Flashcards in Resp failure, breathing sounds, common conditions Deck (10):
What is bronchial breathing?
Consolidated alveoli (which being solid, are excellent at conducting sounds) - which conduct breath sounds from larger airways.
List two conditions which will cause a mediastinal displacement towards the affected side and explain why.
Localised fibrosis – fibrous tissue contracts.
Lung collapse from central airway obstruction
- Blockage of air entering distal airways. Air already present gets absorbed and then alveoli contract down, causing collapse of the alveoli
Give a condition which will cause a mediastinal displacement away from the affected side and explain why.
Increased pressure in pleural cavity due to the large effusion pushing entire mediastinum to the opposite side
Outline the symptoms of acute bronchitis
Acute Bronchitis is an acute viral or bacterial infection of the respiratory tract
- Usually begins 3-4 days after a URTI
- Cough may initially be dry, then productive
- Can have SOB and wheeze
- Symptoms do not vary during the day
- Mild fever may be present. (High fever suggests pneumonia)
- Central chest discomfort on coughing may be present
- No past history of recurrent similar episodes
Outline symptoms of asthma
Not an infection, though episodes may be triggered by respiratory tract infection
- No preceding URTI
- Dry cough, tenacious, scanty white sputum
- Chest tightness
- Breathlessness and wheeze
- Symptoms show variability
- Past history of similar episodes, with trigger factors
- History of atopy
- Family history of asthma/atopy
What causes narrowing of large airways?
Compression (eg by Lymph nodes outside airways)
Narrowing of lumen by tumour
Inhaled foreign bodies
What causes narrowing of the small airways?
Mucus in lumen
Bronchial wall thickening due to hypertrophy of submucosal glands
Loss of radial traction (eg emphysema)
What is the difference between vesicular and bronchial sounds?
Vesicular sounds – these are the normal breath sounds
- Quality suggestive of ‘rustling leaves’
- heard on inspiration and 1st part of expiration with no gap between the inspiratory & expiratory components.
Bronchial breathing – Characteristic blowing sound
- present in both inspiration and expiration with gap between the inspiratory & expiratory components.
- Causes: consolidation, localised fibrosis, pleural effusion
Give two main effects of chronic respiratory failure
1. CO2 retention
- CSF acidic corrected by choroid plexus
- Initial acidosis corrected by the kidney
- Reduction of respiratory drive
- Persisting hypoxia
2. Right Heart Failure (Cor pulmonale)
- Effect of hypoxia on pulmonary arteries causes Pulmonary hypertension
- Chronic respiratory failure is severely disabling