Module 6: Respiratory System Flashcards
is a protective reflex that helps clear the airways by an explosive expiration. Inhaled particles, accumulated mucus.
Cough
inflammation, or the presence of a foreign body
initiates the cough reflex by stimulating the_______?
irritant receptors
What type of cough?
Resolves within 2 to 3 weeks of the onset of illness or resolves with treatment of the underlying condition.
Result of
o upper respiratory tract infections
o allergic rhinitis
o acute bronchitis
o pneumonia
o congestive heart failure
o pulmonary embolus, or aspiration.
Acute cough
What type of cough?
Persisted for more than 3 weeks, although 7 or 8 weeks may be a more appropriate timeframe because acute cough and bronchial hyperreactivity can be prolonged in some cases of viral infection.
Chronic cough
Long term inflammation of the bronchial tubes caused by prolonged exposure to irritants.
- most common cause of chronic cough
- lung cancer to be considered
- ACE inhibitors
chronic bronchitis
is defined as “a subjective experience of
breathing discomfort that is comprised of
qualitatively distinct sensations that vary in intensity.
Dyspnea
Reduced oxygenation of arterial blood (reduced
Pao2), Respiratory alterations
Hypoxemia
reduced oxygenation of cells in tissues. may be caused by alterations of other systems as
well.
Hypoxia
is a bluish discoloration of the skin and
mucous membranes caused by increasing amounts of desaturated or reduced hemoglobin (which is bluish) in the blood.
Cyanosis
Cyanosis generally develops when (how many grams?) of hemoglobin is desaturated, regardless of hemoglobin concentration.
5g of Hb
Slow blood circulation in fingers and toes
- Most often caused by poor circulation resulting from intense peripheral vasoconstriction, such as that observed in persons who have Raynaud disease, are
in cold environments, or are severely stressed.
- Best observed in the nail beds.
Peripheral cyanosis
caused by decreased arterial oxygenation (low
Pao2) from pulmonary diseases or pulmonary or cardiac right-to-left shunts.
- Best detected in buccal mucous membranes and lips.
Central cyanosis
Is the expectoration of blood or bloody secretions.
Blood produced with coughing is usually bright
red, has an alkaline pH, and is mixed with frothy
sputum.
Bronchoscopy, combined with chest computed
tomography (CT), is used to confirm the site of
bleeding.
Hemoptysis
Vomiting of blood. Blood that is vomited is dark, has an acidic pH, and is mixed with food particles.
Hematemesis
is the selective bulbous enlargement of the end (distal segment) of a digit (finger or toe).
It is usually painless.
- Commonly associated with diseases that cause
chronic hypoxemia
Clubbing
Inflammatory condition of the lungs, infection of the pulmonary parenchyma. Leads to the air sacs in the lungs filling with pus.
Pneumonia
General Pneumonia Triad (WHO)
- Fever
- Tachycardia
- Tachypnea (+/- Breathlessness)
Etiology:
- Influenza Virus A & B for adults (<10% of
pneumonia among adults)
- Most common cause of pneumonia in children
(usually RSV)
Vaccine:
FluVax is recommended Annually for Everyone
VIRAL PNEUMONIA
SEASONAL FLU (INFLUENZA A & B)
most common bacterial pneumonia
- at risk: secondary complication to a viral RTI
Sputum:
- PMNs and gram-positive oval-shaped diplococci
Clinical presentation:
- abrupt onset with fever, rigor, pleurisy, and “rusty” sputum; watch for meningeal involvement
CXR:
- classically causes a lobar consolidation (filling of lung with fluid)
Streptococcus pneumoniae
Treatment:
- penicillin G (erythromycin if penicillin allergic;
vancomycin, ceftriaxone or cefotaxime if resistant) x 7-10 days
Prevention: Pneumovax (give once only)
Streptococcus pneumoniae
sudden onset bronchopneumonia
- at risk: secondary complication of influenza infection or in hospitalized patient with underlying disease, severe diabetes, drug abusers, immunocompromised
Clinical presentation:
- high fever, chills, progressive dyspnea, cyanosis, cough, pleuritic pain, quite toxic-appearing
Staphylococcus aureus
Sputum:
- PMNs and gram-positive cocci in clusters, chains, and pairs
Treatment:
- Cloxacillin or vancomycin (if penicillin allergic) x 7-10 days and drain any empyema
Staphylococcus aureus
most common atypical pneumonia; “walking
pneumonia”
- at risk: young adults (especially 5-15 years old)
- incubation: 12-14 days (insidious onset)
CXR:
- Classically worse than clinical presentation; usually bilateral, patchy air-space diseases
Mycoplasma pneumoniae
Sputum:
- more mononuclear cells and fewer PMNs than
bacterial pneumonia, but mycoplasma not visualized
Treatment:
- macrolide, newer generation Quinolones,
Doxycycline x 10-14 days
Mycoplasma pneumoniae
