Term
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Definition
| reverisble airway obstruction due to bronchospasm |
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Term
| how does CHF affect the lungs? |
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Definition
| the bronchiole tree swells b/c the heart can no longer pump fluid out, resulting in backup |
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Term
| what is cardiac asthma? tx? |
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Definition
| bronchoconstriction due to a cardiac problem. tx: cardiac support to treat CHF (diuresis) |
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Term
| what is bronchial asthma? tx? |
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Definition
| bronchoconstriction from allergies - tx: bronchodilators |
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Term
| what can compression from large cancers, benign tumors, big thyroids, and thymomas (neurological disease related to this is myasthenia gravis) cause in the lungs? |
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Definition
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Term
| why is a bronchoscope sometimes needed if a foreign body is suspected in a pt? |
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Definition
| b/c x-rays don't show plastic, some organic material, etc. smokers def need a brochoscope |
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Term
| what is suspected if a pts cough gets worse at night? |
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Definition
| chronic sinusitis or bronchiectasis (total destruction of the bronchial tree - TB, CF, other infections) |
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Term
| what population does aspiration of food generally affect? what is the risk? how is this treated? |
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Definition
| geriatric. aspiration of food can lead to pneumonia. this is treated/prevented by feeding slowing and @ 90 degrees. |
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Term
| what will sputum smell like w/infection secondary to aspiration? |
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Definition
| anerobic bacteria are the "worst smelling" |
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Term
| what will sputum from CHF pts appear as? |
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Definition
| frothy - b/c breathing so fast |
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Term
| what is the primary problem with hemoptysis? |
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Definition
| clotting in other areas, such as the rest of the airway and blocking it |
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Term
| what need to be done to dx hemoptysis? |
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Definition
| bronchoscopy, can r/o bleeding from GI, upper resp tract, etc |
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Term
| what are common causes of hemoptysis? more rare? |
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Definition
| common: TB, neoplasm. rare: osler-weber-renduu (pulm artery HTN, bleeding, lethal sleep apnea). pulm/renal hemorragic syndromes: good pastures (attacks kidney/lungs, nephritis, purpura, do plasmapheresis to remove Ab-Ag complexes), wegners (kidney/lung - ANCAs determine type), and microscopic polyangitis, (also can check ANCAs) |
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Term
| what needs to be checked if a pt has chest pain? |
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Definition
| EKG, cardiac enzymes to r/o cardiac involvement. get alchol hx: can get esophagitis - prelude to esophageal cancer. neuromuscular pain - OMT |
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Term
| if someone has acute SOB and foamy sputum, what is a probable dx? |
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Definition
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Term
| if someone has acute SOB, what is a probably dx if a DVT is found in the leg? |
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Definition
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Term
| if someone has progressive SOB, what is a probable dx? |
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Definition
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Term
| if someone has paroxysmal/intermittent SOB, what is a probable dx? |
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Definition
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Term
| what is the medical term for wheezing? |
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Definition
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Term
| what is inspiratory stridor? |
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Definition
| laryngeal edema - where the vocal cords can't open up, due to: laryngeal infections, edema, irritation from intubation. *only on inspiration* |
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Term
| what needs to be considered with unilateral rhonchi? |
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Definition
| obstructing lesion or foreign body |
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Term
| what part of the hx can help determine cause of rhonchi? |
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Definition
| occupational hx - exactly what the pt does |
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Term
| what is the most common animal for asthma? |
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Definition
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Term
| what should be considered when asking about smoking hx? |
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Definition
| pts will prob admit to 1/2 the amount they actually smoke |
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Term
| what can snoring tell you about a pt's pulm function? |
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Definition
| probable sleep apnea, which puts a strain on the heart, leading to hypertrophy, pulm artery HTN ultimately and heart failure |
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Term
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Definition
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Term
| what things need to be inspected for when doing a lung physical? |
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Definition
| deformities of the thorax (scoliosis), the slope of the ribs (closer together = lung is deflated), abnormal retraction of the interspaces/nasal flaring/suprasternal notch retraction during inspiration (tachypnea), abnormal bulging of the interspaces during expiration (bronchospasm), local lag/impairment in respiratory movement, rate/rhythm of breathing (tachypnea (greater than 24), bradypnea- less than 12, apnea- 0), state of consciousness (zoned out - higher potential for aspiration), and comfort/position of the pt (orthopnea) |
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Term
| where needs to be thoroughly palpated on female pts? |
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Definition
| lymph nodes under the arms - a sign of breast CA |
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Term
| what does a cellophane paper-like crackling upon palpation of the lungs suggest? |
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Definition
| subcutaneous emphysema, which is an indication of possible pneumothorax = increased risk of dropping a lung, need CXR |
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Term
| what can cause tracheal deviation? |
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Definition
| tumor, atelectasis (loss of volume) |
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Term
| what can cause decreased tactile fremitus? |
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Definition
| the bronchus is obstructed, the pleural space is occupied by fluid/air/solid tissue (PET - pneumothorax effusion tumor, in the midstem) |
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Term
| what can cause increased tactile fremitus? |
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Definition
| large bronchi and overconsolidated lung |
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Term
| what does resonance tell you about the lung? |
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Definition
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Term
| what does tympani tell you about the lung? |
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Definition
| the lung is puffed out, like in emphysema |
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Term
| *where do rhonchi come from? what do they sound like? what pathology are they symptomatic for? what are the 2 types? |
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Definition
| the bronchi, and sound like continous wheezes and are characteristic of bronchospasms and secretions. 2 types: high pitched (sibilant) and sonorous (secretions) |
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Term
| *where do rales come from? what do they sound like? what pathology are they symptomatic for? |
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Definition
| the spaces around the alveoli, they sound like discontinuous crackling at the end of inspiration. this is caused by the alveolus popping against fluid/fibrosis. pneumonia can cause rales in the base of the lungs. |
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Term
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Definition
| inspiratory obstruction of the airways due to inflammation, such as that caused by intubation |
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Term
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Definition
| nasal "bleating sound" that makes E sound like A, normally associated with pleural effusion or infectoin |
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Term
| what are the 2 kinds of pleural effusion? |
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Definition
| peripheral (due to peripheral vasoconstriction) and central (bad - due to hypoxemia, measured by arterial blood gas) |
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Term
| what does skin affected by cyanosis feel like? |
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Definition
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Term
| *what is chenyne-stokes respiration? |
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Definition
| hyperapnea alternating with apnea - crescendo/decrescendo, then apnea. it is seen in the presence of circulatory insufficiency and cerebral vascular disease. |
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Term
| *what is biot's respiration? |
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Definition
| periodic irregular breathing (no crescendo-decrescendo pattern), agonal respiration, occurs in the presence of cerebral vascular disease - no one comes back from this. (wiki: abnormal pattern of breathing characterized by groups of quick, shallow inspirations followed by regular or irregular periods of apnea). potential brain damage as a cause. |
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