| Term | Definition |
| SYMPTOM | Evidence of disease or physical disturbance that indicates the presence of bodily disorder. |
| SYMPTOMS DETERMINE | -Seriousness of problem
-Potential cause of problem
-Effectiveness of treatment |
| CHARACTERISTICS OF SYMPTOMS | -Objective
-Measureable
-Assessed values
EX. HR, BP, and Respiratory Rate |
| SIGNS | Subjective experiences reported to the physician from the patient.
Ex. Fatigue |
| SIGNS DETERMINE | -Outcome of current bodily state
-Past existence of disease or condition
-Recognition and Identification of Disease |
| CHARACTERISTICS OF SIGNS | -Subjective
-Patient Description
-Measured by patient perception
Ex. Pain, shortness of breath, cough |
| CARDIOPULMONARY DISEASE | A medical condition in which the heart and lungs don't function properly. |
| PRIMARY SYMPTOMS OF CARDIOPULMONARY DISORDERS | -Cough
-Sputum production
-Hemoptysis
-Shortness of breath (Dyspnea)
-Chest pain |
| COUGH | -Protective reflex
-Stimulation of receptors,
-Pharnyx, larynx, trachea, large bronchi,
lung and visceral pleura |
| COUGH | -Caused by inflammatory, mechanical, chemical, or thermal stimulation of cough receptors |
| COUGH | Key to determine etiology is careful history, physical exam, and CXR |
| POSSIBLE CAUSES OF COUGH RECEPTOR STIMULATION
INFLAMMATORY | -infection -lung abscess
-drug reaction -allergy
-edema -hyperemia
-collagen vascular disease -radiotherapy
-pneumoconiosis -tuberculosis |
| POSSIBLE CAUSES OF COUGH RECEPTOR STIMULATION
MECHANICAL | -inhaled dusts
-suction
-catheter
-food |
| POSSIBLE CAUSES OF COUGH RECEPTOR STIMULATION
OBSTRUCTIVE | -Foreign bodies
-aspirations of nasal secretions
-tumor or granulomas within or around the lung
-aortic aneurysm |
| POSSIBLE CAUSES OF COUGH RECEPTOR STIMULATION
AIRWAY WALL TENSION | -pulmonary edema
-atelectasis
-fibrosis
-chronic interstitial pneumonitis |
| POSSIBLE CAUSES OF COUGH RECEPTOR STIMULATION
CHEMICAL | -inhaled irritant gases
-fumes
-smoke |
| POSSIBLE CAUSES OF COUGH RECEPTOR STIMULATION
TEMPERATURE | -inhaled hot or cold air |
| POSSIBLE CAUSES OF COUGH RECEPTOR STIMULATION
EAR | -tactile pressure in the ear canal (Arnold Nerve Response)
-Otitis media |
| COUGH AFFERENT PATHWAY | -vagus, phrenic, glossopharyngeal, trigeminal nerves |
| COUGH EFFERENT PATHWAY | -smooth muscles of larynx and tracheobronchial tree via phrenic, spinal nerves |
| COUGH PHASES | -inspiratory
-compression
-expiratory |
| REDUCED EFFECTIVENESS OF COUGH | -weakness of inspiratory or expiratory muscles
-inability of the glottis to open or close correctly |
| REDUCED EFFECTIVENESS OF COUGH | -obstruction, collapsibility, or alteration in shape or contours of the airways
-decrease in lung recoil (ex. Emphysema) |
| REDUCED EFFECTIVENESS OF COUGH | -abnormal quantity or quality of mucus production (Ex. thick sputum) |
| ACUTE | -sudden onset
-severe, short cause
-self-limiting
-viral infection |
| CHRONIC | -persistent
-last >3 weeks |
| CAUSES OF CHRONIC COUGH | -postnasal drip -allergic rhinitis
-asthma -GERD
-COPD exacerbation -chronic bronchitis
