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64 Cards in this Set
- Front
- Back
3 main portions of the respiratory system:
_- Humidifies, warms, cleans Nasal cavities, sinuses, pharynx, tonsils & larynx _-Trachea, bronchi & bronchioles _-Air sacs and primary lobules (acini) |
Upper airway
Lower airway Terminal alveoli |
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_- lung disease were pt. gets accumulation of mucus in their lungs (accumulation in the _)
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Cystic fibrosis
lower airway |
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Pulmonary system function:
- - - |
Temperature regulation- exhalation
Hormone secretion Gas exchange- O2 CO2 |
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Pulmonary System Function:
_ —ability to move air in & out of the lungs via a pressure gradient Patho—of the airways, lungs, chest wall & diaphragm affects _ _ —gas exchange that supplies O2 to the blood & body tissues & removes CO2 Patho—of the lungs & CV system, as well as the peripheral tissues affects _ |
Ventilation xs 2
Respiration xs 2 |
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How do we help ppl cough- _
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put them in supine and then push their stomach upward
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ventilation steps:
1. inspiration begins w/contraction of the _ and _ muscles 2. _flattens & descends, increasing _ length 3. _muscles raise ribs & sternum up & outward, increasing the _ surface area 4. _increase results in decreased _ in pleural cavity & alveoli & airways 5. as ribs & diaphragm moves, attached_ pulls adhering _ and _ along with it 6. as _ moves outward, the elastic lungs expand with it, resulting in a _in air _into the lungs 7. at this point, atmospheric pressure is _ intra-alveolar pressure, SO air flows from _ to _ 8. normal expiration—_ and _muscles relax, leading to a _ in thorax size 9. this _, along with natural _ of alveoli, results in increased _ pressure (_atmospheric pressure) 10. so air flows_ of the alveoli into the atmosphere. Quiet expiration is a _process & does not require _. Forced inspiration or expiration does |
diaphragm & external intercostal
diaphragm thoracic cavity external intercostal thorax thorax pressure pleura visceral pleura & lungs visceral pleura decrease pressure > atmosphere to alveoli diaphragm & external intercostal decrease decrease elastic recoil intraalveolar > out passive energy |
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Exhale is a_ process (usually), use the _ to do forced expiration
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passive
rectus abdominal |
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Uses what muscles?
Inspiration: Expiration: |
SCM, scalenes, pectoralis minor & serratus anterior.
abdominals & intercostals |
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-If they have an inspiratory problem those muscle will be _ during inspiration
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predominant
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-putting your hands on your knees makes it _ for the upper inspiratory muscles so they can breath better. To_after exercise is better bc a lot of the blood flow is in your legs.
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closed chain
keep moving |
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Pulmonary Dz:
_ —common condition caused by pulmonary dz or injury. Caused by respiratory alterations or CV compromise. Can lead to-> _ (this is the _ part) _—decrease of O2 to body tissue. Can occur anywhere in the body caused by an alteration in other systems & may not be related to changes in the pulmonary system. Partial pressure of < 80 mmHg (=90% SaO2) is _. (and this is the _ part) |
Hypoxemia
hypoxia. blood Hypoxia hypoxia oxygen |
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hypoxia only precedes hypoxemia with _
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One exception hypoxia precedes hypoxemia with CO2 poison
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Hypoxemia causes: mechanism/common clinical causes:
_ Asthma, Chronic bronchitis, Pneumonia _High altitude,Low O2 content, Suffocation _Lack of neuro center stim of respiratory center, Oversedation, Drug overdose,Neuro damage,COPD _Emphysema, Fibrosis, Edema _ ARDS, Hyaline membrane disease, Atelectasis |
-Ventilation/perfusion mismatch
-Decreased O2 content -Hypoventilation -Alveolocapillary diffusion abnormality -Pulmonary shunting |
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_ S and S
_ normal _mod. tachycardia, possible onset of respiratory distress, DOE _malaise, lightheaded, nausea, vertigo, impaired judgement, incoordination, restlessness _marked confusion, cardiac dysrhythmias, labored respiration _cardiac arrest, decreased renal blood flow, decreased urine output, lactic acidosis, lethargy, LOC |
hypoxemia
80-100 60-80 50-60 35-50 25-35 |
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when puls ox drops below _ S and S begin. if the numbers are even lower we need to have _ on the pt
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90
oxygen |
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S and S _
Cough Dyspnea Chest pain Cyanosis Clubbing Altered breathing patterns |
pulmonary dz
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Occurs frequently in healthy people. A persistent dry _ may be the result of a tumor, congestion, or hypersensitive airways (allergies).
