Respiratory Stuff

Front 1

Marfan Syndrome

Back 1

A genetic disorder of the connective tissue characterized by disproportionately long limbs, long thin fingers, a typically tall stature, and a predisposition to cardiovascular abnormalities, specifically those affecting the heart valves and aorta.

Front 2

Kussmaul Breathing

Back 2

Very deep and labored breathing with normal or reduced frequency, found among people with severe acidosis; a form of hyperventilation. The cause is respiratory compensation for metabolic acidosis, most commonly occurring in diabetics in diabetic ketoacidosis.

Front 3

POLYCYTHEMIA

Back 3

TAKING AWAY OXYGEN Polycythemia occurs in situations of long term decreases in ambient oxygen levels. Mainly it acts as a compensatory mechanism for ↑ elevation by ↑ production of RBC’s that occurs

Front 4

Dalton’s Law

Back 4

Levels of atmospheric pressure is equal to the sum of the individual gas pressures

Front 5

Henry’s Law

Back 5

Pop Bottle Law: gas dissolved in solution= pressure of gas over the solution

Front 6

Boyle’s Law

Back 6

For a fixed amount of gas kept at a fixed temperature, P and V are inversely proportional (while one increases, the other decreases).

Front 7

Charles’ Law

Back 7

At constant pressure, the volume of a given mass of an ideal gas increases or decreases by the same factor as its temperature (in Kelvin) increases or decreases.

Front 8

Shunting

Back 8

when the blood moves from the R side of the pulmonary system to the L side without being oxygenated

Front 9

Bohr effect:

Back 9

Within the tissues, as the hemoglobin becomes bound with CO2, it loses its affinity for O2 and releases it into the cell for metabolism.

Front 10

Cheyne-Stokes respirations

Back 10

Progressively increasing then declining respiration, separated by period of apnea
Terminal illness or brain injury

Front 11

Central neurogenic hyperventilation

Back 11

Deep, rapid respirations
Stroke or injury to brainstem

Front 12

Ataxic (Biot’s) respirations

Back 12

Repeated episodes of gasping separated by apnea
Increased intracranial pressure

Front 13

Apneustic respirations

Back 13

Long deep breaths, stopped during inspiratory phase
Separated by periods of apnea
Stroke or severe central nervous system disease

Front 14

Hemoptysis

Back 14

coughing up of blood or of blood-stained sputum from the bronchi, larynx, trachea, or lungs

Front 15

COPD

Back 15

Chronic Obstructive Pulmonary Disease. Chronic bronchitis & Emphysema

Front 16

Cor pulmonale

Back 16

A change in structure and function of the right ventricle of the heart as a result of a respiratory disorder. Right ventricular hypertrophy is the predominant change in chronic cor pulmonale although in acute cases dilation dominates. Both hypertrophy and dilation are the result of increased right ventricular pressure.

Front 17

Polycythemia

Back 17

A condition in which there is a net increase in the total number of blood cells, primarily red blood cells, in the body.

Front 18

Hypoxic Drive

Back 18

A form of respiratory drive in which the body uses oxygen chemoreceptors instead of carbon dioxide receptors to regulate the respiratory cycle.

Front 19

Asthma

Back 19

Chronic inflammatory
disorder of the airways.
The 3 S’s
release of histamine(swelling)
bronchoconstriction (spasms)
bronchial edema (secretions)

Front 20

Signs of Respiratory Distress

Back 20

Nasal flaring
Intercostal retraction
Use of accessory muscles
Cyanosis (central = lips)
Pursed lips
Tracheal tugging

Front 21

Paroxysmal nocturnal dyspnea

Back 21

Sudden, severe shortness of breath at night that awakens a person from sleep, often with coughing and wheezing. It is most closely associated with congestive heart failure. PND is often relieved by sitting upright, but not as quickly as simple orthopnea.

Front 22

Orthopnea

Back 22

is dyspnea which occurs when lying flat, causing the person to have to sleep propped up in bed or sitting in a chair.

Front 23

Abnormal breath sounds

Back 23

Snoring – upper a/w partially occluded by tongue
Stridor – high pitch on inspiration
Wheezing – whistling on expiration
Rhonchi – rattling due to excess mucous
Crackles – fluids in smaller a/w’s
Pleural friction rub (due to inflamed pleura)– leather rubbing

Front 24

Pulsus paradoxus

Back 24

Pulse becomes weaker as one inhales and stronger as one exhales. It is a sign that is indicative of several conditions including cardiac tamponade, pericarditis, chronic sleep apnea, croup, and obstructive lung disease

Front 25

Pulmonary Edema

Back 25

Condition in which fluid accumulates in the spaces outside the pulmonary vessels

Front 26

Atelectasis

Back 26

A state in which the lung, in whole or in part, is collapsed or without air.

