Podcast
Questions and Answers
What is the principal muscle of inspiration during breathing?
What is the principal muscle of inspiration during breathing?
- Intercostal muscles
- Abdominal muscles
- Diaphragm (correct)
- Scalenes
Which nerves richly innervate the parietal pleura?
Which nerves richly innervate the parietal pleura?
- Intercostal and phrenic nerves (correct)
- Femoral nerves
- Sciatic nerves
- Radial nerves
What produces pleuritic pain in conditions like viral pleurisy and pneumonia?
What produces pleuritic pain in conditions like viral pleurisy and pneumonia?
- Irritation of abdominal muscles
- Irritation of parasternal intercostal muscles
- Irritation of diaphragm
- Irritation of visceral pleura (correct)
What assists in expiration during breathing?
What assists in expiration during breathing?
Which muscles help expand the thorax during breathing, especially running from the cervical vertebrae to the first two ribs?
Which muscles help expand the thorax during breathing, especially running from the cervical vertebrae to the first two ribs?
Where does oxygen diffuse into during breathing?
Where does oxygen diffuse into during breathing?
Which of the following is NOT listed as a possible source of chest pain?
Which of the following is NOT listed as a possible source of chest pain?
Which condition is associated with the esophagus as a source of chest pain?
Which condition is associated with the esophagus as a source of chest pain?
What initial question is recommended to ask a patient presenting with chest pain?
What initial question is recommended to ask a patient presenting with chest pain?
Which of the following is NOT listed as an attribute of chest pain to distinguish among its various causes?
Which of the following is NOT listed as an attribute of chest pain to distinguish among its various causes?
Which condition is associated with the chest wall as a source of chest pain?
Which condition is associated with the chest wall as a source of chest pain?
What percentage of patients with panic and anxiety disorders report chest pain?
What percentage of patients with panic and anxiety disorders report chest pain?
What is the most common cause of acute cough?
What is the most common cause of acute cough?
Which of the following is NOT listed as a potential cause of subacute cough?
Which of the following is NOT listed as a potential cause of subacute cough?
What color sputum is associated with bacterial pneumonia?
What color sputum is associated with bacterial pneumonia?
Which type of sputum is seen in viral infections and cystic fibrosis?
Which type of sputum is seen in viral infections and cystic fibrosis?
Which of the following is NOT listed as a potential cause of chronic cough?
Which of the following is NOT listed as a potential cause of chronic cough?
What should be assessed when a patient complains of cough?
What should be assessed when a patient complains of cough?
What percentage of smokers who try to quit on their own resume smoking within 30 days?
What percentage of smokers who try to quit on their own resume smoking within 30 days?
What causes the powerful and reinforcing rush effect when inhaling nicotine?
What causes the powerful and reinforcing rush effect when inhaling nicotine?
What cognitive therapy techniques are recommended to help smokers quit?
What cognitive therapy techniques are recommended to help smokers quit?
How do counseling and pharmacotherapies affect quit rates for smokers?
How do counseling and pharmacotherapies affect quit rates for smokers?
What is the leading cause of cancer death for both men and women in the United States?
What is the leading cause of cancer death for both men and women in the United States?
What factor is associated with a higher risk of lung cancer?
What factor is associated with a higher risk of lung cancer?
What does foul-smelling sputum indicate in a patient?
What does foul-smelling sputum indicate in a patient?
Which condition is associated with thick tenacious sputum?
Which condition is associated with thick tenacious sputum?
What is the term for blood coughed up from the lower respiratory tract?
What is the term for blood coughed up from the lower respiratory tract?
In which of the following conditions is hemoptysis rare?
In which of the following conditions is hemoptysis rare?
What volume of blood is considered massive hemoptysis?
What volume of blood is considered massive hemoptysis?
Before using the term 'hemoptysis,' what should be confirmed?
Before using the term 'hemoptysis,' what should be confirmed?
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Study Notes
Sources of Chest Pain and Related Causes
- Chest pain can originate from various sources, including the myocardium, pericardium, aorta, trachea, and large bronchi, parietal pleura, chest wall, and esophagus
- Other sources of chest pain include extrathoracic structures, such as the neck, gallbladder, and stomach
- Angina pectoris, myocardial infarction, myocarditis, pericarditis, and aortic dissection are potential causes of chest pain
- Parietal pleura irritation can produce pleuritic pain with deep inspiration in conditions such as viral pleurisy, pneumonia, pulmonary embolism, pericarditis, and collagen vascular diseases
Breathing and Respiration
- Breathing is primarily automatic, controlled by respiratory centers in the brainstem
- The principal muscle of inspiration is the diaphragm
- During inspiration, the diaphragm contracts, descends in the chest, and expands the thoracic cavity, compressing the abdominal contents and pushing out the abdominal wall
- The muscles in the rib cage also expand the thorax, especially the scalenes and parasternal intercostal muscles
Cough and Hemoptysis
- Cough can be caused by various stimuli, including mucus, pus, blood, allergens, dust, foreign bodies, or extremely hot or cold air
- Inflammation of the respiratory mucosa, pneumonia, pulmonary edema, and compression of the bronchi or bronchioles from a tumor or enlarged peribronchial lymph nodes can also cause cough
- Cough can signal left-sided heart failure
- Acute cough can be caused by viral upper respiratory infections, acute bronchitis, pneumonia, left-sided heart failure, asthma, foreign body, smoking, and ace-inhibitor therapy
- Subacute cough can be caused by postinfectious cough, pertussis, acid reflux, bacterial sinusitis, and asthma
- Chronic cough can be caused by postnasal drip, asthma, gastroesophageal reflux, chronic bronchitis, and bronchiectasis
Smoking and Nicotine Addiction
- More than 80% of smokers who try to quit on their own resume smoking within 30 days
- Daily smokers inhale enough nicotine to achieve almost complete receptor saturation, leading to a powerful and reinforcing rush effect
- Quit rates roughly double when counseling is combined with pharmacotherapies such as nicotine replacement, bupropion, and varenicline
Lung Cancer Epidemiology
- Lung cancer is the second most frequently diagnosed cancer in the United States and the leading cause of cancer death for both men and women
- Over 200,000 new cases and nearly 160,000 deaths were expected in 2014
- Cigarette smoking is the leading risk factor for lung cancer, accounting for about 90% of lung cancer deaths
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