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cough
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A productive cough w/ _ may indicate infection, WHEREAS a productive cough w/ _ (stuff that is _) is nonspecific & indicates airway irritation.
Spitting up _ is the next level of _ |
purulent sputum
nonpurulent sputum clear blood Sputum |
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_ indicates a patho condition such as infection, inflammation, abscess, tumor or infarction.
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Hemoptysis
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_ SOB usually indicates hypoxemia but can be from emotions, esp. fear & anxiety.
factors contributing: _ |
dyspnea
orthopnea |
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_—fluid shifts to the lungs, interferring w/gas exchange. Supine & prone positioning exerts pressure on the diaphragm from abdo contents.
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Orthopnea
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_ Usually localized to chest region over the lung fields (ant chest, side or back). May radiate to neck, upper traps, costal margins, thoracic areas, scapula or shoulder.
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chest pain
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_ Pleural irritation is sharp local pain aggravated by respiratory motions. Pain reduced by _. (putting pressure on it, by ones-self)
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chest pain
autosplinting |
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If a rib is fractured can _their rib so they can breath while you treat them
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autosplint
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_— bluish discoloration in oral mucous membranes, lips & conjunctivae & is most often associated w/ R to L shunts & pulmonary dz.
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Central cyanosis
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_—decreased perfusion to extremities, nail beds & nose & is commonly caused by cold temps, anxiety, heart failure or shock.
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Peripheral cyanosis
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_- fits under a vessel Dz problem
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Raynaud’s
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clinically detected cyanosis:
Depends on _ & amount of circulating _. Oxygen saturation in _cyanosis is usually decreased whereas arterial saturation may be normal in _. In _, vasoconstriction w/decreased blood supply & perfusion rather than unsaturated blood is the underlying cause of symptoms. |
oxygen saturation
hemoglobin central peripheral cyanosis peripheral cyanosis |
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_Thickening & widening of the terminal phalanges of fingers & toes. Recognized by loss of angle between nail & nail bed.
Schamrath method—if a diamond shape, then no clubbing. Index finger is then inspected |
clubbing
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normal values for clubbing:
Normal _ degrees Curved nail _ degrees or less Early clubbing: _ degrees and the nail base feels _ to palpation. |
160
160 180 spongy |
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_—fluid shifts to the lungs, interferring w/gas exchange. Supine & prone positioning exerts pressure on the diaphragm from abdo contents.
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Orthopnea
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_ Usually localized to chest region over the lung fields (ant chest, side or back). May radiate to neck, upper traps, costal margins, thoracic areas, scapula or shoulder.
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chest pain
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_ Pleural irritation is sharp local pain aggravated by respiratory motions. Pain reduced by _. (putting pressure on it, by ones-self)
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chest pain
autosplinting |
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If a rib is fractured can _their rib so they can breath while you treat them
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autosplint
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_— bluish discoloration in oral mucous membranes, lips & conjunctivae & is most often associated w/ R to L shunts & pulmonary dz.
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Central cyanosis
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_—decreased perfusion to extremities, nail beds & nose & is commonly caused by cold temps, anxiety, heart failure or shock.
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Peripheral cyanosis
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_- fits under a vessel Dz problem
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Raynaud’s
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clinically detected cyanosis:
Depends on _ & amount of circulating _. Oxygen saturation in _cyanosis is usually decreased whereas arterial saturation may be normal in _. In _, vasoconstriction w/decreased blood supply & perfusion rather than unsaturated blood is the underlying cause of symptoms. |
oxygen saturation
hemoglobin central peripheral cyanosis peripheral cyanosis |
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_Thickening & widening of the terminal phalanges of fingers & toes. Recognized by loss of angle between nail & nail bed.
