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Terms Flashcards

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1
Q

Hemoptysis

A

Coughing up blood or blood streaked sputum from the LUNGS

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2
Q

What are the common causes of massive hemoptysis?

A

Bronchiectasis, lung abscess, and acure or chronic tuberculosis

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3
Q

What is considered massive hemoptysis vs nonmassive?

A

Massive: > 300 ml of blood expectorated over 24 hours

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4
Q

What are the common causes for nonmassive hemoptysis?

A

Infection of airway, tuberculosis, trauma, and pulmonary embolism

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5
Q

What is hematemesis?

A

Blood vomited from the GASTROINTESTINAL TRACT.
Occurs in patients with GI disease
(Sometimes difficult to differentiate the origin of bleeding since committing can stimulate the cough reflex)

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6
Q

Chest pain

A

Pleuritic or NonPleuritic

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7
Q

Pedal Edema

A

Swelling of lower extremities most likely due to heart failure.
2 types
Pitting edema
Weeping edema

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8
Q

Weeping edema

A

Small Fluid leaks from skin with finger pressure often seen with Severe chronic heart failure.

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9
Q

Pitting Edema

A

Indentation mark left in skin after pressure is applied

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10
Q

Someone with chronic hypoxemic lung disease usually develop right heart failure due to pulmonary hypertension, would have this symptom in their lower extremities

A

Pedal Edema

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11
Q

What is the scale to measure severity of pitting edema?

A

“1 plus” -trace pitting with RAPID refill
“4 plus” - severe pitting with refill time more than 2 minutes

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12
Q

Pectus Carinatum

A

Abnormal Protrusion of sternum

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13
Q

Depression of part, or entire, sternum, which can produce a restrictive lung defect

A

Pectus excavatum

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14
Q

Spinal Deformity in which the spine has an abnormal ANTEROPOSTERIOR CURVATURE

A

Kyphosis

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15
Q

Spinal Deformity in which the spine has a LATERAL curvature

A

Scoliosis

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16
Q

Kyphoscoliosis

A

Combination of kyphosis and scoliosis which may produce a severe restrictive lung defect as a result of poor lung expansion

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17
Q

Hallmark Sign of increased breathing effort

A

Recruitment of accessory breathing muscles in the neck and thorax to maintain ventilation

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18
Q

WOB

A

Work of breathing

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19
Q

Common causes of an increase in WOB include :

A

Narrowed airways
“Stiff Lungs” (e.g: acute respiratory distress syndrome, cardiogenic pulmonary edema) both cause fluid to enter alveoli
A stiff chest wall (eg, ascites, anasarca, pleural effusions) these restrict expansion not due to pulmonary issues but surrounding areas

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20
Q

Distortions in the chest wall due to increased WOB

A

Retractions are inward. Sinking of the chest wall during inspiration. Occurred when inspiration muscle contractions generate large negative intrathoracic pressures

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21
Q

Apnea

A

An absence of breathing
Causes: cardiac arrest, narcotic OD, severe brain trauma

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22
Q

Intermittent prolonged gasps and then apnea

A

Agonal Breathing

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23
Q

Apneustic breathing

A

Deep, gasping inspiration with brief, partial expiration
Causes: damage to upper medulla or pins cause by stroke or trauma; sometimes observed with hypoglycemic coma or profound hypoxemia

