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Pulmonary Disease: Cardinal Signs and Symptoms
|What is coughing a reflex to?
|Irritation of trachea and bronchial vessels.
|What does coughing do?
|Clears stuff out of airways (involves the mucous elevator)
|What can be a cardinal sign of respiratory problems/disease?
|What is sputum?
|Excess mucous triggers what?
|What does yellow sputum suggest?
|Infections (Lungs are easily infected).
|what does green sputum tell us?
|Pus - Neutrophils are responding to a problem. Neutrophils release green chemical and pus indicates that infections are occurring deeper in the lungs.
|Throat clearing usually produces sputum from what area of body?
|nasal passages or sinuses. (higher areas)
|Pink, frothy sputum can indicate what?
|acute pulmonary edema. (can come from surfactant - pt is coughing deep).
|What color does hemoptysis look when it is coming from the lower lungs? As opposed to blood from the nose or gut?
|Blood from lower lungs is usually frothy and bright red. Blood from the nose or gut is dark, not frothy.
|What generally is the cause of coughing pure blood? What about sputum with blood IN it?
|Pure blood is bad - tuberculosis. Sputum with blood in it can be from an infection.
|What is the definition of dyspnea?
|Difficulty breathing. (one's sense of being out of breath - subjective)
|Dyspnea is a common indication of what types of problems?
|Cardiovascular, respiratory or both (or really anything).
|Dyspnea can lead to _____________ which can lead to _____________.
|Dyspnea can lead to hyperventilation which can lead to blowing off more CO2 than necessary.
|What is a possible cause of people who are getting enough air and still experiencing dyspnea?
|It's possible that the receptors in the chest can "misread" conditions, and tell the brain that not enough air is coming in, even though there is.
|What is orthopnea? How is this often measured?
|Dyspnea when leaning back (or lying down). Can be measured by the number of pillows under the head required to alleviate the sensation (more pillows = worse orthopnea)
|Why do patients with CHF or other heart problems often experience dyspnea?
|They are having trouble returning blood to the central blood vessels from peripheral vessels.
|What is paroxysmal nocturnal dyspnea?
|Dyspnea that happens in the middle of the night, long after the patient has lain down - fluid collected in the peripheral tissues is returned to the central veins, which produces hypertension. Pulmonary HT and pulmonary edema = dyspnea.
|What is CP that is associated with lung disease?
|What is pleurisy?
|The parietal layer of the pleura gets damaged by infection or ischemia and produces the pain.
|What causes the pain in pleurisy?
|Damage of the parietal layer causes pain . Damage to the visceral layer does not generate pain (no pain receptors).
|What can finger clubbing tell us?
|Finger clubbing shows up mostly in pulmonary diseases, but can also occur in Cardiovascular diseases.
|What is cyanosis?
|Patient appears blue in their skin and/or mucous membranes.
|When a tourniquet is placed on a persons arm, why does the distal part become blue?
|Hemoglobin appears blue inside a person's body when it is oxygen deficient.
|What causes cyanosis?
|Pt has relatively deoxygenated blood. (Reduced Hb in blood is blue)
|Central cyanosis vs. Peripheral cyanosis.
|Central: occurs because of insufficient oxygenation of blood in the lungs causes face, earlobes, under tongue and lips to turn blue. Peripheral - blood flow through an area is abnormal, producing reduced Hb in that area.
|What is hypoxemia?
|Low blood oxygen, detected by arterial oxygen levels and low Hb saturation. (hypoxic in blood and body - will see cyanosis)
|What is hypoxia?
|Deficient tissue oxygenation.
|What has low oxygen in the tissues even though the carrying capacity of the blood is normal?
|What results from deficient carrying capacity - (anything that reduces hemoglobin)?
|what results when cardiac output is reduced (pressure, volume, or maybe both) with normal blood oxygen capacity?
|what happens when cells can't use oxygen that's being made available to it?
|Histotoxic hypoxia (cyanide effects on the electron transport chain).
|Arterial CO2 partial pressure is very near to alveolar CO2 partial pressure, which is ____________.
|What is hypercapnia?
|Arterial CO2 partial pressure above 45 mm Hg.
|What causes hypercapnia?
|This happens because not enough air is exchanging in the alveoli. This will always lead to at least some hypoxia. (not unloading CO2 quick enough)
|What is hypocapnia?
|Arterial CO2 partial pressure is less than 35 mm Hg.