Medical Issues Ch. Pulmonary System and Conditions Flashcards Preview

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Flashcards in Medical Issues Ch. Pulmonary System and Conditions Deck (47):
1

pulmonary system functions

extracts oxygen from the air
exchanges oxygen with carbon dioxide in the blood

2

prevalence of pulmonary pathology

second most frequent cause of disability
fifth leading cause of death among adults
14-15 million people suffer from asthma

3

inspiration A/P

active movement
contraction of diaphragm and external intercostals

4

expiration A/P

passive movement
relaxation of inspiring muscles

5

accessory breathing

the use of muscles other than the respiration muscles to breathe

6

respiration

gas exchange

7

ventilation

movement of air in and out of the lungs

8

ventilation control

medulla oblongata
-senses pH changes in the blood
receptors
-baroreceptors
-chemoreceptors
nervous system
-phrenic nerve
--C3-C5 nerve root

9

effects of exercise on respiratory system

increased blood to the lungs
increased oxygen demand to muscles
increased carbon dioxide produced by muscles
increase in ventilation

10

S/S of pulmonary disease

dyspnea
cough
cyanosis
abnormal breathing patterns
thorax pain

11

types of coughs

dry cough
-allergic irritant
purulent sputum (pus)
-lower respiratory infection
hemoptysis
-lung damage (referral)

12

thorax pain types

tracheobronchial
-occurs over trachea
diaphragm
-can refer to shoulder
-less commonly the neck, ribs
pleurisy
-results from inflammation of parietal pleura

13

medical history and physical exam

family and personal history
symptoms
inspection
palpation
percussion
auscultation
respiration rate and depth
HR
BP
Peak Flow Meter

14

family and personal history questions

smoking

15

inspection

deformities
-pes excavatum
--concave
-pes carinatum
--convex

16

palpation

palpate ribs

17

percussion

lungs should be resonant

18

peak flow meter

establish a baseline for your patient
test patient upon suspicion of bronchospasm
-green zone: 80-100% of baseline
-yellow zone: 50-80% of personal best
--medication is necessary
-red zone: below 50%
--call 911

19

pulmonary pathology sources

environmental influences
trauma
genetic factors
immune response

20

pulmonary pathology disease classification

obstructive
-limits airflow
restrictive
-limits lung expansion

21

flail chest injury

multiple fractures that result in displacement of the ribs
can also sprain the joint between the rib and cartilage

22

pneumothorax

collaped lung (air in the pleural space)
commonly caused by trauma
S/S
-pain
-trouble breathing
-would hear hyper-resonance during percussion
Tx
-referral

23

hemothorax

blood in the pleural space
S/S
-similar to pneumothorax
-coughing up blood (frothy)
-percussion and auscultation differences
Tx
-referral

24

asthma

produces
-bronchial spasms
-chronic bronchial inflammation
-bronchial edema
symptoms
-chest constriction
-fatigue
-anxiety
clinical signs: symptoms worsen at night

25

asthma cont.

onset
-begins early, genetic predisposition to severe allergic responses
causes
-allergens
-infection
-cold/dry air
-emotional states
-exercise
Tx
-patient education is important
-limit inflammation (corticostaroids)
-treat bronchospasms (short and long acting beta-2 agonist)
-control symptoms
-prevent exacerbation by controlling known triggers

26

management of an acute asthma attack

seated position
take deep breaths
exhale through pursed lips (whistle)
tell them to remain calm
administer inhaler
ER is all else fails

27

asthma can cause

pneumothorax
acute right heart failure
hypoxia

28

exercise induced bronchospasm

exercise-induced asthma
more common than asthma
-15% of the population
-90% of people with asthma
-35-40% of people with allergies
occurs 5-10 minutes into exercise, worsens with activity
spontaneous recovery occurs 30-60 minutes after stopping exercise

29

exercise induced bronchospasm
-triggers
-S/S

triggers
-cold, dry air
-allergens
-pollutions
-infection
S/S
-unusual dyspnea
-central chest pain during exercise
-coughing

