RESP Symptoms Word Scramble
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| Question | Answer |
| Signs & Examples | Subjective. Patient description. Measured by patient perception. Examples: pain, cough, SOB |
| Symptoms & Examples | Objective. Measurable. Assessed values. Examples: heart rate, blood pressure, respiratory rate. |
| What are the primary symptoms of cardiopulmonary disorders? | 1. Cough 2. Sputum Production 3. Hemoptysis 4. Shortness of breath (dyspnea) 5. Chest pain |
| Cough | Is a protective reflex. You have a stimulation of receptors: pharynx, larynx, large bronchi, lung and visceral pleura |
| Cough is caused by: | inflammatory, mechanical, chemical, or thermal stimulation of cough receptors |
| Possible causes of inflammatory stimulation: | Infection, lung abscess, drug reaction, allergy. |
| Possible causes of mechanical stimulation: | Inhaled dust, suction catheter, food |
| Possible causes of obstructive stimulation: | Foreign bodies, aspirations of nasal secretions, tumor |
| Possible causes of chemical stimulation: | Inhaled irritant gases, fumes, smoke |
| Possible causes of temperature stimulation: | Inhaled hot or cold air |
| Two pathways of cough: | 1. Afferent Pathway - vagus, phrenic, glossopharyngeal, trigeminal nerves. 2. Efferent Pathway - smooth muscles of larynx and tracheobronchial tree via phrenic, spinal nerves |
| Phases of Cough: | 1. Inspiratory 2. Compression 3. Expiratory |
| Reduced effectiveness of cough: | Weakness of inspiratory/expiratory muscles. Inability of glottis to open/close correctly. Obstruction/alteration of shape of the airways. Decrease in lung recoil (emphysema). Abnormal quality of mucus. |
| Acute Clinical Presentation: | Sudden onset. Severe. Self-limiting (viral infection) |
| Chronic Clinical Presentation and Causes: | Persistent. Lasts > 3 weeks. Causes = asthma, COPD, GERD, chronic bronchitis, allergic rhinitis |
| Paroxysmal Clinical Presentation: | Periodic. Prolonged, forceful episodes. |
| Associated Symptoms of Cough | 1. Wheezing 2. Stridor 3. Chest Pain 4. Dyspnea |
| Complications of Cough: | 1. Torn Chest Muscle 2. Rib Fracture 3. Disruption of Surgical Wounds 4. Syncope 5. Arrhythmia 6. Esophageal Rupture 7. Incontinence (Urinary) 8. Pneumothorax |
| Sputum Production: | 1. Sputum: secretions from tracheobronchial tree, pharynx, mouth, sinuses, nose 2. Phlegm: secretions from lungs and tracheobronchial tree |
| Components of Sputum | Mucus, cell debris, microorganisms, blood, pus, foreign particles |
| Normal Sputum Production: | 100 mL/day |
| Abnormal Sputum Production | excessive production by inflamed glands. Caused by: infection, smoking, allergies |
| Hemoptysis | Sputum containing blood. (streaking to frank bleeding) |
| What causes hemoptysis? (5) | 1. Bronchopulmonary 2. Cardiovascular 3. Hematologic 4. Systemic disorders 5. Tuberculosis/fungal infection |
| Description of Hemoptysis | 1. Amount: MASSIVE - 400 ml/3h or 600 ml/24h (emergency condition - cancer, TB, trauma). STREAKY - pulmonary infection, lung cancer, thromboemboli. 2. Odor 3. Color 4. Acuteness |
| Hematemesis | Vomited blood. 1. Oropharynx - swallowed from respiratory tract 2. Esophagus/Stomach - alcoholism or cirrhosis of liver |
| Shortness of Breath | Cardinal symptom of cardiac distress, most distressing symptom |
| Dyspnea | Subjective breathing discomfort. Sensory input to cerebral cortex. |
| Dyspnea Scoring Systems | Scale of 0 (no SOB) to 10 (max SOB). Visual Analog Scale. Modified Borg Scale. ATS SOB Scale. UCSD SOB Questionnaire. |
| Clinical Presentations of Dyspnea | 1. WOB abnormally high. 2. Ventilatory capacity reduced 3.Drive to breathe is elevated |
| Clinical Types of Dyspnea (1) | 1. Cardiac/Circulatory - inadequate supply of O2 to tissues (during exercise) |
| Clinical Types of Dyspnea (2) | 2. Psychogenic - panic disorder, not related to exertion. |
| Clinical Types of Dyspnea (3) | 3. Hyperventilation - rate/depth exceeds body's metabolic need (results in hypocapnia/decreased cerebral blood flow) |