Front 27

Adult Respiratory Distress Syndrome Treatment

Back 27

Provide supplemental oxygen
Support respiratory effort
Provide positive pressure ventilation if respiratory failure is imminent
Monitor cardiac rhythm and vital signs
Consider medications
Corticosteroids

Front 28

Emphysema

Back 28

Destruction of alveolar walls distal to the terminal bronchioles
Contributing factors
Heredity
Cigarette smoking
Environmental factors
Pink puffer, prefers to tripod
Barrel chested, thin appendages, prolonged expiratory phase, JVD

Front 29

Diagnosing Emphysema

Back 29

History:
Recent weight loss, dyspnea with exertion
Cigarette and tobacco usage
Lack of cough
Physical Exam:
Barrel chest
Prolonged expiration and rapid rest phase
Thin
Pink skin due to extra red cell production
Hypertrophy of accessory muscles
“Pink Puffers

Front 30

Chronic Bronchitis

Back 30

Increased number of goblet cells in the respiratory tree
Production of large quantity of sputum Often occurs after prolonged exposure to cigarette smoke
Alveoli not severely affected
Gas exchange is compromised
Decreased alveolar ventilation
Hypoxia
Pulmonary vasoconstriction
Cor pulmonale
Vital capacity is decreased
Chronic mucous production and plugging of the airways

Front 31

Diagnosing Chronic Bronchitis

Back 31

History
Frequent respiratory infections
Productive cough
Physical Assessment
Often overweight
Rhonchi present on auscultation
Jugular vein distention
Ankle edema
Hepatic congestion
“Blue Bloater.”

Front 32

Cystic Fibrosis

Back 32

Hereditary disease
Secretion of thick mucous in lungs and blocks the internal passages
Leads to increase respiratory infections, pneumonias and atelectasis

Front 33

Signs and Symptoms of Cystic Fibrosis

Back 33

Dyspnea, sudden and unexplained coughing fits
Cyanosis, clubbing of fingers / toes
Yellow-green sputum
Wheezes, crackles

Front 34

Pulmonary Fibrosis

Back 34

Scaring of the lung tissue wherein the alveoli become replaced by fibrous tissue
Huge ↓ compliance
Usually chronic, occurring after repetitive lung infections
Causes
scarring from viral / bacterial infection
inhaled pollutants
ARDS
Aspiration pneumonia

Front 35

DRUGS TO TREAT ASTHMA AND COPD

Back 35

Steroids (Corticosteroids)
Inhaled glucocoriticoids are drug of choice for moderate to severe asthmatics
Help control the inflammation process
Reduce the hypersensitivity of the airway smooth muscle but does not affect constriction of it
Work by reversing mucosal edema, decreasing capillary permeability and inhibit the enzymes responsible for inflammation

Front 36

Beta 2 –

Back 36

Cause smooth muscle relaxation

Front 37

Examples of Bronchodilators

Back 37

Ventolin (salbutamol), terbualine, albuteral, salmeterol

Front 38

Cholinergic Antagonists (anticholinergics)

Back 38

Block the contraction of smooth muscle which can be stimulated by vagal stimuli
Examples include: ipratropium, atropine

Front 39

Theophyline

Back 39

Bronchodilator which is being phased out
Overdose is very easy and it reacts poorly with a large number of other drugs

Front 40

Ventolin

Back 40

Relaxes smooth muscles of the bronchial tree (bronchodilator) and peripheral vasculature by stimulating β-adrenergic receptors (making it a β2 agonist) of the SNS

Front 41

Beck's triad

Back 41

is a collection of three medical signs associated with acute cardiac tamponade, an emergency condition wherein fluid accumulates around the heart and impairs its ability to pump blood. The result is the triad of JVD, Distant Heart sounds, Hypotension with Narrowing Pulse Pressure.

Front 42

Signs Symptoms of Chest Wall Injuries

Back 42

Blunt or Penetrating Trauma to Chest, Erythema, Ecchymosis, Dyspnea, Hypoventilation, Paradoxical Movement, Crepitus.

