (takes mos to ossify)
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"back doors" between alveoli during obstruction
..present in..? |
canals of lambert; pores of kahn.
not yet present in child; obstructions are thus more severe |
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lung tissue in infant vs adult:
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from 0-6 years it grows nonlinearly
(during this time the incidence of lung disease is higher) |
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infant presents with:
tachypnea (>40 bpm) cough - not powerful cyanosis pallor (lighter skin) sweating (unusual in babies) irritability grunting (keeps airways open to exhale) nasal flaring (babies are obligatory nose breathers) retractions: breathing in so hard as to suck in intercostal spaces drooling |
respiratory distress
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swollen larynx (obstructed airway) wheezes on inhale and exhale (sounds like a seal)
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croup
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First part of airway that can become inflamed. viral. must do trach if pt is obstructed
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epiglottis
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obstruction at level of bronchioles. no respiration can occur
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bronchiolitis obliterans with organizing pneumonia (BOOP)
*respiration occurs at ends of bronchioles |
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common pathogen causing viral infection in lungs; very communicable Nov-March. carried by adults
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RSV (respiratory syncytial virus)
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pneumococcus
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strep
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H flu
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not a flu; bacteria
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infection deadly to kids; airways closed up. must be intubated.
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B Pertussis (whooping cough)
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lung immaturity; insufficient surfactant to keep alveoli open
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Respiratory Distress Syndrome
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treatment for respiratory distress syndrome:
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ventilation support
positioning-optimize secretion removal (if absolutely necessary) early intervention education |
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often sequelae of respiratory distress syndrome; iatrogenic due to high o2 and mechanical ventilatory pressure requirements
ABGs: paO2 low paCo2 high BS: crackles, wheezes |
bronchopulmonary dysplasia
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pulmonary malformation whereby cilia are immobile
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(line airways, move secretions in and out).
no beating= no clearing. if dysfunctional in lungs, probably elsewhere too |
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tracheoesophageal fistula:
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no wall between esophagus and trachea. kid aspirates. surgical repair mandatory
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meconium aspiration syndrome
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combines pulmonary hypertension and obstructive airway disease with considerable inflammatory rxn. babies in distress during birth process: if meconium gets evacuated into amniotic fluid, it will enter baby's lungs. check amn fluid; if opaque = problematic (sticky, hard to clear from lungs)
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diaphragmatic hernia
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diaphragm never closed properly. colon protrudes through hole. child will turn blue upon first breath. won't know beforehand.
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biggest risk factor for COPD
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smoking
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controlled drugs. drugs taken on regular basis
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maintenance drugs
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resp drugs used on intermittent basis to control symptoms (inhaled drug, used to prevent EIB for ex., shouldnt be used more often than a couple x/week. if needed more frequently, then it's not controlled.
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rescue drugs
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resp drugs for trauma: when breakthru symptoms can't be relieved. intravenous or intramuscular (when maintenance drugs and rescue drugs aren't working)
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crisis drugs
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routes of adm of resp drugs:
most direct? |
oral
inhaled (most direct) IV |
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cat of resp drugs:
mimic sympathetic system, bronchodilator, incr HR, BP, airway size, nervousness, insomnia |
sympathomimetics
available as -maintenance: long acting beta 2 agonist -rescue: short-acting beta 2 agonist -crisis |
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cat of resp drugs:
bronchodilator; acts by closing down parasympathetic nervous system. used for maintenance. not powerful enough for rescue or crisis |
anticholinergic
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cat of resp drugs:
bronchodilator (modest anti-inflammatory). many interactions. only crisis or maintenance. not inhaled. |
methylxanthine
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category of resp drug:
oral bronchodilator and anti-inflammatory- only used for maintenance, not rescue. |
leukotriene modifier
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category of resp drugs:
decreases airway edema and increases beta 2 receptor sensitivity. (steroids) appropriate for maintenance and crisis, not rescue. lots of side effects |
anti-inflammatory drugs. corticosteroids.
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category of resp drug that inhibits/stabilizes mast cells' provocation of vasoconstriction. only appropriate for maintenance. can take 4-6 weeks to start working. improves peak expiratory flow. to prevent EIB
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mast cell stabilizers (cromones)
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Seretide
Advair Combivent are.. |
combination drugs
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Bacteriocidal
Bacteriostatic are.. |
anti-microbial drugs
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supplemental oxygen for:
maintenance: rescue: crisis: |
maintenance: low flows
rescue: cannula or mask crisis: 100% non breather mask (intubation) |
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pt PW:
pain (esp w/inspiration) SOB crepitus asymmetrical breathing pattern |
rib fx
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treatment for rib fx:
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pain control
breathing exercises caution with manual techniques |
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2/more ribs fx (usually ribs 3-6). section of rib no longer connected to thorax. (negative pressure creates dyskinesia within rib)
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flail chest
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patient pw:
pain sob crepitus CXR, BS asymmetrical breathing pattern paradoxical movement of certain section |
flail chest
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PT tx for small flail:
large flail: |
small:
pain control breathing ex caution w/manual techniques large: may need splint positive pressure ventilation (air forced in, entire thorax pushed out-until callous forms) |
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pt pw:
pain sob bs (can hear sucking sound) cxr nonfixed tracheal deviation *first responder should.. |
pneumothorax
*place vaseline gauze to cover wound |
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difference b/w tension and non-tension pneumothorax:
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tension pneumothorax: tearing of lung tissue with resulting tear in visceral pleura. air leaks into parietal pleural space (non-functional). common in tall male who's outgrowing his tissue extensibility
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treatment for pneumothorax/hemothorax:
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chest tube (rid thorax of substance)
breathing exercises bl replacement treat associated injuries v/Q positioning |
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cardiac tamponade
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person bleeding into pericardial sac
compresses heart. heart can't accept blood..or function!! |
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myocardial contusion
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heart ms is bruised; won't contract too strongly, but will be ok
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aortic rupture
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emergency
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treatment for COPD:
mild moderate severe very severe |
mild: short-acting bronchodilator as needed
mod: regular rx w/long-acting beta 2 and rehab sev: add inhaled steroid very severe: add o2 |
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treatment for GINA
very mild: mild: more severe: severe: |
very mild: short-acting bronchodilator as needed
mild: controlled rx, inhaled steroid more severe: long-acting beta 2; possible leukotriene severe: everything. oral steroids, methylxanthine, etc |
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treatmetn for CF:
(multi-system): -pulmonary -digestive -pancreatic |
-pulm: bronchodilators, mucolytics, anti-inflammatories
-dig: stool softeners, reflux -pancreas:pancreatic enzymes, insulin |
