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Respiratory System Pahology
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Auscultation


Listening to sounds within the body, performed with a stethoscope. Helpful to diagnose conditions of the lungs, pleura, heart, and abdomen, as well as to determine the condition of the fetus during pregnancy.


Percussion


Tapping on a surface to determine the difference in the density of the underlying structure. Solid organs


Pleural Rub


Scrarchy sound produced by pleural surfaces rubbing against eachother. Occurs when the pleura are roughened and thickened by inflammation, scaring, or neoplastic cells.


Rales (crackles)


Fine crackling sound heard on auscultation (during inhalation) when there is fluid in the alveoli.


Rhinchi (singular: Rhonchus)


Loud rumbling sounds heard on auscultation of bronchi obstructed by sputum. Indicative of congestion and inflammation in the large bronchial tubes.


Sputum


Material expelled from the bronchi, lungs, or upper respiratory tract by spitting. Purulent: pus which is green or brown.


Stridor


Strained, high-pitched sound heard on inspiration caused by obstruction in the pharynx or larynx. Common causes of stridor include throat abscess, airway injury, croup, allergic reaction, or epiglottitis and laryngitis.


Wheezes


Continuous high-pitched whistling sounds produced during breathing. Wheezes are heard when air is forced through narrowed or obstructed airways as in asthma.


Croup


Acute viral infection of infants and children with obstruction of the larynx, barking cough, or stidor.


Diphtheria


Acute infextion of the thrpat and upper respiratory tract caused by the diphtheria bacterium Corynebacterium. Inflammation occurs, ans a leathery, opaque membrane forms in the pharynx and trachea.


DPT injection


Diphtheria, pertussis and tetanus toxins vaccinations


Pertussis


Whooping cough; highly contagious bacterial infection of the pharynx, larynx, and trachea cause by Bordetella pertussis. Pertussis is characterized by paroxysmal (violen, sudden) spasms of coughing that ends in a loud \"whooping\" inspiration.


Asthma


Chronic bronchial inflammatory disorder with airway obstruction due to bronchial edema and constriction and increased micus production. S/S: dyspnea, wheezing and cough. Etiology: allergy and infection. Triggers: exercise, strong odors, cold air, stress, allergens ( dust, molds, pollens, foods), and medications ( aspirin, beta-blockers)


Asthma Treatments


•anti-inflammatory agents inhaled (long term control glucocorticoids) •bronchodilators- quick relief control (albuterol) •Leukotriene-blockers reduce inflammatory symptoms with inhaled meds such as singular •Trigger avoidance with pt education


Bronchiectasis


Chronic dilation of a bronchis secondary to infection. Caused by chronic infection with loss of elasticity of the bronchi. S/S are cough, fever, and expectoration of foul-smelling, purulent sputum. Treatment is palliative and includes antibiotics, mucolytics, bronchodilators, respiratory therapy, and surgical resection if other therapies are not effective.


Chronic Bronchitis


Inflammation of bronchi persisting over a long time; type of chronic obstructive pulmonary disease (COPD). Infection and cigarette smoking are etiologic factors. S/S: excessive secretion of often infected mucus, a productive cough, and obstruction of respiratory passages. Chronic bronchitis, asthma, anf emphysema are components of COPD.


Cystic Fibrosis (CF)


Inherited disorder of exocrine glands resultjng in thick mucous secretions in the respiratory tract that do not drain normally.


Emphysema


Hyperinflation of air sacs with distruction of alveolar walls. High CO2 levels. Loss of elasticity and the breakdown of the alveolar walls result in expiratory flow limitations. As a result of the destruction of lung parenchyma, including blood vessels, pulmonary artery pressure rises and the right side of the heart must work harder to pump blood this leads to Cor Pulmonale.


Lung Cancer


Malignant tumor arising from the lungs and bronchi. lung cancer is divided into 2 categories: non-small cell lung vancer (NSCLC) and small cell lung cancer (SCLC).


