Respiratory Disease Manifestations

Study Notes

General Manifestations of Respiratory Disease

Breath sounds: rales (light, bubbly, or crackling sounds with serous secretions), rhonchi (deeper or harsher sounds from thicker mucus), and absence (non-aeration or collapse of lungs)
Dyspnea: shortness of breath, feeling of discomfort, often caused by increased carbon dioxide or hypoxemia (low level of O2 in the blood), and often noted on exertion
Paroxysmal nocturnal dyspnea: sudden acute type of dyspnea, common in patients with left-sided congestive heart failure, wakes up from sleep with cough and gasping for breath
Orthopnea: occurs when lying down, usually caused by pulmonary congestion
Cyanosis: bluish coloring of skin and mucous membranes, caused by large amounts of unoxygenated hemoglobin in blood
Pleural pain: results from inflammation or infection of parietal pleura
Friction rub: soft sound produced as rough, inflamed, or scarred pleural move against each other
Clubbed digits: result from chronic hypoxia associated with respiratory or cardiovascular diseases, painless, firm, fibrotic enlargement at the end of the digit
Changes in arterial blood gases: hypoxemia (inadequate oxygen in blood), hypercapnia (increased carbon dioxide in blood)

Infectious Diseases

Lower Respiratory Tract Infections:
- Bronchiolitis: viral infection, caused by respiratory syncytial virus (RSV), transmitted by oral droplet, virus causes necrosis, inflammation in small bronchi and bronchioles
- Pneumonia: 3 types, including lobar pneumonia, bronchopneumonia, and interstitial pneumonia

Obstructive Lung Diseases

Cystic fibrosis: inherited (genetic) disorder, gene located on chromosome 7, exocrine glands cause abnormally thick secretions, primary effects seen in lungs and pancreas
- Lungs: sticky mucus obstructs airflow, causing air trapping/atelectasis, permanent damage to bronchial walls, infections common, caused by Pseudomonas aeruginosa and Staphylococcus aureus, bronchiectasis and emphysematous causes respiratory failure and corpulmonale
- Digestive tract: abnormality in newborn is meconium ileus, preventing excretion of meconium, pancreas duct becomes blocked, leading to malabsorption and malnutrition, resulting in diabetes, bile duct becomes blocked, preventing bile from reaching duodenum, affecting digestion and absorption of fat and fat-soluble vitamins, severe obstruction causes inflammation and permanent damage to liver, causing biliary cirrhosis
Bronchiectasis: permanent enlargement of parts of the airways of the lung, symptoms include chronic cough with mucus production, shortness of breath, coughing up blood, and chest pain
Emphysema: long-term, progressive disease of the lungs, cause shortness of breath due to over-inflation of the alveoli
Chronic obstructive pulmonary disease (COPD): chronic respiratory disorder, characterized by progressive tissue degeneration and airway obstruction, irreversible and progressive damage to lungs, debilitating conditions affect individuals' ability to work, may lead to co-pulmonary disease, respiratory failure may occur
Asthma: inflammation of the mucosa with edema, bronchoconstriction (contraction of smooth muscle), increased secretion of thick mucus that blocks the airways, changes create obstructed airways, partial or total

Expansion Disorders

Atelectasis: collapse of lung or part of the lung, leading to decreased gas exchange and hypoxia, alveoli become inflamed then collapse, process interferes with blood flow through the lung, ventilation and perfusion are altered
Common causes of atelectasis: hypoventilation, compression, airway obstruction, and adhesion