Respiratory

Term Definition
Myalgia Pain in muscle
Pharyngitis GABHS/GAS Spread by droplet transmission. Fiery-red pharyngeal membrane Pt develop a painful sore throat 1-5 days after exposure. Malaise, fever, headache, myalgia, painful cervical adenopathy, nausea, tonsils roof of mouth are erythematosus
Trismus Inability to open mouth
Dysphagia Difficulty swallowing
Otalgia Pain in the ear
Polycythemia Increase in red blood cell count not WNL
Urticaria Hives
Epistaxis Nosebleed
Hyposmia Decreased smell
Recurrent acute rhinosinusitis dx with >4 episodes of ABRS occur per year with no s/s of rhinosinusitis between episodes.
Chronic Rhinosinusitis Affects 20-40 yo dx >12 weeks with 2 or more s/s mucopurulent drainage, nasal obstruction, facial pain-pressure-fullness, hyposmia Usually caused by mechanical obstruction
Tympany Lung sound associated with loud intensity, high pitch, medium duration Location example gastric air bubble Caused by large pneumothorax
Hyperresonance Lung sound associated with very loud intensity, lower pitch, long duration Location example NONECaused by emphysema, pneumothorax
Flatness Sound found in lungsSoft intensity, high pitch, short durationLocation example thighCause large pleural effusion
Hypopnia Shallow breathing
Common cold Viral rhinitis is the most frequent viral infection in the general population also known as ?
Upper Respiratory Infection Most common reason for seeking health care and work/school absenteeism. pain is managed with Tylenol
Epitaxis Nose bleed, anterior septum most common site.Risk Factors: hemophilia, blood thinners, drug snorting, nose blowing/picking, liver disease, infection, HTN
Xerostomis Dryness of the mouth
Rhinorrhea Drainage of large amounts of fluids from the nose
Pharyngitis Inflammation of the throat usually viral or bacterial90% is caused by viral infection: adenovirus, influenza, Epstein-Bar (Mono), Herpes simplex
Pleurisy Occurs when the tissues that line the lungs become inflammed or infected, causing extreme pain during respirations
Empyema Pus in the pleural space. Visural and periatal Usually develops after pneumonia
Thoracoscopy Dx procedure where the pleural cavity is examined with an endoscope, and fluid and tissue samples can be obtained Used primarily for pleural effusion, pleural disease, tumor staging
Bronchial Expiratory sounds last longer than inspiratory ones loud, high, heard over the manubrium if heard at all
Endoyracheal intubation Insertion of a breathing tube though the nose/mouth into trachea
Ventilation Movement of air I/O of airways
Tidal Volume Volume of air inspired and expired with each normal breath Normal Value 5-10mL/kg
Functional Residual Capacity The volume of air remaining in the lung after a normal expirationFRC=ERV+RV= normal value 2300mLThis may be increased with COPD and decreased in ARDS and Obesity
Hering-Breuer reflex Activated by stretch receptors in the Alveoli
Baroreceptors Located in the Aortic and carotid bodies that respond to an increase or decrease in arterial BP and cause reflex ventilation
Compliance Measure of the force required to expand the lungNormal = 1L/cm H2O
Increased Compliance Occurs when lungs loose their elastic recoil and become overdistended as with emphysema
Respiration Gas exchange between the atmospheric air and the blood and between the blood and cells of the body
O2 Saturation % of hemoglobin that is bound to O2. normal is 20.84%
Hypoxia Decrease in O2 supply to the tissues and cells
Hypoxemia Decrease in arterial O2 tention in the blood
Pulmonary Diffusion Exchange of gas molecules: O2 & CO2 from areas of high concentration to areas of low concentration at the air blood interface
Pulmonary Perfusion Blood flow through the pulmonary vasculature
Decreased Compliance Occurs if the lungs & thorax are STIFFCauses: morbid obesity, pneumothorax, hemothorax, pleural effusion, pulmonary edema, atelectasis, pulmonary fibrosis, ARDS.
Vital capacity The maximum volume of air exhaled from the point of maximum inspiration Normal Value 4600mLA decrease may be found with: neuromuscular disease, generalize fatigue, atelectasis, pulmonary edema, COPD & obesity
Residual Volume The volume of air remaining in the lung after a maximum exhalationNormal Value 1200mLMay be increased with obstructive disease
Allergic Rhinitis The mucosa appears pale and swollen
Chronic Rhinitis nasal polyps may develop between the inferior and middle turbinates, the polyps are distinguished by their gray appearance
URI's can involve sinuses, nares, pharynx, tonsils, adenoids, peritonsils, larynx: epiglottis, vocal cords and cartilages, trachea
Viral Rhinitis contagious period: 1-4 days before onset of s/s. If you have a fever you are always contagious.Transmission: dropletS/S: nasal congestion, nasal discharge, cough, increased mucosal secretions, low grade secretions.