Schamrath method—if a diamond shape, then no clubbing. Index finger is then inspected |
clubbing
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normal values for clubbing:
Normal _ degrees Curved nail _ degrees or less Early clubbing: _ degrees and the nail base feels _ to palpation. |
160
160 180 spongy |
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Gasping inspiration followed by short expiration
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apneustic
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Fast deep breaths interspersed w/abrupt pauses in breathing
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biots respiration
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Repeated cycle of deep breathing followed by shallow breaths or no breathing (bad sign)
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cheyne-stokes
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Discontinuous low-pitched sounds heard mostly during inspiration that indicated secretions in peripheral airways (if you hear this follow it up with precussions )
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crackles/rales
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Distressing dyspnea w/increased resp. rate, increased depth of respiration, panting, & labored respiration typical of air hunger
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kussmaul's respiration
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Anterior chest flattening w/excessive flaring of the lower ribs in supine
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lateral-costal breathing
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All or part of the chest wall falls in during inspiration, may be abdo expansion during exhalation; reverse breathing.
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paradoxical breathing
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Shrill harsh sound heard during inspiration in presence of laryngeal obstruction
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stridor
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High pitched continuous whistling sound, usually w/expiration & related to bronchospasm or other constriction of the airways.
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wheezing
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_ Common feature of all types is an inflammatory response to an offending organism or agent.
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pneumonia
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_ susceptible-> Older people, infants, bedridden or people w/altered consciousness are more susceptible
Mostly _ is preceded by a Upper Respiratory Infection, mostly viral in nature. |
pneumonia
pneumonia |
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lung infections- _ -Causes: bacteria, virus, fungus, mycoplasma infection, inhalation of toxic chemicals or aspiration.
It is a leading cause of death in the US. ~30% are _, ~50% are_. |
pneumonia
bacterial viral |
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types of pneumonia:
-_ -_ Histoplasmosis, coccidioidomycosis, bastomycosis are limited to specific geographic areas -_Bronchial walls become edematous & infiltrated w/WBC’s. The bronchial epithelium sloughs off & prevents mucociliary clearance -_ _ get to the alveolar surfaces, WBC’s & fixed macrophages assist with clearing out _ |
aspiration
fungal viral bacterial bacteria bacteria |
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_ s and s depends on the type
Sudden & sharp pleuritic chest pain aggravated by chest motion Hacking productive cough (rusty, green) {bacteria} Dyspnea Tachypnea (rapid resp associated w/fever) accompanied by decrease of chest excursion on the affected side Cyanosis HA Fever & chills (bacteria) Generalized aches & myalgia that may extend to the thighs & calves (viral) Fatigue |
pneumonia
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_: Hypercapnea—build up of CO2 in blood.
Specifically, paCO2 is > 45 mmHg. (amount of CO2 in the arteries) Cause can be anything that alters lung fx. |
pulmonary dz
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_ Declined but coming back due to HIV
Etiology—bug can live on a table for weeks! Pathogenesis—primary infection->hypersensitivity of T cells develops. Secondary infection is reactivation. |
TB
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_ S and S
Fatigue, malaise, anorexia, weight loss, low grade fevers, night sweats, frequent productive cough, dull chest pain |
TB
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_ Hyperplasia of mucous glands & goblet cells of endothelium (excess amount of mucus)
Causes– smoking & urban pollution Pathogenesis—excess mucous caused by smoking |
bronchiti
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_3 months of excessive mucous over 2 consecutive years
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chronic brochitis
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_ s and s
Persistent cough w/production of sputum (worse in AM & PM than @ mid-day) Reduced chest expansion Wheezing Fever Dyspnea Cyanosis Pulmonary edema |
bronchitis
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blue bloaters
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bronchitis
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progression from bronchitis to _
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CHF
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_ patients are usually on O2, short walk gets them out of breath
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bronchitis
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Emphysema & Bronchitis (go together like a horse & carriage...which leads to _..leads to _)
95% are due to _ |
COPD
CHF smoking |