Where are the Central Chemoreceptors located?

Where are the Peripheral chemoreceptors located?

Central=Medulla

Peripheral=Carotid and Aortic Arch

Sneezing-reflex response to irritation in the upper tract

Coughing-irritation caused by nasal discharge dripping into oropharynx or from lower respiratory tract or from inhaled irritants

Sputum-THY PR

Thick muscus-asthma or CF

Hemoptysis-blood tinged frothy sputum usually associated w/pulmonary edema

Yellow-green-often bacterial

Purlent-pus w foul odor-bronchiectasis

Rusty or dark-pneumonia

Kussmaul-deep rapid breaths following acidosis or strenuous exercise

Wheezing-whistling sounds indicating obsruction in small airways

Stridor-high bubbly or crackling sounds associated w pulmonary edema

Rales-light bubbly or crackling sounds associated serous secretions

Rhonchi-deeper and harsher sounds resulting from thick mucus

Subjective feeling of discomfort  when pt is unable to inhale enough air.  Dysmia on Exertion (DOE).  SOB.  If severe, flaring of nostrils, use of accessory respiratory muscles, retraction (pulling in) of themuscles between the ribs.  Orthopnea is dyspnea while lying down

Paroxysmal nocturnal dyspnea is a sudden acute dyspnea occuring in patients wiht CHF

Hypoxemia-common condition caused by pulmonary disease or injury.  Caused by respiratory alterations or CV compromise.  Can lead to hypoxia

Hypoxia-decrease of 02 to body tissues.  Its caused by an alteration of other systems may not be related to changes in the pulmonary system

What are Hypoxemia Signs and Symptoms?

80-100=normal

60-80=mod tachycardia, possible onset of respiratory distress, DOE

50-60 malaise, lightheaded, nausea, vertigo, impaired judgement, incoordination, restlessness, marked confusion,

35-50 marked confusion, cardiac dysrhythmias, labored respiration

25-35 cardiac arrest, decrased renal blood flow, decreased urine output, lactic acidosis, lethargy, LOC

Sinusitis:  Ususally a bacteria infection secondary to a cold or allergy.  As exudate accumulates, pressure builds up inside the sinus cavity, causing severe pain.  Pain may be associated with HA or toothache.  May have nasal congestion, fever, sore throat

Influenza-viral infection that may affect upper and lower tracts.  There are three groups of flu that mutate constantly.  Differs from cold because with the flu, because:

Sudden acute onset w fever

Aching pains

Marked fatigue, may lead to bacterial pneumonia, may lead to death

Cold-caused by a viral infection of the URI.  The most common pathogen is rhinovirus, Spread through respiratory droplets.  Signs and Symptoms:  Nasal congestion, copious watery discharge.  May be sore throat, HA, fever, malaise

Bronchiolitis:  caused by respiratory syncytial virus, common in 2-12 mo olds, transmitted by oral droplet and occurs in winter months.  Family hx of asthma and smoking play a factor.  Signs include wheezing, dyspnea, cough, rales, chest retractions, fever, and malaise

Pneumonia:  caused by bacteria, virus, fungus, mycoplasma infection, inhalation of toxic chemicals or aspiration.  it is the leading cause of death in the US.  Older people, infants, bedridden or ppl w altered mental states are more susceptible

What is bronchiolitis?

What is Pneumonia?

Bronchiolitis:  caused by respiratory syncytial virus, common in 2-12 mo olds, transmitted by oral droplet and occurs in winter months.  Family hx of asthma and smoking play a factor.  Signs include wheezing, dyspnea, cough, rales, chest retractions, fever, and malaise

Pneumonia:  caused by bacteria, virus, fungus, mycoplasma infection, inhalation of toxic chemicals or aspiration.  it is the leading cause of death in the US.  Older people, infants, bedridden or ppl w altered mental states are more susceptible

Lung pathology that leads to pulmonary HTN, leading to RSHF.  Examples: Bronchitis and Emphysema

Bronchitis:  hypoventilatoin due to mucus in the bronchi.  Not much air coming in or out.  Reflex vasoconstriction--increases resistance to bloodflow thereby increasing R sided pressure

Emphysema--loss of lung parenchyma and lung capillaries--increases resistance to blood flow, right sided pressure.  at the end stage emphysema--go into cor pulmonale

leading neoplasm for death.  Incidence is high

Etiology:  sudden mentation change and htis leads to lunc CA discovery.  Types:  Squamous cell carcinoma, adenocarcinoma, large cell undifferentiated carcinoma, small cell carcinoma, bronchoalveolar neoplasms, carcinoid neoplasm

Hemoptysis-coughing up blood from the respiratory tract

Dyspnea

Wheezing

Seizures

recurrent pneumonia

Sudden unexplained weight loss

1.  Extrinsic:  breath in particle----allergen response----igE lands on on a mast cell in the bronchial tree---bronchoconstriction, the patient will say that they cant get air in but the problem is they cant get air out

2.  Intrinsic:  sucks in cooler air which causes bronchoconstriction and mucus production.  Example exercise induced asthma

Mild:  symptoms reverse w cessation of activity

Moderate: audible wheezing, use of accessory mm's leaning forward to catch breath

Severe:  Blue lips/fingernails, tachypnea depsite cessation of activity, cyanotic induced seizures, skin and rib retraction