NSCLC (non-small cell lung cancer)


Accounts for 90% of lung cancers. 2 types: Adenocarcinoma - derived from mucus-secreting cells. Squamous cell carcinoma - derived from the lining cells of the upper airway.


SCLC ( small cell lung cancer)


Derives from small, round (oat cells) cells found in pulmonary epithelium.


Pneumoconiosis


Annormal condition cause by dust in lungs, with chronic inflammation, infection, and bronchitis. Anthracosis= coal dust (black lung disease), asbestosis= asbestos particles, silicosis= silica/or glass (grinders disease).


Pneumonia


Acute inflammation and infection of alveoli, which fill with pus or products of the inflammatory reaction. Infection damages alveolar membranes so that an exudate (fluid, blood cells, and debris) consolidates the alvioli ( sacs become \"glued\" together, making air exchange less effective).


Infiltrate


A fluid-filled area within the lungs as seen on cxr or ct scan.


Lobar Pneumonia


Involves the entire lobe of lung


Bronchopneumonia


Common in infants and the elderly, involves patchy consolidation (abscess) in the lung parenchyma


Community Aquired Pneumonia


Results from a contagious respiratory infection, caused by a variety of viruses and bacteria (mycoplasma bacteria). Treated with oral antibiotics.


Aspiration pneumonia


Caused by material, such as food or vomitus, lodging in bronchi or lungs.


Pulmonary Abscess


Large collection of pus in the lungs, secondary to an infection ans caused by broncjiectasis, CF.


Pulmonary Edema


Fluid in the (air sacs) alveoli and bronchioles. Caused by Left sided heart failure, CHF. Acute pulmonary edema requires immediate medical attention, including drugs(diuretics: lasix/bumex), (vasodilators: nipride), oxygen in high concentrations, and keeping the patient in a sitting position to decrease venous return to the heart.


Pulmonary Embolism (PE)


Clot or other material lodges in vessels of the lung. Embolus travels from distant veins, usually in the legs. Embolus can cause a pulmonary infarction. PE causes acute pleuritic chest pain (pain on inspiration) and may be associated with blood in the sputum, fever, and respiratory insufficiency. CT angiography is useful in the diagnosis of PE. Medical management anticoagulants (warfarin), LMWH (enoxaparin), fibrinolitics (streptokinase) lyses the clot. NI: TED stockings,


Pulmonary Fibrosis


Formation of scar tissue in the connective tissue of the lungs. Chronic inflamaor irritation caused by tuberculosis, pneumonia, or pneumoconiosis.


Sarcoidosis


Chronic inflammatory disease in which granulomas (small nodules) develop in lungs, lymph nodes, and ther organs. Cause is unknown. Bilateral hilar lymphadenopthy or lung involvement is visible on cxr in most cases. Corticosteroid drugs are used to prevent progression in these pts.


Tuberculosis


Infectious disease caused by Mycobacterium tuberculosis; lungs usually are involved, but any organ may be affected. Rod-shaped bacteria called bacilli invade the lungs, producing small tubercles of infection. S/S: cough, weight loss, night sweats, hemoptysis and pleuritic pain Antituberculosis chemotherapy (isoniazid, rifampin) is the first line of drugs. PPD skin test (ID injection of .02 cc) if positive the bleb would be gone and the skin would be raised greater than 2cm


Allergic Rhinitis


Allergic Rhinitis and allergic conjunctivitis (hay fever) are atopic allergic conditions that result from antigen-antibody reactions in the nasal membranes, nasopharynx, and conjunctiva from inhaled or contact allergens. Common causes: tree, grass, weed pollens, mold spores, fungi; house dust, mights and animal dander; and some foods. S/S: Occular-photophobia, excessive tearing, blurring vision and pruritis. Rhinitis - excessive secretions or inability to breathe through the nose because of congestion/edema. Otitis media- occurs in Eustachian tube. Medical management: Avoid allergen,