-bronchiectasis -left heart failure |
| PAROXYSMAL | -periodic
-prolonged, forceful episodes |
| ASSOCIATED SYMPTOMS OF COUGH | -wheezing
-stridor
-chest pain
-dyspnea |
| COMPLICATIONS OF COUGH | -torn chest muscle
-Rib fractures
-Disruption of surgical wounds |
| COMPLICATIONS OF COUGH | -pneumothorax of pneumomediastinum
-syncope
-arrhythmia |
| COMPLICATIONS OF COUGH | -esophageal rupture
-urinary incontinence |
| SPUTUM | Secretions from tracheobronchial tree, pharynx, mouth, sinuses, nose |
| PHLEGM | Secretions from lungs and tracheobronchial tree |
| SPUTUM PRODUCTION COMPONENTS | -mucus, cellular debris, microorganisms, blood, pus, foreign particles |
| NORMAL SPUTUM | -upward displacement via wavelike motion of cilia until swallowed |
| ABNORMAL SPUTUM PRODUCTION | -excessive production by inflamed glands caused by; infection, cigarette smoking, allergies
-Describe color, quantity, consistency, time of day, presence of blood |
| HEMOPTYSIS | -Expectoration of sputum containing blood
-from streaking to frank bleeding |
| HEMOPTYSIS CAUSES | -Bronchopulmonary -Systemic disorders
-Cardiovascular -Turberculosis
-Hematologic -fungal infections |
| DESCRIPTION OF HEMOPTYSIS | -Amount
-massive hemoptysis:
400 ml/3h or 600 ml/24h |
| DESCRIPTION OF HEMOPTYSIS | -odor
-color
-acuteness |
| HEMATEMESIS | Vomitted blood |
| DETERMINE SOURCE | -oropharynx
-swallowed from respiratory tract
-esophagus or stomach
-alcoholism or cirrhosis of liver |
| SHORTNESS OF BREATH | -Most distressing symptom of respiratory disease
-single most important factor limiting
ability to function
-cardinal symptom of cardiac disease |
| DYSPNEA | -Subjective experience of breathing discomfort
-components
-sensory input to cerebral cortex
-perception of the sensation; breathless,
short-winded, feeling of suffocation |
| DYSPNEA SCORING SYSTEMS | -Scale of 0(no SOB to 10(max SOB)
-visual analog scales
-modified Borg scales
-ATS SOB scale
-UCSD SOB Questionnaire |
| CLINICAL TYPES OF DYSPNEA:
CARDIAC AND CIRCULATING | -Inadequate supply of oxygen to tissues
-Primarily during exercise |
| CLINICAL TYPES OF DYSPNEA:
PSYCHOGENIC | -panic disorder
-not related to exertion |
| CLINICAL TYPES OF DYSPNEA:
HYPERVENTILATION | -Rate, depth exceeds body's metabolic need
-Results in hypocapnia and decreased cerebral blood flow |
| ACUTE AND RECURRENT: CHILDREN | -Asthma
-Bronchiolitis
-Croup
-Epiglottitis |
| ACUTE AND RECURRENT: ADULTS | -pulmonary embolism -pulmonary edema
-Asthma -hyperventilation
-Pneumonia -panic disorder
-Pneumothorax |
| CHRONIC DYSPNEA | -Most common causes:
-COPD
-CHF |
| PAROXYSMAL NOCTURNAL DYSPNEA (PND) | -Sudden dyspnea when sleeping in recumbent position
-Associated with coughing
-Sign of left heart failure |
| ORTHOPNEA | -Dyspna when lying down
-Associated with left heart failure |
| TREPOPNEA | -Dyspnea when lying on one side
-unilateral lung disease, pleural effusion |
| PLATYPNEA | -Dyspnea in upright position |
| ORTHODEOXIA | -Hypoxemia in upright position relieved by returning to a recumbent position |
| CHEST PAIN | -Causes
-cardiac ischemia
