Respiratory Assessment Quiz

Respiratory Assessment

• COPD is being studied as a comparison to tuberculosis
• Respiratory functions include ventilation, respiration, acid-base balance, speech, and fluid balance.

Ventilation

• Air moves in and out of the respiratory system during inspiration and exhalation.

Respiration

• Gas exchange (oxygen and carbon dioxide) occurs at the alveolar level.
• Oxygenated blood is transported to body tissues by the circulatory system (perfusion).
• Deoxygenated blood returns to the lungs for reoxygenation.

Acid-Base Balance

• The respiratory system plays a role in acid-base balance by exchanging carbon dioxide and oxygen.
• The renal system also contributes by secreting bicarbonate.

Speech

• Air movement through vocal cords produces spoken words.

Sense of Smell

• Air movement through the nose allows detection of odors.
• Sense of smell is connected to sense of taste.

Fluid Balance

• Water is removed as vapor through exhalation, maintaining fluid balance.

Respiratory System Anatomy

• Includes head structures like adenoids, eustachian tubes, tonsils, pharynx, and nasal chambers.

Upper Respiratory Tract

• Structures include the hyoid bone, glottis, cricoid cartilage, and bronchi.
• Air travels from the nose to the bronchi.

Lower Respiratory Tract

• Bronchi branch into smaller airways, culminating in alveoli, where gas exchange occurs.

Visualizing the Lungs

• Resembles a tree with large bronchi as branches and tiny leaves (alveoli) for gas exchange.
• Pleural friction can cause pain.

Sinus Anatomy and Issues

• Frontal sinus inflammation can lead to forehead pain due to excess mucus.

Key Structures

• Epiglottis, hyoid bone and trachea can be palpated for assessment.

True Vocal Cords

• Responsible for sound production.

False Vocal Cords

• Support the true vocal cords.
• Prevent aspiration.

Respiratory Physiology

• Inspiration: Diaphragm contraction lowers it, expands the chest cavity, and draws air into the lungs. Air pressure in the lungs is lower than outside.
• Expiration: Diaphragm relaxation increases chest pressure, expelling air.

Respiration

• Exchange of oxygen and carbon dioxide in alveoli.
• Deoxygenated blood from the body is exchanged for oxygen.
• Oxygenated blood carries oxygen to the body, returning deoxygenated blood to the lungs.

Dead Space

• Areas in the respiratory tract where gas exchange does not occur.

Pulmonary Embolism

• Blockage in pulmonary artery or alveolar capillaries is extremely serious and can be life-threatening.
• Requires immediate medical attention.

Treatment (for Pulmonary Embolism)

• Tissue plasminogen activator (TPA) medication to dissolve clots.

Patient History

• Medical conditions like COPD could impact oxygen levels.
• Past experiences with lung issues should be noted
• Asking specific questions (such as cough, breathing, pain, etc.) is crucial.
• Environmental factors (e.g., smoke) also play a role.

Current Medications

• Asthma and COPD medications.

Allergies

• Triggers that may worsen respiratory problems.

Family and Occupational History

• Family history of lung diseases could be significant.
• Exposure to environmental factors (e.g. asbestos) is important.

Social History

• Previous and current smoking habits, travel history is important

Physical Examination

• Speech, clubbing of the fingers, mouth, and neck conditions are assessed.

Vital Signs

• Respiratory rate, depth, and effort should be noted, Ideally, the patient is unaware they are being observed.
• Normal respiratory rate is under 20 breaths per minute.
• Anything under 12 breaths per minute is bradypnea.
• Anything over 20 breaths per minute is tachypnea
• Oxygen saturation (SpO2) should be measured

Lung Auscultation

• "99" should be a clear sound during auscultation, not muffled or abnormal.
• Assess both lung sides( equal expansion is normal).
• Use percussion to detect abnormalities (e.g., dullness/tympany).
• Auscultate from apex to base, avoid bony prominences
• Identify sounds that are not typical for normal breathing

Arterial Blood Gases (ABGs)

• Normal values for pH, PaCO2, HCO3, and PaO2, should be reviewed.

Oxygen Saturation (SpO2)

• A normal SpO2 reading is between 95%.

COPD Progression

• It's a progressive disease that worsens over time.

Personal Examples

• Illustrate cases where individuals with COPD needed to adapt.

Patient History

• Knowing a patient's medical history, helps to understand their condition and how to manage care.

Pulse Oximetry

• A pulse oximeter measures oxygen saturation levels in the blood.
• Normal levels are 90%-99% but, COPD patients may function normally with lower levels (88%-89%)

Capnography

• Used for patients with PCA pumps, to monitor CO2 levels.
• Can help to identify abnormalities.

Sputum Collection

• Collected for culture to identify the microorganism causing the infection.
• A broad-spectrum antibiotic should be started before the culture results are known
• Identify TB and malignancies.

Types of Pneumonia

• Viral, bacterial, and fungal pneumonia.
• Viral infections typically resolve within 10 days; bacterial or fungal require different treatments.

Diagnostic Studies

• Chest x-rays
• Identification of relevant abnormalities (consolidation, fluid buildup, etc.)
• X-rays assess pneumonia, tuberculosis, etc
• X-rays will reveal walled off nodules for tuberculosis.

Pulmonary Function Tests (PFTs)

• Measures lung capacity and function
• Evaluate lung volume and airflow

Bronchoscopy

• Direct visualization of the respiratory tract.
• Helpful in collecting specimens, placing tubes, and removing obstructions.

Thoracentesis

• Removing fluid or air from the pleural space.
• Can be used for diagnostic purposes and to alleviate problems like fluid buildup.

Lung Biopsy

• Removal and analysis of lung tissue.

Methods

• Explains different ways of acquiring lung tissue for testing

Case Studies

• Illustrative examples showing patient details like symptoms and diagnoses