PHS3300 Respiratory Disorders 2023 Part 1 PDF

Jackie Carnegie, PhD, M.Ed, [email protected] http://www.biotopics.co.uk/humans/inhexh.html CLINICAL MANIFESTATIONS OF PULMONARY ALTERATIONS 1. “Pnea” is a Greek word meaning “respiration” or “breathing” Dyspnea: sensation of difficult or uncomfortable breath...

Jackie Carnegie, PhD, M.Ed, [email protected] http://www.biotopics.co.uk/humans/inhexh.html CLINICAL MANIFESTATIONS OF PULMONARY ALTERATIONS 1. “Pnea” is a Greek word meaning “respiration” or “breathing” Dyspnea: sensation of difficult or uncomfortable breathing; sensation of shortness of breath, laboured breathing, preoccupied with breathing SIGNS: flaring of nostrils, use of accessory muscles of respiration & retraction; variety of possible reasons; initially on exertion, then at rest Orthopnea: difficulty breathing (shortness of breath) when lying down – usually result of increased fluid in lung that is helped by being upright – e.g. left ventricular heart failure, pulmonary edema for any other reason Apnea: temporary cessation of breathing (e.g. sleep apnea) Bradypnea: rate of breathing < 12 breaths/min; e.g overuse of narcotics, brain disorders, hypothyroidism Tachypnea: rate of breathing > 20 breaths/min (shallow breaths) – causes include lung disease, obesity, pulmonary embolism 2. Some abnormal breathing patterns/sounds: eupnea is rhythmic (8-16 breaths/min; tidal volume = 400-800 ml); short expiratory pause; sigh breaths (10-12/hr) Kussmaul respiration: deep, rapid breaths that allow unloading of CO2 – e.g. during diabetic ketoacidosis Cheyne-Stokes respirations (any condition that slows blood flow to brain stem; heart failure or brainstem disease) – alternating apnea and hyperventilation while asleep as oxygen saturation varies between 90% and 100% - rising CO2 levels will trigger periods of hyperventilation Examples of abnormal breath sounds: wheezing (asthma), crackles (pneumonia, pulmonary fibrosis), stridor (airway obstruction) https://www.youtube.com/watch?v=U8byn2NT_lo 3. Hypoventilation: results in hypercapnia (PCO2>44 mm Hg) & ⇓ blood pH 4. Hyperventilation (not to be confused with hyperpnea or with tachypnea): results in hypocapnia (PCO220): ▪ usually affects adults, more common in women ▪ can have a negative personal history for allergy, eczema, rashes, hives ▪ caused by anything other than allergens; eg – can be triggered by exercise, anxiety, stress, cold air, dry air, smoke, viruses, hyperventilation, aspirin,... – these triggers also able to increase IgE ▪ will not be seasonal; will not be helped by allergy shots ▪ usually develops later in life, often as a result of multiple respiratory tract infections and tends to be chronic http://www.hon.ch/Dossier/MotherChild/pree xisting_conditions/asthma.html Asthma: Clinical Manifestations signs & symptoms closely linked to status of airways 1) bronchospasm leads to obstruction of airways, trapping air in lungs 2) trapped air in alveoli flattens diaphragm (not as effective in inspiration); lower chest cannot expand properly because intercostal muscles pulled horizontally 3) wheezing: initially wheezing during expiration; then both inspiration & expiration 4) pulmonary function tests reveal decreased peak expiratory flow rate and FEV1 5) blood gases show decreased PCO2 & respiratory alkalosis early, but hypercapnia & hypoxemia will develop due to exhaustion (fatigue a key problem - extra work to breathe) 6) mucus is thick & very obstructive 7) difficulty to breathe → anxiety → increased difficulty to breathe → increased anxiety Treatments (usually via a nebulizer): bronchodilators and corticosteroids  TAV: due to collapse of small and mid-sized airways during expiration Fig. 30.1 Fig. 30.2 https://favpng.com/png_view/child-asthma-inh aler-royalty-free-clip-art-png/yB4M74ua End of Part 1