Front 43

Signs and symptoms of Tension Pneumothorax

Back 43

Decreased or absent breath sounds on the affected side
JVD, Tracheal deviation , Unequal chest rise, Dyspnea, Tachypnea, Tachycardia, Hypotension, Hypoxia, Pale, cool, clammy skin, Sub-Q
Cyanosis, Treatment involves the insertion of a needle into the second intercostal space on the mid-clavicular line, thereby releasing the pressure in the pleural cavity and converting the tension pneumothorax to a simple pneumothorax.

Front 44

Barotrauma

Back 44

is physical damage to body tissues caused by a difference in pressure between an air space inside or beside the body and the surrounding gas or liquid.[1][2]

Barotrauma typically occurs to air spaces within a body when that body moves to or from a higher pressure environment, such as when a SCUBA diver, a free-diving diver or an airplane passenger ascends or descends. Boyle's law defines the relationship between the volume of the air space and the ambient pressure.

Front 45

Emphysema

Back 45

Symptoms include shortness of breath on exertion and later at rest, hyperventilation, and an expanded chest.
Mild emphysema sufferers often maintain perfect blood oxygen levels by hyperventilating, and so are sometimes called "pink puffers". Signs of emphysema include pursed-lipped breathing, central cyanosis and finger clubbing. There may be decreased breath sounds and audible expiratory wheeze. In advanced disease, there are signs of fluid overload such as pitting peripheral edema. The face has a ruddy complexion if there is a secondary polycythemia

Front 46

Treatment for Chronic Bronchitis

Back 46

Antibiotic: or acute exacerbations of chronic bronchitis, if antibiotics are used, amoxycillin or doxycycline is recommended, Bronchodilators,
Corticosteroids, Stop Smoking

Front 47

Adult Respiratory Distress Syndrome (ARDS)

Back 47

A serious reaction to various forms of injuries to the lung. This is the most important disorder resulting in increased permeability pulmonary edema.
ARDS is characterized by inflammation of the lung leading to impaired gas exchange with inflammation, hypoxemia and frequently resulting in multiple organ failure. This condition is life threatening and often lethal, usually requiring mechanical ventilation and admission to an intensive care unit.

Front 48

Positive end-expiratory pressure (PEEP)

Back 48

A method of holding the alveoli open by increasing expiatory pressure. Some bag valve units used in EMS have PEEP attachments. Also, EMS personnel sometimes transport patients who are on ventilators with PEEP attachments.

Front 49

Managing Lung Cancer

Back 49

Administer Oxygen, support ventilation be aware of DNR order, Provide Emotional Support.

Front 50

Managing Toxic Inhalation

Back 50

Ensure safety of rescue personnel, remove patient from toxic environment, maintain an open airway, provide humidified high concentration oxygen.

Front 51

Managing Carbon Monoxide Inhilation

Back 51

Ensure safety of rescue personnel, remove patient from exposure site, maintain open airway, provide high concentration oxygen.

Front 52

Beta2-adrenergic agonist

Back 52

They act on the Beta-2 adrenergic receptor, thereby causing smooth muscle relaxation resulting in dilation of bronchial passages, vasodilation in muscle and liver, relaxation of uterine muscle and release of insulin. Side effects such as insomnia, anxiety, and tremor occur in some patients. All β2 agonists are available in inhaler form (either metered-dose inhalers, which aerosolize the drug, or dry powder which can be inhaled).

Salbutamol (known as albuterol in the U.S.) also comes in a solution form for nebulization, which is more commonly used in emergency rooms than inhalers. Salbutamol and terbutaline are also both available in oral forms. Bronchial dilator.

Front 53

Beta-1 adrenergic receptor

Back 53

Increase cardiac output
Increase heart rate in SA node Increases conduction and automaticity of AV node, Renin release, Lipolysis in adipose tissue.

Front 54

alpha-1 adrenergic receptor

Back 54

An adrenergic receptor with the primary effect of vasoconstriction. Vasoconstriction of arteries to heart. Vasoconstriction of veins, Decrease motility of smooth muscle in gastrointestinal tract

Front 55

Alpha-2 adrenergic receptor

Back 55

Individual actions of the α2 receptor include:
Mediates synaptic transmission in pre- and postsynaptic nerve terminals.
Decrease release of acetylcholine
Decrease release of noradrenaline + Inhibit noradrenaline system in brain
Inhibition of lipolysis in adipose tissue.
inhibition of insulin release in pancreas.
induction of glucagon release from pancreas.
platelet aggregation
contraction of sphincters of the gastrointestinal tract
↓ Secretion from salivary gland
relax gastrointestinal tract(presynaptic effect)