30

Acute EIB management

similar to an asthma attack
remove from exercise
reassure
assess and monitor

31

when to refer w/ EIB

cyanosis
syncope
symptoms >60 minutes

32

short acting Beta-2 agonists

albuterol (proventil, ventolin)
bronchodilators
can also prevent the tightening of the muscle around the airways caused by asthma triggers

33

Beta-2 agonist how to use

inhaled
nebulizer or MDI
take 2 puffs from a MDI 2-3 minutes apart, not more often than every 4 hours apart
can take up to 30 minutes for effects to occur
athlete may need to get on field earlier than most to warm up
side effects
-jittery

34

inhaled corticosteroids

most common for chronic asthma sufferers
will only fix the problem of inflammation, not bronchoconstriction
comes in inhaled and oral forms
-inhaled for more chronic
-oral for acute exacerbation
other names
-Vanceril DS
-Flovent
-Axmacort

35

long acting Beta-2 agonist

not to be a substitute for corticosteroids
used in addition to corticosteroids
effects can diminish after even a month of use
other names
-Serevent
-Foradil
great for multi-sport or for young kids who play all day long

36

exercise induced anaphylaxis

breathing disorder + chronic use of NSAIDs
produces an abnormal immune response
S/S
-flushing
-urticaria
-cough, croup (deep "honking" cough)
-stridor
--harsh wheezing sound
-hypotension & tachycardia (shock)

37

EIA treatment

administer Epipen
call 911

38

acute bronchitis

caused by infection or irritant that produces an inflammatory response
-most commonly viral
early S/S
-fever
-nonproductive cough
-sore throat
-chest pain
progresses to
-productive cough
-wheezing
treatment
-cough suppressants
-rest
-hydration

39

chronic bronchitis

caused by prolonged or repeated exposure to irritants
inflammation of the bronchial mucous membranes
S/S
-wheezing
-dyspnea
-cough that is more productive in the mornings and evenings
symptoms present from 3 months - 2 years
treatment
-avoid irritants

40

pneumonia

every year more than 60,000 Americans die of pneumonia
infection and inflammation in the lungs
recognition and early treatment is the best option

41

pleurisy

inflammation of the pleura
may develop secondary to other infections
fluid can accumulate at the site of the inflammation
can cause coughing, dyspnea, tachypnea, cyanosis, and retractions
diagnosis
-auscultation
-pain at one site with laughing, coughing

42

pleurisy
-doctor may order

chest X-ray
CBC
chest CT or ultrasound
thoracentesis
important to look for underlying pathology

43

influenza

the "Flu"
viral
S/S
-high fever
-headache/body aches
-cough
-chest pain
-shortness of breath
-fatigue
-loss of appetite
-nasal congestion
-sore throat
refer when
-close contact with other person's diagnosed influenza
-symptomatic
diagnosis
-clinincal grounds mainly
-antigen testing
-CBC's
-sputum cultures
-fever is generally the hallmark

44

upper respiratory infections

rhinovirus
very easily spread through cough or sneeze
mild symptoms very similar to influenza but don't last as long
secondary bacterial infection can happen
7-10 day duration

45

tuberculosis

highly contagious bacterial infection
-mycobacterium tuberculosis
airborne droplets cause infection
immunocompromised people are more likely to get active TB
S/S
-fatigue
-fever
-weight loss
-cough
-hemoptysis
-shortness of breath/wheezing
diagnosis
-skin test
-symptomatic
-positive radiograph

46

pulmonary obstructive disorders (COPD)

Chronic obstructive pulmonary disease is a classification of diseases involving partially blocked airways
-asthma
-bronchitis
-emphysema
-cystic fibrosis
decreased vital capacity, increased CO2, decreased O2, thus disrupting the diffusion gradient across the alveoli

47

emphysema

complication of chronic pulmonary disease + prolonged smoking
causes destruction of alveolar walls, capillaries, and lung elasticity
S/S
-SOB
-increased exhalation effort
-infection
-Cor pulmonale (right sided heart failure)
irreversible, poor prognosis