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Questions and Answers
Which structure carries air to the lungs?
Where does bronchial constriction occur?
What is the total surface area of alveoli in an average adult?
Which structure participates in gas exchange?
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What medical procedure may be used to drain large effusions from the lungs?
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What condition occurs when air collects between the visceral and parietal pleura, causing the lungs to collapse?
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Which of the following may be prescribed to veteran patients to reduce blood clot formation in the legs?
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What can cause a confusing presentation in the early stages of pulmonary embolism?
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What can result from hypoventilation?
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In what condition might patients experience numbness and tingling in their hands and feet, chest pain, and carpal pedal spasm?
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What is the primary cause of hyperventilation?
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What can impair lung function or breathing mechanics and cause hypoventilation?
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What is obstructive breathing indicative of?
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What can abnormal breath sounds like wheezes, crackles, rales, and stridor indicate?
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What might chocolate brown skin and mucous membranes indicate?
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What may cyanosis develop earlier in?
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What is the mnemonic SAMPLE used for in medical history?
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What does jugular venous distension indicate in a neuro assessment?
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What can auto peep cause if patients have difficulty exhaling?
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What can pulse ox readings help detect?
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What is the purpose of vasodilator treatments in pulmonary edema?
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What does hypoxic drive occur when a person's breathing stimulus comes from?
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What may chronic obstructive pulmonary disease include?
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What can cancer, especially lung cancer, present with?
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What occurs during an asthma attack?
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What is the purpose of using a stethoscope?
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Study Notes
- Respiratory diseases are common emergency medical services dispatches.
- Asthma and COPD are among the top 10 chronic conditions causing restricted activity, with approximately 15 million Americans having COPD and approximately 25 million Americans having asthma.
- Pneumonia is a common fatal illness in developing countries.
- Respiratory diseases can be caused by genetic or intrinsic factors, as well as external or extrinsic factors.
- The trachea, which is the windpipe, carries air to the lungs and extends about four to five inches from the larynx to the right and left main stem bronchi.
- The tracheobronchial tree then branches into lobes of lungs, secondary or lober bronchi, tertiary or segmental bronchi, and sub-segmental bronchi before ultimately becoming bronchioles.
- Bronchioles have protective mucus and are not shielded by smooth muscle or more rigid structures, making it difficult for foreign matter to be expelled once it reaches the terminal bronchioles and alveoli.
- Smooth muscle surrounds conducting airways down to the subsegmental level, and bronchial constriction occurs when the smooth muscle narrows.
- Alveoli, the terminal airways, have a total surface area of about 70 square meters in an average adult and are covered in capillaries, participating in gas exchange.
- The mediastinum, a space in the middle of the chest, consists of the heart, large blood vessels, conducting airways, and other organs.
- Pulmonary blood flow is essential for adequate oxygen to come into contact with the blood.
- Cardiovascular regulation and lungs are closely linked, with changes in heart function having pulmonary consequences.
- The body takes in air by negative pressure, and air is pulled in through the mouth, nose, or other turbinates, and around the epiglottis and glottis.
- The thorax is an air type box with the flexible diaphragm at the bottom and an open tube or trachea at the top.
- The kidneys play a role in controlling fluid balance, acid-base balance, and blood pressure, which can affect the pulmonary mechanisms that deliver oxygen to body tissues.
- Hypoventilation, a condition where the lungs fail to work properly, can cause carbon dioxide to accumulate in the blood and result in acidosis.
- Conditions that impair lung function or the mechanics of breathing can cause hypoventilation.
- Hyperventilation occurs when people breathe in excess of metabolic need, resulting in alkalosis.
- In an acute hyperventilation syndrome, patients may feel they cannot breathe at all and experience numbness and tingling in their hands and feet, chest pain, and carpal pedal spasm.
- Thorough respiratory assessment is needed to establish and maintain an open airway, assess oxygen demand and work of breathing, and identify any abnormal breath sounds or breathing patterns.
- Normal breath sounds can be heard in abnormal places in certain pathologic conditions.
- Abnormal breath sounds include wheezes, crackles, rales, and stridor.
- Noisy breathing is obstructive breathing, and quiet breathing may suggest hyperventilation or shock.
- Sputum note can provide valuable information regarding infection or other causes of respiratory distress.
