Diseases of the Respiratory System: Signs and Symptoms

Dyspnea

Subjective sensation of uncomfortable breathing.

Orthopnea

Dyspnea while lying down.

Paroxysmal nocturnal dyspnea (PND)

Violent attacks of severe shortness of breath and coughing, generally occurring at night and awakening from sleep.

Chronic hypoxia

Long-standing low oxygen levels in the blood.

Clubbing

A physical sign characterized by the enlargement of the ends of fingers or toes.

Cyanosis

Patient appears blue; caused by low oxygen levels in the blood.

Cough

Protective reflex to clear the airway via an explosive expiration.

Productive cough

Cough with sputum.

Acute cough

Cough that resolves within 2 weeks.

Chronic cough

Cough that persists beyond 3 weeks.

Unproductive cough

Dry cough without mucus or other material.

Sputum

Mucus or other material that is coughed up from the lungs; can also be called phlegm.

Hemoptysis

Coughing up blood.

Pink (frothy) sputum

Associated with left-sided heart failure.

Tachypnea

Respiratory rate greater than 20 breaths per minute.

Bradypnea

Respiratory rate less than 20 breaths per minute.

Hypoventilation

Reduced breathing leading to high levels of CO2 in the blood (hypercapnia).

Hyperventilation

Increased breathing leading to low levels of CO2 in the blood (hypocapnia).

Wheezes

Sounds like a whistle.

Fine crackles

Sound like twirling your hair.

Coarse crackles

Sound like crumbling paper or velcro.

Pneumothorax

Accumulation of air in the pleural space.

Tension pneumothorax

Severe hypoxemia, tracheal deviation away from the affected lung, and hypotension.

Hypoxemia

Low levels of oxygen in the blood.

Pleurodesis

A procedure that sticks your lung to your chest wall to prevent fluid or air from building up.

Restrictive pulmonary disorder

Condition where lungs are restricted from fully expanding.

Obstructive pulmonary disorder

Condition where it is hard to exhale all the air in the lungs.

Acute respiratory distress syndrome (ARDS)

A life-threatening lung condition that causes severe difficulty breathing.

Pulmonary Edema

It occurs when fluid builds up in the lungs, preventing them from exchanging oxygen and carbon dioxide effectively.

Atelectasis

Collapse of the lung tissue (alveoli) with decreasing lung volume.

Atelectasis Symptoms

Alveoli become airless, inability of the lungs to expand, decrease gas exchange (perfusion) and hypoxia.

Types of Atelectasis

Absorption (resorptive or obstructive) atelectasis, compression, surfactant impairment (adhesive).

Acute Respiratory Distress Syndrome (ARDS)

Acute lung injury and inflammation of the alveolocapillary membrane; most severe form of acute lung injury.

ARDS Signs & Symptoms

Dyspnea & hypoxia, hyperventilation, decreased tissue perfusion, increased work of breathing, respiratory failure, decreased cardiac output, hypotension, death.

ARDS Treatment

Treat underlying cause and provide supportive therapy.

Obstructive Lung Diseases

Narrowing of airways leading to airway obstruction that is worse with expiration.

Obstructive Lung Diseases Symptoms

Required accessory muscles of expiration, increased work of breathing, ventilation-perfusion (V/Q) mismatch, decreased forced expiratory volume in one second (FEV1).

Asthma

Reversible airway obstruction characterized by airway inflammation and Type I hypersensitivity.

Asthma Prevalence

Prevalent chronic disease in childhood; multifactorial: genetic & environment.

Asthma Symptoms

Cough, marked dyspnea, wheezing.

Diagnosis of Asthma

Measures the levels of oxygen (O2), carbon dioxide (CO2), and pH (acidity) in the blood, and determines the percentage of hemoglobin that is saturated with oxygen.

Chest Imaging Techniques

Uses X-rays to create images of the chest organs and structure.

Chest Imaging Severity

Expiratory: mild to moderate; expiratory & inspiratory: severe.

Laboratory Assessments for Asthma

Laboratory assessments and studies are not routinely indicated for the diagnosis of asthma, but they may be used to exclude other diagnoses.

Arterial Blood Gas

A test that measures the levels of oxygen (O2), carbon dioxide (CO2), and pH (acidity) in the blood.

Pulse Oximetry

A test that determines the percentage of hemoglobin that is saturated with oxygen.

Computed Tomography (CT scan)

An imaging technique used to create detailed images of internal organs.

Magnetic Resonance Imaging (MRI)

An imaging technique that uses magnetic fields and radio waves to create detailed images of organs and tissues.

Nuclear Imaging

A technique that uses small amounts of radioactive material to diagnose and determine the severity of diseases.

Asthma Physical Signs

Rapid & labored breathing, nasal flaring, use of accessory muscles, exercise intolerance.

