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37 Cards in this Set
- Front
- Back
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Control of Breathing/Airways |
Brain Stem = Rhythm Center
CO2 receptors in the brain stem O2 chemoreceptors in carotid bodies, aortic arch |
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Bronchial muscle tone - Cholinergic |
Parasympathetic, vagus nerve
Bronchoconstriction, mucus secretion |
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Bronchial Muscle tone - adrenergic |
sympathetics, adrenal catechols
Relax smooth muscles, inhibit secretion |
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Bronchial Muscle tone - C Fibers |
Afferent, fire off in response to cold air, inflammation |
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Respiratory Sounds |
Stridor - abnormal high pitched musical sound on inspiration produced by blockage in larynx
Wheezes - whistle from air moving through narrowed breathing tubes
Crackles/Rales - clicking/rattling on inhalation |
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Pectus |
pectus excavatum - abnormal formation of rib cage that gives the chest a sunken appearance |
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Flail Chest |
segment of thoracic cage is separated from the rest of the chest wall
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Signs/Symptoms of Respiratory Disorders |
Cough - sputum production/color? Hemoptysis - cough up blood Dyspnea Orthopnea Angina Abnormal breathing pattern Cyanosis Clubbing |
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Pneumonia - general |
Inflammation of the parenchyma (tissue) of lungs
Treatment: pulmonary hygiene, hydration, chest PT, antibiotics
Streptococcus Pneumonia = most common |
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Aspiration pneumonia |
Right side more common
May form lung abcesses |
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Pneumocystis carinii Pneumonia (PCP) |
Important opportunistic infection in AIDS patients
Slow onset of sx/sy - cough, fever, fatigue, malaise, SOB
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Pulmonary Tuberculosis |
Primary vs Reactivation
Latent TB detected by skin test (ppd)
Requires prolonged course of multiple antibiotics for treatment
Active TB patients kept isolated until no longer infectious - RESPIRATORY PRECAUTIONS |
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Obstructive Disease |
Obstruction to airflow within airways
Asthma - acute inflammation/bronchospasm, reversible
Chronic Obstructive Disease - irreversible (bronchitis, emphysema) |
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Restrictive Disease |
Inhibition of lung expansion
Pulmonary fibrosis Pleural Disease Skeletal/chest wall abnormalities Morbid Obesity |
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Asthma Treatment |
Avoidance of precipitants Bronchodilators - Beta agonists, anticholinergics, methylxanthines Anti-inflammatory meds Inhaled/oral treatments maintenance vs rescue treatments |
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Asthma Implications |
Exercise induced asthma - monitor sy, have patient self-administer inhaler
Prophylactic use of medications b4 exercise
Recognize effects of meds - Beta agonists = tachycardia, tremulousness - Steroid effect on bone density (long term) |
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COPD - chronic bronchitis |
"blue bloaters" bronchial inflammation/destruction chronic productive cough Dyspnea recurrent pulmonary infections steady decompensation cyanosis associated chf |
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COPD - emphysema |
"pink puffer" Alveolar destruction bronchiolar collapse pursed lip breathing stepwise decompensation Exertional dyspnea progressing to dyspnea at rest |
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IF COPD PATIENT SUDDNLY LOSES WEIGHT |
either they're developing cancer or current disease is so advanced it costs way more energy to breathe than normal |
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COPD - cor pulmonale |
chronic scarring/fibrosis
Pulmonary hypertension
Right side CHF |
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COPD management goals |
prevent progression relieve symptoms improve exercise tolerance/health status prevent complications reduce mortality minimize side effects of meds
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COPD implications |
Sedentary lifestyle --> deconditioning
Use a pulse oximeter
Exercise training is good |
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Bronchiectasis |
IRREVERSIBLE destruction and dilation of airways following infection or congenital disorders |
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Obstructive Sleep Apnea |
Repetitive pauses in breathing during sleep, despite effort to breathe Usually last 20-40 sec, includes snoring Associated with reduction in blood oxygen saturation
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Sleep apnea treatment |
CPAP and/or surgical intervention |
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Pulmonary Fibrosis |
results in RESTRICTIVE lung disease - stiff lung
Thick interstitium prevents normal gas exchange
chronic hypoxia
prolonged steroid treatment - eventual respiratory failure
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Pneumoconiosis |
Inorganic Dust inhalation (coal worker's lung)
Decades of exposure
Fibrosis --> obstruction |
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Other occupational lung diseases |
occupational asthma
Hypersensitivity pneumonitis
smoke inhalation
environmental tobacco smoke |
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Cystic Fibrosis |
inherited disorder of ion transport (Na and Cl) in the exocrine glands
Affects the lungs, liver, pancreas, intestines and reproductive organs
over 300 mutations, so no genetic screening
Thickened pulmonary secretions |
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Cystic Fibrosis Treatment |
Multidisciplinary approach
Supervised exercise program
Antibiotics and digestive enzymes
Mucolytics and chest pt
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Atelectasis |
collapse of any part of the lung
Obstruction or compression
prevented by deep breathing, frequent position change, incentive spirometry |
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Pulmonary Edema |
Excess fluid in lung tissue, air spaces, or both
Cardiac causes - LV failure, valvular disease
Non cardiac causes - infections/toxins, kidney disease, ARDS, high altitude, near drowning
MEDICAL EMERGENCY |
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Acute Respiratory Distress Syndrome (ARDS) |
Form of acute respiratory failure following severe systemic or pulmonary insult
50-70% mortality, but if survived, normal lung function after 1 year |
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Sarcoidosis |
multisystem disorder of unknown etiology
90% of patients have lung involvement
non-caseating granulomas in involved organs
pulmonary infiltrates
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Lung Cancer |
(bronchogenic carcinoma)
No good screen, often metastatic
Most preventable
Treatment - radiation, chemo and surgery
Median survival - 6 months |
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Pneumothorax |
air leaked outside the lung into the pleural space |
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Venous thrombo-embolism |
MOST COMMON COSD in hospital patients |
