Respiratory System Evaluation Quiz

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Questions and Answers

What is the third most common cause of death in Zambia?

Respiratory diseases

What is the key to diagnosing any disease?

A clear and carefully recorded history

Which of the following are the most common symptoms of respiratory problems? (Select all that apply.)

  • Breathlessness (correct)
  • Excessive Sputum (correct)
  • Chest Pain (correct)
  • Haemoptysis (correct)
  • Wheeze (correct)
  • Cough (correct)

Breathlessness that occurs at rest is called dyspnea.

<p>True (A)</p> Signup and view all the answers

What are the possible causes of dyspnea? (Select all that apply.)

<p>Thyrotoxicosis (A), Hypercapnia (B), Hypoxia (C), Primary Respiratory Disease like Pneumonia (D), Anemia (E), Cardiac Disease (F), Metabolic Acidosis (G)</p> Signup and view all the answers

Where are the cough receptors mainly located?

<p>On the posterior wall of the trachea, pharynx, and at the carina of the trachea</p> Signup and view all the answers

Cough receptors are abundant in the distal airways.

<p>False (B)</p> Signup and view all the answers

What nerve carries impulses from the cough receptors to the brain?

<p>The vagus nerve</p> Signup and view all the answers

The cough centre in the brain has been definitively located.

<p>False (B)</p> Signup and view all the answers

What are the two main nerves involved in transmitting signals back from the cerebral cortex and medulla during the cough reflex?

<p>The vagus nerve and the superior laryngeal nerve</p> Signup and view all the answers

Which muscles contract during a cough? (Select all that apply)

<p>Other expiratory muscles (A), Abdominal muscles (B), External intercostal muscles (C), Diaphragm (D), Glottis muscles (E)</p> Signup and view all the answers

The glottis opens during the forceful expulsion of air in a cough.

<p>False (B)</p> Signup and view all the answers

A cough can be either dry or productive.

<p>True (A)</p> Signup and view all the answers

What is the term used to describe a cough that produces a large amount of sputum, exceeding one cupful?

<p>Bronchiectasis</p> Signup and view all the answers

What is the medical term for coughing up blood?

<p>Haemoptysis</p> Signup and view all the answers

Which of the following could be potential causes of haemoptysis? (Select all that apply.)

<p>Injury (A), Carcinoma (B), Tuberculosis (D)</p> Signup and view all the answers

What happens to the airways during wheezing?

<p>The airways are tightened, blocked, or inflamed.</p> Signup and view all the answers

What are some common causes of wheezing? (Select all that apply.)

<p>Allergies (A), Cold (B), Chronic Obstructive Pulmonary Disease (COPD) (C), Asthma (D)</p> Signup and view all the answers

What respiratory condition can be caused by inflamed pleura?

<p>Pneumonia</p> Signup and view all the answers

Which of the following are potential causes of chest pain? (Select all that apply.)

<p>Pneumonia (A), Pulmonary Embolus (B), Pneumothorax (C), Cancer (D), Myocardial Ischaemia (E)</p> Signup and view all the answers

Which of the following are relevant to upper airway history in a respiratory evaluation? (Select all that apply.)

<p>Change in Voice (A), Problems of Ear, Nose, and Throat (B), Rhinosinusitis (C), Post Nasal Drip of Rhinitis (D)</p> Signup and view all the answers

Smoking history is an important factor to consider in a respiratory assessment

<p>True (A)</p> Signup and view all the answers

Family history is irrelevant to respiratory evaluations.

<p>False (B)</p> Signup and view all the answers

Occupational history can be a valuable tool for diagnosing respiratory problems.

<p>True (A)</p> Signup and view all the answers

Flashcards

Respiratory diseases in Zambia

Respiratory diseases are the third most common cause of death in Zambia.

Medical History

The process of gathering information from a patient about their symptoms, medical history, and lifestyle to aid in diagnosis.

Presenting Complaint

The most frequent symptom that prompts a patient to seek medical attention.

Breathlessness

The subjective experience of difficulty breathing.

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Dyspnea

Breathlessness occurring at rest or with minimal effort.

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Cough

The act of expelling air from the lungs, often forcefully.

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Productive Cough

Coughing up sputum, which is the mucus produced by the respiratory system.

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Haemoptysis

Coughing up blood.

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Wheezing

A high-pitched whistling sound during breathing; often associated with airway narrowing.

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Chest Pain

Pain in the chest region.

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Inflamed Pleura

Inflammation of the pleura, the membranes lining the lungs and chest cavity.

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Asthma

A condition in which the airways become narrow and inflamed, making breathing difficult.

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Chronic Obstructive Pulmonary Disease (COPD)

A chronic lung disease characterized by airflow obstruction and shortness of breath.

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Rhinosinusitis

Inflammation of the sinuses, cavities in the skull connected to the nasal passages.

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Post Nasal Drip

Mucus dripping down the back of the throat.

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Change in Voice

Changes in the voice, such as hoarseness.

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Problems of the Ear, Nose, and Throat (ENT)

Any health problems related to the ears, nose, and throat.