-inflammatory disorders of thorax, abdomen
-musculoskeletal disorders, trauma, anxiety
-referred pain from indigestion, dissecting
aortic aneurysm |
| CARDINAL SYMPTOMS OF HEART DISEASE | -Angina
-quickly assess if pain is an emergency
condition |
| PULMONARY CAUSES OF CHEST PAIN | -Involvement of chest wall or parietal pleura
-Pleuritic pain
-Inspiratory, sharp, and abrupt in onset |
| PULMONARY CAUSES OF CHEST PAIN | -Worsens w/ inspiration, cough, sneeze, hiccup, or laughter
-increase w/ pressure and movement |
| CHEST WALL PAIN | -Intercostal and pectoral muscles
-well localized |
| DIZZINESS AND FAINTING (SYNCOPE) | -Temporary loss of consciousness
-resulting from reduced cerebral blood flow
and oxygen |
| DIZZINESS AND FAINTINR (SYNCOPE) CAUSES | -Thrombosis, embolism, atherosclerotic obstruction
-Pulmonary: embolism, bouts of coughing,hypoxia, hypocapnia |
| VASOVAGAL | -Most common type of syncope
-loss of peripheral venous tone |
| ORTHOSTATIC HYPOTENSION | -Sudden drop in blood pressure when a person stands up.
-Dizziness,blurred vision, weakness, syncope
-Elderly, vasodilator use, dehydration |
| CAROTID SINUS SYNCOPE | -Hypersensitive carotid sinus
-slows pulse rate, decrease blood pressure, syncope |
| TUSSIVE SYNCOPE | -Syncope caused by strong coughing
-seen most often in men with COPD, obesity, a positive smoking history, and frequently use of alcohol |
| DEPENDENT EDEMA | -Edema is soft tissue swelling from abnormal accumulation of fluid |
| BILATERAL PERIPHERAL EDEMA | -Most often occurs in ankles and lower legs
-Most often caused by right or left heart failure
-right heart failure often caused by cor pulmonale |
| EUTHERMIA | -97 TO 99.5 degrees Fahrenheit |
| FEVER (HYPERTHERMIA PYREXIA) | -sustained
-remittent
-intermittent
-relapsing |
| CAUSES OF FEVER | -Hot Environment
-Dehydration
-Reaction to chemicals
-Drugs
-Hypothalamic damage
-Infection
-Malignancy |
| PULMONARY INFECTIONS | Lung abscess, empyema, tuberculosis, pneumonia
-Remittent fever in mycoplasma, pneumonia, Legionnaires disease, acute viral infections |
| INFECTIONS WITH NO FEVER | -High-dose corticosteroids
-Immunosuppressants
-Immunocompromised (Leukemia, AIDS) |
| HEADACHE | A Manifestation of cerebral hypoxia and hypercapnia
-Lung disease altitude |
| ALTERED MENTAL STATUS IN HYPERCAPNIA | -From affected alertness to coma |
| PERSONALITY CHANGES IN ADVANCED PULMONARY DISORDERS | -Forgetfulness, inability to concentrate, anxiety irritability |
| SNORING | -Serious concern when associated with apnea
-evaluation for OSA |
| INCIDENCE AND CAUSES OF SNORING | -10% to 12% of children
-10% to 30% of adults
-Peak at age 50 to 59 (male), 60 to 64 (female) |
| INCIDENCE AND CAUSES OF SNORING | -Obesity is one the most common
-Fatigue
-Excessive daytime sleepiness (daytime somnolence) |
| GASTROESOPHAGEAL REFLUX (GERD) | -Heart burn and regurgitation
-Extraesophageal manifestations
-Laryngitis, asthma, chronic and nocturnal dry cough, chest pain, dental erosion
-GER more than twice a week = GERD |
| Risk Factors | -Obesity
-Cigarette smoking
-Pregnancy |
