• Chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis
• Asthma
• Bronchiectasis
• Cystic fibrosis

• Interstitial lung disease, such as idiopathic pulmonary fibrosis
• Sarcoidosis
• Obesity
• Scoliosis
• Neuromuscular disease, such as muscular dystrophy or amyotrophic lateral sclerosis (ALS)

Cough

Dyspenea

Abnormal Breathing Patters

Hypoventilation 

Hyperventilation 

Cyanosis

Clubbing

Hemoptysis

Pain 

Serves as a protective mechanism 

Forced expiratory maneuver

Irritants stimulate airway receptors 

Resolves in less then 3 weeks

URI

Allergic rhinitis

Acute bronchitis

Pneumonia 

CHF

Pulmonary embolism

Aspiration 

Smoking history r/t chronic bronchitis or lung caner  

Non smoking r/t asthma

Postnasal drainage

Gastro-esophageal reflux 

SOB

Unable to take in air, feeling of breathlessness 

• Increased ventilatory rate
• No expiratory pause
• Hyperpnea 
• R/t strenous exercise
• Metabolic acidosis 

• Alternating periods of deep and shallow breathing
• Periods of apnea 
• R/t decreased blood flow to brain stem 

• Bluish discoloration 
• Desaturation
• Evident with severe hypoxia 

• Sharp
• Caused by infection and inflammation 

Muscle Pain

Rib Fractures 

• Too much PaCO2 in arterial blood
• Alveoli hypoventilation 

• Drugs
• CNS infections
• Trauma
• Spinal cord disruption 
• Neuromuscular disorders
• Sleep apnea

• Reduced oxygenation of arterial blood
• Too little O2 

• Respiratory problems
• Non respiratory problems 
• Ventilation - perfusion abnormalities 

• Direct lung injury
• Major surgical procedures
• Atelectasis (collapse of lung)
• Pneumonia 
• Pulmonay edema (fluid)
• Pulmonary emboli (clot)

• Compression - external pressure
• Absorption - removal of air 
• Most commonly a postoperative complication 

• Frequent turning 
• Deep breathing and incentive spirometry 
• Early ambulation 
• Air humidification 

• Heart problems
• Injury to endothelium 
• Blockage of lymphatic vessels 

• Impaired swallowing mechanisms
• CNS of PNS abnormalities 

Right side 

Usually middle and lower lobes 

• Hot dogs
• Grapes 
• Small idems
• Marbles 

• Paradoxical breathing
• Pain
• You will hear no breath sounds on the effected side

• Transudative
• Exudative
• Hemothorax 
• Empyema 

Infected pleural effusion 

Pus in pleural space

• Occurs when the chest wall is separated from chest cage
• Results from fracture of ribs of sternum 
• Causes paradoxical breathing 

Paradoxical breathing is seen when inhalation results in a decreasing, or asymmetrical, chest movement rather than a normal chest expansion

• Pneumoconiosis 
• Allergic Alveolitis 

• Causes by inhalation of inorganic dust particles
• Silicosis
• Coal worker (black lung)
• Asbestosis 

• Inhalation of organic dust particles
• Extrinsic allergic alveolitis - hypersensitivity pneumonitis 

What is Acute Respiratory Distress Syndrome?

(ARDS)

• Acute lung inflammation 
• Life threatening condition that prevents O2 from getting into you blood 

• Diffuse alveolar capillary injury 
• Injury to pulmonary capillary endothelium
• Inflammation and platlet acivation 
• Inability of cells to produce surfactant 

Decreased lung compliance 

Causes Ventilation-perfusion abnormalities 

• Severe dyspnea
• Rapid, shallow breathing
• Respiratory alkalosis
• Decreased lung compliance
• Acute hypoxemia 

• Asthma 
• Chronic Bronchitis
• COPD
• Emphysema 
• Pneumococcal Pneumonia 
• Absces
• Pulmonary fibrosis
• Chest wall restriction
• Tuberculosis
• Acute Bronchitis
• Pulmonary Embolism  

• Intermittent airway obstruction
• sudden onset
• Most common in US
• Increasing prevalence 

• You hypersecrete mucous
• chronic productive cough
• bronchial cells hypertrophy

• It increases mucous production
• It increases size and number of mucous glands 

• Chronic bronchitis
• Emphysema 

• Enlargement of gas exchange airways (but it is inadequate)
• Increased lung compliance  (this is bad bc lungs get stretched out over time)
• Decreased diffusion capacity
• Increased airway resistance 

• Excessive amount of fibrous or connective tissue in the lung
• Hardening of the lung 

• Deformation
• Immobilization
• Obesity 

• Xray
• Sputum culture 

• Usually self limiting
• Commonly follows a viral illness
• Symptoms similar to pneumonia except NO pulmonary consolidation and chest infiltrates 

• Blockage in one or more arteries in your lungs 
• Caused by blood clots that travel to your lungs from another part of your body 

• Thrombus
• Embolus
• Tissure fragment
• Lipids
• Air bubbles

• Vessel Wall Damage 
• Venous stasis
• Blood Coagulability 

• Venous Duplex
• CT 

• Gravity 
• Valves
• Skeletal contraction
• Thoracic pressure
• Abdominal pressure
• Arterial flow
• Right atrial pressure 

• You have even a slight increase in pressure
• Anything greater then 20 mmHg

• Idiopathic

• Respiratory diseases
• Hypoxemia
• Pulmonary arteriole vasoconstriction 

• Right ventricular enlargement and failure 
• This creates chronic pressure overload in the right ventricle 

• A disease passed down through families
• It causes thick, sticky mucus to build up in the lungs, digestive tract, and other areas of the body

Whites

About 1 in 28 whites 

• Respiratory 
• GI
• Persistent cough
• Wheezing
• Reoccurring pneumonia 

• Has increased to 40-50 years
• With high health maintenance which includes medications and respiratory treatments 

• Multi organ failure
• but primarily effects on the lungs and respiratory failure 

• Chronic inflammation
• Mucous plugging
• Chronic infection 

• Sweat Chloride Test (concentration in excess of 60mEq/L)
• Genotyping 

• Smoking 
• Enviornmental 
• Occupational

• Larynx
• Oral cavity
• Esophagus
• Urinary Bladder 

• Non small cell carcinoma
• Small cell carcinoma 

Non small cell carcinoma

• Better type
• Squamous cell
• "Large cell carcinoma"

• Really bad
• Very rapid growth rate