Corticosteroids

Anti-inflammatory medications used in asthma treatment.

Beta-agonists

Medications like albuterol that relax bronchial muscles to relieve asthma symptoms.

Anti-cholinergic

Ipratropium, a medication that helps open airways in asthma treatment.

Phosphodiesterase enzyme inhibitor

Theophylline (xanthine), a drug that relaxes the muscles of the airways.

Mast cell stabilizer

Cromolyn sodium, used to prevent asthma attacks.

Leukotriene receptor antagonist

Zafirlukast, a medication that blocks substances that cause asthma symptoms.

Monoclonal antibodies

Omalizumab, used for severe asthma treatment.

Combination drugs

Medications that combine a beta-agonist with a steroid for asthma management.

Chronic Obstructive Pulmonary Disease (COPD)

Characterized by persistent airflow limitation or obstruction.

Chronic bronchitis

Hypersecretion of mucus and chronic productive cough lasting at least 3 months for 2 consecutive years.

Emphysema

Abnormal permanent enlargement of the gas-exchange airways with destruction of alveolar walls.

Risk factors for COPD

Cigarette smoking, air pollution, and genetic factors.

Pathophysiology of Chronic Bronchitis

Includes inflamed mucosa, hypertrophy of mucous glands, and thickening of bronchial walls.

Clinical manifestations of Chronic Bronchitis

Cough, fever, and pain behind the sternum aggravated by coughing.

Treatment for Chronic Bronchitis

Includes smoking cessation, treatment of infection, and nutritional supplements.

Pathophysiology of Emphysema

Destruction of alveolar walls leading to loss of surface area for gas exchange.

Spirometry

Diagnostic test that evaluates lung function, with FEV1/FVC < 70% indicating COPD.

Signs & symptoms of COPD

Exertional dyspnea, increased shortness of breath, and development of barrel chest.

Diagnostic tests for COPD

Includes chest radiography, pulmonary function tests, and arterial blood gas analysis.

Treatment & Management of COPD

Focuses on improving functional status and preventing exacerbations.

Pneumonia

Any infection of the lung tissue of the lower respiratory tract.

Typical pneumonia

Characterized by high fever (> 101.5 degrees F) and productive cough.

Atypical pneumonia

Characterized by low-grade fever (< 100 degrees F) and non-productive cough.

Clinical Setting for Pneumonia

Involves assessing patients based on the setting in which they became sick.

Influenza

A viral infection that can cause respiratory illness.

Legionella

A genus of bacteria known to cause pneumonia.

Aspiration pneumonia

Pneumonia caused by inhaling foreign materials, often associated with alcohol use.

Atypical pneumonia

Pneumonia caused by organisms such as Mycoplasma and Chlamydia.

Respiratory syncytial virus

A virus that commonly affects children and can cause respiratory infections.

Para-influenza

A virus that commonly affects children and can lead to respiratory illness.

Influenza A & B

Types of influenza viruses that primarily affect older populations.

Adenovirus

A virus that can cause respiratory illness, especially in military barracks or close quarters.

Nosocomial pneumonia

Pneumonia acquired during hospital stays.

Gram (-) rods

Bacteria such as Klebsiella pneumoniae, E. coli, and Pseudomonas aeruginosa that can cause pneumonia.

S. aureus (MRSA)

Methicillin-resistant Staphylococcus aureus, a type of bacteria that can cause pneumonia.

Ventilator-associated pneumonia

Pneumonia that occurs in patients on mechanical ventilation, with the highest propensity for infection.

Pathogenesis of pneumonia

The process by which pneumonia develops, often involving compromised defense mechanisms.

Community-acquired pneumonia

Pneumonia acquired outside of a hospital setting, commonly bacterial in origin.

Exudative fluid

Fluid that fills alveolar air spaces in cases of pneumonia.

Diagnosis of pneumonia

Includes chest radiograph, gram stain of sputum, and blood cultures.

Treatment of pneumonia

Involves identifying the organism and selecting appropriate antibiotics.

Pulmonary Tuberculosis

An infectious disease caused by Mycobacterium tuberculosis.

Etiology of Tuberculosis

Caused by Mycobacterium tuberculosis, an acid-fast bacillus.

Epidemiology of Tuberculosis

Factors include living in crowded conditions, immunodeficiency, and chronic diseases.

Airborne droplet transmission

The method by which tuberculosis spreads from person to person.

Tubercle formation

Granulomatous lesions formed in response to tuberculosis infection.

Caseous necrosis

A cheese-like material that can form in tuberculosis infections.

Ghon tubercles

Fibrotic and calcified areas formed in the lungs as a result of tuberculosis.

Diagnostic tests for Tuberculosis

Includes tuberculin skin test, IGRA, and acid-fast sputum test.

Signs & symptoms of Tuberculosis

Include cough, night sweats, hemoptysis, and fatigue.