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19 Cards in this Set
- Front
- Back
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Wilkins clinical assessment Chapter 3 4 and 5 plus questions Egans fundamentals chapter 16 read |
assignment |
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Cough |
Protective reflex Stimulation of receptors :Pharynx, larynx, trachea, large bronchi, lung and visceral pleura Caused by inflammatory, mechanical,, chemical or thermal stimulation of cough receptors Key to determine etiology is careful history, physical exam, and cxr |
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Table 3:1 wilkins |
possible causes of cough receptor stimulation |
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Cough |
Afferent pathway :Vagus, phrenic, glossopharyngeal, trigeminal nerves Efferent pathway :Smooth muscles of larynx and tracheobronchial tree via phrenic, spinal nerves |
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Cough |
Phases :irritation :Inspiratory :compression :expiratory phase |
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Cough |
Reduced effectiveness of cough :weakness of inspiratory or expiratory muscles ::people with neuromuscular disease :Inability of the glottis to open or close effectively ::could be vocal cord paralysis from tracheostomy or a tube in the glottis :Obstruction, collapsibility, or alteration in shape or contours of the airways :Decrease in lung recoil (emphysema) :Abnormal quantity of quality of mucus production (thick sputum) |
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Cough |
Acute :Sudden onset :severe, short course :Self limiting ::Viral infection Chronic :Persistent :Lasts greater than 3 weeks :Causes ::Postnasal drip, asthma, COPD, exacerbation, allergic rhinitis, GERD, chronic bronchitis, bronchiectasis, left heart failure |
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Cough |
Paroxysmal :periodic :Prolonged, forceful episodes |
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Associated symptoms of cough |
Wheezing Stridor Chest Pain Dyspnea |
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Complications of cough |
Torn Chest muscle Rib Fractures Disruption of surgical wounds (dehissence is sutures coming out from cough) Pneumothorax or pneumomediastinum Syncope Arrhythmia Esophageal rupture Urinary incontinence |
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all of the following are common causes of a weak cough, except |
steroid administration |
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Cardiopulmonary symptoms |
Sputum production :Mucus from tracheobronchial tree not contaminated by oral secretion is called "phlegm" :Mucus from lower airways but is expectorated through mouth is called "sputum" :sputum having pus cells "purulent" :Foul smelling sputum "fetid" :Recent changes in sputum color, viscosity, or quantity may indicate infection |
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Sputum production |
Components :Mucus, cellular debris, microorganisms, blood, pus, foreign particles Normal sputum production is 100 ml/day :Upward displacement via wavelike motion of cilia until swallowed
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Abnormal sputum production |
Excessive production by inflamed glands :Caused by : infection, cigarette smoking, allergies Describe: :Color ::Yellow, green (pseudomonas), most of the time yellow becomes green when it stays in :Quantity :Consistency :Odor, pseudomona has a classic fetid odor :Time of day :presence of blood
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Table 3:3 wilkins |
Presumptive sputum analysis
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Cardiopulmonary symptoms |
Hemoptysis :Coughing up blood or bloody sputum :Characterized by massive or non massive ::Massive :::More than 300 mls of blood expectorated in 24 hours :::Common causes, bronchiectasis, lung abscess, and acute or old tuberculosis :::Distinguished from hematemsis (vomiting blood from gastrointestinal tract) ::Non massive :::Common causes include, infection of airway, tuberculosis, trauma, and pulmonary embolism |
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Hemoptysis |
Expectoration of sputum containing blood :From streaking to frank bleeding Causes :Bronchopulmonary lesion :Cardiovascular in nature :Hematologic :Systemic disorders :Tuberculosis or fungal infections |
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Box 3-1 notable causes of hemoptysis |
Frequent causes of hemoptysis
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Hemoptysis |
Amount :Massive Hemoptysis: 400 ml in 3hours or 600 ml is 24 hours ::Emergency condition ::Cancer, tuberculosis, bronchiectasis, trauma :Streaky; pulmonary infection, lung cancer, thromboemboli Odor Color Acuteness |