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Smoking History

The inhalation of smoke from tobacco products.

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Family History of Respiratory Diseases

The occurrence of respiratory diseases in other family members.

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Occupational History

Any exposure to substances or conditions at work that may affect the respiratory system.

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Examination of the Respiratory System

A physical examination of the respiratory system involves inspecting, listening to, and feeling the chest to assess lung function.

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Cough Receptors

Cough receptors are located mainly on the back wall of the trachea, pharynx, and at the point where the trachea branches into the main bronchi.

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Carina of the Trachea

The point where the trachea divides into the left and right main bronchi.

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Afferent Neural Pathway

The neural pathway that carries signals from the cough receptors to the brain.

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Efferent Neural Pathway

The neural pathway that carries signals from the brain to the muscles involved in coughing.

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Diaphragm

The muscle responsible for breathing in or inhaling.

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External Intercostal Muscles

Muscles between the ribs that aid in breathing.

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Glottis

The opening between the vocal cords.

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Glottis Muscles

Muscles around the glottis that control vocal cord movement.

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Cough Mechanism

The process of forcefully expelling air from the lungs to clear irritants or mucus.

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Purulent Sputum

Sputum that is yellow or green in color, indicating the presence of pus.

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Excessive Sputum

A large amount of sputum, exceeding one cupful, often a sign of bronchiectasis.

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Study Notes

Respiratory System History

  • Respiratory diseases are the third leading cause of death in Zambia.
  • A clear and carefully recorded history is key to diagnosis for any disease.

Essential Components of a Respiratory Evaluation

  • History taking
  • Physical examination
  • Differential diagnosis
  • Laboratory investigations
  • Diagnosis
  • Treatment
  • Discharge/Death
  • Follow up

History Details

  • Presenting complaint (symptoms)
  • History of presenting complaint
  • Past medical history
  • Drug history
  • Smoking and alcohol history
  • Social history
  • Immunization history
  • Occupational history
  • Health status of guardian/parents
  • Review of systems

Common Respiratory Symptoms

  • Breathlessness
  • Cough
  • Excessive sputum
  • Haemoptysis
  • Wheeze
  • Chest pain

Breathlessness (Dyspnea)

  • Strenuous exertion-related breathlessness
  • Breathlessness inappropriate to the level of physical exertion or that happens at rest is called dyspnea
  • Causes include:
    • Hypoxia (low blood oxygen)
    • Hypercapnia (high blood carbon dioxide)
    • Cardiac disease
    • Anemia
    • Thyrotoxicosis
    • Metabolic acidosis
    • Primary respiratory disease (e.g., pneumonia)

Cough Reflex (Cough-1)

  • Cough receptors are mostly located on the posterior wall of the trachea, pharynx, and carina.
  • Receptors are less abundant in the distal airways and absent in the bronchioles.

Cough Reflex (Cough-2)

  • Impulses travel via the internal laryngeal nerve (branch of the superior laryngeal nerve, which branches from the vagus nerve) to the medulla of the brain.
  • This is the afferent neural pathway.
  • No definitive cough center in the brain has been identified.

Cough Reflex (Cough-3)

  • Efferent neural pathway follows after the afferent pathway signals.
  • Signals are transmitted from the cerebral cortex and medulla via the vagus and superior laryngeal nerves to the glottis, external intercostals, diaphragm, and other major inspiratory and expiratory muscles.

Cough Reflex (Cough-4)

  • Coughing mechanism:
    • Diaphragm and external intercostal muscles contract, creating negative pressure in the lungs.
    • Air rushes into the lungs to equalise pressure.
    • The glottis closes, and vocal cords contract, thus closing the larynx.

Cough Reflex (Cough-5)

  • Actions of the abdominal and other expiratory muscles increase the pressure in the lungs.
  • Air is released at over 100 mph through the bronchi and trachea slits, clearing any irritants from the respiratory lining.

Cough Characteristics in History Taking

  • Nature (dry or productive)
  • Duration
  • Time of onset (day or night)
  • Aggravating factors

Sputum Characteristics in History Taking

  • Color (yellow, green—purulent)
  • Amount (small amounts, very thick, or jelly-like—suggestive of asthma; large amounts exceed one cupful—suggestive of bronchiectasis).

Haemoptysis

  • Coughing up blood in the sputum.
  • Check for epistaxis (nosebleed)
  • Inquire about melena (black, tarry stool).
  • Possible causes include tuberculosis, carcinoma, and injury.

Wheezing

  • Wheezing occurs when airways are constricted, blocked, or inflamed, producing a whistling or squeaking sound during breathing.
  • Possible causes: cold, asthma, allergies; or more serious conditions like COPD.

Chest Pain

  • Possible causes: inflamed pleura, pneumonia, cancer, pneumothorax, pulmonary embolus, myocardial ischemia.

Relevant History for Respiratory System

  • Upper airway problems
  • Rhinitis
  • Postnasal drip
  • Change in voice
  • Ear, nose, and throat problems
  • Smoking history
  • Family history
  • Occupational history

Examination of the Respiratory System

  • (Specific details of examination procedures are not provided in the uploaded document)

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