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24
Q

Prolonged exhalation with recruitment of abdominal muscles

A

Asthmatic breathing. Caused by obstruction to airflow out of the lungs

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25
Biots Respiration
Clustering of rapid, shallow breaths w the same volumes coupled with periods of apnea Causes: Damage to medulla or pons caused by stroke or trauma ; severe intracranial hypertension
26
Deep and Fast Respiration
Kussmaul breathing. Caused by diabetic ketoacidosis and metabolic acidosis
27
Cheney-Stokes respiration
Irregular type of breathing: breaths increase and decrease in depth of volume and rate with periods of apnea Causes : Most often caused by severe damage to bilateral cerebral hemispheres and basal ganglia (usually infarction) Also see. In patients with CHF owing to increased circulation time and in various forms of encephalopathy
28
Paradoxical breathing
Abnormal movement of the abdomen and thorax
29
Abdominal paradox
Abdominal wall moves inward on inspiration and outward on expiration Diaphragmatic fatigue or paralysis
30
Chest Paradox
Part or all of the chest wall moves inward with the inhalation and out with exhalation Typically observed in chest trauma with multiple rib (flail chest) or sternal fractures ; also found in patients with high spinal cord injury with paralysis of intercostal muscles
31
Hoover sign
Contraction of a flat diaphragm tends to draw in the lateral costal margins instead of normal expansion outward
32
Signs of diaphragmatic fatigue
Tachypnea Diaphragm and rib cage muscles take turn powering breathing (respiratory alternans) Abdominal paradox occurs with complete diaphragmatic fatigue
33
Vocal Fremitus
Vibrations created by vocal cords during speech. Vibrations transmitted down the tracheobronchial tree and through the lung to the chest wall.
34
Vibrations felt on the chest wall
Tactile fremitus Asking patient to repeat the word “ninety nine” while RT palpates the anterior lateral and posterior portions
35
Increased with pneumonia and atelectasis (consolidation)
Vocal and tactile fremitus
36
Reduced with emphysema, pneumothorax, and pleural effusion
Vocal and Tactile Fremitus
37
Percussion of the chest
Tapping on a surface to evaluate the underlying structure, provides a sound and palpable vibration useful in evaluating underlying lung tissue
38
Evaluated with percussion
Resonance of chest. Normal . Increased or decreased resonance
39
Decreased Resonance during percussion of the chest
Pneumonia or pleural effusion (consolidation)
40
Increased Resonance
Emphysema or pneumothorax (air)
41
Normal breath sounds
Lung sounds are audible vibrations primarily generated by turbulent airflow in the larger airways Sounds are altered as they travel through the lung periphery and chest wall Passes low frequency sounds
42
Heard directly over trachea. Created by turbulent flow. Loud with expiratory component equal to or slightly longer than inspiratory content
Tracheal breath sounds
43
Bronchovesicular breath sounds
Heard around sternum, softly and slightly lower in pitch
44
Heard of lung parenchyma (tissue) ; very soft and low pitched
Vesicular breath sounds
45
Adventitious lung sounds (not normal) types
Discontinuous and Continuous
46
Discontinuous adventitious lung sounds
Intermittent crackling Bubbling sounds of short duration Referred to as “crackles”
47
Continuous Adventitious lung sounds
Heard over bronchi , bronchioles is called “wheezes” Heard over the upper airway (larynx) is called “stridor”
48
Bronchial breath sounds
Abnormal if heard over peripheral lung regions Replacing normal vesicular sound when lung tissues density increases
49
Diminished breath sounds
Occur when sound intensity at site of generation (larger airways) is reduced due to shallow or slow breathing When sound transmission through lung or chest wall is decreased. (COPD or asthma)
50
A high or low pitched quasi-musical sound (lower airway- bronchioles)
Wheezes Monophonic wheezes indicate one airway is affected. Polyphonic wheezing indicates many airways are involved
51
High pitched airflow sound. Audible. Upper airway-Larynx
Stridor. Chronic stridor (laryngomalacia) Acute Stridor (croup) Inpiratory stridor - narrowing above glottis-epiglottis Expiratory stridor- narrowing of lower trachea
52
Coarse crackles (upper airway)
Airflow moves secretions or fluid in AIRWAYS
53
Fine crackles (lower airway)
Sudden opening of small airways in lung deep breathing Heard w pulmonary fibrosis and atelectasis Fluid overload conditions such as CHF Fined end inspiratory crackes: Atelectasis or fluid Pleural friction rub
54
Lung sounds
Wheezes Stridor Coarse crackles Fine crackles
55
Lung sound that is Caused by asthma or CHF
Wheezes. Rapid airflow through obstructed airways. High pitched , usually expiratory
56
Stridor lung sounds
Rapid airflow through UPPER AIRWAY, high pitched, monophonic, Croup, epiglottis, Post extubation laryngeal edema
57
Coarse Crackles
Excess airway secretions moving through airways. Coarse , inspiratory and expiratory Causes: severe pneumonia, bronchitis
58
Fine crackles
Sudden opening of peripheral airways Fine , late inspiratory Causes: atelectasis, fibrosis , pulmonary edema
59
Examination of extremities
Checking for clubbing and cyanosis
60
Clubbing (not common)
Is seen in large variety of chronic conditions: congenital heart disease, bronchiectasis, various cancers, and interstitial lung diseases. Depth of finger at the base of the nail is greater than the depth of the interphalangeal joint with clubbing
61
Bluish or purplish discoloration of the skin
Cyanosis
62
Types of Cyanosis
Peripheral or central.
63
Peripheral cyanosis
Signifies poor perfusion of the extremities (digits) so that the tissues extract more o2
64
Central cyanosis
When the mucosa or the torso are invoked and may signal severe lung diseases, profound hypertension, or presence of certain congenial heart diseases
65
Digital cyanosis (acrocyanosis)
Sign of poor perfusion, hands and feet typically cool to touch in such cases
66
Capillary refill
Assess peripheral perfusion by pressing firmly on fingernails until nail bed is blanched . Then released to refill. Normal refill time is 3 seconds or less
67
Diagnosis:
The process of identifying the nature and cause of illness
68
Differential diagnosis
The term used when signs and symptoms are shared by many diseases and the exact cause is UNCLEAR
69
Objective data:
Gathered by clinician (vital signs, CXR, r rays, blood work)
70
Subjective data;
Patient provided information. (Pain SOB anxious etc)
71
Social space
4-12 feet
72
Personal space
2-4 ft
73
Common questions
When did the symptom start How severe is it Where on the body is it What seems to make it better or worse Has it occurred before
74
Dyspnea
Sensation of breathing discomfort by patient
75
Positional Dypnea types
Orthopnea Platypnea Orthodeoxia Trepopnea
76
Dyspnea that is triggered when the patient assumes the reclining position
Orthopnea. Common in patients with CHF, mitral valve disease, and superior vena cava syndrome (left side heart failure)
77
Dyspnea triggered by assuming the upright position
Platypnea. Typically occurs in patients following pneumonectomy and in those with chronic liver disease
78
Orthodeoxia
Oxygen desaturation on assuming an upright position. Accompanied platypnea
79
When lying on one side relieves Dyspnea
Trepopnea. Usually associated with either CHF or pleural effusion. (Excess fluid in pleural cavity)

RCP 100 (6 decks)

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