| Paroxysmal Nocturnal Dyspnea (PND) | Sudden dyspnea when sleeping (recumbent position), associated with coughing, sign of left heart failure |
| Orthopnea | Dyspnea when lying down, associated with left heart failure |
| Trepopnea | Dyspnea when lying on ONE side, unilateral lung disease/pleural effusion |
| Platypnea | Dyspnea when in upright position - seen in patients with right-to-left intracardiac shunts or venoarterial shunts. |
| Orthodeoxia | Hypoxemia in upright position, relieved in recumbent position - seen in patients with right-to-left intracardiac shunts or venoarterial shunts. |
| Causes of Chest Pain | Cardiac ischemia, inflammation of thorax/abdomen, musculoskeletal disorders/trauma/anxiety, referred pain from indigestion |
| Cardinal Symptom of Heart Disease | Angina |
| Pleuritic Pain | Inspiratory, sharp, and abrupt onset. Worsens with cough, sneeze, hiccup, laughter. Increases with pressure/movement. |
| Chest Wall Pain | Intercostal/pectoral muscles, well localized. |
| Dizziness/Fainting (Syncope) | Temporary loss of consciousness because of reduced cerebral blood flow and O2. |
| Causes of Dizziness/Fainting | Thrombosis, embolism, atherosclerotic obstruction. Pulmonary embolism, coughing, hypoxia, hypocapnia. |
| Most common type of Syncope | Vasovagal - loss of peripheral venous tone |
| Orthostatic Hypotension (Dizziness/Fainting) | Sudden drop in BP when standing, dizziness, blurred vision, weakness, dehydration. |
| Carotid Sinus Syncope | Hypersensitive carotid sinus - slows pulse rate, decreases BP |
| Tussive Syncope | Caused by strong coughing - seen mostly in men with COPD, obesity, smoking history, frequent use of alcohol |
| Edema | Soft tissue swelling from fluid accumulation. |
| Bilaterial Peripheral Edema | Ankles/lower legs, caused by right/left heart failure - right heart failure often caused by cor pulmonale |
| Euthermia | 97F to 99.5F; 36C to 37.5C |
| Causes for Fever | Hot environment, dehydration, drugs, rxn to chemicals, infection, malignancy, etc |
| Intermittent Fever | Daily elevation with a return to normal or subnormal between spikes |
| Remittent Fever | Continuously elevated with wide, usually diurnal variations - In patients with Legionnaire's Disease, Acute viral Infections, and Mycoplasma Pneumonia. |
| Relapsing Fever | Reoccurring in bouts of several days with periods of normal temps. |
| Fever and Pulmonary Infections | Lung abscesses, empyema, TB, pneumonia. |
| Infections with NO Fever | High-dose corticosteroids, immunosuppressants, Immunocompromised. |
| Headache as a manifestation of? | Cerebral hypoxia and hypercapnia - lung disease, high altitude |
| Altered Mental State in? | Hypercapnia - from affected alertness to coma. |
| Personality Changes in? | Pulmonary Disorders - forgetfulness, inability to concentrate, anxiety, irritability |
| Snoring | Serious concern with apnea. Children - 10% to 12%; Adults - 10% to 30%. |
| Excessive Daytime Sleepiness | Occupational Accidents, Motor Vehicle Accidents, Loss of employment, Social dysfunction. |
| GERD | Heartburn/regurgitation. Gastroesophageal Reflux more then TWO times per week = GERD. |
| Assess symptoms to determine: | Seriousness of problem, potential underlying cause, effectiveness of treatment |
| Key to determine etiology: | careful history, CXR, physical exam |
| Sputum, describe? | color, odor, quantity, quality, time of day, blood, consistency |
| Frequent causes of hemoptysis: | TB, acute/chronic bronchitis, bronchogenic carcinoma, bronchiectasis |
| Hemoptysis from? | cardiopulmonary, coughed up from lungs/chest |
| Hematemesis from? | gastrointestinal, vomited from stomach |
| Apnea | not breathing for more than 20 sec |
| Eupnea | Normal rate of breathing |
| +1 edema | rapid |
| +2 edema | 10-15 sec |
| +3 edema | 1-2 min |
| +4 edema | >2 min |
| High grade fever | > 101 (38.2C) |
| Low grade fever | 99.5-101 (37.5-38.2C) |
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hbcole10
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