Rhinosinusitis Acute: less than 4 weeksSubacute: 4-12 weeksChronic: greater than 12 weeksS/S: purulent nasal drainage, nasal obstruction, facial pain, pressure, or sense of fullness of face
Rhinosinusitis pharmacologic therapy Antihistamines 1st line Decongestants (ability to cause hyperness so only give in the AMExpectorants
Antihistamines First line treatment is Diphenhydramine (Benadryl). Most common treatment of rhinosinusitis, administered for sneezing, puritis (runny nose) and rhinorrhea. Side Effects: drowsiness, dizziness, fatigue, & disturbed coordinations, nt colerginic
Systemic Decongestants, Used primarily for allergic rhinitisephedrine, oxymetazoline (afrin) stimulate alpha-adrenergic receptors that produce: nasal vascular vasoconstriction, shrink nasal mucous membranes, decrease nasal secretions.cant use more than 3 days r/t rebound nasal congestion
Expectorants, Guaifenesin Action: loosen bronchial secretions by reducing surface tension of secretions.Used for dry, nonproductive cough.Side Effects: drowsiness, nausea when taken on a empty stomach
pharyngitis S/S: pain, fever, vasodilation, edema, tissue damage manifested by redness and swelling in tonsillar pillars, uvula, and soft palate
viral pharyngitis supportive measures: liquid/soft diet, analgesics, if severe IV fluids
Bacterial Pharyngitis (STREP) antibiotics: penicillin V q5d first line. cephalosporin (amoxicillin) if allergic to penicillin q5-10 dmacrolides(Zpac) q3d not very effective on GABHS
Peritonsillar Abscess most common complication of sore throatS/S: acutely ill with fever, sever sore throat, trismus, and drooling, dysphagia, can be life threatening.Treatment antimicrobial agents & corticosteroids.Surgical: needle aspiration, incision and drainage
Nuchal Rigidity stiffness in the neck.can be a sign of tonsillitis
Cancer of the Larynx accounts for half of all head and neck cancers, most common in pt over 65 and 4x more common in men.S/S early hoarseness
TB-airborne transmission take meds for 6-12 months, no aged cheese, not considered contagious after 2-3 weeks of continuous medication administration
Eustachian tubes drain into the nasopharynx
Decongestants contraction of bronchial smooth muscle; as in asthmathickening of bronchial mucosa; chronic bronchitisobstruction of airway-by mucus; tumor or foreign objectloss of lung elasticity; emphysema: which is characterized by connective tissue encircling t
Causes of increased airway resistance contraction of bronchial smooth muscle; asthmathickening of bronchial mucosa; chronic bronchitisobstruction of airway; mucus, tumor, or foreign object.
causes of increased airway resistance loss of lung elasticity; as in emphysema, which is characterized by connective tissue encircling the airways thereby keeping them open during inspiration/expiration
ROM exercises in immobilized pt's stimulates breathing proprioceptors in the muscles and chest wall respond to body movement, causing an increase in breathing
FYI The amount of dissolved O2 is directly proportional to the partial pressure PaO2 regardless of how high the O2 pressure becomes
PaO2 when the PaO2 is 150mmHg, hemoglobin is 100% saturated and doesn't combine with any additional O2. Normal Value for PaO2 is 80-100mmHg & SaO2=70% saturation
CO2 amount of CO2 in transit is 1 of the major determinations in acid-base balance. 90% og CO2 is carried by RBC, the small 5% remains dissolved in the plasma (partial pressure of CO2 (PCO2)) is the critical factor in determines CO2s movement I/O of the blood
bronchitis morning cough with sputum product may indicate bronchitis
Hemoptysis Blood from lung is usually bright red, frothy & mixed with sputum. Initial S/S: tickling in the throat, a salty taste, a burning or bubbling sensation in the chest. pt tends to splint the bleeding side and blood has a pH greater than 7.0
Hemoptysis blood from the stomach is vomited rather than expectorated, may be mixed with food, is usually much darker (coffee ground emesis) this blood has a pH less than 7.0
Cyanosis Cyanosis appears when there is 10g/dL or less of unoxygenated hemoglobin. Normal Value is 15g/dL.cyanosis is still not a reliable sign for hypoxia
eupnea normal breathing
lung sounds resonant-over lungs dull- over masstympany-abdomen/ hollow organs
Normal ABG's pH is 7.35-7.45PaCO2 is 35-45PaO2 is 80-100HCO3 is 22-26O2 Sat. is greater than 94%
rigid bronchoscopy used to remove foreign object
Lung absess S/S mild productive cough, fever, sputum, leukocytosis, pleurisy, dyspnea, weakness, anorexia, <lbs. Pleural friction rub. DX:CXR, sputum culture, fiberoptic bronchoscopy. Antibiotics 4-12 weeks long time to heal
Pleural effusion Chest pain on inspiration, dry cough, dyspnea, DX with chest xrayTreatment is a Thorocentesis that is ultrasound guided, collect drainage to sample
Hospital Aquired Pneumonia Develops >48 hrs after admission
TB Erythema without induration in not considered significant,0-4 mm is considered not important,>5 is significant if pt is immunocomprimized pt are considered noncontagous after 2-3 weeks of coniued antibiotic therapy Use a 1 ml tuberculin syringe with a 1
Neuritis Inflammation of the nerve
Cor Pulmonale Heart of the lungs; enlargement of the right ventricle from hypertrophy or dilation or as a secondary response to disorders that affect the lung
Posture Drainage 5 different positions that pt must stay in 10 minutes each performed 2-3x daily
Chronic Bronchitis DX: presence of cough & sputum production for at least a combined total of 3 months for 2 years in a row

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