- Altered respiratory patterns may indicate a neurologic insult or overdose with a central nervous system depressant.- Person may show cyanotic blue discoloration during cardiac arrest, with some having deep blue skin and others being pale
- Cyanosis may develop earlier in patients with high hemoglobin levels and in those with chronic respiratory conditions
- Chocolate brown skin and mucous membranes may indicate high levels of methyl hemoglobin from nitrates or toxic exposures
- Pale skin is due to reduced blood flow to small vessels near the skin surface
- Dry cracked lips, dry furrowed tongue, and dry sunken eyes may indicate dehydration
- Patients with respiratory problems are often transported to the closest hospital, but a facility with emergency dialysis may be a better option
- During history taking, patients may not be able to speak due to severe respiratory distress, so medical history may need to be obtained from family members or clues
- Oxygen or air slice therapy may be given before a complete history can be obtained
- Asthma attacks may be caused by an underlying infection, requiring treatment of the trigger before symptoms end
- Innovation is necessary if medications are not available or have expired
- Seasons, bacteria, mold, fungi, excessive heat/humidity, cold, pollen, or dust can cause respiratory disease flare-ups
- Some patients rebel against therapy, misunderstanding its long-term nature or only sporadically using it
- Mnemonic SAMPLE is used to obtain the history of the present illness and medical history: S (signs and symptoms), A (allergy), M (medications), P (pertinent past medical history), and L (last oral intake and events)
- Neuro assessment may indicate jugular venous distension, which can indicate cardiac failure as the source of dipsnea
- Trachea deviation may indicate pneumothorax or other neck conditions
- Chest and abdomen exam should assess for vibrations, trauma, and edema or cyanosis
- Use a stethoscope and clean its ear pieces and wipe the main tubing with an all-purpose cleaner
- Pulse ox readings should match the patient's palpated heart rate, and a hemoglobin level affects the pulse ox reading
- End-tidal carbon dioxide monitor can detect CO2 levels and help manage oxygen therapy
- Peak expiratory flow meter measures maximum airflow during a forced exhalation and can indicate airway obstruction
- Patients should be reassessed regularly and changes should be reported to medical control
- Emergency medical care aims to provide supportive care, administer oxygen, and transport patients
- Manual ventilation and CPAP/BiPAP may be used in respiratory failure
- Vasodilator treatments can be used for pulmonary edema to decrease preload and restore fluid balance
- Diuretics may help reduce blood pressure and maintain fluid balance in patients with heart failure, but they can cause potassium loss
- Support or assisting ventilations should be done aggressively and carefully to avoid causing further harm
- Chronic obstructive pulmonary disease (COPD) includes emphysema and chronic bronchitis, with different causes and symptoms
- COPD patients may have difficulty tolerating trauma, and normal oxygen saturations might be less than 90%
- Hypoxic drive occurs when a person's breathing stimulus comes from a decrease in pao2, and oxygen should be administered carefully in these cases
- Auto peep can cause pneumothorax and cardiac arrest if patients have difficulty exhaling, so ventilations should be done slowly and carefully
- Pulmonary infections can be caused by bacteria, viruses, fungi, or other organisms, and can result in mucus production and decreased air flow
- Atelectasis occurs when alveoli collapse from obstruction, external pressure, or damage from smoke or toxins
- Cancer, especially lung cancer, can present with coughing up blood and uncontrolled coughing when tumors obstruct the airways
- Pleural effusions can be caused by infections, tumors, or trauma and can decrease lung capacity and cause dyspnea
- Pulmonary embolism occurs when a blood clot or other material blocks the pulmonary artery, preventing normal blood flow to alveoli
- Pulmonary edema occurs when fluid builds up in the lungs, and can be caused by high pressure (cardiogenic) or low permeability (non-cardiogenic) factors. Non-cardiogenic edema can occur after acute hypoxia or from toxins or drugs in the bloodstream. Large effusions may be drained at a medical facility in a procedure called thoracentesis.
- Pneumothorax occurs when air collects between the visceral and parietal pleura, causing the lungs to collapse. This can be caused by simple activities like coughing or by aggressive ventilations.
- Pleural effusions can cause difficulty breathing due to decreased lung capacity, and large effusions may be drained at a medical facility.
- Pulmonary embolism can have a confusing presentation, with normal breath sounds in early stages and sudden dyspnea and cyanosis in later stages. Clots may form in large veins of the neck and migrate into the pulmonary circulation.
- Veteran patients are often prescribed anticoagulants or special stockings to reduce blood clot formation in the legs. A filter may be inserted into patients with a history of deep veinous thrombosis to collect clots traveling from the legs. A large pulmonary embolism can be immediately fatal.
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Description
Test your knowledge on respiratory diseases, their causes, assessment, and emergency medical interventions with this quiz. From asthma and COPD to pulmonary embolism and pneumothorax, this quiz covers a wide range of topics related to respiratory emergencies.
